Digital Precision in Orthodontics: A Review of Three-Dimensional Implant Splints as Surgical Guides.
DOI:
https://doi.org/10.65795/2fv5zv50Keywords:
3D printing, skeletal anchorage, temporary anchorage device, orthodontic mini-screw, digital orthodonticsAbstract
Skeletal anchorage has transformed contemporary orthodontics by providing stationary anchorage that is independent of patient compliance and capable of supporting complex tooth movements with high biomechanical precision. Temporary anchorage devices (TADs), particularly orthodontic miniscrews, are now routinely used for intrusion, distalization, en-masse retraction, asymmetry correction, and vertical control.However, the clinical success of TADs depends heavily on accurate placement because errors in angulation, depth, or insertion site may compromise stability and increase the risk of root contact, cortical perforation, or injury to adjacent anatomical structures. The development of three-dimensional implant splints has addressed many of these limitations by enabling digitally planned, patient-specific, and highly controlled insertion of miniscrews. This manuscript reviews the evolution of orthodontic skeletal anchorage and the transition from freehand placement to guided insertion using 3D implant splints. It outlines the digital workflow, including cone-beam computed tomography (CBCT), intraoral scanning, virtual planning, computer-aided design, and additive manufacturing. The principles of guide design, site selection, and biomechanical planning are discussed together with major clinical applications such as anterior intrusion, open-bite and deep-bite correction, space closure, molar distalization, and management of midline discrepancies. Evidence from recent clinical and systematic investigations indicates that guided miniscrew placement improves positional accuracy, reduces operator dependency, lowers the incidence of root damage, and may enhance survival rates, especially in anatomically challenging areas. Despite limitations related to cost, radiation exposure, software dependency, and technique sensitivity, 3D implant splints represent a major advance in digital orthodontics and are likely to become an increasingly important component of safe, precise, and individualized anchorage management.
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No new datasets were generated or analyzed during the preparation of this review article. All information discussed in the manuscript is derived from previously published literature cited in the reference section.
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Copyright (c) 2026 Nabeesath Shijila C.N., Arun S. Urala, Ramya Vijeta Jathanna (Author)
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Accepted 25-06-2026
Published 09-07-2026
