Editor's note: You can see Part 1 of this two-part series from Dr. Doug Smail and CDOCS in its entirety by clicking here.
Video transcript
"Now in this case, you can see that we're doing tooth #19, and we did all of our checks in the beginning. We planned a 9-mm implant. And then when we got to the surgery day, we still couldn't get it completely open enough to get the drill in. And you can tell from the plan, everything looks fine. But again, when we went to put the key in with the drill for the Astra EV system, it wouldn't fit all the way. And you can see, and the key itself isn't down all the way.
"So what did I do? Well, remember, that's the 9-11 drill. So I switched immediately to the 6-8 drill, knowing that it was going to drill 1 mm less than what I needed. OK, so once I put the 6-8 drill in with the sleeve, it fit all the way down. As you can see in the picture, the key went all the way in and we could get the drill straight.
"So what did that mean? I had to drill each drill separately. So I did the 6-8, knowing that it only went down to eight, had to drill it to a nine, and then put the next drill on the next size up and on and on, step by step, all the way through. Now we were able to get through the case pretty well with no problems.
"Now, here's another tip just in case that didn't work. So if that doesn't work, what you've got to do then is you can use the initial burr as you see here. That initiator is a whole lot shorter than the six to eight drill. And you can use that to score the alveolar crest. If you had to do the rest freehand, but at least now you have a mark that you can easily see to do that. If you take the guide off and you pull the flap back, you can see that mark there. So again, we were able to get the case completed with the six to eight drill going back and forth. It took a little extra time, but it worked out fine."
