Full guided vs pilot guided: exoplan protocols & libraries

Guided implant placement has two basic scenarios: pilot guided surgery and full guided protocol. The difference isn't the quality of the guide, but how far the surgeon works through the sleeve. The protocol you choose determines which surgical guide library you load into exoplan and which drill kit you need in the clinic.

In the DentalLibs catalog, exoplan libraries are sorted by protocol: around 328 kits are designed for full guided and 26 for pilot guided. That ratio reflects reality: most systems today support full guidance, but the pilot protocol stays in demand for complex anatomy and budget surgical kits.

What is pilot guided surgery

With pilot guided (sometimes called partially guided at the start), only the pilot drill passes through the guide sleeve — the very first, thin drill that sets the axis and entry point of the implant. The surgeon then shapes the osteotomy and places the implant freehand, following the defined direction.

This protocol keeps tactile control of the bone and doesn't require long guide keys, so it's chosen in constrained conditions:

• limited interocclusal space where there's no room for a full set of keys;
• atypical or soft bone where tactile feedback matters;
• an affordable entry into digital surgery without buying a full guided kit.

In exoplan, pilot protocols such as Straumann VeloDrill Pilot and BioHorizons CGS Pilot fit here — their sleeve geometry is designed specifically for the pilot drill.

Full guided protocol: fully guided surgery

The full guided protocol (fully guided) means the entire drilling sequence passes through the sleeve and interchangeable drill keys, and often the implant itself is placed through the guide. Axis, depth and position are controlled at every step, not just at entry.

Fully guided libraries are usually named Full, Guided or EasyGuide — for example Straumann TLX protocol. This kit encodes the full drilling depth and sleeve height, so it can't be mixed with pilot drills.

Partially guided — the intermediate option

Between the two extremes sits partially guided: not only the pilot but part of the drilling sequence passes through the guide, while the final preparation or placement is done freehand. It's a compromise between control and flexibility.

Some systems offer several protocols within one line — for example Straumann VeloDrill has both a pilot version and VeloDrill PartiallyGuided. It's essential to load the exact library your surgical kit was built for.

Pilot guided vs full guided: accuracy and when to choose which

The logic is simple: the more steps that pass through the sleeve, the less deviation accumulates in axis and apex. Full guided gives the smallest discrepancies between plan and result, while pilot is a compromise where everything after the first drill depends on the surgeon's hand.

That doesn't mean full is always better. In narrow access, long keys physically won't fit, and in soft bone the surgeon needs to feel density rather than rigidly follow an axis. So protocol choice is a clinical decision, not just a matter of accuracy.

• single unit in the esthetic zone, proximity to the mandibular canal → full guided;
• posterior areas with limited mouth opening → pilot or partially;
• flapless surgery and immediate loading → full guided for predictability.

Which exoplan libraries you need for pilot and full guided

In exoplan, a surgical guide library is the pairing of a sleeve and a drilling protocol for a specific implant system. The pilot protocol needs the pilot version of the library; full guidance needs the full/guided kit. These are different files and you can't swap one for the other: their sleeve height and drill offsets don't match.

Fully digital kits like Dentium SuperLine Full Digital cover full guided for a specific implant line. All the listed libraries for exoplan and RealGUIDE are available in the DentalLibs catalog — protocols are labeled there so you won't confuse the pilot and full kits.

FAQ about pilot and full guided