Implants - Lecture 6: Surgical Guides Flashcards
A guide derived from a diagnostic wax-up and
worn during the radiographic exposure to relate the tooth position to the anatomical structures; it serves to assist in the diagnosis and planning phase for dental implants
Radiographic template
Device created for a specific case to assist the surgeon in placing the implants in the intended location
Surgical guide
Purpose = ensure accurate angulation, depth, and positioning of implants
Surgical guide
Benefits = minimize surgical errors, improves outcomes, enhances pt safety
Surgical guide
Limitations:
Cost and accessibility
Learning curve for digital workflows
Potential inaccuracies in poorly fitted guides
Dynamic navigation as an alternative solution
Surgical guide
We make surgical guides for ___________ in implant placement, _________ chair time and surgical complications, and better __________ and functional outcomes
precision; reduced; esthetic
Implant placement needs to be planned in all _____________
dimensions
(apico-coronal, mesio-distal, bucco-lingual)
Implants should be _____ mm below the free gingival margin
3mm
Implants should be _____ mm from adjacent teeth
1.5mm
Implants should be _____ mm from adjacent implants
3mm
Implants should be _____ mm from buccal bone
2mm
What are the 2 fabrication methods for surgical guides?
Manual
Digital
Which fabrication method for surgical guides?
Impression & stone model
Wax-up & clear acrylic fabrication or denture duplication
Drilling template for implant positioning
Manual
Which fabrication method for surgical guides?
CBCT scanning for 3D anatomical data
Impression using scanner
CAD software for guide design
3D printing or milling of the guide
Digital
Which fabrication method for surgical guides?
Cost-effective, but limited by manual errors
Manual
Which fabrication method for surgical guides?
Superior accuracy, time-efficient, patient-specific
Digital
What are the 3 support types for surgical guides?
Tooth-supported
Mucosa-supported
Bone-supported
Which support type for surgical guides?
Most accurate and easiest guide to use
Tooth-supported
Which support type for surgical guides?
Indications:
Partially edentulous pts
Sufficient number of teeth for guide support
Tooth-supported
Which support type for surgical guides?
Requirements (1 of the following):
Diagnostic cast + CBCT
Scanned diagnostic cast + CBCT
Digital impression + CBCT
Tooth-supported
Which support type for surgical guides?
Flapless surgeries for edentulous pts
Mucosa-supported
Which support type for surgical guides?
Indications:
Only for edentulous pts
Must have sufficient support (stabilizing pins); for the maxilla - palate; for mandible - sufficient vestibular or lingual support
Mucosa-supported
Which support type for surgical guides?
Requirements:
Dual scan technique - CDs with markers (CBCT)
Mucosa-supported
Which support type for surgical guides?
Requires extensive full-thickness reflection to expose bony ridges to allow proper seating of the guide
Bone-supported
Which support type for surgical guides?
Indications:
Edentulous pts
Partially edentulous (> 3 missing teeth)
Bone-supported
What are the 3 types of restrictions for surgical guides?
Non-restricted
Partially restricted
Completely restricted
Which restriction type for surgical guides?
Generalized location of the ideal implant site
No actual directional guide is built
May result in unacceptable implant placement
(angulation and positioning)
Non-restricted
Which restriction type for surgical guides?
Guided sleeve or a slot for the pilot drill
Remaining of the osteotomy and implant placement are free-handed
Partially restricted
Which restriction type for surgical guides?
Restricts all of the instruments used for the osteotomy in a buccolingual and mesiodistal plane
Drill stops limit the depth of implant placement
The final position of the implant is known before the surgery
Completely restricted
Benefits = flexibility and real-time visualization
Limitations = cost and learning curve
Computer-assisted navigation for implant placement
