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One of the most common questions in guided surgery today is: "Should I use metal sleeves or go sleeveless?"
While metal sleeves have been the industry standard for years, advancements in 3D printing resins and drill kits have made sleeveless (or "keyless") guides increasingly popular. Here is a technical breakdown to help you decide.
1. Traditional Metal Sleeves
These guides use a titanium or steel cylinder embedded in the resin to guide the drill.
* Pros: Compatible with almost all older surgical kits; provides a hard stop feel that some clinicians prefer.
* Cons: Heat generation is a major risk if irrigation is blocked by the metal. There is also a risk of the sleeve detaching if the offset is not perfectly calibrated during printing.
2. Sleeveless (Keyless) Guides
In this design, the guide channel is printed directly from the resin, sized perfectly for the drill or spoon key.
* Pros:
* Better Cooling: Irrigation can flow freely around the drill, reducing necrosis risk.
* Higher Accuracy: Eliminating the gap between the sleeve and resin reduces tolerance stacking errors.
* Smaller Profile: Requires less vertical opening (interocclusal space), making it ideal for posterior sites.
* Cons: Requires a compatible surgical kit and a high-precision 3D printer (to prevent resin abrasion).
Conclusion
If you have limited mouth opening or want maximum irrigation, sleeveless is often the better choice. For generic kits, metal sleeves remain a reliable workhorse. We design for both.
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