SURGICAL GUIDES
A drill guide uses a hole in a layer to guide a drill along an axial trajectory while permitting off-axis excursions of the drill during use. A number of such drill guides at varying heights from a target surface may be used sequentially or concurrently to enforce the axial trajectory in three dimensions during a surgical operation. A drill guide may include a hole in a layer that establishes a single point along the axial trajectory, or the drill guide may include multiple layers in a single device to establish two or more points along the trajectory while allowing off-axis insertion of a drill into the guide. The drill guide may be cuttable to accommodate intraoperative changes to the axial trajectory. In embodiments, a window or the like may be provided to permit a surgeon to view drill depth, drill orientation, the surgical site and the like during a procedure.
1 . A device comprising:
a surgical guide for a dental procedure, the surgical guide including a first hole in a first layer, the first hole positioned to align a tool to an axial trajectory at a first point along the axial trajectory and the surgical guide including a second hole in a second layer, the second layer vertically spaced apart from the first layer along the axial trajectory and the second hole positioned to align the tool to the axial trajectory at a second point along the axial trajectory; and
a support to secure the surgical guide in relation to a location where the axial trajectory meets a target surface of a surgical site.
2 . The device of claim 1 wherein the target surface includes one or more of soft tissue and bone.
3 . (canceled)
4 . The device of claim 1 wherein the surgical site includes a dental implant site.
5 - 6 . (canceled)
7 . The device of claim 1 wherein the first hole and the second hole are shaped and sized to align an object to the axial trajectory including one or more of a drill, a surgical drill, a rotary tool, and a surgical hand tool.
8 . The device of claim 1 wherein the support includes a surface formed to dentition around the surgical site, thereby providing tooth support for the surgical guide.
9 . The device of claim 8 wherein the surface is formed to a full arch containing the surgical site.
10 . The device of claim 1 wherein the support includes a surface formed to bone around the surgical site, thereby providing bone support for the surgical guide.
11 . The device of claim 10 wherein the support includes one or more bone attachment points for securing the device to a jawbone.
12 . The device of claim 1 wherein the support includes a surface formed to at least one of gingival and mucosa around the surgical site, thereby providing soft tissue support for the surgical guide.
13 - 14 . (canceled)
15 . The device of claim 1 wherein the first layer contacts the target surface in an area surrounding the first hole when the device is placed for use at the surgical site.
16 . The device of claim 1 wherein the second layer is spaced apart from the target surface in an area surrounding the second hole when the device is placed for use at the surgical site.
17 . The device of claim 16 wherein the second hole has a diameter larger than the first hole.
18 . The device of claim 1 further comprising a space between the first layer and the second layer that permits an insertion of the tool off-axis from the axial trajectory.
19 . The device of claim 1 wherein at least one of the first layer and the second layer includes one or more visible alignment marks to assist a user in locating a center of the first hole.
20 - 22 . (canceled)
23 . The device of claim 1 further comprising a window for at least one of visual inspection of the target surface and physical access to the target surface while the surgical guide is in use.
24 . (canceled)
25 . The device of claim 1 wherein the device is fabricated from a cuttable material.
26 . (canceled)
27 . The device of claim 1 further comprising a plurality of holes in each of the first layer and the second layer for a plurality of axial trajectories.
28 . The device of claim 1 further comprising a plurality of devices each including a third hole positioned to align one of a number of progressively larger diameter drills to the first point on the axial trajectory.
29 . (canceled)
30 . The device of claim 1 wherein at least one of the first hole and the second hole has a sleeve that protects the surgical guide against a cutting edge of the tool.
31 . (canceled)
32 . The device of claim 1 wherein the surgical guide and the support are formed of a clear material.
33 - 177 . (canceled)
178 . The device of claim 1 wherein the axial trajectory is determined using implant planning software.