Use of precise implantological surgical guides in reconstructions adjacent to teeth with unusual anatomy – use of Dentistry 4.0 technology

  • 1 Medical and Dental Engineering Centre for Research, Design and Production ASKLEPIOS, Gliwice, Poland


This study aims to present the practical application of the Dentistry 4.0 concept based on obtaining data on the patient’s intraoral situation and bone base using CBCT, processing them into a digital model, creating a digital twin, and then developing an intraprocedural navigation procedure through a dedicated surgical guide and then designing and manufacturing, using 3D printing, implantprosthetic restorations. The study describes the results of the author’s work, indicating the engineering aspects of implant prosthetic treatment based on the description of cases related to the reconstruction of single missing teeth using dental implants implanted in the case of difficult anatomical conditions of the bone base and/or adjacent teeth, with a discussion of the material selection methodology, technological and structural design, using additive manufacturing.
The technology for the design, manufacture and application of implant-prosthetic restorations developed by the author, preceded by a fully navigated implantation procedure of dental screw implants, illustrates in practice the full application of the Dentistry 4.0 concept, where the latest technologies, including primarily computer-aided design and computer-aided CAD/CAM manufacturing, the use of a digital twin, supporting surgical procedures through the use of templates navigating the operator’s actions and additive manufacturing allow for a radical increase in the availability of implant-prosthetic solutions for patients with difficult anatomical conditions, both due to a limited bone base and anomalies of the anatomy of adjacent teeth. Thanks to the latest technology, not only is it possible to perform this type of procedure, but it is also possible to perform the procedure in a short time, with minimal interference in the patient’s tissues and ensuring the optimal shape of the prosthetic restoration itself.



  1. L.A. Dobrzański, L.B. Dobrzański, J. Dobrzańska, Chapter 8. Ethical imperatives towards the development prospects of the triad of Dentistry 4.0, dental engineering, and nanoengineering, in: M.H. van de Voorde, G. Jeswani (eds), Ethics in Nanotechnology: Social Sciences and Philosophical Aspects, de Gruyter, Berlin, Germany, 2021, 157-248. DOI:
  2. L.A. Dobrzański, A.D. Dobrzańska- Danikiewicz, L.B. Dobrzański, Effect of Biomedical Materials in the Implementation of a Long and Healthy Life Policy, Processes 9/5 (2021) 865. DOI:
  3. L.A. Dobrzański, L.B. Dobrzański, A.D. Dobrzańska-Danikiewicz, J. Dobrzańska, The Concept of Sustainable Development of Modern Dentistry, Processes 8/12 (2020) 1605. DOI:
  4. L.A. Dobrzański, L.B. Dobrzański, Approach to the design and manufacturing of prosthetic dental restorations according to the rules of the Industry 4.0, Materials Performance and Characterization 9/1 (2020) 394-476. DOI:
  5. Rüßmann, M.; Lorenz, M.; Gerbert, P.; Waldner, M.; Justus, J.; Engel, P.; Harnisch, M. Industry 4.0: The Future of Productivity and Growth in Manufacturing Industries; Boston Consulting Group: Boston, MA, USA, 2015. Available online:
  6. Kagermann, H.; Wahlster, W.; Helbig, J. Recommendations for Implementing the Strategic Initiative Industrie 4.0: Final Report of the Industrie 4.0 Working Group; Federal Ministry of Education and Research: Bonn, Germany, 2013.
  7. Hermann, M.; Pentek, T.; Otto, B. Design Principles for Industrie 4.0 Scenarios: A Literature Review; Technische Universität Dortmund: Dortmund, Germany, 2015.
  8. L.B. Dobrzański, Advanced engineering materials and materials processing technologies in dental implant and prosthetic treatment with clinical cases, Journal of Achievements in Materials and Manufacturing Engineering 121/1 (2023) 7-45. DOI:
  9. Surovas, A. A digital workflow for modeling of custom dental implants. 3D Print Med 5, 9 (2019). 019-0046-y
  10. Garg V, Bagaria A, Kaur G, Bhardwaj S, Hedau LR. Application of Cone Beam Computed Tomography in Dentistry- A Review. J Adv Med Dent Scie Res 2019;7(4): 73-76.
  11. Khanna, A.B. Applications of cone beam computed tomography in endodontics. Evid.-based endod 5, 1 (2020).
  12. Nadeem Karimbux, Hans-Peter Weber (eds), Clinical Cases in Implant Dentistry, by John Wiley & Sons, Inc, Oxford, 2017
  13. L.A. Dobrzański, L.B. Dobrzański, A. Achtelik-Franczak, J. Dobrzańska, Application Solid Laser-Sintered or Machined Ti6Al4V Alloy in Manufacturing of Dental Implants and Dental Prosthetic Restorations According to Dentistry 4.0 Concept, Processes 8/6 (2020) 664. DOI:
  14. L.A. Dobrzański, L.B. Dobrzański, Dentistry 4.0 Concept in the Design and Manufacturing of Prosthetic Dental Restorations, Processes 8/5 (2020) 525. DOI:
  15. Suresh Sajjan MC, Yekula PS, Kovvuri SS, Venkata Alluri RR. A simple technique for fabrication of a surgical guide for predictable placement of dental implants. J Dent Implant 2017;7:11-4.
  16. Salem D (2019) Surgical Guides for Dental Implants; a Suggested New Classification.J Dent Oral Health 6: 1-8.
  17. Revilla-León, M., Sadeghpour, M. & Özcan, M. An update on applications of 3D printing technologies used for processing polymers used in implant dentistry. Odontology 108, 331–338 (2020).
  18. Melchels, F.P.W.; Domingos, M.A.N.; Klein, T.J.; Malda, J.; Bartolo, P.J.; Hutmacher, D.W. Additive manufacturing of tissues and organs. Prog. Polym. Sci. 2012, 37, 1079–1104. [CrossRef]

Article full text

Download PDF