Surgical Stent for Dental Implants: Is this Necessary?


Alan asks:
I had #30 & #31 extracted with allografts three months ago. #29 now has two cracks from grinding (after the loss of these teeth my bite is a mess) so my oral surgeon (OS) referred me to a prosthodontist who is preparing a crown. He recommended making a surgical stent, or guide, for the OS to use for the dental implant placement. The OS had no plans to use a stent, but he also had no plan to do a CT prior to placement. I am considering using a different OS, and he doesn't use stents, either, but does do CT scans. My question is - how important is a surgical stent? The cost is $350.00, and if it is highly recommended I will have one made, but I would greatly appreciate hearing what a few more experts think. Thanks so much.

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Expert Advice and Comments
ekusek's picture


Answered By: Dr. Edward Kusek - Sioux Falls , SD

I have a few statements to your question. First, alot of surgeons do not use a stint. If you know the anatomy and tooth positions you could get by without one. Secondly, The fee you are quoted for the stint is probably a lab fabricated stint which does not take account for the anatomy of your mouth. Finally, there are stints that utilize the CT anatomy and correct tooth position, but it is far more expensive for this type of stint.

I personally use a CT fabricated stint for all my cases. There are situations when the patient is draped that you loose orientation for the correct position. There are also situations where correct implant placement is critical by either anatomy or tooth positioning and maximum aesthetics. It makes me more prepared for each case to know the anatomy before the surgery. That being said, others do not wish to treat like this at this time, but with medical/legal concerns, I would say in the future this is the way things will go.

good luck

Dr. Edward Kusek

cboudet's picture

Surgical Stent for Dental Implants: Is this Necessary?

Answered By: Dr. Carlos Boudet - West Palm Beach , FL

Dear Alan:
A surgical stent gives the surgeon the information about the planned treatment, things like the size, shape and position of the teeth that are going to be placed on the implant(s).
There are a lot of surgeons that do not use a surgical stent and still do a good job, but by fabricating a stent, the prosthodontist is making sure that he has given the surgeon all the information that he can to help him place the implant in the ideal position.
Sometimes the adjacent teeth can serve as a guide when only one implant is being placed, but the greater the number of implants planned, the greater the surgical stent is recommended.
A CT scan is an excellent way to obtain as much information about the anatomy and the volume and morphology of the bone before the surgery is planned.
I hope this helps and good luck with the surgery.

Carlos A. Boudet, DDS, DICOI

drjbdmd's picture

Necessity of Surgical Stents

Answered By: Dr. Jeffrey Brook - Massapequa , NY

Surgical stents are used in implant dentistry to allow implants to be placed in the jaw bone with the most precise position possible. They can be made from a simple stone model of the jaw or through precise Cone Beam (3-D) imaging software. They are not necessary for every case but can be useful in many cases.
As a surgeon, I use them to place implants to provide me with the most accuracy when there is a critical anatomical structure present that I need to avoid. Prosthodontists provide them to surgeons so that the surgeon can place the implant where the prosthodontist needs them to complete the case properly.
It is difficult for me to determine the stent's necessity for your case from the information you provided, but the use of the stent should only enhance the result that your implant team will provide to you.
Good luck with your implants.
Jeffrey R. Brook, D.M.D.

Dr. Jeffrey Brook

Theodore M Grossman DMD's picture

Surgical Guides & Stents for Multiple Implant Case

Hi Alan
A Maxillofacial C.T. scan and pre-operative mounted models of your dentition will allow the surgeon and prosthodontist to evaluate your occlusion. These diagnostic tools allow evaluation of ridge width, boney anatomy, nerve location, dental occlusion, size of crowns to be constructed, implant diameter, angulation and placement site of implant fixtures. A radiographic guide/stent can be fabricated (with opaque markers) for you to wear during the radiographic survey. It can be modified to become the surgical guide. A precision osteotomy minimizes operator placement error. A panoramic film with radio opaque guide/stent can also be used in less demanding cases. Surgical stents can also be fabricated directly from some C.T. software programs.
The dictum, "Plan twice, cut once" is appropriate. I consider the surgical guide/stent as "my standard of care" for multiple implant or complex cases. The prosthodontist may provide the surgical stent for the surgeon.
Good Luck!

drkazemi's picture

Surgical guide or stent for dental implant placement

Answered By: Dr. H. Ryan Kazemi - Bethesda , MD


The simple answer is: Absolutely YES.
Those who do not use surgical guide take a risk because what they see (even with good knowledge of anatomy) does not always correspond to where the implant needs to be. Implant position is based on bite and position of the crown. Without a properly made surgical guide, it is simply a guess. For long term success, optimal aesthetics, and easy cleaning, one can not be just close enough. It needs to be right on with precision- That means to have a surgical guide- My recommendation: do not do your implant surgery without one.

Dr. Kazemi

Dr. H. Ryan Kazemi

Alane's picture

Surgical Stents for Dental Implants: Is This Necessary

Thank you, kind doctors, for your excellent advice! I truly appreciate your time and wisdom, and will have the stent made!

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