Howe MS, Keys W, Richards D. Long-term (10-year) dental implant survival: A systematic review and sensitivity meta-analysis. J Dent. 2019; 84:9-21
Chen ST, Buser D, Sculean A, Belser UC. Complications and treatment errors in implant positioning in the aesthetic zone: diagnosis and possible solutions. Periodontol 2000. 2023; 92:220-234
Pal US, Chand P, Dhiman NK Role of surgical stents in determining the position of implants. Natl J Maxillofac Surg. 2010; 1:20-23
Abdelhay N, Prasad S, Gibson MP. Failure rates associated with guided versus non-guided dental implant placement: a systematic review and meta-analysis. BDJ Open. 2021; 7
Apostolakis D, Kourakis G. CAD/CAM implant surgical guides: maximum errors in implant positioning attributable to the properties of the metal sleeve/osteotomy drill combination. Int J Implant Dent. 2018; 4
Meade MJ, Millett DT. Vacuum-formed retainers: an overview. Dent Update. 2015; 42:24-34

Technique Tips: Vacuum-formed Implant Surgical Guides

From Volume 51, Issue 4, April 2024 | Pages 283-284


Mohammad Majduddin Sulaiman

DDS, MFD (Ireland), DClinDent (Prosth), MProsth RCSEd

Dental Lecturer, School of Dental Sciences, Universiti Sains Malaysia, Malaysia

Articles by Mohammad Majduddin Sulaiman

Email Mohammad Majduddin Sulaiman

Tim Friel


Senior Clinical Lecturer, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK

Articles by Tim Friel

Sarah Waia

DDS, MFDS RCSEd, DClinDent (Prosth), MProsth RCSEd, FHEA

Clinical Lecturer in Prosthodontics, Specialist in Prosthodontics, Honorary Trust Dentist, Barts Health NHS Trust, Institute of Dentistry, Queen Mary University of London

Articles by Sarah Waia

Lochana Nanayakkara


Consultant in Restorative Dentistry, Director of Dental Education, Royal London Hospital, Barts Health NHS Trust; Honorary Senior Lecturer, Co-Lead for DClinDent Programme in Prosthodontics, Institute of Dentistry, Queen Mary University of London; Specialist Practitioner, Private Practice, London

Articles by Lochana Nanayakkara


Implant-supported prostheses are an option to replace missing teeth. A systematic review reported the survival rate of dental implants at 10 years was 96.4%.1 Although dental implants have high survival rates, the overall success of implant treatment depends on both aesthetic and functional outcomes. Correct implant placement influences the position and shape of the final restoration. Previously, dental implant placement was dictated by the quality and quantity of bone and protocols for placement reflected this. This bone-driven implant placement approach sometimes resulted in malpositioned implants causing aesthetic, biological and technical complications. Aesthetic complications include elongated implant crowns and disharmony of the soft tissue profile including the absence or reduction of interdental papillae.2 These complications can be caused by incorrect planning and can be reduced by an awareness of the need for prosthetically driven implant placement.

Planning for implant placement is enhanced by the use of cone beam computed tomography (CBCT) in conjunction with a diagnostic wax-up of the proposed restoration. From these diagnostic tools, a suitable surgical guide for placement can be made. The surgical guide, which is fabricated with radiopaque markers will allow the surgeon to verify the three-dimensional relationship of the implant in the mesiodistal (sagittal), corono-apical (transverse) and bucco-lingual (coronal) planes to the proposed restoration.3 Despite the advantage of using surgical guides, the conventional method of free-hand implant placement is still widely used. A systematic review reported that both guided and free-hand implant placement resulted in high implant survival rates. The number of implant failures, such as occurs when implants are not osseo-integrated or are aesthetic failures, were three times greater for those placed free hand than those with guided placement.4

Register now to continue reading

Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Up to 2 free articles per month
  • New content available