Method for realizing an axial trajectory in a surgical drilling process
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 method for realizing an axial trajectory of a cutting process in a dental procedure comprising:
fabricating a first guide with a first hole aligned to the axial trajectory and a second guide with a second hole aligned to the axial trajectory by a computer-controlled process, wherein the first guide and the second guide are integrated into a single device for concurrent use and wherein the first guide is vertically spaced apart from the second guide along the axial trajectory to create a space between the first guide and the second guide for off axis insertion of a cutting tool;
guiding a first cutting tool with a the first guide at a first point along the axial trajectory when the first guide is positioned for use at a surgical site while permitting movement of the first cutting tool away from the axial trajectory at one or more other points along the axial trajectory; and
guiding a second cutting tool with the second guide at a second point along the axial trajectory.
2. The method of claim 1 wherein the second point lies on the axial trajectory where the axial trajectory intersects a target surface.
3. The method of claim 1 wherein the first cutting tool is the same as the second cutting tool.
4. The method of claim 1 wherein the first cutting tool has a larger diameter than the second cutting tool.
5. The method of claim 1 further comprising guiding one of a plurality of progressively larger diameter drills with the second guide.
6. The method of claim 1 further comprising providing a plurality of guides with a respective plurality of larger holes for at least one of the first point and the second point along the axial trajectory.
7. The method of claim 1 wherein the surgical site is a dental implant site.
8. The method of claim 1 wherein at least one of the first cutting tool and the second cutting tool includes one or more of a drill, a surgical drill, a rotary tool, and a surgical hand tool.
9. The method of claim 1 further comprising supporting the single device with a support including one or more of a bone support, a tooth support, and a soft tissue support.
10. The method of claim 1 wherein at least one of the first cutting tool and the second cutting tool includes a drill with a drill stop.
11. The method of claim 1 wherein the single device includes a window for visual access to the surgical site when placed for use at the surgical site.
12. The method of claim 1 wherein the single device includes a window for physical access to the surgical site when placed for use at the surgical site.
13. The method of claim 1 wherein the first guide includes one or more visible alignment marks to assist a user in centering the first cutting tool on the axial trajectory.
14. The method of claim 1 wherein the second guide includes one or more visible alignment marks to assist a user in centering the second cutting tool on the axial trajectory.
15. The method of claim 1 wherein at least one of the first guide and the second guide is formed of a cuttable material.