Advancing Guidelines for the Design of Tooth-Supported Surgical Guides with Free-End Configurations: A Simulation Study of the Influence of Surgeon’s Hand Force

Numerous studies have demonstrated that tooth-supported dental guides improve the accuracy of implant placement. However, current manufacturing procedures and available materials are not yet optimal and may still lead to deviations from the planned implant position. The influence of the surgeon’s manual force on the deformation of dental guides during implant placement has not yet been sufficiently investigated. Therefore, this study evaluates the mechanical behavior of dental guides using finite element analysis (FEA) in order to assess the influence of the surgeon’s hand force during clinical application. Finite element simulations of deformation and stress were performed for four types of tooth-supported dental guides, including cantilever dental guides with free ends and beam-type guides with a large span between the supporting teeth. The manual force applied by the surgeon was arbitrarily set to 30 N. Simulations were conducted for five commonly used biocompatible polymer materials: Stratasys MED610, VeroGlaze MED620, EOS PA2200, Formlabs FLSGAM01, and Stratasys ULTEM 1010. The numerical results quantified the deformation of dental guides caused by the applied manual force during surgical manipulation. For all analyzed guide designs, the deflection was primarily influenced by the arm length, i.e., the distance between the support and the point of force application. Based on the obtained results, design diagrams were developed to provide guidelines for the design of beam-type (A and A1) and cantilever-type (B and B1) tooth-supported dental guides.