Comparing Different Types of Dental Fiducial Markers: Which One is Best?

Nowadays, computer-assisted implantology (CAIS) is becoming more advanced and even wants improved accuracy, which dental fiducial markers can provide. These fiducial markers are reference points in image registration for guided implant procedures. They are very useful in aligning CBCT scans with digital dental models, ensuring optimum implant positioning, and minimizing surgical errors. But there are many types of fiducial markers, and which one is really the best?

Digital Arches offers state-of-the-art digital dentistry solutions to enhance accuracy and convenience. In this blog, we will compare the different types of dental fiducial markers in terms of visibility, material composition, and shape. This will ultimately help us decide which to use.

Why Are Dental Fiducial Markers Important?

Before making a comparison, it is necessary to understand the importance of fiducial markers. In static computer-assisted implant surgery (sCAIS), the surgeon uses a set of CBCT scans to visualize the structure of the patient's jaw. These scans are then imported into digital dental casts to create a surgical guide for accurate implant placement.

Two primary registration methods are used in sCAIS:

• Dental Surface Registration – Matches CBCT images with digital dental casts based on tooth surface.

• Fiducial Marker Registration – Stereolithographic (SLA) uses radiopaque markers placed on a radiographic template to improve registration accuracy.

Fiducial markers have been shown to give better accuracy than surface registration in cases where metal restorations or absent teeth compromise the clarity of the stars obtained from CBCT scans.

Types of Dental Fiducial Markers: A Comparative Analysis

1. Gold Fiducial Markers

Best for: 

Situations where X-ray visibility is critical but not ideal for a CBCT-based digital workflow.

2. Polymer Fiducial Markers

Best for: 

When CBCT-guided implant surgery is necessary, minimizing image distortion is essential.

3. Carbon Fiducial Markers

Best for: 

Special cases that require minimal imaging distortion.

4. Radiopaque Fiducial Markers

Best for: 

GIRT (Image-Guided Radiotherapy) and high-precision dental implant procedures.

Factors to Consider When Choosing a Dental Fiducial Marker

1. Visibility in CBCT and X-ray Imaging

The ideal dental fiducial marker should be highly visible without causing excessive artifacts in imaging techniques. Polymer and radiopaque markers offer the best balance.

2. Biocompatibility

Since these markers are placed in and around the oral cavity, they must be safe for human tissue. Gold and polymer markers have high seeding ability.

3. Risk of Migration

The marker should remain stable during the entire implant planning and surgical procedure. Rod-shaped markers with secure designs (e.g., Optisplint, Arc Tracer) help prevent movement.

4. Cost and Accessibility

Although gold markers are delicate, they are also expensive. Polymer markers provide an economical and efficient alternative.

Conclusion: Which Dental Fiducial Marker is Best?

There is no one-size-fits-all solution when it comes to dental fiducial markers. However, based on clinical research and expert analysis:

• Gold markers: Best for X-ray & CT visibility

• Polymer markers: Best for CBCT-guided surgery 

• Carbon & radiopaque markers: Best for minimal artifact interference

Digital Arches utilizes the best digital dentistry technologies to optimize implant accuracy and efficiency. If you are a dentist or oral surgeon looking for advanced dental imaging solutions, contact us today to explore our state-of-the-art digital workflow.