Surgical guides / Tooth-supported
Tooth-supported surgical guides
Custom implant planning and guide design, supported by your patient’s existing teeth.
A tooth-supported surgical guide is a custom surgical template that fits over the patient’s remaining teeth. It helps the clinician prepare the implant sites through guided drilling (osteotomy), following an approved digital implant plan.
On this page
At a glance
Case selection
Dentate or partially dentate patients.
What we need
A full-arch CBCT scan, upper and lower intraoral scans, and a bite scan.
What you receive
Planning documents, a digital model design and surgical guide STL files, with prepared print files for Formlabs and SprintRay users.
Who this is for
Tooth-supported guides may be suitable for dentate or partially dentate patients requiring dental implants.
For our tooth-supported workflow, we require at least 3 supporting teeth in the arch being treated, ideally 5. The supporting teeth must be stable and free of mobility. We review their condition and distribution to assess whether they can provide suitable support for the guide.
If extractions are planned, please identify which teeth will be removed so the guide’s support can be considered throughout the surgical sequence.
What to submit
- Full-arch CBCT scan of the arch being treated, exported as the complete original DICOM dataset.
- Upper intraoral scan in STL format.
- Lower intraoral scan in STL format.
- Bite scan in STL format, with the upper and lower scans aligned to the recorded bite.
Please also include the intended implant sites, any planned extractions, and the implant system and guided surgical kit.
For Formlabs and SprintRay users, we also provide a prepared print file, with the guide positioned on the build platform for your confirmed printer and material workflow.
Our workflow
- Submit your case. Send the required records and case information through the client portal.
- QC and Treatment Planning We check the records for completeness and quality, then prepare the proposed digital implant plan.
- Review and approve. The treating clinician reviews and approves the plan by email or during a Zoom call before guide design begins.
- Design and Delivery We design the surgical guide and provide the planning documents and digital files for your case.
Turnaround and deliverables
Turnaround
| Stage | Turnaround | When it begins |
|---|---|---|
| Implant planning | 1 business day | Once all required records and case information have been received |
| Surgical guide design | 1 business day | Once the implant plan has been approved and all design requirements are available |
These times apply to digital planning and guide design. If you choose our manufacturing service, allow 3–5 business days total from implant-plan approval to delivery at your office.
What you receive
- Implant Plan Report
- Drilling protocol for the selected implant system and guided surgical kit.
- Case presentation
- Digital model design
- Surgical guide design in STL format.
- Prepared print file for Formlabs or SprintRay users, configured for the confirmed printer and material workflow.
Need a manufactured guide?
We can also manufacture your surgical guide if you do not have a 3D printer. Allow 3–5 business days from implant-plan approval to delivery at your office. This period includes guide design, manufacturing and delivery.
Frequently asked questions
How many supporting teeth are needed?
We require at least 3 supporting teeth in the arch being treated, ideally 5. Their stability and distribution are also reviewed to assess suitability.
Which scans do I need?
Please provide a full-arch CBCT scan of the arch being treated as the complete original DICOM dataset. Submit the upper, lower and bite scans in STL format, with the upper and lower scans aligned to the recorded bite.
Can I print the guide in my clinic or laboratory?
Yes. We provide STL design files for compatible 3D printing or milling workflows. For Formlabs and SprintRay users, we also provide a prepared print file configured for the confirmed printer and material workflow.
Can Virtual DDS manufacture the guide for me?
Yes. Allow 3–5 business days from implant-plan approval to delivery at your office, including guide design and manufacturing.
When does guide design begin?
Guide design begins after the treating clinician approves the implant plan and all design requirements are available. The design turnaround is 1 business day.
Your case. Our support.
Send us your records, or get in touch to discuss what your case needs. We are here to support you and your team, from patient consultation to final restoration.
Clinical evidence
In a 2026 retrospective clinical study of 180 implants, Smojver et al. found that tooth-supported guides had lower angular deviations and smaller positional deviations at the implant neck and apex than bone- and mucosa-supported guides.
These findings support the value of stable tooth support in suitable cases. The appropriate guide type still depends on the patient's remaining teeth, anatomy and planned treatment.
Reference
Smojver I, Bjelica R, Vuletić M, Stojić L, Njari Galić V, Gabrić D. Accuracy of Static Computer-Aided Implant Surgery: A Clinical Comparison of Tooth-, Bone-, and Mucosa-Supported Surgical Guides. Journal of Functional Biomaterials. 2026;17(4):194. doi:10.3390/jfb17040194.