The guided insertion of implants is part of the digital approach procedures for implant-prosthetic rehabilitation. It consists in the use of surgical templates through which osteotomies are performed and implants are inserted. The technique may vary depending on the implant system, providing for the use of drill holder keys or holders. The result is always to insert the implants in a position corresponding to that envisaged in a three-dimensional project carried out starting from the 3d images of the alveolar skeleton, to which the images relating to prosthetic devices present or object of the project can be associated, spatially oriented of clinician and technician. The diagnostic design process involves the registration of 3d datasets relating to the dentition and soft and hard periodontal tissues, the editing of a project and the production of tools necessary for the guided positioning of the implants. The aim of this work is to show the diagnostic-design-production process followed by our group and show the surgical results obtained. Despite the accuracy of the system and the obvious advantages of the technique, we believe that prospective and comparative studies still need to be carried out which sanction, once and for all, indications and critical issues without a shadow of a doubt the conclusion of a digital design cycle with guided surgery enhances the goodness, safety and usefulness of this new approach to the most delicate or problematic rehabilitations.