Computer-Guided Dental Implant Surgery
in Honolulu, HI
 Computer-guided dental implant surgery uses 3D imaging and digital planning software to map the precise position, angle, and depth of each implant before the surgical visit, then executes that plan in your mouth with either a 3D-printed surgical guide or real-time navigation technology.
At Pacific Maxillofacial Center, our board-certified oral and maxillofacial surgeons use computer-guided techniques for the implant cases that benefit most from millimeter-level precision, at both our Honolulu and Waipi’o offices.
This page focuses specifically on the guided execution of dental implants. The implants themselves, the restorations placed on top, and the overall implant timeline work the same way as any other implant case. What changes with computer-guided surgery is how the implant is positioned during placement, and the planning process that leads up to that visit.
Computer-guided surgery is one tool in our dental technology stack. The same CBCT scanner used for general implant planning also drives the digital plan for guided cases, and our in-office 3D printing capability lets us fabricate surgical guides when a static guide is the right choice. For dynamic cases, the X-Guide real-time navigation system lets the surgeon see implant trajectory live during placement.
On This Page
What Is Computer-Guided Dental Implant Surgery?
 Computer-guided implant surgery has two parts: digital planning before the visit and guided execution during the visit. The planning phase uses a CBCT scan of your jaw to map bone, nerves, and sinuses in three dimensions. We then load that scan into implant planning software and design the exact position, angle, and depth of each implant. On the day of surgery, we execute that plan in your mouth using one of two guidance methods.
Static Surgical Guides
A static surgical guide is a 3D-printed tool that fits over your teeth or gums during surgery. The guide has precisely positioned sleeves that direct the implant drill along the planned trajectory. We design and print these guides in our office for cases that benefit from this approach.
Dynamic Navigation (X-Guide)
X-Guide is a real-time navigation system that tracks the position of the surgical handpiece during the procedure and displays it against your CBCT plan on a monitor. The surgeon sees implant trajectory live during placement, which allows in-the-moment adjustments without needing a physical guide.
Both methods rely on the same CBCT-based plan. The choice between static and dynamic depends on the case, including the number of implants, the presence of remaining teeth to reference, the complexity of the anatomy, and the surgical access available.
When Computer-Guided Surgery Adds the Most Value
Not every implant case requires computer-guided surgery. Single implants in straightforward positions can often be placed accurately with conventional planning. Computer guidance becomes most valuable when the anatomy is complex, the case involves multiple implants, or precision in a specific direction is critical.
The cases that benefit most include:
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Full-arch reconstructions – All-on-4 and similar cases where 4 to 6 implants must work together
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Multiple-implant cases – Replacements where each implant’s position affects the final restoration
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Implants near the nerve – Lower-jaw cases close to the inferior alveolar nerve
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Implants near the sinus – Upper-jaw cases close to the maxillary sinus
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Narrow ridges – Where the margin for surgical error is small
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Augmented sites – Implants placed in areas previously rebuilt with ridge augmentation |
All-on-4 dental implants are perhaps the most common application, since the four implant trajectories must converge precisely for the prosthesis to fit correctly. Cases replacing multiple teeth also benefit from guidance to ensure all implants align with the planned restoration. Implants placed in sites previously rebuilt with ridge augmentation commonly use guided surgery to avoid disturbing the rebuilt bone.
Patients with simple, accessible implant sites and adequate bone can usually have their implants placed without computer guidance. We discuss the right approach for your specific anatomy at the consultation.
Your Oral Surgery Team in Honolulu
Pacific Maxillofacial Center was founded in 1999 by Dr. Todd K. Haruki, who completed 12 years of graduate and post-graduate surgical training, including a hospital-based oral and maxillofacial surgery residency at the University of Louisville. He is a Diplomate of the American Board of Oral and Maxillofacial Surgery and a Fellow of the American Dental Society of Anesthesiology.
Dr. Neil Oishi holds DDS and MD degrees from the University of Southern California and the University of Florida College of Medicine respectively, and completed his oral and maxillofacial surgery residency at the University of Florida. He is also a Diplomate of the American Board of Oral and Maxillofacial Surgery, a Member of the International Team of Implantology, and serves as an on-call facial trauma surgeon at Queen’s Medical Center.
Computer-guided surgery sits at the intersection of surgical skill and digital planning expertise. Both Dr. Haruki and Dr. Oishi handle the CBCT-based planning and the guided execution for cases at our office. Dr. Oishi’s ITI Member status reflects ongoing training in implant techniques that include computer-guided protocols.
The Computer-Guided Implant Procedure, Step by Step
 Most computer-guided implant cases follow the same sequence, with the planning work done before you arrive on surgery day.
Step 1: Consultation, CBCT, and Digital Scans
At your consultation, we take a CBCT scan that captures the 3D anatomy of your jaw, including bone density, nerve positions, and sinus boundaries. If you have remaining teeth that will sit next to the implant, we also take a Trios digital impression to capture their exact shape. The CBCT and the digital scan together give us the complete picture for planning.
Step 2: Implant Planning and Guide Design
Between visits, we plan each implant’s position, angle, and depth in implant planning software. For static guide cases, we design a 3D-printed surgical guide that fits over your teeth or gums and directs the implant drill along the planned trajectory. For dynamic navigation cases, we set up the X-Guide system to track the surgical handpiece against your plan in real time during the procedure. Both approaches work from the same plan.
Step 3: Guided Surgical Visit
On surgery day, we numb the area with local anesthesia and administer your chosen sedation. The full range of sedation options is available, from local-only for shorter cases to IV sedation or general anesthesia for full-arch reconstructions. We then place the implants following the digital plan. With a static guide, the guide sits in your mouth during placement. With X-Guide, no physical guide is in your mouth; the system tracks the handpiece position live.
Step 4: Recovery and Restoration
Recovery from a computer-guided implant placement is similar to a conventional implant case, often easier because the surgical approach is more precise and sometimes flapless. The implant integrates with your bone over the next 3 to 6 months. From there, the restoration phase follows the same protocol as any dental implant case at our office.
Benefits of Computer-Guided Implant Surgery
For the cases where computer guidance is the right choice, the benefits show up across the entire treatment timeline, from the planning visit through recovery.
The clearest benefit is precision placement. CBCT-based planning lets us identify the ideal implant position, angle, and depth before any surgery happens, and the guide or navigation system delivers that plan in the operatory. For cases near the inferior alveolar nerve or maxillary sinus, that precision is the difference between safe placement and a complication risk. We use this approach routinely for full-arch and multi-implant cases.
In suitable cases, computer guidance enables flapless surgery or surgery with a smaller-than-usual incision, meaning we make a smaller opening in the gum tissue because we already know exactly where the implant will go. Less tissue manipulation generally means less post-operative swelling and faster healing. We evaluate whether a flapless approach is appropriate during the planning stage, based on the CBCT data and the surgical access available at the site.
Computer guidance also lets us coordinate the surgical position of each implant with the planned final restoration. For All-on-4 and multiple-implant cases, the implants need to land in positions that the restorative dentist or laboratory has already accounted for in the prosthesis design. That coordination happens at the planning stage in our office, before we perform any surgery.
For complex cases, the digital plan also lets us preview the implant placement before surgery day, which makes the case more predictable. Surprises during surgery are uncommon when the CBCT plan, the guide design or navigation setup, and the surgical execution all reference the same digital model. Predictability matters most for full-arch cases, where rework is more involved than for a single implant.
Why Choose Our Practice for Computer-Guided Implant Surgery
Our two-office structure on Oahu means patients in Honolulu and the West Oahu corridor can both reach a board-certified oral surgeon for computer-guided implant surgery. The Honolulu office is at 1060 Young St #312, and the Waipi’o office is at 94-1221 Ka Uka Blvd #B-204 in Waipahu.
The full technology stack matters because computer-guided surgery is not a single piece of equipment. CBCT imaging, the Trios digital scanner, implant planning software, in-house 3D printing for surgical guides, and X-Guide dynamic navigation each play a role in different cases. Having all of these in one office means the planning and the execution happen with the same team and the same data.
Because our office performs both the planning and the surgical execution, the entire computer-guided workflow stays with one team. There is no handoff between a planning specialist and a surgeon. Dr. Oishi’s membership in the International Team of Implantology brings additional implant-focused training to the planning side of complex cases.
Computer-guided cases that involve multiple implants or full-arch reconstructions are often longer procedures, and we administer and monitor the deeper sedation those cases call for in-house. Dr. Haruki’s ADSA Fellowship and both surgeons’ MD-level training cover the anesthesia oversight without coordinating with an outside provider.
Computer-Guided Implant Surgery Cost and Insurance
Cost matters, and computer-guided implant surgery typically includes the standard implant fees plus the additional cost of the CBCT-based planning and the guide fabrication or navigation system use. For cases where guidance is the right choice, the additional fee is generally modest compared to the precision and predictability it adds to the procedure.
Dental insurance coverage of computer-guided implant surgery follows the coverage of the underlying implant procedure. Plans that cover implant placement typically apply the same benefit to the planning and guidance portion, though specific codes and breakdowns vary by plan. Medical insurance generally does not contribute to implant-related costs. Our front office staff verifies benefits before treatment, and our insurance and financing section covers payment options for any remaining patient responsibility.
Call our Honolulu office at 808-585-8455 if you want benefits checked before scheduling.
Schedule Your Consultation
Computer-guided surgery starts with a CBCT consultation. The visit confirms whether your case benefits from guided placement and what the planning timeline looks like. Call our Honolulu office at 808-585-8455 or request an appointment online. Our Honolulu office is at 1060 Young St #312, Honolulu, HI 96814. We also see patients at our Waipi’o office. The Contact page is the easiest way to reach us in writing.
Frequently Asked Questions
What is the difference between computer-guided and conventional implant surgery?
In conventional implant surgery, the surgeon plans the implant position from imaging and places it freehand using clinical judgment and intraoperative landmarks. In computer-guided surgery, we create a digital plan in software before the surgical visit, and the placement happens using either a 3D-printed guide or real-time navigation. Both approaches can produce excellent results; computer guidance adds precision for cases where the margin for error is small. At our office, we use computer guidance for full-arch and complex multi-implant cases where the precision benefit is most pronounced.
Am I a candidate for computer-guided implant surgery?
The decision is case-specific. We typically recommend computer guidance for full-arch cases like All-on-4, multiple-implant placements, implants near the nerve or sinus, narrow ridges, and implants placed in previously augmented bone. Straightforward single-implant cases in adequate bone often do not need guidance to achieve a good result. We make the recommendation at the consultation based on your CBCT scan, and the planning fee only applies if guidance is the right call for your case.
Will I have a 3D-printed guide in my mouth during the surgery?
This depends on which guidance method we use for your case. For static guide cases, yes; the 3D-printed guide fits over your remaining teeth or gums during placement and directs the implant drill. For dynamic navigation cases using X-Guide, no physical guide is in your mouth; the system tracks the surgical handpiece position against your CBCT plan in real time. The choice between methods depends on your specific case.
Is computer-guided surgery less painful than conventional implant surgery?
The procedure itself happens under the same anesthesia and sedation, so the experience during placement is similar. The difference often shows up in recovery. Computer guidance frequently allows for a smaller incision or, in some cases, a flapless approach. Smaller incisions generally mean less post-op swelling and faster healing, though individual recovery varies. The full after dental implant placement timeline applies to guided cases as well as conventional ones.
Does the surgery take longer with computer guidance?
The total time investment includes the additional planning step, which happens between the consultation and the surgical visit. The surgical visit itself is often shorter for guided cases because the position is pre-planned and the placement is faster once execution begins. For multiple-implant or full-arch cases, the time savings on surgery day can be meaningful.
Does insurance cover the computer-guided portion?
Dental insurance coverage of computer-guided implant surgery typically follows the coverage of the underlying implant procedure. Some plans treat the planning and guidance as part of the implant fee; others have separate codes that may or may not be covered. Medical insurance generally does not contribute. Our front office staff verifies your specific benefits and gives you a clear estimate before treatment, and the insurance and financing section covers payment options for any remaining responsibility.
How accurate is computer-guided implant placement?
Computer-guided systems are well-studied and demonstrate consistent improvements in accuracy compared to freehand placement, particularly for complex cases. Published research generally reports angular deviations under 4 degrees and linear deviations under 1.5 millimeters from the planned position. Accuracy varies with the system used, the case complexity, and the surgeon’s technique. The X-Guide system we use is well-validated in clinical studies of dynamic navigation.
What if the planned implant position cannot be used during surgery?
This is uncommon when the CBCT and digital scans are accurate and the plan is properly designed. In rare cases where intra-operative findings change the plan, such as unexpected bone quality, the surgeon adjusts the placement using clinical judgment. Computer guidance does not replace surgical experience; it adds a layer of precision to the work that experienced surgeons already do. |
