Guided Full-Arch Implant Surgery

Michael Tischler, DDS


This month’s Implants Today section is focused on guided full-arch implant surgery. We are fortunate to have an article by our Implants Today advisory board member Dr. Scott Ganz and his colleague Dr. Isaac Tawil on this very topic. Their excellent article entitled “Full-Arch Implant Surgical and Restorative Considerations,” is the first article of 2 planned on this topic. (The second article is scheduled to be published sometime in 2020.)

The topic of guided full-arch surgery is something I have been following for many years, and I have favored non-guided full-arch surgery in the past. However, because of recent advancements, many of which are outlined in this month’s article by Drs. Ganz and Tawil, I have now embraced full-arch guided surgery as part of my treatment protocols. My evolution and paradigm shift in thinking is simply progress based on innovations and advancements in technology that are now available.

Although guided surgery for full-arch treatments has evolved to a predictable level with many advantages, I still believe and feel it is important for clinicians to still be able to perform full-arch surgery in a non-guided manner, and to thus understand the fundamental principles of full-arch surgery and prosthetics in order to safely deliver guided full-arch treatment plans. If a guided case doesn’t work out as planned, the clinician must be able to take over without the guide. In other words, the knowledge and principles needed for non-guided surgery are the principles needed to plan for a guided case.

You might be interested in why I have shifted toward including guides for full-arch treatment. The main reason is that guide positions are now based on verification of tooth positions that are translated to bone positions. This month’s article outlines this. It is this hard tissue to hard tissue reference that now allows a predictable starting point for these stacked guide systems. The digital workflow now available with stacked guides also affords many advantages toward creation of the final prosthesis in fewer appointments.

Predictable and verified guide positions, a digital workflow that creates fewer appointments, and a provisional at the time of surgery have changed my paradigm of treatment. I call this justified evolution.

If you have any questions or comments about this topic, or any other subject presented in Implants Today, feel free to contact Dr. Tischler at

Related Articles

Implant Treatment Complications

Sharing Different Perspectives

Implant Placement Strategies