Introduction to 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
Radiographic template (radiographic guide)
A radiographic template serves to assist in the __ and __ phase for dental implants
diagnosis and planning
Device created for a specific case to assist the surgeon in placing the implants in the intended location
Surgical Guide (surgical template)
What is the purpose of a surgical guide
ensure accurate angulation, depth, and positioning of implants
What are the benefits of a surgical guide
Minimizes surgical errors, improves outcomes, enhances patient safety
3 reasons why we use a surgical guide
Precision in implant placement
Reduced chair time and surgical complications
Better aesthetic and functional outcomes
What dimensions does placement need to be planned
Apico-coronal
Mesial-distal
Bucco-lingual
Ideal positioning of an implant
1.5 mm from adjacent teeth
3mm below the free gingival margin
2mm of buccal bone
3 mm from adjacent implant
1 mm of lingual bone
3 types of surgical guides
Fabrication method
support type
restriction
Surgical guides:
Fabrication method can be __ or __
Manual or digital (LOOK at pics)
Surgical guides:
Fabrication method-
How is manual done
Impressions and stone model creation
wax-up and clear acrylic fabrication or denture duplication (correct occlusion)
Drilling template for implant positioning
LOOK AT PICTURES
Surgical guides:
Fabrication method-
How is digital done
CBCT scanning for 3D anatomical data
Digital impressions using intraoral scanners
CAD software for guide design
3D printing or milling of the guide
LOOK AT PICTURES
Surgical guides:
Fabrication method-
Manual vs digital
Manual = cost effective, but limited by manual errors
Digital = superior accuracy, time- efficient, patient-specific
Surgical guides:
What are the 3 support types
Tooth supported
Mucosa supported
Bone supported
Surgical guides:
Support types-
The most accurate and easiest guide to use
Tooth-supported
What are the indications for a tooth supported surgical guide
Partially edentulous patients
sufficient number of teeth for guide support
With a tooth supported surgical guide, one of the following requirements are necessary
Diagnostic cast + CBCT
Scanned diagnostic cast + CBCT
Digital impression + CBCT
When is a mucosa supported surgical guide used
Flapless surgeries for edentulous patients
What are the indications for a mucosa supported surgical guide
Only edentulous patients
Must have sufficient support (stabilizing pins)
- maxilla (palate)
- Mandible : sufficient vestibular or lingual support
What is the requirement for mucosa supported surgical guides
Dual scan technique - CDs with markers (CBCT)
Look at PIC
This type of surgical guide requires extensive full thickness reflection to expose the bony ridges to allow proper seating of the guide
Bone- supported
What are the indications for a bone supported surgical guide
edentulous patients
Partially edentulous (>3 teeth missing)
What are the 3 possible types of restrictions for surgical guides
Non-restricted
Partially restricted
Completely restricted
With a non restricted surgical guide we get a __ of the ideal implant site
generalized location
With a non restricted surgical guide non __ is built
actual directional guide
A non restricted surgical guide may result in __
unacceptable implant placement (angulation and positioning)
A partially restricted implant guide is a guided sleeve or a slot for the __ but the remaining of the osteotomy and implant placement are
pilot drill
free-handed
A completely restricted surgical guide restricts all of the instruments used for the osteotomy in a __ and __ plane
buccolingual and mesiodistal
With a completely restricted surgical guide the drill stops limit the __
depth of implant placement
With a completely restricted surgical guide the __ is known before surgery
final position of the implant
What are the benefits and limitations of computer assisted navigation for implant placement
Benefits: flexibility and real - time visualization
Limitations: cost and learning curve. Potential inaccuracies in poorly fitted guides
(dynamic navigation as an alternative solution )
