Digital Planning Technique for Surgical Guides for Prosthetic Implants before Orthodontic Treatment

Background: The use of digitalization allows clinicians to plan the position of dental implants in orthodontic patients treated with aligners in the beginning of their orthodontic treatment, instead of waiting until the end of orthodontic treatment, integrating implant restorations with orthodontic biomechanics. Aim: The aim of this case report is to describe a digital workflow for aligner treatment supported by implants, in which implants are placed at the beginning of the treatment and support the orthodontic treatment. Materials and Methods: Digital planning for orthodontic treatment with clear aligners and the preparation of surgical guides for implant surgery before orthodontic treatment are used to solve two multidisciplinary cases. Cone-beam computed tomography (CBCT) and virtual dental impressions are used for the virtual planning. Successively, a surgical guide for implant placement and aligners are used in the treatment plan. Results: The digital orthodontic setup with the integration of the root position allows the clinician to plan the position of dental implants on the final occlusion. The placement of the implant before the start of the orthodontic treatment allows the implants to be used as skeletal anchorage, thereby helping the orthodontic biomechanics. Conclusions: This study describes how to perform a digital workflow with orthodontic virtual planning and the design of surgical guides for implant placement. This technique is potentially promising for complex orthodontic cases.