Table : Partially limiting design
author (y) | material used for fabrication of the template | radiographic marker used | imaging system used | conversion process | indication/ advantages |
Engelman et al9 | auto polymerizing acrylic resin | metal bearings | panoramic radiography | remove lingual surface, leaving only facial surface of the teeth in the proposed implant site | inexpensive, easy, improved visibility, external irrigation |
Adrian et al10 | auto polymerizing acrylic resin | leaf foil over the maxillary and mandibular incisors, left mandibular occlusal plane, intaglio surface of mandibular trial denture | lateral cephalography |
determine implant trajectory and location using radiopaque images use cephalometric tracing paper, protractor, and surveyor to reproduce these data in a resin plane joining maxilla and mandible; |
Guides implant position and trajectory, serves as a bite-block, retracts the tongue and flap, lessens chance of titanium contamination |
Tarlow11 |
acrylic resin duplicate denture vacuum-formed thermoplastic matrix (0.02 inch) adapted over duplicate denture |
remove anterior lingual portion of matrix; remove anterior labial portion of duplicate denture; |
indicated in anterior edentulous mandible; matrix dictates implant location and angulation, with minimal interference to surgical access |
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Espinosa Marino et al |
heat polymerizing acrylic resin | dual-curing composite resin mixed with colored chalk | CT | trim buccal side of the template |
indicated in partially edentulous patient |
Stellino et al 13 | acrylic resin provisional FPD | gutta-percha | CT | remove gutta-percha from channels in the pontic |
alternative for removable radiologic template where a provisional FPD bridges the implant site |
Pesun and Gardner14 |
vacuum-formed thermoplastic matrix adapt over diagnostic cast and on the duplicate cast of diagnostic wax-up fill orthodontic resin in the space between these 2 matrices |
gutta-percha | CT | reduce vertical height of the guide; remove gutta-percha |
indicated in severely worn dentition |
Takeshita et al15 | denture base: auto polymerizing acrylic resin; teeth; mix powder consisting of 4; 1 ratio of resin polymer and barium sulfate with monomer | stainless steel tubes |
panoramic radiography, CT |
remove tube sprues |
barium sulfate depicts outline of the predesigned superstructure stainless steel tubes represent location and inclination of the intended implant placement |
Sicilia et al16 | orthodontic wires and auto polymerizing acrylic resin | contrast blocks, gutta percha blocks | CT | using wire, create 2 profiles of the missing teeth - occlusal and gingival. Join these to acrylic resin block to make template solid and add self-retaining feature |
profiles mark the vestibular and mesiodistal limit of the teethl the profile replaces buccal surface of the template |
Minoretti et al17 | vacuum-formed thermoplastic matrix or auto polymerizing acrylic resin | guide sleeve | insert Kirschner wires through mucosa/ bone using dental handpiece; fit guidance cylinders fitting trephine drill ( diameter = 3.5 mm, ITI Dental Implant system ) to the guide free |
indicated in completely edentulous patient of in augmented alveolar ridges where template position after flap reflection is difficult. Improves precision of implant placement - improving guidance during drilling process |
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Ku and Shen18 | vacuum-formed thermoplastic matrix filled with auto polymerizing resin acrylic resin | gutta-percha | CT | remove marker with carbide bur |
single implant therapy or short-span implant-supported prostheses |
Becker and Kaiser19 (Figure 2) | vacuum-formed thermoplastic matrix (0.020 inch) and orthodontic resin | 5/32 and 3/16 inch brass tubes | attach 3/16 inch tube to the template 5/32 inch tube guides the pilot drill |
precise surgical guide resulting in a functional and esthetically pleasing restoration |
|
Cehreli et al20 (Figure 3) | vacuum-formed thermoplastic matrix (2.0 x 125 mm) | pins (1 mm diameter) | CT | fabricate 2 acrylic templates covering only residual ridges with guide channels of 2 diameters inner lamina: remove foil covering edentulous ridges, secure bur ends bilaterally - guides insertion of removable surgical acrylic resin template; outer lamina: remove palatal portion, prepare occlusal holes |
posterior maxillary region with poor bone density; outer lamina contains radiopaque markers for radiographic evaluation and verify alignment of implants; inner lamina accepts 2 removable surgical guides bilaterally |
Almog et al9. |
Vertical lead strip guide; custom tray material/ auto polymerizing resin with vacuum-formed thermoplastic matrix (0.02 inch); | lead strip (2 mm) vertically on the lingual/ palatal wall of the buccal access groove; | CT | remove lead strip |
surgical osteotomy but more error in the buccolingual placement |
Almog et al9. Gutta-percha guide (figure 4); |
custom tray material/ auto polymerizing resin with vacuum-formed thermoplastic matrix (0.02 inch); | gutta-percha | CT | remove gutta-percha |
surgical osteotomy allowing for some surgical latitude in preparation of the osteotomy sites |
Almog et al9 Metal sleeve guide (figure 5); |
custom tray material or auto polymerizing resin | metal guide sleeves | CT |
precise surgical osteotomy guide |
|
Cehreli et al21 |
auto polymerizing acrylic resin | pins (1 mm diameter) | CT | attach internally stacked stainless steel guides |
place implants in low-density bone; dual-purpose guide incorporating 3 drill guides |
Alsa et al22 |
auto polymerizing acrylic resin | - | used when CT is not required for evaluation of buccolingual angulation of available bone; construct 4-mm thick flat horizontal plane | construct perpendicular resin plane on lingual side of the flat plane; prepare guide channels; transfer mesiodistal reference axis to the perpendicular partially |
indicated in posterior edentulous mandible; reference axis on the perpendicular plane guides mesiodistal implant angulation; retracts the mucoperiosteal flap lingually improves site visualization |
McArdle23 |
vacuum-formed thermoplastic matrix, light cured restorative material | restorative material forms guide core; prepare center guide channels |
single tooth implant-supported restorations; flexible material |
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Koyanagi24 (Figure 6) |
auto polymerizing acrylic resin | Orthodontic wire, stainless steel ball, gutta-percha point | conventional tomography | | Laser weld orthodontic round tube to the front cap of a latch type contra-angle handpiece |
template guides the head of the contra-angle handpiece, preventing the drill from contacting the template; allows objective assessment and determination of implant location, inclination, and depth for individual treatment cases |
Kopp et al25 (Figure 7) |
auto polymerizing acrylic resin | barium sulfate liquid coat, thin orthodontic wire (0.014-0.016 mm) glued to the buccal aspect | CT | modify surveyor table using a protractor secure 22-mm diameter milled cylinders in the template |
cylinders guide pilot drill Buccal guide wire guides all future drills in the buccolingual and mesiodistal direction |
Tsuchida et al26 (Figure 8) |
auto polymerizing acrylic resin |
silicone impression material |
CT |
remove silicone markers; remove buccal/ lingual portion of the surgical template |
silicone markers: clear radiopaque markers that do not create artifacts in CT scanning |
Windhorn27 (Figure 9) |
light polymerizing custom tray material |
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use wooden stick as reference for molding resin around handpiece head |
wooden stick simulate implant location and angulation 2-piece implant placement guide |
Al-Harbi and Verrett28 (Figure 10) |
auto polymerizing acrylic resin |
|
CT of arch prior to extraction treatment planning using SimPlant software |
; transfer planning data to surgical guide using milling machine; trim occlusal surgace and buccal flanges; maintain 5-mm coronal-apical thickness of resin; |
for immediate implant placement following complete arch odontectomy; stable guide following staged tooth extraction |
Arfai and Kiat-Amnuary29 (Figure 11) |
auto polymerizing acrylic resin |
brass rod (3/52 inch); |
periapical radiography |
remove the rods |
placement of multiple implants in adequate osseous structure; dental surveyor improves accuracy |
Wat et al30 (Figure 12) |
auto polymerizing acrylic resin mixed with barium sulfate (ratio of 4:1) |
barium sulfate cylindrical channels drilled at proposed implant sites in radiographic template |
CT |
remove non-salvageable teeth to modify guide; place guide on the mounted cast; connect to the record base fabricated on the opposing arch, using embedded stainless rods and tubes
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convenient, economical, less traumatic, stable for edentulous arch opposing a partially edentulous arch, compatible with all implant systems |
Oh and Saglik33 |
auto polymerizing acrylic resin (DPRD); attach vacuum-forming thermoplastic matrix (1 mm) to the DPRD using acrylic resin |
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trim buccal and lingual denture base extensions; prepare guide channels in the middle of acrylic resin teeth with buccal windows |
thermoplastic sheet engages the remaining dentition, assists in an accurate orientation, and maintains the DPRD to serve as a surgical template; permits stable intraoral placement of denture for successful implant placement |
Annibali et al32 |
auto polymerizing acrylic resin |
stainless steel or titanium cylindrical |
panoramic and periapical radiography, lateral cephalography, CT |
cylindrical marker guides the pilot drill |
uses silicone matrix that depicts the emergence profile and the ideal loading center of the proposed restoration |
Serial posts:
- Types of Implant Surgical Guides in Dentistry: A Review
- Nonlimiting Design : Types of Implant Surgical Guides in Dentistry
- Partially Limiting Design : Types of Implant Surgical Guides in Dentistry
- Completely Limiting Design : Types of Implant Surgical Guides in Dentistry
- CAD / CAM-based Surgical Guide : Types of Implant Surgical Guides in Dentistry
- Conclusion : Types of Implant Surgical Guides in Dentistry
- Table : Partially limiting design