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So, an interesting question to pose from someone who has invested heavily in money, time and emotion in the guided surgery bandwagon.

Does it make it better?

Are our outcomes better?

Is our quality better?

The more heavily involved that I become with the digital aspects of dentistry, the more complexity in those questions I find.

The first thing to remember, in all of these discussions, is the principle of pattern recognition.

I can look at an OPG radiograph of a wisdom tooth and pretty accurately call the difficulty or otherwise of the extraction.

I have spent decades learning pattern recognition from OPG’s through trial and error in surgery.

I have extracted at least 3000 impacted lower third molars.

The person who comes next, who comes after me will never, ever have the opportunity to pattern learn like that.

The world is just not like that anymore.

In implant surgery I have pattern learned. I can lift a flap and see it and guide the surgery myself and most of the time it is pretty good.

I can do the same with guided surgery and most of the time that is pretty good too.

In both of these formats I can have a disaster on any given day.

The fact is though, that the opportunity to learn from pattern recognition in implant surgery is considerably less even than that for third molar removal.

We have a situation at the moment where there are many people who are very experienced in implant dentistry who I’ve been asked to teach in guided surgery, who perhaps don’t need the help of guided surgery as much as the people who have never been trained in guided surgery, but are relatively new to implant dentistry.

The opportunity to try and fail is much reduced and therefore we have to be really safe and secure from the very outset and it stifles creativity and it stifles pattern recognition and it also stifles the opportunity to gain experience by numbers.

In these circumstances, perhaps, guided surgery becomes essential, but perhaps even more so for the decision making that is undertaken when it is properly planned than even the execution with a guide in the mouth.

The consideration that is made in terms of implant position, associated anatomy, requirement for bone grafting, prosthetic design and implant design is something that was often massively overlooked in the days before digital guided planning.

All most everyday people are posting things that say “would never have been able to do this without guided surgery” some of the older guys that I know who are considerably older than me would perhaps tell you that’s because they never learned how to do it like that in the first place.

This is a paradox and only the people who are prepared to discuss the paradox honestly are the ones you should listen to.

Blog Post Number - 2190