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What is the surgical workflow, and how does flapless differ?

The workflow begins like any standard CHROME GuidedSMILE case, using a stackable set of anchored guides built from the patient's CT scan, digital impressions, and photographs. What distinguishes GuidedSMILE Natural is an additional contouring guide that helps sculpt individual sockets to receive both tissue and prosthetic. Implants are placed slightly deeper than a standard hybrid case, a provisional is delivered the same day, and a duplicate RAPID Appliance captured during surgery is later used to convert to the final restoration.

The Handbook's step-by-step surgical drilling protocol:

Step Action
1 Seat the Pin Guide and Fixation Base
2 Optional flapless protocol
3 Extract teeth if present
4 Assess the bone-to-guide relationship for passivity, and adjust bone if needed so the Osteotomy Guide seats
5 Perform initial OEM pilot drilling or the Universal Shapers Drills (USD) process, following the appropriate drill protocol
6 Remove the OEM guide, seat the optional USD customized guide, and use the Cortical Release drills
7 Freehand the pontic sites with the USD Mushroom Shapers, verifying visually and by seating the prosthesis
8 Deliver implants using the leave-a-mount-behind stabilization technique
9 Remove the Osteotomy Guide and move to prosthetic conversion
10 Verify the prosthesis seats passively, adjusting prosthesis or bone to full seat
11 Block out the MUAs
12 Perform the pick-up

MUA placement: select the planned MUA for each implant, ideally the lowest collar height, seat slowly and carefully, verify full seating, then torque to specification (or less if the implant torque is lower). When seating the bridge or provisional, verify a passive fit into the CHROME Locs, trim bone if there is interference, and confirm full seating with a 1 to 2 mm tissue gap.

Universal Shapers Kit (USK): a purpose-built instrument set for site drilling and profile creation. Its cortical release drills establish an ideal emergence profile, and its mushroom shapers create concave pontic sites and smooth bone, refining emergence beyond what standard profiling drills achieve. GuidedSMILE can design custom "C"-shaped open-face osteotomy guides to position the USK drills accurately.

Approach Guidance
Flapless Viable when minimal-to-no bone augmentation is anticipated. You must inform your planning specialist during the consultation so the guide is designed to seat over the tissue.
Flapped (default) If the planner is not told you want flapless, the guide is designed for a flapped approach. The Osteotomy Guide may then contact tissue and fail to fully seat. Flap also gives better visualization for recontouring or grafting.

 

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    Contact Information

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