In brief: For All-on-4 and All-on-6, Dazzle plans every implant digitally before surgery. A CBCT scan and an intraoral scan are combined in planning software, the implants are positioned around the planned bridge, and surgery follows that plan using a printed surgical guide or ClaroNav Navident real-time guidance. The same digital files are used by the in-house lab to make the temporary and final teeth.
The position of an implant in bone, its depth, angle, location and distance from nerves and the sinus, directly affects how well the bridge fits, how bite forces are spread and how stable the bone stays over time. Those results depend on the planning done before the surgical appointment as much as on the surgery itself.
Digital dentistry at Dazzle Dental Clinic means a continuous digital chain from CBCT imaging through virtual planning to guided implant placement and in-house bridge fabrication. Each step is described below.
CBCT Imaging: Why 3D Planning Matters for Full-Arch Cases
A panoramic X-ray shows bone height in two dimensions. It cannot measure bone width, cannot place the inferior alveolar nerve accurately in three dimensions and cannot assess bone density. In All-on-4 or All-on-6, where the back implants are often tilted at 30 to 45 degrees, the 3D shape of the bone at each site is essential planning information.
CBCT is part of every full-arch implant workup at Dazzle. From the 3D scan, the implantologist measures bone height, width and density at each site; maps the nerve canal, mental foramen and sinus floor; checks for leftover roots or other pathology; and chooses the diameter, length and angle of each implant before surgery.
Radiation is low. Studies report an effective dose of roughly 20 to 100 microsieverts for a dental CBCT, comparable to a few days of natural background radiation and far lower than a medical chest CT.
Virtual Planning: Designing the Case Before Surgery
The CBCT is merged with an intraoral scan in implant planning software. The intraoral scan supplies the accurate shape of teeth and gums, which CBCT shows poorly because metal fillings and crowns cause scatter. The two are aligned on shared landmarks to give one model of bone, teeth and gum.
Each implant is then placed virtually to: get good bone contact at the chosen size; create enough front-to-back spread (AP spread) to support the bridge; keep safe margins from the nerve, sinus and nasal floor; and give screw access holes and emergence angles that suit the planned bridge. The implants are positioned from the bridge backwards, not placed first and worked around later. The plan also checks that the bridge extension behind the last implant stays within safe limits.
Virtual planning vs guided surgery
The two terms are often used together but mean different things. Virtual planning is designing the surgery on the computer. Guided surgery is carrying that plan out with a device that controls the drill. Planning without guidance improves diagnosis but does not control the drill during surgery.
Smile Simulation: Seeing the Result First
When appearance is a priority, the planned tooth positions and gum line can be shown on your facial photos and scans as a 3D smile simulation. You see the proposed result and give feedback before any surgery, and the approved design guides the implant plan so the implants support that bridge shape.
The simulation is a design proposal, not an exact copy of the final teeth. Shade, shape and length are refined again at the provisional and final stages.
Guided Surgery: Printed Guides and Real-Time Guidance
A surgical guide is a custom device made from the virtual plan and printed on our in-house Asiga Max 3D printer. It fits over the gum or remaining teeth and has sleeves that hold the drill to the planned position, angle and depth. A depth stop prevents drilling too deep near the nerve. The guide is tried in before surgery starts to confirm it seats accurately.
Dazzle also uses ClaroNav Navident, a real-time guidance system that tracks the drill against the CBCT plan on screen during surgery. The surgeon sees the drill's position and angle relative to the planned implant and to nearby nerves and sinus, and can make small corrections as the surgery proceeds.
Studies report that guided placement usually keeps the implant tip within about 1 mm, and the angle within about 2 degrees, of the plan. Guide fit, bone density and surgical technique still affect the result, so guidance reduces error rather than removing the surgeon's judgement.
On the day of surgery
The implants are placed through the guide or with real-time guidance. Insertion torque and implant stability are measured as each implant is seated, and those readings decide whether fixed provisional teeth can be attached the same day. The provisional bridge, made in advance from the plan, is then adjusted to the actual implant positions, the bite is checked and it is screwed in.
Intraoral Scanning: Digital Impressions Instead of Putty
Dazzle uses a TRIOS 5 intraoral scanner, a small handheld wand that records the teeth and gums as a 3D colour model in a few minutes. It replaces putty-filled impression trays, which many full-arch patients find hard to tolerate because of a strong gag reflex or loose, sore teeth.
The scanner is used at two points in an All-on-4 or All-on-6 case. Before surgery, the surface scan is matched to the CBCT, and the provisional bridge and surgical guide are designed from it. After osseointegration, small scan bodies are screwed onto the implants and scanned to record their exact positions for the final bridge. The files go straight to the in-house laboratory, with no posted impressions or plaster models that can distort.
In-House Laboratory: Completing the Digital Chain
The final bridge is designed in CAD software from the post-healing scan and milled from solid zirconia on the in-house Amann Girrbach unit. Clinicians and technicians work on the same case in the same building, with no outside-lab delays. For international patients, the provisional bridge is made before surgery so it can be fitted on the day.
International patients can often send an existing CBCT scan (DICOM files) for a preliminary review and estimate before travelling. On our fees page, a guided surgery plan is listed at ₹15,000 and All-on-4 starts from ₹3,00,000 per arch; the final quote follows the consultation and CBCT. See our All-on-4 treatment page for the full process.
FAQs
Does guided surgery make placement perfect?
No, but it greatly reduces deviation from the plan. Guide fit, bone density and surgical technique still play a part. Read more in our ClaroNav Navident guided surgery article.
Can I review the plan before surgery?
Yes. The treatment plan consultation covers where the implants will go and what the bridge will look like, and your feedback is built in before surgery is booked.
What if the plan needs to change during surgery?
CBCT planning makes this uncommon. Small position changes within safe margins can be made during surgery; any larger change is discussed with you.
Do all clinics use guided surgery for All-on-4?
No. It needs CBCT, planning software and a guide or guidance system, and some clinics skip these steps. Asking whether guided surgery is included is a fair question before you commit.
Want to see how your case would be planned? Book a Consult at our Bandra West or Kemps Corner clinic.
