Guided Surgery in Grafted Site
If primary stability of a 5x8.5 mm implant in the
grafted site is insufficient, the
implant placement depth
will be increased by 1 mm (from Fig.4 to 5).
Dr. Wei: You may find surgical reports and drilling sequence for the
patient.
I have put 2 drilling sequence one for the regular drilling sequence and the
other one for 1mm deeper drilling sequence.
As it is close to nerve, please put more attention into the depth control.
Jennifer
Jennifer: One more question. When an implant does not obtain primary
stability, it keeps spinning without going down. It suggests that the drill
depth is not enough. May I use 4x13 mm drill and barely touch the sleeve? I am
fully aware of the risk. But with purely infiltration anesthesia instead of
block anesthesia, the patient may not allow me to touch the nerve. If I use
4.5x13 mm drill, the osteotomy may be too large. Thanks
To answer your question, I would not recommend that because the concept of
NeoNavi guide is to fully engage the cylinder part with the metal sleeve in
order to get more accuracy. I understand that you want to drilling deeper,
but barely touching sleeve will not increase the accuracy of the implant
placement followed by the planning. It's almost like free-hand case.
If you want to I can send you another sequence with smaller diameter but
let's not go with lengthwise.
The reason is because you need to be aware that there's additional tip end
of 1.2mm on every osteotomy drill.
So, even we say 8.5 (now it's 10mm due to 10.5mm OFFSET), the actual length
is 10.7mm (11.2mm with the offset) and you are getting close to the nerve
which is only 2.5mm away from the apex.
You can customize and make up your own drilling sequence based on the
patient's condition, bone density you are actually feeling on the surgery
day and others, but I would like recommend to drill deeper than that.
Jennifer
Can I use one O-ring attached to 1.5 mm extra long drill so
that I can get .5 mm deeper, which is not free hand? Thanks for advice. If
I do not raise the question, I may feel puzzled in surgery in case the
question arises. What I really meant previously drill does not touch the
sleeve: actually drill does not completely stop at the end of the
sleeve.
Return to
Lower
Molar Immediate Implant, Armaments
Xin Wei, DDS, PhD, MS 1st edition 04/19/2018, last revision
05/01/2018
