Table : Partially limiting design
author: Kathleen Manuela DSouza, BDS Meena Ajay Aras, MDS | publisher: drg. Andreas Tjandra, Sp. Perio, FISID
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
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
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
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
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
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
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
| 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 |
||
|
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 |
|
| 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 |
||
|
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 |
|
|
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
|
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 |
|
|
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 |
- 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