Journal of Oral Implantology October 2012 - (Page 639)

CASE REPORT Simplistic Partially Limiting Surgical Guide for Flapless Implant Placement: A Case Report Aditi Nanda, MDS1* Veen Jain, MDS2 The accurate positioning of implant in bone is important in order to meet the biological, esthetic, and biomechanical requirements of the prosthesis. This becomes crucial in flapless implant placement. The combination of bone sounding and use of a surgical guide will allow precise placement of a dental implant, abutment, and provisional restoration in a minimally invasive manner. A technique to transfer the diagnostic information to the surgical guide is described in this report. The chief advantage of the procedure is the ability to apply flapless implant placement surgery and immediate loading. Key Words: implant, surgical, guide INTRODUCTION etermining the correct positioning of an implant in the bone to prevent encroachment on vital structures and adjacent teeth and to enable a prosthetic restoration that meets biological, esthetic, and biomechanical requirements is a challenge.1 The challenge is increased with the ‘‘blind’’ procedure of flapless implant placement because the different angulations of the drills may perforate the cortical plates, especially on the lingual surface in the mandibular molar area and the anterior maxilla.2 Bone sounding has been used in clinical dentistry to determine the thickness of the soft tissue overlying the bone and available bone volume.3 This provides the clinician with reliable information and a small margin of safety. Many types of surgical guides have been proposed to achieve correct implant placement.1,4 Information acquired in the preoperative planning phase is transferred to the surgical guide. Design concepts vary from simple nonlimiting, to partially limiting, and, finally, to completely limiting surgical Department of Prosthodontics, Maulana Aza Institute of Dental Sciences, New Delhi, Delhi, India. 2 Department of Prosthodontics, All India Institute of Medical Sciences, New Delhi, Delhi, India. * Corresponding author, e-mail: aditinanda@yahoo.com DOI: 10.1563/AAID-JOI-D-10-00123 1 D guides. The nonlimiting design, in general, provides the surgeon with an indication as to where the proposed prosthesis is located in relation to the selected implant site. The partially limiting design offers the possibility of having a guide sleeve direct the first drill used for the osteotomy. The remainder of the osteotomy and implant placement is then finished freehand by the surgeon. The completely limiting design restricts all of the instruments used for the osteotomy in the buccolingual and mesiodistal plane. As the surgical guides become more restrictive, less of the decision making and subsequent surgical execution is done intraoperatively.1 However, fabricating completely limiting guides may require advanced software (image-guided implantology5), may be expensive, or may require specialized training not amenable to all clinicians. Careful implementation of treatment plan will produce quality results even with partially limiting designs. This combination of bone sounding and use of a surgical guide will allow precise placement of a dental implant, abutment, and provisional restoration in a minimally invasive manner. A technique to transfer the diagnostic information to the surgical guide is described in this report. CASE REPORT A 21-year-old patient with missing right lower first and second premolars (28, 29) and first molar (30) Journal of Oral Implantology 639

Table of Contents for the Digital Edition of Journal of Oral Implantology October 2012

Should the Implant Fit the Patient or Should the Patient Fit the Implant?
Histologic and Biomechanical Evaluation of Alumina-Blasted/Acid-Etched and Resorbable Blasting Media Surfaces
Impact of Dental and Zygomatic Implants on Stress Distribution in Maxillary Defects: A 3-Dimensional Finite Element Analysis Study
Precision of Implant Placement With Stereolithographic Templates: A Pilot In Vitro Study
An Evaluation of Biocompatibility of Indigenously Produced Pure Titanium: An Experimental Study in Rabbits
Relationship Between Smoking and Bleeding on Probing
Stress Analysis in Platform-Switching Implants: A 3-Dimensional Finite Element Study
Acrylic Resin Polymerization in Direct Contact to the Abutment and the Temperature at Bone-Implant Interface: A Pilot In Vitro Study
Clinical Application of Stereolithographic Surgical Guide With a Handpiece Guidance Apparatus: A Case Report
Fixed Rehabilitation of Severely Atrophic Jaws Using Immediately Loaded Basal Disk Implants After In Situ Bone Activation
A Functional Open-Tray Impression Technique for Implant-Retained Overdenture Prostheses
Use of Plasma Rich in Growth Factor for Schneiderian Membrane Management During Maxillary Sinus Augmentation Procedure
A Technique to Facilitate the Fabrication of Provisional Restorations for ITI Solid Abutments
Influence of Etiologic Factors in Peri-Implantitis: Literature Review and Case Report
Simplistic Partially Limiting Surgical Guide for Flapless Implant Placement: A Case Report
Types of Implant Surgical Guides in Dentistry: A Review
Rehabilitation of Atrophic Posterior Maxilla With Zygomatic Implants: Review

Journal of Oral Implantology October 2012