Surgical guides are used to improve the accuracy and safety of a treatment so that implants can be placed correctly for the best possible esthetics and surgical outcome. As illustrated in Fig. 1, a surgical guide has the following basic elements:
- an adaption surface, which fits onto the patient's anatomy,
- drilling holes with sleeves inserted, which comply with the treatment plan and guide the actual drills, and
- optional form features like irrigation windows, screw holes, anchor pin holes, etc.
The form features of surgical guides
Surgical Guide Design Capability
With GuideMia, surgical guide design covers all clinical situations, and can generate bone level, tissue level and tooth level surgical guides.
When a bone-borne guide is designed, the geometric model of the patient bone/teeth structure is created from the CT scan. A 3D geometric model with a thickness of about 2-3 mm is derived. This model can fit onto patient’s bone/teeth just like a denture. Then “guide drilling holes” are created on this model. Sleeves will be inserted into the holes. During the surgery, the guide will be put onto patient’s bone/teeth, and the holes will guide the drills through.
Tissue-based guides are designed to fit onto patient's soft tissues (gums) and teeth. In order for the models to fit, the system can use any geometric models with a duplication or approximation of the tissue and tooth surfaces. This includes but is not limited to the following:
- Prefabricated denture-like guides, often referred as radiographic guides. A digital model of this kind of guide is obtained by CT scan and surface reconstruction.
- Stone/plaster models. The digital models are acquired through optical scans.
- The patient's Intra-oral scans.
- Impressions. The digital model can be from CT scan or optical scan.
Surgical Guide Design for Surgical Kits
Surgical guides are designed to be used with surgical kits. Implant manufacturers design and make their surgical guides according to their implant specifications, and they also have the version of kits that are specially designed for image guided surgery. The goals of surgical kits are basically to ensure proper drilling sizes, orientations, depths, as well as the drilling sequences. Surgical guides will need to be designed according to the implants and surgical kits. When no surgical kits are available for implants used in a case, the surgical guides will be designed for pilot drills only.
Surgical Guide Design - Simple as You Hope
Don't be scared by the word "Design". With GuideMia, surgical guide design is almost automatic. All you need is a couple of mouse clicks to define the boundary of a surgical guide. For dual scan cases, we have made this all automatic. Single mouse click will bring the surgical guide design onto your desktop.