Statement of problem: The proper implant placement requires a proper and adequate planning for the anatomic limitations and achievement of the best restorative results. The Cone Beam C.T can properly diagnose implant positioning, but transfer of the preplanned position to the surgical field was missed. From there it became mandatory to perform surgical guide to transfer the preplanned position of implants to the surgical field to ensure accuracy of implant placement.

Purpose: The interest from this study was to evaluate the accuracy of implant placement using different surgical guides; the surgical guides with closed sleeve versus the surgical guides with open sleeve. After placement of the implants via the surgical guides investigate if there was any deviation of the preplanned implant position with the actual placed implant positioning to evaluate the accuracy of implant placement.

Many radiographic techniques had been used to diagnose implant placement positioning, computed tomography considered to be the most superior above all other radiographic technique. After scanning of the patient by cone beam C.T the scanned file was uploaded to a specialized software (BLUE SKY), through this software virtual planning of implant was done and after that fabrication of the surgical guide to place the implant in the preplanned position that had been done. After implant placement another cone beam scan was done and then superimpose of the preoperative cone beam C.T with the Post-operative cone beam C.T was done through BLUE SKY software to calculate if there were any deviation from the preplanned implant positioning.