By Dr Brijesh Mandli – Lead Mentor, Global Implant Centre (Perth, WA)
Introduction
When I reflect on how implant dentistry has evolved over the past decade, the most transformative shift has undoubtedly been the rise of fully digital workflows. What once required multiple analogue steps, numerous appointments, and considerable manual labour can now be achieved with remarkable precision and efficiency using digital tools.
Yet, I still meet dentists across Australia who approach implant treatment with outdated methods, traditional impressions, freehand placement, inconsistent communication with laboratories, and occasional uncertainty during surgery. These clinicians may have good fundamentals, but they often tell me the same thing: “I feel confident in what I know, but I am aware that technology has moved ahead of me.”
Digital workflow is no longer a luxury or an optional add-on. It is the foundation of modern implant dentistry. Whether you are planning a straightforward single implant or a full-arch immediate-load rehabilitation, digital integration enhances every stage of care.
In this article, I will walk you through the full digital pathway, from the initial scan to the guided surgery and finally the digitally fabricated prosthesis. My goal is to give you a clear understanding of how digital dentistry elevates accuracy, reduces chair time, and provides a more predictable and comfortable experience for both clinicians and patients.
Why digital dentistry matters more today than ever
If there is one thing I emphasise repeatedly in our Fellowship and Residency programmes at the Global Implant Centre, it is the importance of thinking prosthetic-first. Digital workflow ensures that every decision follows a prosthetically driven plan.
Here is why digital integration is now indispensable:
- Greater precision: CBCT and intraoral scans allow incredibly accurate merging of bone and soft-tissue data.
- Improved safety: Virtual planning identifies anatomical constraints like the sinus, inferior alveolar nerve, and bone concavities.
- Predictable implant positioning: Digital tools ensure implants emerge exactly where the final crown or bridge requires.
- Reduced chair time: Fewer appointments, fewer retakes, fewer adjustments.
- Higher patient acceptance: Seeing their proposed smile digitally reassures patients and improves case acceptance.
- Seamless lab communication: Digital files eliminate misinterpretation and material distortion.
Once a dentist experiences the ease and clarity of digital planning, it becomes difficult to return to analogue methods.
The digital implant workflow: a step-by-step overview
In a fully digital environment, the workflow can be divided into several stages. Let me walk you through each one as we teach and practise it here in Perth.
1. Digital diagnostics: CBCT and intraoral scanning
The first step is always information gathering. Traditionally, we would rely on 2D imaging and physical impressions, both of which had limitations. Today we use:
Cone Beam Computed Tomography (CBCT)
A CBCT scan provides three-dimensional views of the maxilla or mandible, giving us precise data on:
- Bone density and quality;
- Cortical thickness;
- Anatomical boundaries;
- Nerve pathways;
- Sinus position.
Even before planning begins, I can visualise whether immediate loading may be possible based on expected torque values.
Intraoral Scanning
Intraoral scanners (such as Trios, Medit, or iTero) capture the surface anatomy and occlusion without the need for impression material.
Why it matters:
- No gagging, discomfort, or retakes;
- No temperature distortion or material inaccuracies;
- Instant digital models are ready for merging.
When CBCT and scanning are combined, they provide an accurate digital foundation for virtual implant planning.
2. Merging data sets and virtual planning
One of the most exciting aspects of digital dentistry, especially for clinicians transitioning from analogue, is the merging of these data sets.
The CBCT provides the hard-tissue view, while the scanner provides the soft-tissue and occlusal view.
Virtual implant placement
Using software such as coDiagnostiX or BlueSkyPlan, we:
- Position implants according to the prosthetic outcome;
- Align the long axis for optimal load distribution.
- Evaluate bone support around each implant.
- Determine the need for bone reduction;
- Assess the safety margins around anatomical structures.
This process is often eye-opening for dentists in our programme. Many realise how much freehand placement could deviate from ideal angulation without digital guidance.
3. Designing the surgical guide
Once virtual planning is complete, we move to guide design.
Types of guides
- Tooth-supported: For partially edentulous cases, using remaining teeth for stability.
- Mucosa-supported: For fully edentulous cases.
- Bone-supported: Used when significant bone reduction is required.
A well-designed guide:
- Stabilises the drill path;
- Ensures angulation accuracy;
- Controls depth and entry point;
- Shortens surgery duration;
- Improves safety.
I often describe guided surgery as an additional “assistant” that maintains precision throughout the procedure.
4. Printing or milling the guide
After design, the guide is either 3D-printed or milled.
3D printing has made surgical guides significantly more accessible. With biocompatible resins and high-resolution printers, guides are produced with remarkable accuracy.
Quality checks before surgery
In every residency session, I encourage participants to review:
- Fit and seating stability;
- Sleeve or tube tolerance;
- Occlusal clearance;
- Soft-tissue accommodation;
- Angulation verification.
A guide is only as accurate as its planning. Everything must align perfectly before surgery begins.
5. Guided implant surgery: precision in action
Guided surgery allows the clinician to execute the plan with minimal guesswork. However, it is not “automatic” surgery; experience is still essential.
During surgery, we monitor:
- Primary stability and torque;
- Pone density variations;
- Plap design and soft-tissue tension;
- Depth, angle, and trajectory;
- Seating of the guide throughout drilling.
Even with a guide, I always encourage dentists to be clinically aware, not mechanically dependent.
Guided surgery is particularly valuable for:
- immediate implants;
- full-arch cases;
- challenging anatomical situations;
- avoiding vital structures;
- maintaining prosthetically driven emergence.
Participants often tell me they cannot imagine planning a full-arch case without a digital guide once they experience its accuracy.
6. Digital impressions and provisionalisation
After implant placement, we take digital impressions immediately.
Benefits:
- No distortion compared with conventional impressions
- Rapid prosthetic workflow
- Immediate loading when appropriate
- Seamless communication with the laboratory
For full-arch cases, we can immediately fabricate a temporary bridge based on the pre-planned design.
Patients are often astonished by how efficiently their treatment progresses.
7. Designing and fabricating the final prosthesis
The final prosthesis, whether zirconia, hybrid acrylic, or monolithic resin, is designed digitally.
Advantages include:
- Precise fit
- Controlled occlusion
- Predictable aesthetic design
- Reduced adjustments
- Better long-term durability
Every parameter, from the screw access holes to the gingival contours, can be digitally previewed and refined before fabrication.
The impact of digital workflow on clinical outcomes
Digital dentistry not only makes treatment easier; it makes it safer, more consistent, and more predictable.
1. Greater accuracy
Implant positioning is prosthetically driven rather than bone-constrained. This leads to better emergence profiles and long-lasting restorations.
2. Reduced complications
Angulation errors, perforations, accidental nerve proximity, and prosthetic misfit are significantly reduced.
3. Enhanced patient communication
Digital previews help patients visualise outcomes, improving acceptance and trust.
4. Shorter appointments
Digital impressions eliminate long chairside time. Guides reduce surgical duration.
5. Streamlined lab collaboration
Digital workflows avoid miscommunication with laboratories.
What general dentists need before adopting digital workflows
Many dentists want to adopt digital systems but feel unsure about where to start. The key is to learn the technology gradually and meaningfully.
You will need:
- A good intraoral scanner.
- Access to CBCT imaging;
- An understanding of implant planning software.
- Knowledge of surgical guide workflows;
- Mentorship in interpreting digital data.
At the Global Implant Centre, our digital modules help clinicians transition confidently. We guide them through each stage, from the first scan to the full-arch digital workflow, making adoption smoother and more intuitive.
Common mistakes when using digital workflows for implants
I have observed that dentists transitioning into digital workflows often encounter similar challenges:
- Relying too heavily on guides without understanding fundamentals
- Inaccurate merging of CBCT and intraoral scan data
- Failure to plan prosthetic space properly
- Overlooking the need for bone reduction
- Misjudging occlusal requirements
- Underestimating the learning curve
Digital workflow is powerful, but it demands clinical awareness and proper mentorship.
Cost and return on investment
Dentists often ask me whether digital systems are worth the investment. The answer is yes, if integrated correctly.
A scanner will generate returns quickly because:
- Ampression remakes disappear;
- Appointment times decrease.
- Patients appreciate comfort;
- Laboratories prefer digital files.
- Implant restorations become more predictable.
Full-arch digital workflows also reduce chair time and complications, improving the financial sustainability of each case.
Conclusion
Digital workflow has reshaped the way we approach implant dentistry. It brings clarity, confidence, and precision to every stage, from planning to execution. For general dentists preparing to expand into advanced implantology, mastering digital dentistry is not optional; it is essential.
If you are planning to adopt digital workflows or want structured training in full-arch guided surgery, I encourage you to explore our programmes at the Global Implant Centre. The combination of hands-on exposure, digital planning, guided surgery, and mentorship provides a complete pathway to becoming a confident, modern implant clinician
FAQ
1. Do I need a scanner to begin digital implant dentistry?
Yes, an intraoral scanner is essential for modern workflows.
2. Should every implant be placed using a surgical guide?
Not necessarily, but guided surgery enhances accuracy in most cases, especially full-arch cases.
3. How difficult is it to learn planning software?
With proper training and repetition, most clinicians adapt quickly.
4. Does digital workflow reduce complications?
Yes. It improves angulation, depth control, and occlusal planning.
5. Can I learn digital workflows at Global Implant Centre?
Yes. We provide step-by-step instructions as part of fellowship and residency programmes.