Multifunctional Guide with Palatal Referencial

The difficulty of placing implants in the ideal position, during surgery in the edentulous maxilla, suggested the need for the development of a surgical guide that optimizes prosthetic rehabilitation. Created to preserve the esthetic and functional conditions established during wax-up, the surgical guide was modified and incorporated new features during planning and prosthetic procedures, becoming multifunctional.

Objective: The objective of this research was to describe the construction technique for a multifunctional guide with palatal reference and its use in every phase of implant-supported rehabilitation in the edentulous maxilla, based on anatomic and clinical references.

Methods: A wax-up was prepared, based on functional and esthetic parameters of rehabilitation of the edentulous maxilla, and then was duplicated in colored acrylic. The removal area of the multifunctional guide with palatal reference was limited to the canine and incisor cingula, and the occlusal sulcus contained the corresponding area of the hard palate and the vestibular flange.

Results: The proposed changes to the guide design, relative to that described in the current literature, were intended to increase the mechanical resistance to cracks and fractures, and also to determine one anatomically stable point for immobilization and stabilization of the guide during surgery, as well as procedures for transference molding and intermaxillary register.

Conclusion: The multifunctional guide with palatal reference reduced the clinic time and increased the pre-visibility in implant-supported rehabilitation in the edentulous maxilla, mainly in terms of immediate loading.