CT Guided Surgery

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CT Guided Surgery with nSequence

What’s the difference? Why use nSequence?

The answer is simple: experience and extreme precision. No other organization in the world has the knowledge and the experience that we do when it comes to prosthetic planning and guided surgeries. For the last 15 years we have observed, studied, and dissected the science and technology behind guided implant surgery. We have assembled the best there is to offer in technique, software, and experienced technician to give you the best experience you can possibly get during surgery and even at time of restoration.

 

Current surgical guidance compatibility:

  • Ankylos ExpertEase
  • AstraTech Facilitate
  • BioHorizons Guided Surgery
  • Biomet 3i Navigator (Tapered and Parallel)
  • CAMLOG (special keyless system)
  • HiOssen
  • Megagen
  • Neodent
  • Neoss
  • Nobel (all platforms and connections supported by guidance)
  • Straumann
  • Z-Systems (Unique to nSequence)
  • Zimmer Dental
Implant manufacturers: Don’t see yours on the list? Contact us for custom guidance or to collaborate with our system!

Implant Planning Software

nSequence is capable of accepting treatment plans from all guided surgery software. Our proprietary method translates the implant positions into our very own MavenPro software. We can currently accept SimPlant (with all variants), NobelGuide, In2Guide, and SICAT/Galileos. Give us a call to find out how we can help create the best surgical guide you’ll ever use!

No software? No problem! If you do not currently own an implant planning software, you have two choices:

1. Purchase our Maven Pro Software

2. Let us do treatment planning for you and you will approve case through live web collaboration session

 

Surgical Guide Design

Depending on the complexity and type of case, we can design highly customized surgical guides to suit the requirements of the treatment plan. See below to learn about the various designs.

Teeth SupportedTeeth Supported Guide

These guides are typically designed for small single unit or small bridge cases. Teeth supported guides are designed to fit the patient’s impressions or model. Supports of the surgical guide are based on the surrounding teeth and in free-end distal extensions, also the tissue. Palatal tissue may also be utilized if additional stability is required.

Tissue supported guideTissue Supported Guide

This type of surgical guide is best used for fully edentulous cases where tissue anatomy is captured by dual scan protocol utilizing the patient’s existing denture if present or special bite-block scan appliance if there is no existing denture. The guide is usually validated into position by utilizing a verification bite against the opposing and then secured into the bone with 3 fixation screws or pins.

Bone supported guideBone Supported Guide

In certain circumstances, teeth and tissue cannot be used to support the surgical guides. Keeping in mind of the surgery being as minimally invasive as possible, we customize the design for as little tissue reflection as possible. Fixation pin or screw guidance are built in to maximize stability.

Guided Surgery Instrumentation

One of the most common questions is what instrumentation to use. The basic principles of guided surgery are as follows:

  1. Drilling parts and instrumentation accessories that are long enough to compensate for surgical guide height, tissue/bone penetration, and the implant’s apical position in the bone.
  2. Cylindrical tube adapters and surgical master tubes that would accommodate the different diameters of drilling within the required drill sequence. These tube adapters assist in guiding drill sequence through the same trajectory consequently from start to finish.
  3. In most guided surgery kits, complete implant guidance requires the existence of guided implant mounts, which are typically the same outside diameter as the inside diameter of surgical master tubes so it could properly guide the implant into position.

implantguidestack

If these listed requirements are not met, only 2mm guidance may be provided. Compromising accuracy using guided surgery is not recommended!

The following guided surgery kits are compatible with our treatment planning system and surgical guidance.

Ankylos® ExpertEase™

Ankylos ExperteaseAnkylos® ExpertEase™

Entering the 2012-2013 market in North America, Ankylos users have the ability to guide A implants (Ø3.5mm) and B implants (Ø4.5mm). Experience guided surgery with accurate drilling, reamer, tap, and implant guidance with the Ankylos® ExpertEase™ guided surgery kit.

Key features:

  1. Implant size capability: Ø3.5mm and Ø4.5mm
  2. Drilling features: One size drilling per implant site
  3. Guide features: Non-adjustable guide design height/One size surgical design
  4. Implant guidance: Complete depth, trajectory, and rotation

ASTRA TECH Implant System™ Facilitate™

 

Astra FacilitateASTRA TECH Implant System™ Facilitate™

A popular guided surgery kit in the industry, the ASTRA TECH Implant System™ Facilitate™ is one of the most versatile and easy to use systems. Guide Ø3.5mm, Ø4.0mm, Ø4.5mm tapered, Ø5.0mm, and Ø5.0mm tapered ASTRA TECH implants with ease!

Key features:

  1. Implant size capability: Ø3.5mm, Ø4.0mm, Ø4.5mm tapered, Ø5.0mm, and Ø5.0mm tapered
  2. Drilling features: 4 possible drills to use with 4 possible handle heights to use
  3. Guide features: Adjustable guide design height/3-size possible surgical design
  4. Implant guidance: Complete depth, trajectory, and rotation
  5. Special notes: Include “stamp-style” tissue punches; surgical kit does not include drills. Drills are bought separately per case and are considered ‘disposable’

BioHorizons® Guided Surgery

biohorizonsguidedBioHorizons® Guided Surgery

Introduced in 2014, the BioHorizons Guided Surgery system utilizes multiple drill and handle system that boasts easy to use color-coded handles and sequential flow charting in the surgical kit designed specifically for Tapered 3.0, Tapered Internal, and Tapered Plus.

Key features:

  1. Implant size capability: Ø3.0mm, Ø3.8mm, Ø4.6mm, and Ø5.8mm in Tapered 3.0, Tapered Internal, and Tapered Plus
  2. Drilling features: 4 drill lengths, 7 drill diameters
  3. Guide features: Adjustable guide design height/4-size possible surgical design
  4. Implant guidance: Complete depth, trajectory, and rotation
  5. Special note: Includes tissue punches

 

BIOMET 3i™ Navigator® (Tapered & Parallel)

3i Navigator Tapered3i Navigator ParallelBIOMET 3i™ Navigator® (Tapered & Parallel)

One of the oldest, and yet most current guided surgery kits, the BIOMET 3i™ Navigator® can guide both Tapered or Parallel implants (note: each type has its own kit). Guide Ø3.25mm, Ø4.0mm, and Ø5.0mm BIOMET 3i™ implants to exact planned positions in the bone.

Key features:

  1. Implant size capability: Ø3.25mm, Ø4.0mm, and Ø5.0mm
  2. Drilling features: Parallel – uses 5 possible length drills; Tapered – uses 1 drill for each length
  3. Guide features: Adjustable guide design height/2-size possible surgical design
  4. Implant guidance: Complete depth, trajectory, and rotation
  5. Special note: Includes coveted bone profiler tool

 

CAMLOG® Guide System

Guided CamlogCAMLOG® Guide System

Nicely engineered guided surgery system, the CAMLOG® guided system does not require the use of adapter handles or tube adapters. The entire system is built with simplicity and efficiency in mind. The system currently supports Ø3.8mm and Ø4.3mm CAMLOG® implants only.

Key features:

  1. Implant size capability: Ø3.8mm, Ø4.3mm
  2. Drilling features: No handles or tube adapters. 1 specific size for each implant length
  3. Guide features: Non-adjustable guide design height/One size surgical design
  4. Implant guidance: Complete depth, trajectory, and rotation
  5. Special note: Due to the no-handles design, some cases will require tissue reflection because of short required vertical height of guide (only 3.5mm from implant to bottom of guide). Drills are ordered on a per-case-basis and are considered disposable

 

HiOssen OsstemGuide™

osstemguide

Another newly introduced guided surgery system, the HiOssen OsstemGuide™ provides an excellent method to which HiOssen implants could easily be guided for implant placement surgeries. The kit is quite comprehensive and color coded for ease of use.

Key features:

  1. Implant size capability: All HiOssen diameters
  2. Drilling features: One drill for one implant length. Requires the use of included guide handles.
  3. Guide features: Non-adjustable guide design height/One size surgical design
  4. Implant guidance: Complete depth, trajectory, and rotation
  5. Special note: Due to one-size prolongation design, the HiOssen system may be difficult to use when longer implants are desired in posterior cases with small vertical patient opening.

 

Implant Direct Guided Surgery

implantdirectguidesurgery

ImplantDirect Guided System

This ImplantDirect guided system is considered an add-on universal system. It does not feature any drivers, mounts, or drills, but only handle or tube adapters. To use the system, you must already have the Implant Direct drill kit or Zimmer drill kit. You may guide up to Ø5.7mm implants as long as you have the proper drills already. The surgical guide is fabricated using existing drill’s required lengths. For instance, if you have a Zimmer 22mm length drill, the surgical guide will be fabricated compensating for the guide handle, implant length, and vertical requirement.

Key features:

  1. Implant size capability: up to Ø5.7mm
  2. Drilling features: Not applicable
  3. Guide features: Not applicable; dependent on drill to be used
  4. Implant guidance: None
  5. Special note: No drivers, mounts, or drills. Add-on universal system only

     

Neoss

Neoss® Guide

Neoss® Guide

Neoss continues their tradition of intelligent simplicity with Neoss® Guide, arguably the simplest fully guided kit available.  Because the kit is used in conjunction with the regular surgical kit, fully guided placement is easily accomplished with a minimum of components. This is your simplified and cost-effective alternative to other complex and expensive fully guided implant placement systems.

 

Key features:

 

  1. Fully guided placement capability
  2. Neoss® Guide is used with the standard surgical kit – no additional drills are necessary
  3. “Drill to hub” protocol allows for safety and accuracy when drilling and placing implant
  4. 5mm and 6mm guide sleeves are available for placement of implant diameters of Ø3.5mm to 6.0mm
  5. The same kit is used with ProActive Straight or ProActive Tapered implants

 

Nobel Biocare® NobelGuide™

nobelkit

Nobel Biocare® NobelGuide™

NobelGuide is a term to cover all 4 of Nobel’s guided surgery systems: Brånemark System® Groovy and Shorty/NobelSpeedy Groovy and Shorty, NobelActive, NobelReplace® Tapered/Replace Select Tapered, and NobelReplace® Straight/Replace Select Straight/NobelSpeedy Replace. One of the most popular kits today, the Nobel guided surgery kits have everything you need to do all things guided with Nobel implants.

Key features:

  1. Implant size capability: All implant diameters; Ø3.3mm, Ø3.5mm, Ø4.0mm, Ø4.3mm, Ø5.0mm, Ø6.0mm
  2. Drilling features: Varies. Most non-Tapered implant systems have 2 available drill lengths if needed. Tapered system use one drill, one length design
  3. Guide features: Non-adjustable guide design height/One size surgical design
  4. Implant guidance: Complete depth, trajectory, and rotation
  5. Special note: Each system requires specific guided kit. Be sure to order the appropriate kit for the system you are using

 

Straumann® Guided Surgery

Straumann GuidedStraumann® Guided Surgery

An easy-to-use system, the color-coded Straumann® Guided Surgery allow dental professionals to quickly and accurately perform implant surgery. Guide all implant sizes in Straumann® and even prepare the implant site for tissue level emergence with the provided profiling burs.

Key features:

  1. Implant size capability: All implant diameters; Ø3.3mm, Ø4.1mm, Ø4.8mm
  2. Drilling features: 2 possible handle heights with 3 possible drill lengths combination
  3. Guide features: Adjustable guide design height/3-size possible surgical design
  4. Implant guidance: Complete depth, trajectory, and rotation
  5. Special note: “Guided Implant” must be ordered with guided surgery for complete implant guidance. By ordering “Guided Implant”, your implant order will come pre-assembled with a guided mount capable of delivering your Straumann® implant to depth, trajectory, and rotation

 

Zimmer® Guided Surgery Instrumentation

Zimmer Guided SurgeryZimmer® Guided Surgery Instrumentation

The Zimmer® Guided Surgery Instrumentation has evolved over the years from starting as a standard freehand surgical kit into a robust guided surgery instrumentation system. The good news is, if you already have the first Zimmer® surgical kit, you can simply purchase the add-on for the remaining components to convert your existing surgical kit into the Zimmer® Guided Surgery Instrumentation.

Key features:

  1. Implant size capability: All implant diameters; Ø3.3mm, Ø3.7mm, Ø4.1mm, Ø4.7mm, Ø6.0mm
  2. Drilling features: 1 possible handle height with 4 possible drill lengths combination
  3. Guide features: Adjustable guide design height/5-size possible surgical design
  4. Implant guidance: Freehand implant placement
  5. Special note: Zimmer® implants must be free-handed into position

 

Z-Systems® Z-scout

Z System GuidedZ-Systems® Z-scout

The Z-System® Z-scout kit is a basic kit that will allow mostly anterior positions to be guided. The drills are extremely long and are suitable where space is available.

Key features:

  1. Implant size capability: All implant diameters; Ø3.3mm, Ø3.7mm, Ø4.1mm, Ø4.7mm, Ø6.0mm
  2. Drilling features: Long drills, best suited for anterior implants
  3. Guide features: Uses zirconia ring adapters inside metal surgical guide tubes
  4. Implant guidance: Freehand implant placement
  5. Special note: Z-Systems® implants must be free-handed into position

 

Guided Surgery Resources

Downloads:

CT Guided Scan Protocol

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