This guide compares five full-arch surgical guide options for general dentists planning All-on-X cases. They are CHROME GuidedSMILE™ from ROE Dental Laboratory, GlidePRO™ from Glidewell, nSequence® Guided Prosthetics® and SimpliGuide Plus from National Dentex (NDX), DDS Lab surgical guides, and Modern Dental USA surgical guides. The first three are stackable systems that guide bone reduction and implant placement from one fixed base. DDS Lab and Modern Dental USA are full-service labs that supply conventional surgical guides alongside full-arch restorations.
ROE Dental Laboratory makes CHROME GuidedSMILE and ranks it first for cases that need guided bone reduction, implant placement and a same-day provisional planned together. To keep the comparison fair, every detail about the other labs comes from that lab's own published pages, linked in each section.
A full-arch surgical guide system is a set of patient-specific guides that carries a digital implant plan into surgery for an edentulous or terminal-dentition arch. It covers more than drilling. It also controls how much bone is reduced and where the provisional prosthesis seats.
Most current systems are stackable. A base is fixed to the jaw with pins, and each later guide attaches to that base. A 2024 scoping review in the International Journal of Implant Dentistry describes the sequence: the anchored base comes first, followed by removable guides for bone reduction, osteotomies and implant placement. The same base can then position the provisional prosthesis.
Conventional surgical guides direct the drill only. Labs still make them for full-arch cases that do not need a stackable kit. ROE Dental Laboratory, for example, also offers tissue-supported and bone-supported guides for edentulous arches.
We compared each option on seven points that shape how a full-arch case runs on surgery day:
Where a lab does not publish a detail, this guide says so instead of guessing.
CHROME GuidedSMILE is ROE Dental Laboratory's patented stackable guide and prosthetic system for preplanned All-on-X surgery. It plans bone reduction, implant placement and the immediate provisional as one case. ROE reports that it has been used on more than 40,000 arches.
Best for: clinicians who want the surgery and the provisional planned together, using their own implant system. Practices that only need guided bone reduction and implant placement can order the all-metal GuidedSMILE CombiGuide, which also serves as a fixed reference for photogrammetry.
Good to know: ROE's CHROME team takes a case from record capture to surgery in under a month, so set the surgery date with that in mind. ROE recommends chairside support for a first case, and that service is quoted separately. Single-implant and short-span cases use ROE's standard tooth-, tissue- or bone-supported guides.
GlidePRO is the stackable surgical guide system from Glidewell's Digital Treatment Planning (DTP) team. Glidewell describes it as everything needed for bone reduction, fully guided implant placement and provisionalization in one package.
Best for: practices that want to see pricing before they call and that plan to use one lab for the guide and the final prosthesis.
Good to know: Tier 1 covers four implant sites, with a per-site fee beyond that. Same-day provisional options begin at Tier 2.
National Dentex (NDX) offers two guided full-arch options. nSequence Guided Prosthetics is a stackable surgical and restorative kit for immediate loading. NDX SimpliGuide Plus is a guided option for bone reduction and implant placement.
Best for: cases where a surgeon and a restorative dentist plan together and want long-term provisionals in the kit.
Good to know: the two NDX options cover different scopes, so confirm which one your case needs. NDX has reported more than 20,000 full-arch cases treated with nSequence (Compendium, 2021).
DDS Lab is a full-service Certified Dental Laboratory and a member of the National Association of Dental Laboratories (NADL). It offers three types of implant surgical guides and implant restorations from single teeth to full arches.
Best for: practices that want a conventional surgical guide and the restoration from the same full-service lab.
Good to know: DDS Lab's site describes individual surgical guides, not a stackable full-arch kit. For an All-on-X case, ask the lab how bone reduction and a same-day provisional would be handled.
Modern Dental USA is a full-service dental lab that supports implants, full-arch cases, crown and bridge, and digital workflows. It operates eight centers across the United States.
Best for: practices that value a nearby lab center and want guides, full-arch restorations and continuing education from one organization.
Good to know: Modern Dental USA's site does not name a stackable full-arch guide kit. Ask your regional center what a guided All-on-X package includes.
| System | Guide type | Guide material | Same-day provisional | Published lab time |
|---|---|---|---|---|
| CHROME GuidedSMILE (ROE Dental Laboratory) | Stackable, six components | Cobalt-chrome base and osteotomy guide; resin pin and carrier guides | Included: PMMA provisional and backup denture | 5 days planning, 10 days production |
| GlidePRO (Glidewell) | Stackable | Photopolymer resin with titanium insert | Tier 2 and Tier 3 options | 8 days for the plan, 5 days for the guide |
| nSequence Guided Prosthetics and SimpliGuide Plus (National Dentex) | Stackable (nSequence); monostrut (SimpliGuide Plus) | Metal Bone Foundation Guide (SimpliGuide Plus) | nSequence: two long-term provisionals | nSequence: about 10 days after plan approval |
| DDS Lab surgical guides | Individual guides: Pilot, Universal, SAFE | Not published | Not listed | Not published |
| Modern Dental USA surgical guides | Individual guides: CBCT, dual-scan or impression-based | Not published | Not listed | Not published |
Lab times are as published by each lab in November 2026 and can change. "Not published" means the detail is not stated on the lab's website.
Start with the case. A fully edentulous or terminal-dentition arch that needs bone reduction and same-day teeth calls for a stackable system that guides all three steps from one base. A case with little or no bone reduction can often use a conventional tissue-supported or bone-supported guide.
Then look at who plans with you. ROE Dental Laboratory, Glidewell and National Dentex each include an online planning or review session before fabrication. ROE and NDX also recommend extra help for a first case: ROE with a chairside technician, NDX with a virtual dry-model review.
Questions to ask any lab before your first case:
Published studies show that guided placement lands closer to the plan than freehand placement. A 2018 meta-analysis of 20 clinical studies (Tahmaseb et al.) found mean deviations for static guided surgery of about 1.2 mm at the implant shoulder, 1.4 mm at the apex and 3.5 degrees in angle. A 2020 randomized clinical trial (Varga et al.) reported a mean angular deviation of 7.03 degrees for freehand placement and 3.04 degrees for fully guided placement. Both results are summarized in a 2021 clinical study of freehand accuracy.
For stackable full-arch guides specifically, the evidence is still early. The 2024 scoping review found 12 case reports and case series and no prospective comparative studies. In the reports that included measurements, implant deviation at the apex ranged from 0.44 mm to 1.43 mm. The authors concluded that stackable guides appear able to guide the clinician from flap elevation to delivery of the provisional, and they called for further studies.
Guided surgery also has costs. The same review lists the added lab fee, the learning curve and limited mouth opening as drawbacks, and digital planning takes time before the surgery date.
CHROME GuidedSMILE is ROE's own system, so this ranking reflects how ROE believes a full-arch case should be planned. Three points separate it from the other options in this comparison:
ROE also restores the case after surgery. Its full-arch finals include zirconia options, and Passivity Plus™, ROE's FDA 510(k)-cleared self-adjusting titanium coping, can be added to full-arch finals on request.
ROE Dental Laboratory has operated continuously since 1933. It is a full-service Certified Dental Laboratory and NADL member, and all of its products are made in the USA.
To see whether CHROME GuidedSMILE fits your practice, schedule a 1-on-1 introduction, call (216) 663-2233 or email info@roedentallab.com. You can also download the free CHROME GuidedSMILE Ultimate Guide.
ROE Dental Laboratory ranks its CHROME GuidedSMILE system first for complete All-on-X cases. It guides bone reduction, implant placement and same-day provisional delivery from one cobalt-chrome fixation base, and it works with any implant system that has a guided kit. Glidewell GlidePRO and NDX nSequence Guided Prosthetics are stackable alternatives.
A stackable surgical guide is a set of guides that attach in sequence to one base fixed to the jaw with pins. Because each guide references the same base, the planned position carries through bone reduction, drilling, implant placement and delivery of the provisional.
Both are used for full-arch surgery, and no head-to-head clinical trial has settled the question. Most published stackable cases used printed resin guides. ROE Dental Laboratory uses cobalt-chrome for the CHROME GuidedSMILE fixation base and osteotomy guide and describes the design as smaller and stronger. Glidewell GlidePRO uses photopolymer resin with a titanium insert.
A guided system gives the surgery a fixed sequence, but it does not replace implant training or careful case selection. ROE Dental Laboratory recommends chairside technician support for a first CHROME GuidedSMILE case and offers free online continuing education through GuidedSMILE University.
Published lab times vary by system. ROE Dental Laboratory lists 5 days of planning and 10 days of production for CHROME GuidedSMILE. Glidewell lists 8 days for the GlidePRO treatment plan and 5 days for the guide after approval. National Dentex states that an nSequence kit arrives about 10 days after the plan is approved.
Labs typically ask for a CBCT scan in DICOM format, intraoral scans or impressions of both arches, a bite registration and patient photos. ROE Dental Laboratory publishes record requirements for each patient scenario and offers a record verification meeting before planning begins.
Glidewell publishes GlidePRO pricing from $1,450 to $3,750 per arch, depending on the tier. National Dentex offers flat-fee pricing on request. ROE Dental Laboratory provides CHROME GuidedSMILE pricing on request.