In the Case of the Week for Episode 166 of “Chairside Live,” I decided to explore two cases to compare and contrast different implant surgery methods: guided and freehand. Each method has its pros and cons, with many factors to consider. Read through the following cases to see how I utilized each method.
Freehand surgery, where a flap is reflected and the implant is placed according to the available diagnostic information, is a cost-effective approach that is advantageous in many cases. When case circumstances indicate that freehand surgery can be safely and predictably executed, the approach will appeal to patients and doctors alike due to the reduced cost and chair time. On the other hand, guided surgery, in which the osteotomy is created with the aid of a digitally designed and printed surgical guide, has the potential to afford the highest level of precision and control. The superior level of accuracy afforded by this approach makes it ideal in situations where there are concerns related to bone volume or the proximity of vital patient anatomy; however, the increased cost and time associated with fabricating the surgical guide may not always be warranted.
Both guided and freehand surgery have their place in modern implant dentistry. The circumstances of each case and the situation of the patient ultimately dictate which approach is most appropriate. For each case, a cost-benefit analysis should be conducted to assess whether the necessity for added precision justifies the increased expense and added chair time of guided surgery.