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Project Description

Tooth #31 with “nightmare” access: minimal vertical clearance and deep site, with bone loss on distal of tooth #30, featuring ThinLayer® Guide

This case could not have been done with a tube guide. The only guided technique by which this case could have been done is with the ThinLayer® guide.

This case involves “nightmare access” to tooth #31. The patient had limited mouth opening and molar site was deep and positioned quite posterior in the mandible.

The preoperative view of the implant site shows bone loss on the distal of tooth #30. The set of ThinLayer® guides included an on-surface guide and an off-surface guide. The on-surface guide contains a guide hole on the gingival surface and was used to create an initial pilot hole. The guide hole at the occlusal surface in the off-surface guide is identical to the top of a guide tube in a tubed guide. The pilot hole and off-surface guide form two points that sequentially define a trajectory, without the need for a tube.

The 2 mm drill is inserted into the guide hole in the on-surface guide to create a 2-3 mm deep pilot hole through the gingiva. The vertical space required is the same as that needed for freehand drilling. After the pilot hole has been prepared, the on-surface guide is removed and the off-surface ThinLayer® guide is placed. A tube guide could not have been used in this case due to minimal vertical space.

The drill is placed through the guide hole of the off-surface guide at an angle and rotated upright until the tip engages the pilot hole. The drill is centered in the guide hole of the off-surface guide and drilled to depth.

Radiograph shows implant placement.

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

Related Downloads

ThinLayer® Guide case, nightmare access 31 Download

Related Slide Presentation (from Oct 2012 webinar)

Project Details

  • Date January 12, 2013
  • Tags Cases
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