An open system approach for surgical guide production.

PURPOSE Surgical guides for oral implantology were made with a new open system independent of implant planning software based on a universal computed tomography/cone beam computed tomography (CBCT) scan plate for fiducial markers. MATERIALS & METHODS For this in vitro study, CBCT scans were taken of 18 models based on a universal computed tomography/CBCT scan plate (Bego Medical, Bremen, Germany) for fiducial markers. The models were made from radiopaque composite with several integrated radiopaque gutta-percha points used as a reference. The coDiagnostiX (Institut Straumann, Basel, Switzerland) and implant 3D (med3D, Heidelberg, Germany) software programs were used for virtual implant planning. Coupling devices on the scan plate allowed for the precise connection to a special transfer plate (Bego Medical), which transfers the implant position to the drill guide. The horizontal distance of the final implant position to the gutta-percha markers was compared with the implant planning values. RESULTS Planning of 18 implants was performed with the Institut Straumann system and 18 with the med3D system. The horizontal deviation of the final implant placement compared with the implant planning made with the med3D system showed a mean error of 0.33 mm for implants 1 and 2. The difference between the CBCT measurements of the Institut Straumann models was larger than that of the med3D measurements. The mean error for implant 1 was 0.65 mm and 1.13 mm for implant 2. CONCLUSION The reduction in the dental laboratory costs, the freedom to use different implant planning software programs, and the easy handling might facilitate the distribution of guided surgery and provide significant benefits for the clinician and the dental laboratory.