Teeth #29,30 flapless, with tube and ThinLayer^® guides

The surgical plan was developed in Blue Sky Plan, with cross-sectional, axial, panoramic, and 3D views of the bone, gingiva, and teeth. The surgery was performed with the tube and ThinLayer^® guides from Guided Surgery Solutions, who manufacture the guides from the 3D plan and provide custom drill stops for each drill in the sequence. The inner diameter of each drill stop holds it flush to the drill shaft and fluted area. The outer diameter of each stop is flush with the inner diameter of the tube (in the tube guide) and the diameter of the hole in the ThinLayer^® Guide.

First the tube guide was placed, and a spear drill placed through the insert (drill stop) in the tube guide to create bleeding points in the implant positions. An endo file through the insert could also be used, if preferred. Next, a spear or lance drill was used through the insert/tube to create pilot hole by placing the tip into the bleeding point and drilling through gingiva to 4-5 mm bone depth.

The tube guide was removed and a flap was reflected before the ThinLayer^® Guide was placed. Its guide hole replicates the top of a guide tube. The open buccal window allows unobstructed view of surgical site. The 2 mm drill is placed through guide hole at an angle, which requires no more vertical space than freehand drilling. The drill is uprighted until the tip of the drill is in the pilot hole, then the drill is inserted to depth.

This is repeated with drills of increasing diameter, until the final drill is placed through guide hole and used. The countersink and implant driver were centered in the guide hole. This can be especially helpful in Type 3 or Type 4 bone.

Radiographs of the planned and final implant positions are included.

Please visit our Advantages page for more information for about the ThinLayer^® Guide system.

Related Downloads

Related Presentation (from May 2013 webinar)