You're drilling TOO SLOW when placing implants!

[@robertgomez5248]

Amazing video, you are talking about experiences that encounter on a daily basis but only a fraction of the population can follow. I love that I can relate. When I started doing guided I was so afraid of trusting the guide and giving up the control. It took me a while to get used to it. I've never heard anyone actually vocalize it.

[@Stanleyinstitute]

Thank you for your kind words. As Dentists, we often work alone, that is why when you hear a colleague present, and every day fact of life, there’s a sense of validation, because it is real. Thanks for watching and stay tuned for more “real” reels😅

[@sria8163]

So true

[@redefinedentistry4187]

Sir how to prevent wobbling of drill when larger size drills are used

[@Stanleyinstitute]

If you are using freehand there are little options. With guided you will have a small amount of play built into the guide which is called clearance. It is necessary so the drills can fit into the guide. My unpublished research showed my error was 200 micros or less. This is good enough for almost any case. One trick is to reduce the speed of your bigger diameter drills. For example. Our 6mm diameter drill speed is only 1000rpm.

[@drshadykhalifa4839]

What if i put 4 diameter in 10 mm length and implant stop on motor half inside and half out … i should drill to length 11 mm …. Some drs say that… wat is the trik in drilling more 1-1.5 down length .. why implant sit ? Why not sit with same 10 mm

[@Stanleyinstitute]

If I get too much resistance during the insertion of my implants prior to reaching the prescribed depth what I do is, I use the dental implant as a bone tap. The way I do it is I insert the implant one turn, then back it out half of one turn, and then repeat, until I reach the desire depth. I am not fond of over preparing the osteotomy by drilling deeper because typically that’s where the vital structures live.

[@drshadykhalifa4839]

@@Stanleyinstitute you are talented sir … i really appreciate … sometimes also i go perfect to the 4/5 of implant inside amazing only 2-3 mm remaining i chexk torque by motor is 35 when it stop .. then i continue by wrench i found torque less sometimes 20 or less .. thats make me crazy i didn’t find a logic reason why this happen to me

[@manificcc]

​​​@@drshadykhalifa4839cuz u having torque by crestal bone , hard one , like first 1 2mm making the body of implant stop here , after u going deeper , you losing torque because neck of implant , abit smaller than body , and like 90% of implant positioned in softer d3 /d4 bone

[@huynguyenthanh7152]

​@@drshadykhalifa4839 i think when 35Ncm you are in cortical bone at the alveolar ridge, when you use torque wrench 2-3mm, the implant comes into trabecular bone and torque will be 20Ncm or less... I think that because i have many cases like that...

[@retrogamerdave362]

But what if your guide is wrong? And what if your guided instruments fall on the floor? I just use my doctor hands and place unguided. It makes me a better surgeon. However there are plenty of tricky placements when I said to myself: "Wow, this would have been a great guided case!" But then you have to wait to get the guide, that is my least favorite thing about guided surgery. It is great, no question, but you can do excellent implant dentistry without a guide. It's just easier with a guide. But imagine your whole career doing guided surgery and then trying to do it without a guide on a difficult case? I don't like those odds.

[@Stanleyinstitute]

Guides are only incorrect if you design them incorrectly. Properly designed guides will not break. The measure of success should not be determined by whether primary stability has been achieved. This is the anatomical approach the industry initially adopted, which has resulted in the overwhelming majority of complications over the years. The true measure of success is the correct implant placement in the appropriate prosthetic location. This cannot be achieved consistently without a guide. In other words, using a simple tool (guide) ensures the optimal execution of the prosthetic plan. The notion that one can arbitrarily remove the guide and achieve the same outcome without a guide is flawed due to the inherent properties and shape of the bone. If a genuine guide complication occurs, the prudent course of action is to quickly fabricate a new guide using a 3D printer or to reappoint the patient, emphasizing the importance of proper execution for the form, function, and longevity of the tooth replacement therapy.