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What clinical considerations and troubleshooting tips should I keep in mind?

While tooth-supported guides are highly accurate, a few clinical factors deserve attention to ensure a smooth surgery.

Space and drill length, especially in the posterior. ROE always recommends careful consideration of available space and guided drill length requirements, particularly when placing posterior implants. Anatomical constraints in these areas may require special attention to ensure optimal surgical access and implant positioning. Confirm that there is enough inter-arch and inter-tooth space for the guide sleeve, key, and drill assembly before the day of surgery.

Common considerations and troubleshooting:

Consideration Guidance
Guide rocks or does not fully seat Before drilling, visually inspect the seating windows to confirm full intimate seating with no rock. If the guide rocks, do not proceed; reverify the fit on the model and intraorally.
Limited posterior access Plan for guided drill length and available vertical space early. Posterior sites may have restricted mouth opening that affects drill and handpiece clearance.
Patient has mostly metal-based restorations Metal can scatter the CBCT signal. In these cases, send models to ROE for scan appliance fabrication rather than relying on the standard scan.
Scanning the arches For dentate patients, always separate the arches with cotton rolls, a bite stick, or a CT bite fork. Never scan in occlusion, as this compromises the planning data.
No guided drill kit on hand ROE can provide keys/spoons, a sleeve-in-sleeve solution, or multiple printed guides to guide your sequence (see FAQ 5).
Design sign-off ROE conducts an online design approval meeting with you before fabrication, so review the plan and drill report carefully at this stage.

Sterilization note: Among the external clinical references ROE links for this product is peer-reviewed work examining the dimensional stability of 3D-printed tooth-supported implant surgical guides after autoclave sterilization. Follow your implant manufacturer's and the guide material's validated sterilization instructions, and inspect the guide for fit after any sterilization step.

If you have questions on a specific case, contact ROE at (800) 228-6663 or info@roedentallab.com.

 

Resources

Contact Information

For immediate chairside support or troubleshooting assistance, contact ROE Dental Laboratory: