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How a decade of digital precision began

by: Michael Stuart

Ten years since its launch, we take a look at how the NobelGuide guided surgery concept evolved from an ambitious idea to become a solution many clinicians find indispensable.


Planning NobelGuide treatment in the NobelClinician Software

1990s – Starting the journey

It all started back in the 1990s when Professor Matts Andersson, who had been influential in producing the very first CAD/CAM restorations a few years earlier, was contacted by Professor Daniel van Steenberghe.

Professor van Steenberghe had just lead a virtual planning development project at the Catholic University of Leuven, Belgium. His group there had developed a promising program for dental treatment planning based on CT imaging. However, they hadn’t yet found a way to link the virtual plan to a physical model. They had contacted the right person. Professor Andersson immediately saw a possible way to couple the two together. A special project had begun.

Related: Digital precision for all indications

Andreas Petersson (front left) explores some options with
Professor Daniel van Steenberghe (front right).

2000s – Guiding the way

Development of the concept moved quickly after that, as Professor van Steenberghe recalls:  “Matts attended a surgery on cadavers and saw it matched perfectly with the preoperative planning.”

Things moved fast. A group that included Andersson, van Steenberghe, Professor Ingvar Ericsson, Andreas Petersson and Izidor Brajnovic, CDT, developed a guided surgery concept remarkably quickly. An early version of NobelGuide was born.

Related: Find a guided surgery course near you

Supporting IT system architecture was then developed, taking advantage of then-revolutionary internet-based technology. This enabled interaction with other systems, laying the foundation for the commercial success and rapid growth that was to come.

In 2001, Izidor Brajnovic produced the first flapless surgical template. Shortly after, the idea of the radiographic and surgical index was introduced.

Years of work fully paid off in 2002 when the first patient was successfully treated with the concept. NobelGuide was ready to take centre stage – literally.

2003 – Live in Las Vegas

A year later saw the Nobel Biocare World Conference take place in Las Vegas. Attendees from around the world watched in awe as two NobelGuide surgeries were simultaneously beamed to them live. The guided implant placements by Professor Ingvar Ericsson, who was operating in Stockholm, and Dr. Peter Moy, who was treating his patient in Yorba Linda, were watched on adjacent screens by a packed auditorium at the Rio Hotel.  

The stage is set in Las Vegas for Professor Ericsson (seen in the upper left and right of the photo on the projection screen) and Dr. Peter Moy (not pictured) to perform the first simultaneous live surgeries using NobelGuide. 

When Professor Ericsson was first approached about the idea, he couldn’t believe his ears. “Never in my life will I do such surgeries,” he recalls.

“There were more than 2000 people in attendance during the live surgery – but the room was so silent you could hear anything falling to the floor.”

Related: Take your learning on the road at one of our events

2005 – 

The NobelGuide revolution didn’t stop there. 2005 saw the full launch of the concept, and it’s been developing ever since. This is the key to its success according to Dr. Giovanni Polizzi from Italy.

“Some clinicians, including me, were trained with an early concept, so we understood it and had already treated some patients before the NobelGuide launch,” Dr. Polizzi (pictured left) explains. 

“When it was launched in 2005 it was quite improved and definitively more flexible. It was a great breakthrough for the profession and for our patients.

“The fact that you could achieve such results with a minimally invasive flapless technique and considerable post-operative comfort for the patient was remarkable.

“The concept has since been enriched by new options. Nowadays it is possible to guide most of the Nobel Biocare implants, as well as the new NobelParallel Conical Connection implants.”

Also possible is to opt for guided surgery for pilot drilling only, should the clinician wish to work freehand for the rest of the drilling protocol.

Like many clinicians, Dr. Polizzi is a fan of the SmartFusion technology in the Nobel Clinician Software. This feature combines hard and soft tissue information for optimized treatment planning, particularly when preparing for guided implant surgery.

According to Dr. Polizzi, “SmartFusion allows, with pilot drilling or fully guide sleeves, the optimal insertion of any implant, making implant treatment much safer.”

Related: Why NobelClinician is the key to successful treatments

A decade of “predictable” placement

In the ten years since its launch, NobelGuide has become an important tool for clinicians aiming to increase treatment predictability and safety.

Dr. Polizzi would now not be without it, and suggests others could benefit also:

“I use it in almost all maxillary cases and more often in partial and single cases in the mandible.

“The key benefit is the optimized diagnostic and implant planning, resulting in predictable, precise treatment that is prosthetically oriented. There’s the possibility of flapless or mini-flap surgery, meaning less invasiveness in many cases and the possibility to treat complex cases and sites that have limited bone quantity.

“I would recommend guided surgery to colleagues…it can only improve their treatments.”

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