In-house printed implant surgical guides ready for prime time

A recently published study by the Journal of Oral and Maxillofacial Surgery has found that implant surgical guides produced using 3Shape solutions and a Formlabs Form 2 in-office 3D printer to be a “convenient, cost-effective, and an accurate means of providing implant surgery for patients.”

According to the study, the findings are important as surgical guides from an implant manufacture or laboratory can cost anywhere from 275-700 USD and take at least a week for delivery. In contrast, printing your own guides using the Form 2 in-house printer can be done for just 20-70 USD.

The study confirmed that there is little loss in accuracy for in-house printed guides. And that in-house printing using 3Shape TRIOS intraoral scanner and implant software and Formlab to create guides “provides a convenient and cost-effective means of assuring proper implant placement.” (1)

Danish surgeon, Dr. Simon Kold has been printing his own guides since last year. He says that because of the accuracy and low cost he now uses guides on nearly every surgery.

Studies have also shown implant placement to be more accurate when using surgical guides as compared to non-guided surgery. (2, 3)

In March this year, 3Shape and Formlabs announced a partnership to develop integrations to streamline the guide design and manufacturing workflow. With Dr. Daniel Whitley, one of the co-authors of the study and user of both systems saying, “I can go from patient scans, to planned case, to fully manufactured guide with only a few clicks of the mouse.”

He adds “With a Formlabs printer costing between 3500 and 4000 USD with accessories and everything, the ROI is met after only a few implant surgeries.

Cost has been a big barrier to guided surgery. Implants are expensive. When you add an upfront 500 USD expense for the guide before the patient even walks in the door, you might reconsider using a guide. What happens if the patient backs out of the surgery? These things happen. Printing in-house instead, you are only looking at a 50 USD guide expense.

In addition, by using 3Shape Implant Studio and digital technology, I’ve reduced my hands-on time in cases down to 30 minutes or less. With what 3Shape has done with Implant Studio and continues to do, it’s only going to get easier.

Dentists are not technicians so the idea of Implant Studio being almost plug and play, is really an advantage.” 

Co- author of the study and Associate Professor and Director of Digital Dentistry, Virginia Commonwealth University Dr. Sompop Bencharit adds that, “It is very helpful that with 3Shape Implant Studio, you can manipulate the design of the surgical guide. Most programs you cannot. With Implant Studio, you can do pretty much anything and have unlimited freedom for creating surgical guides.” 

3Shape is launching Implant Studio 2017 in the beginning of September, which includes new, optimized settings for the Formlabs printer. Later this year, Implant Studio will also include full printer integration for an even faster and easier workflow to print guides in-house.

Dr. Sompop Bencharit adds: “In our study, we focused on the range of deviation and wanted to compare it to published studies made with other systems. It was very impressive to see the guides we made work just as well as a 1000 USD guide.

We are presently working on a follow up in-vivo study with patients. Interestingly, we are finding guides to be more accurate in-vivo as compared with in-vitro. But this is not documented yet.”  

The study concluded that “Guided surgery always requires more upfront time preparation than non-guided surgery. The benefit of guided surgery is mainly to reduce chair time and therefore reduce cost. More importantly it prevents surgical complications from miss-placed implants. While we recognize that in office 3D printing for implant surgical guides has a great potential to expand the use of guided implant surgery, like other new technology there is a learning curve. Clinicians should get appropriate training and become familiar with implant planning software and the fabrication of 3D printed guides.”

Join 3Shape and Formlabs for a joint webinar: Affordable In-Office 3D Printed Surgical Guides with 3Shape and Formlabs (September 19, 2017, 16.00 EDT and 13.00 PT

1. How Accurate are Implant Surgical Guides Produced with Desktop Stereolithographic
3D-printers? (Journal of Oral and Maxillofacial Surgery)
George R. Deeb, DDS, MD, Associate Professor, Riley K. Allen, BS, Dental Student,

V. Patrick Hall, DMD, Resident, Daniel Whitley, III, DDS, Daniel M. Laskin, DDS, MS,
Professor and Chair Emeritus, Sompop Bencharit, DDS, MS, PhD, FACP, Associate
Professor
2. Deeb GR, Soliman O, Alsaad F, Jones P, Deluke D, Laskin DM. Simultaneous Virtual
Planning Implant Surgical Guides and Immediate Laboratory-Fabricated Provisionals: An
Impressionless Technique. The Journal of oral implantology. 2016;42(4):363-9.
3. Vercruyssen M, Coucke W, Naert I, Jacobs R, Teughels W, Quirynen M. Depth and lateral
deviations in guided implant surgery: an RCT comparing guided surgery with mental navigation
or the use of a pilot-drill template. Clinical oral implants research. 2015;26(11):1315-20.

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