Dental News - Guide Right components predict, position and place implants precisely

Sean W. Meitner, DDS, MS

Thu. 10 June 2010

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Promoting excellence and avoiding failure is the standard of my implant practice. To ensure precise implant placement, I have found that in-office fabrication of Guide Right template guide sleeves using multiple inserts in conjunction with radiography have resulted in measured implant placement accuracy that allows me the control, communication and confidence with everyone involved in a case.

It offers the opportunity to see, evaluate, verify and accurately place an implant, without wasting valuable time and chancing an implant failure.

The beauty of this template fabrication technique is its simplicity and versatility. The components used to create a basic template are a guide post and a guide sleeve placed over the guide post to position it with acrylic gel to securely capture the guide sleeve brackets and register the guide sleeve to the adjacent teeth.

The template is then placed in the patient’s mouth to verify the proposed axis visible in the radiographic image prior to going to surgery. A cone-beam 3-D X-ray is necessary to verify the template in 3-D mesio-distal and bucco-lingual views. A periapical radiograph will only verify the axis in 2-D for mesio-distal views.

If the X-ray shows an incorrect angle, the guide posts are bent with the bending tool or are available to correct the angle. The template is remade and re-verified. The open guide sleeve technique offers increased visibility to see the drill depth markings as you drill through it. It is especially beneficial if you are placing an implant in posterior sites.

Guide sleeves are available in stainless steel and ceramic. The use of ceramic sleeves reduces scatter in cone- beam X-rays when the template is verified in the patient’s mouth. Stainless-steel and titanium inserts are used with increasing drill sizes. A protractor can be placed over the X-ray to determine the angle and to assist in making angle corrections.

Why take a chance when you can observe and control your implant placement? Why not enter every osteotomy with peace of mind? Guide Right Techniques provides you with the components to predict, position and place an implant precisely.

About the author

Sean W. Meitner DDS, MS, is founder of Guide Right by DePlaque. He is associate professor at the Department of Periodontology of Eastman Dental Center, University of Rochester, Rochester, NY, USA. He is in private practice in periodontics, in Pittsford, NY, USA. Contact him at swm@deplaque.com.

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