Basic information · instant.guide
Guided surgery protocol
Depth control, drill sequence and the chairside check for every implant site, worked out from your lab form and checked before the guide leaves us.
1.The depth rule
The drill stops on the handle cylinder, the handle sits in the T-sleeve, and the sleeve sits a fixed height above the planned implant shoulder. Add the four and you have the guided length of the drill. Any implant bed from 4 to 16 mm is reached by choosing the sleeve position, the handle cylinder and the drill length.
1.1T-sleeve position
The Ø5.0 mm T-sleeve is set at one of three heights above the planned implant shoulder: H2, H4 or H6. The height is the distance between the bottom of the sleeve and the shoulder. It is chosen from:
- the mucosal thickness;
- the type of guide: tooth, mucosa or bone supported;
- access for irrigation.
Note: For maximum precision choose the lowest position possible; the sleeve must not touch the tissue. Use H4 or H6 when the implant is placed guided, and avoid 6 mm and 8 mm implants at H2.
1.2Two handle cylinders
Each Drill Handle has a 1 mm and a 3 mm cylinder, marked with one dot and three dots. The cylinder sits on the sleeve and adds its height to the stack, so the wrong cylinder moves the osteotomy floor by 2 mm.
1.3Three drill lengths
Guided drills come in three guided lengths: short 16 mm, medium 20 mm and long 24 mm, marked by one, two or three laser bars on the shank. One length step is 4 mm of depth: a long drill in place of a medium one cuts 4 mm deeper.
1.4The equation
Implant length + sleeve position + 5 mm sleeve + handle cylinder = guided length of the drill. The lengths step by 4 mm and the cylinders by 2 mm, so each case has exactly one drill and handle that fit, or none. The table below is computed by the same code that checks every instant.guide case, and it matches the manufacturer's published matrix cell for cell.
Note: A dash means no guided drill reaches that depth from that position: choose another position, or finish conventionally.
| Implant length | 6 mm | 8 mm | 10 mm | 12 mm | 14 mm | 16 mm |
|---|---|---|---|---|---|---|
| H2 · 2 mm | short+3 handle | short+1 handle | medium+3 handle | medium+1 handle | long+3 handle | long+1 handle |
| H4 · 4 mm | short+1 handle | medium+3 handle | medium+1 handle | long+3 handle | long+1 handle | — |
| H6 · 6 mm | medium+3 handle | medium+1 handle | long+3 handle | long+1 handle | — | — |
2.Drill sequence by bone class
After the pilot drill, determine the bone class at the site. The sequence then follows the implant maker's drilling protocol for soft, medium or hard bone. C marks coronal widening of cortical bone: 4 mm deep for 6–8 mm implants, 6 mm deep from 10 mm. P marks the profile drill of tissue-level and BLC implants.
2.1Example: BLX Ø4.0 mm
Note: Guided drilling ends at Ø4.2 mm, the widest Drill Handle. Wider steps are drilled freehand after the guide is removed, and implants too wide for the Ø5.0 mm sleeve are placed freehand.
3.The chairside check
A guide is only as accurate as the instrument in the surgeon's hand. Most depth errors are not in the design. They come from a drill one length too long, the wrong handle cylinder, or an implant driver stopped at the wrong mark. Every protocol sheet lists what each mix-up would do, in millimetres.
3.1Implant driver marks
The guided implant driver carries H2, H4 and H6 marks. Stop when the planned mark meets the sleeve rim. One mark higher leaves the implant 2 mm proud of the plan; driving on to the next mark sinks it 2 mm deeper, more subcrestal than planned.
3.2What each mix-up does
| If the surgeon uses… | Depth | Result |
|---|---|---|
| the next longer drill | +4 mm | Osteotomy 4 mm deeper than planned. |
| the +1 mm handle instead of +3 mm | +2 mm | Osteotomy 2 mm deeper than planned. |
| the driver stopped one mark high | −2 mm | Implant shoulder 2 mm above the plan. |
| the driver taken one mark low | +2 mm | Implant 2 mm deeper, more subcrestal than planned. |
4.Protocol calculator
Choose the implant, the sleeve and its position. The sheet below is the one our designers check before release. It is a reference: the treating surgeon confirms every protocol against the planning software and the manufacturer's current instructions for use. Nothing you enter here is stored.
| Site | Implant | T-sleeve | Position | Drill | Handle | Milling cutter | Driver |
|---|---|---|---|---|---|---|---|
| — | Straumann BLX Ø4 × 10 mm · RB | Ø5.0 mm T-sleeve 034.053V4 | H4 | medium · 20 mm | +1 mm | 034.415 500 rpm max | H4 |
| Bone class | Drill sequence (800 rpm max; profile drills 300 rpm) |
|---|---|
| Soft · D4 | Ø2.2Ø2.8 |
| Medium · D2–D3 | Ø2.2Ø2.8Ø3.5Ø3.7 · 6 mm |
| Hard · D1 | Ø2.2Ø2.8Ø3.2Ø3.7 |
- For maximum precision use the lowest T-sleeve position possible; the T-sleeve must not touch the tissue. Straumann 707745 §1.2
| Chairside check · if this happens | Depth | Result |
|---|---|---|
| Long drill instead of medium | +4 mm | Osteotomy 4 mm deeper than planned. |
| Short drill instead of medium | −4 mm | Bed 4 mm short: the implant will not seat at the planned depth. |
| +3 mm handle (three dots) instead of +1 (one dot) | −2 mm | Bed 2 mm short. |
| Stopping the driver at H6 instead of H4 | −2 mm | Implant 2 mm higher than planned (shoulder above the plan). |
| Driving on to H2 instead of H4 | +2 mm | Implant 2 mm deeper than planned (more subcrestal). |
5.Quality control before release
instant.guide sits between the clinic and the design lab. The lab form you fill in is the reference the design is checked against before it comes back to you.
- 01Lab form
You record the sites, the sleeve system and your instructions for the case.
- 02Design
The guide is planned by our design team and partner designers.
- 03Protocol check
For each site the designer records the implant, sleeve and position. Drill length, handle, sequence and driver mark are computed and checked against the lab form.
- 04Named sign-off
The check is stored with the case under the designer's name. A site with a blocking issue cannot be returned by our designers.
- 05Release
You receive the guide with its protocol sheet, ready for the surgical tray.
6.Sources
Instrument data and the depth rule are transcribed from the manufacturer's Basic Information documents. Always follow the current instructions for use.
- Straumann® iEXCEL Guided Surgery System Instruments, Basic Information, 707745/en (04/2024): depth control, T-sleeves, handles, drills, matrices §5.1–5.4.
- Drilling protocol Straumann® BLC/TLC and BLX/TLX, 707786/en (09/2023): drill sequences by bone class.
- Straumann iGuide™, Basic Information, 707930 (06/2025): sleeve Ø5.2 mm, drills with stop, P1–P3.
Straumann®, VeloDrill™, TorcFit™, iGuide™ and coDiagnostiX® are trademarks of their owners. instant.guide is an independent service and is not affiliated with or endorsed by Institut Straumann AG.