What clinical considerations and troubleshooting tips for tissue supported surgical guides should I keep in mind?
Tissue-supported guides carry specific considerations that are important to understand before selecting this option.
Accuracy is the key limitation. ROE is direct that tissue-supported guides represent the least accurate option in its surgical guide portfolio. The pressure exerted during surgery, combined with the natural resilience of the mucosa, may cause guide movement that can affect placement precision. The mucosal support system may introduce directional movement, particularly when combined with flap reflection procedures that add complexity to the protocol. ROE works closely with you to optimize design and fit, but this inherent limitation should factor into guide selection.
Common considerations and troubleshooting:
| Consideration | Guidance |
|---|---|
| Guide rocks or will not fully seat | Verify a full seat through the window before drilling. If rocking cannot be adjusted out and a full seat is not possible, stop and begin again with new records. |
| Movement during surgery | Use fixation pins where included. Hold the guide firmly in position throughout drilling. If the guide has integrated teeth, close the patient into the bite to help set fixation. |
| Poor-fitting denture or soft liner | A poor fit or any denture movement during scanning causes errors in the template. Replace soft liners with a hard reline or simulate the relined intaglio with Green Mousse before scanning. |
| Denture contains metal | The scan appliance must contain zero metal, since a metal substructure causes CBCT issues. |
| Markers moved between scans | Markers act as constants across both scans. If they are moved or removed, the scan images cannot be merged and the data is unusable. |
| Verify before dismissing the patient | Check the scans for black voids between the tissue and the appliance before the patient leaves. It is better to rescan than to reschedule. |
Recommended scan settings: set gantry tilt to 0 degrees (none) and slice thickness to 0.4 mm or less, and ensure the patient removes jewelry and stays still to avoid scatter.
If you have questions on a specific case, contact ROE at (800) 228-6663 or info@roedentallab.com.
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Contact Information
For immediate chairside support or troubleshooting assistance, contact ROE Dental Laboratory:
- Phone: (216) 663-2233
- Email: info@roedentallab.com