CATEGORY 40 AUSTRALASIAN DENTIST CLINICAL the guide adapter offers the option to prepare an undersized osteotomy, a technique especially useful when working with softer bone. Here, using a drill with a reduced diameter and preplanned length minimizes the amount of native bone removed when creating the osteotomy and subsequently fosters a more favorable environment for osseointegration.3 This protocol is especially advantageous in cases with insufficient bone quantity or quality as it enhances primary stability by compressing the bone around the implant during insertion.4,5 By incorporating the option of a reduced osteotomy, the PRO5000 kit allows for versatility, where chairside modifications can be made to optimize outcomes in challenging anatomical scenarios. Once the gingival tissue is removed (traditional flap procedure or flapless using a tissue punch) the osteotomy is initiated with a bone leveler to flatten the ridge. This is followed by a short pre-drill allowing for early engagement of the guide adapter with the master cylinder for guidance (Figure 3b). As the length of the drill increases to create a depth-increasing osteotomy, two points of engagement become available: 1) the tip of the drill nesting into the existing osteotomy and 2) the guide adapter nesting into the surgical guide (Figure 3c). This dual guidance reduces the potential for drill deviation. Accuracy is a key technical benefit of digitally planned, prosthetically driven guided surgery. As such, the PRO5000 kit allows for a guided osteotomy preparation and guided implant placement. An accuracy verification test was completed on a 3.0 x 15mm implant, considered a worst case with small diameter and long length, usually more prone to positional deviation.6 Vertical angulation of implants placed and orientation of the indexing feature using the PRO5000 were measured. Implant insertion angles measured with respect to the vertical axis, deviated by an average of 3.13°. Clinically acceptable angular deviation averages 3.5°, and may go up to 5.0°, varying based on the degree of edentulism and technique used, as reported by a systematic review on over 2,000 implants placed via guided surgery.7 The PRO5000 kit and instrumentation support clinically accurate implant placement. Digital guided workflows streamline dental procedures, from planning, customization, clinic-to-lab communication to final placement and restoration. Guided workflows can also provide a less invasive surgical approach (via the use of tissue punches) by reducing the need for open-flap surgeries to visualize bone which can improve patient experience and reduce recovery time.8,9 Additionally, this workflow can significantly reduce the time required for each surgical step, reducing patient chair time and allowing clinicians to complete more cases during a clinic workday.8,10 Yet, prior to the PRO5000 launch, clinicians had limited ability to switch from guided to freehand at the time of surgery if the case required it. The PRO5000 kit is loaded with a drill bank that supports freehand osteotomy and implant placement within the same guided kit, offering full surgical flexibility (Figure 4 and Figure 5). The PRO5000 kit streamlines guided surgeries and simplifies digital workflows, offering many benefits including: u Customisation: Digital planning allows for the customization of the surgical protocol and final dental restoration to match the patient’s unique anatomy. u Improved patient experience: Patients benefit from less invasive procedures and shorter chair times. u Enhanced communication: Digital files can be easily shared, facilitating communication between dental clinics and labs. u Predictable outcomes: Use of digital planning tools and guided surgery leads to more predictable and consistent results. u Surgical lexibility: Clinicians may perform both guided and freehand surgery with a single PRO5000 kit. u Contact gapmagazines@gmail.com for a complete list of references. A B C Figure 4: Instruments used for freehand placement within the PRO5000 are outlined in orange. Figure 5: Summary of the PRO5000 features. Figure 3: (a) The guide adapter is inserted into the master cylinder to ensure there is proper clearance with soft tissue and bone. (b) The guide adapter is engaged into the master cylinder prior to osteotomy initiation with pre-drill. (c) Two points of engagement with subsequent drills in the osteotomy and the master cylinder.
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