Guided implant surgery in Santiago

The most important part of an implant happens before surgery, in front of a screen. I am Pablo Atria, dentist, with a Master's in Biomaterials and a PhD in Biomedical Sciences from NYU College of Dentistry, where I direct the Advanced Clinical Fellowship in Operative and Digital Dentistry. Computer-guided surgery starts from that idea: the exact position of the implant, its depth and its angulation are decided on a three-dimensional model of the patient, and only then do we bring that plan into the mouth. At AS Odontología Digital, in Vitacura, I plan and place implants with this workflow, and it is how I approach implant dentistry in most cases.

It helps to explain how this differs from conventional, freehand surgery. In the classic approach, the surgeon decides the implant position during the operation, reading the bone directly and relying on experience as a guide. It works, and for many cases it remains reasonable. Guided surgery moves the moment of decision: the position is defined beforehand, on the computer, with full information about the bone, the neighboring roots, the inferior alveolar nerve and the maxillary sinus in view. Surgery then executes a plan that is already solved, rather than solving it on the patient.

The workflow has two phases. The first is planning: I take a cone-beam CT (CBCT), which provides bone volume in three dimensions, and an intraoral scan, which captures the exact shape of the teeth and gums. With both files superimposed, I design the position of each implant relative to the structures that must be respected. The second phase is the surgical guide: a template that rests on the teeth or the mucosa and directs the drill to exactly the planned position. That guide is designed and 3D-printed inside the clinic, which lets me control the whole process and manage the case timeline.

Guided surgery is more predictable for one concrete reason: it shrinks the distance between what I planned and what ends up in the mouth. By defining the trajectory in advance, I keep a safety margin from the inferior alveolar nerve and the floor of the maxillary sinus, the structures that most constrain implant work in the posterior region. In many cases it allows working without raising a wide gum flap, a minimally invasive approach usually associated with less swelling and a more comfortable recovery. The guide also shortens chair time, because the difficult decision is already made.

Not every patient needs guided surgery, and I prefer to say so plainly. It is especially useful when little bone is available, when the implant sits close to the nerve or the sinus, when several implants must end up parallel to one another, and when a full-arch rehabilitation is planned where the position of each implant shapes the final prosthesis. Real candidacy depends on the health of the gums, the volume and quality of the bone, and each person's general situation. That assessment is always clinical, based on the examination and the CBCT, not something settled in advance.

When the case allows, digital planning enables immediate loading: placing a provisional restoration on the implants the same day as surgery, instead of waiting through the months of osseointegration with an empty space. It is not an option for every case, because it depends on the stability the implant achieves in the bone and on how the bite distributes forces, but when it is indicated, it is planned from the start along with the implant position. All of this rests on the clinic's same digital workflow, the intraoral scanner and CAD/CAM planning, which connects the surgery to the prosthesis without intermediate steps that lose precision.

If you are looking for where guided implant surgery is done in Santiago, what sets one treatment apart from another is the complete workflow behind it, well beyond owning a scanner. At AS Odontología Digital that workflow is in-house: cone-beam diagnosis, 3D planning, a guide printed in the clinic, CAD/CAM restoration and immediate loading when appropriate, with my NYU training behind how I approach implant dentistry. You can see the detail on our dental implants page (/en/services/dental-implants). The first step is always the same: an evaluation with CBCT and a scan to determine whether your case is a candidate and what the right approach is for you.