Case MH edentulous

Preoperative view of lower arch. Implants to be placed at the teeth #21, 25, and 28 sites.

Preoperative view of lower arch

Spear drill in insert through tube guide to create a bleeding point

Bleeding points indicating implant positions

Incisions through bleeding points and flaps reflected

Bone screw placed to secure tube guide to mandible

Tube guide secured to mandible with three bone screws over closed flaps

2 mm drill with drill stop in guide tube to prepare osteotomy. Due to flap reflection, the flap edges are not cut by the drills, facilitating primary closure.

After the three osteotomies were drilled, the tube guide was removed and a ThinLayer™ guide secured with two bone screws in the same position. The guide holes in the ThinLayer™ guide are in the exact position as the tops of the guide tubes in the tube guide. The ThinLayer™ guide allows the flaps to be reflected with visual and physical access to the surgical site.

The flap was reflected and the implant inserted in the tooth #25 site through the guide hole in the ThinLayer™ guide. The site was visible as the implant was placed 4 mm below the adjacent crest.

Due to the uneven anatomy of the crestal bone at the tooth #28 site, the final osteotomy was completed using the guide hole in the ThinLayer™ guide, allowing direct vision of the surgical site.

Implants placed at the teeth #21, 25 and 28 sites with ThinLayer™ guide in place

Tooth #25 site implant placed 4 mm below the adjacent crest

The crest was leveled by removing 4 mm of crestal bone adjacent to the tooth #25 site implant.

Implants with cover screws in place at the teeth #21, 25, and 28 sites.

Primary closure over the implants

Fully edentulous case for overdenture, with tube and ThinLayer^® guides

Implants were placed at the teeth #21, 25, and 28 sites.

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. Incisions were made through the bleeding points and the flaps reflected. Three bones screws were placed to secure the tube guide to the mandible.

Next, a 2 mm drill was used through the insert/tube to prepare the osteotomies. Due to flap reflection, the drills do not cut the flap edges, which facilitates primary closure.

After the three osteotomies were drilled, the tube guide was removed and a ThinLayer^® Guide secured with two bone screws in the same position. The guide holes in the ThinLayer^® Guide are in the exact position as the tops of the guide tubes in the tube guide. The ThinLayer^® Guide allows the flaps to be reflected with visual and physical access to the surgical site. The flap was reflected and the implant inserted in the sites through the guide hole in the ThinLayer^® guide. The site was visible as the implant was placed 4 mm below the adjacent crest at #25. The crest was leveled by removing 4 mm of crestal bone adjacent to the tooth #25 site implant.

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

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ThinLayer^® Guide case 21,25,28 fully edentulous

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