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What is the day-of-surgery workflow for the stacked CombiGuide components?

The CombiGuide is a stackable, fixated system. Each component seats onto the fixation base in sequence. The general surgical sequence is as follows.

Step Action
1. Reflect tissue Reflect a flap to expose the bone for fixation and reduction.
2. Seat the pin guide and fixation base Seat the pin guide (the delivery device) together with the fixation base, then drill and place the fixation pins.
3. Remove the pin guide Remove the pin guide. The fixation base stays in the mouth for the remainder of the procedure.
4. Reduce the bone Reduce bone down to the level of the fixation base, which acts as the bone reduction reference.
5. Verify with the carrier guide Try in the carrier guide. If it seats passively, reduction is adequate. If not, reduce more bone and re-test until it seats passively.
6. Seat the osteotomy guide Seat the osteotomy guide and create the osteotomies. Rotation is controlled by the sleeve slot and by indexing nubs on the guide.
7. Place implants and MUAs Place implants through the guide, then attach the multi-unit abutments (MUAs).

The passive-seat verification at Step 5 is what makes bone reduction predictable. It is a tactile and visual check that the planned vertical space has been achieved before any osteotomy is started. Rotation indexing at Step 6 helps ensure that implants and their temporary cylinders end up straight, rather than relying on freehand confirmation.

In the documented teaching case, a BioHorizons guided kit was used, and its implants pass directly through the guide. Because CombiGuide supports all guided kits, your specific drilling protocol will follow the kit you select during planning.

 

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