Guided surgery – NobelGuide

Complete treatment concept for diagnostics, prosthetic-driven treatment planning and guided implant surgery

NobelGuide surgical templates – for edentulous jaws, for partially edentulous jaws and for pilot drilling.

Predictable implant placement

Planning of a partially edentulous case with the user-friendly NobelClinician Software. Clinical case courtesy of Dr. Peter Wöhrle.

NobelGuide is a complete treatment concept for diagnostics, treatment planning and guided implant surgery – from a single missing tooth to an edentulous jaw. It helps you diagnose, plan the treatment and place your implants based on restorative needs and surgical requirements.

Why NobelGuide?

Experience powerful diagnostics and treatment planning

Avoid surprises during the treatment process through careful diagnosis and treatment planning with the user-friendly NobelClinician Software.

Discover the NobelClinician Software

Predictable implant placement

Make your treatment plan a clinical reality with customized surgical templates. You can choose between guided pilot drilling (available for partially edentulous cases) and fully guided implant insertion.

Optimize the restorative outcome

Offer high esthetics and function to your patients with a comprehensive range of prosthetic solutions.

Increase patient satisfaction

Achieve the best possible outcome with as little discomfort for the patient as possible.

Simplify the treatment with our surgical protocols

Our surgery kits have a step-by-step drilling protocol and consistently color-coded components. This simplifies site preparation and ensures a predictable outcome. Dedicated guided surgery kits are available for our major implant systems.1

Workflow – partially edentulous

Two NobelGuide treatment workflows

Every case is different. That's why NobelGuide offers two treatment workflows — with and without the use of a radiographic guide. If you're treating a partially edentulous patient, then you can save time by skipping the radiographic guide and, with that, avoid an additional patient visit.

1 Clinical diagnostics and treatment acceptance

Examine your patient and diagnose critical anatomical structures with the NobelClinician Software. Take a definitive impression and get treatment acceptance from your patient before making further investments.

2 Digitizing prosthetic information

Collaborate with your lab technician and capture soft tissue information using the NobelProcera 2G System's precise model scan. You have the option of including the diagnostic tooth setup.

Discover the NobelProcera 2G System

3 Treatment planning

Visualize the patient’s (CB)CT data together with the intra-oral situation including soft tissue and the diagnostic tooth setup. This is possible thanks to NobelClinician’s SmartFusion technology.

Discover the NobelClinician Software

4 Treatment communication

Collaborate effectively with your treatment partners. Help your patient understand the treatment plan by explaining it in a clear and visual way with the NobelClinician Communicator iPad® app.

5 Guided surgery

Choose guided drilling and implant insertion using a customized surgical template based on your treatment plan. Select either guided pilot drilling or fully guided implant insertion.

6 Restoration

Choose immediate loading and use the option to fabricate a provisional prosthetic solution before surgery. Alternatively, opt for early or delayed loading depending on the clinical indication.

Workflow – edentulous

Two NobelGuide treatment workflows

Every case is different. That's why NobelGuide offers two treatment workflows — with and without the use of a radiographic guide. If you're treating an edentulous patient, choose the radiographic guide with a double-scan protocol.

 

1 Clinical diagnostics

Examine the patient and take an impression for study models and, later on, the master cast.

2 Diagnostic tooth setup

Fabricate and clinically validate the diagnostic tooth setup.

3 Fabrication of radiographic guide

Transform the tooth setup into a radiographic guide. This'll be your prosthetic reference during your planning.

4 Digitization with (CB)CT scan

Make a (CB)CT scan of your patient and the radiographic guide by following the double-scan protocol.

5 3D diagnostics and treatment planning

Define implant position(s) from a clinical, anatomical and prosthetic perspective by combining the tooth setup with the patient anatomy.

6 Treatment communication

Collaborate effectively with your treatment partners. Help your patient understand the treatment plan by explaining it in a clear and visual way with the NobelClinician Communicator iPad® app.

7 Guided surgery

Go for fully guided drilling and implant insertion using a customized surgical template based on your treatment plan.

8 Restoration

Choose immediate loading and use the option to fabricate a provisional prosthetic solution before surgery. Alternatively, opt for early or delayed loading depending on the clinical indication.

Cases

Dr. Giovanni Polizzi, Italy – immediately loaded full-arch rehabilitation using NobelGuide

Situation: Male patient with edentulous upper jaw.

Solution: Placement of NobelActive and NobelSpeedy implants immediately after tooth extraction, following the NobelGuide treatment concept with Immediate Function.

Dr. Andrew Dawood, UK – full-arch restoration

Situation: Male patient, 48 years old, presented with several painful and highly compromised teeth in both jaws.

Solution: Full maxillary reconstruction with NobelActive implants in combination with a precision-milled fixed NobelProcera Implant Bridge Titanium. In the mandible, replacement of teeth with NobelProcera Crowns Zirconia cemented to individualized NobelProcera Abutments Titanium.

View case (PDF, 872 kB)

Lower anterior tooth replacement

Case courtesy of Prof. Alessandro Pozzi, Italy

Situation: Male patient, 66 years old. Vertical tooth drift of the four lower incisors, class II dento-skeletal malocclusion, chronic periodontitis, tooth mobility and dental caries.

Solution: NobelParallel Conical Connection 3.75 x 13 mm. NobelGuide pilot drill surgical template in fresh extraction socket. Flapless surgery. Immediate provisionalization. NobelProcera Zirconia Implant Bridge

View case (PDF, 799 kB)

Dr. Alessandro Pozzi, Italy – All-on-4® treatment concept in the maxilla and the mandible

Situation: Female patient, 62 years old, edentulous maxillary and mandibular jaw.

Solution: All-on-4® treatment concept using NobelReplace Conical Connection implants with guided surgery. Final restoration with NobelProcera Hader Bar in the maxilla and NobelProcera Zirconia Implant Bridge in the mandible.

View case (PDF, 576 kB)

Dr. Lesley A. David, Canada – immediately loaded full-arch rehabilitation using NobelGuide

Situation: 65-year-old male, edentulous in the upper jaw. The dentures were made six years prior.

Solution: In the maxilla, five Brånemark System Mk III Groovy implants and one NobelSpeedy Shorty implant were placed. As a final restoration, a NobelProcera Implant Bridge Titanium with acrylic teeth was chosen.

View case (PDF, 228 kB)

Dr. Christopher B. Marchack, USA – Mandibular rehabilitation with implant-supported overdenture

Situation: Female patient, 92 years old, bad fitting prosthesis with decreased stability especially while eating.

Solution: Extraction of the remaining teeth. A conventional denture was advised in the maxilla and a placement of two NobelReplace Tapered implants with Locator Abutments and a new implant-retained overdenture in the mandible.

View case (PDF, 567 kB)

Dr. Paulo Maló, Portugal – All-on-4® treatment concept with NobelGuide

Situation: Totally edentulous female patient in her early 50s, rehabilitated with upper and lower removable dentures over 15 years prior.

Solution:  Fixed implant-supported bimaxillary rehabilitation using the All-on-4® treatment concept. The NobelGuide protocol (flapless) is followed in the maxilla and the conventional flap technique with the All-on-4® Guide is followed in the mandible. As a final prosthesis, fixed precision-milled NobelProcera Implant Bridges were chosen for both the maxilla and the mandible.

View case (PDF, 184 kB)

Dr. Andrew Dawood, UK – full-arch maxilla case with guided surgery

Situation: Male patient, 65 years old, edentulous maxilla, with request for a fixed restoration.

Solution: Full-arch restoration with six NobelReplace Conical Connection implants and a NobelProcera Implant Bridge.

View case (PDF, 2 MB)

Dr. Marwan Daas, Dr. Karim Dada and M. Jean Marc Etienne, France - anterior restoration

Situation: Ectodermal dysplasia cross-linked with multiple congenitally absent teeth leading to typical occlusal disorders. These agenesia are associated with severe alveolar bone atrophy.

Solution: Placement of six NobelReplace CC NP implants using NobelClinician software and guided surgery. Six NobelProcera ASC Abutments serve as screw-retained restorations.

View case (PDF, 391 kB)

Dr. Roland Glauser, Switzerland – Immediate placement and immediate provisionalization

Situation: Missing maxillary first premolar, healed site 

Solution: Immediate implant placement using a NobelParallel CC RP 4.3 implant and NobelGuide Pilot Drill Surgical Template. Immediate provisionalization on the day of surgery.

Immediate placement and immediate provisionalization

Case courtesy of Dr. Roland Glauser, Switzerland

Situation: Missing maxillary first premolar, healed site 

Solution: Immediate implant placement using a NobelParallel CC RP 4.3 implant and NobelGuide Pilot Drill Surgical Template. Immediate provisionalization on the day of surgery.

Testimonials

Prof. Alessandro Pozzi from Italy explains why he enjoys working with NobelGuide for the NobelReplace Conical Connection implant.

Prof. Alessandro Pozzi, Italy

"The NobelGuide System merges the well-proven predictability of the computer-assisted and template-guided implant placement with the outstanding biomechanical and biological features of the NobelReplace Conical Connection."

Watch video

Dr. Chris Marchack from the USA explains why he likes the evolution that NobelGuide has created.

Dr. Chris Marchack, USA

"I have been involved with NobelGuide and NobelClinician since the very beginning in 2002. The evolution it has created, with the workflow today, is spectacular."

Watch video

Dr. Gary Orentlicher from the USA explains why he likes the NobelGuide instrument tray.

Dr. Gary Orentlicher, USA

"The NobelGuide instrument tray is by far the most exquisitely designed instrument tray on the market. It is easy, simple, intuitive and excellent."

Watch video

Dr. Lambert Stumpel from the USA explains why he likes NobelGuide.

Dr. Lambert Stumpel, USA

"I started with dental implants in 1982, and my focus was restorative. With NobelGuide, I suddenly have a different career as it allows me to place implants."

Watch video

Literature

 

Already a Nobel Biocare customer?
Log in to your personal MyNobel portal to access additional literature, handling instructions and guidelines in My Library.

NobelActive, NobelReplace Conical Connection (incl. PMC), Replace Select Tapered (incl. PMC), NobelReplace Tapered,, NobelReplace Platform Shift, NobelReplace/Replace Select Straight, NobelSpeedy Replace, Brånemark System and NobelSpeedy Groovy.