TRANSCRIPT:

Alright guys, so in this video, I'm going to show you how to get started with making your first initial pilot drill. So the first thing I do is evaluate the bone. I'm looking at it. Buccal, Lingual width and I want to take my two fingers here and just kind of pinch, pinch the area. Just buccal lingually just to see exactly what I'm working with sometimes thicker tissue throws you off a little bit so you really got to make sure that you're comfortable knowing where the bone is. So that's why I recommended, that's why I'm recommending flapping for your first 50 cases or so.

But in any case, once you find the boundaries once you see where the Buccal boundary is and the lingual boundary is, you can go ahead and start with your first drill for bone. That's a little bit. Fatter, ridges that are a little bit fatter. I like to use this round pilot drill so I just make a little dimple with this round. This round burr. And I feel like it's it's really nice because it'll basically set it up for my future drills. It helps me, it helps me. So that my future drills, don't slip out of the way.

Sometimes when you're using them, when you go straight to using the skinny, Lance pilot drill your, your pilot drill kind of slips off the Ridge. And so using that round bur is really nice, just to get it started. So, if you're all right, so now you can see that. I'm using my Lance pilot drill. It's the pointy pilot drill. I put it right in the middle of the bone. So right buccal lingually right in the middle and between those two teeth, right in the Middle, I want to make sure I’m not angled it distally or mesially. I want to make sure that the angle that the, the pathway follows the long axis of the teeth.

I look at that from the buccal view and I also want to make sure I'm looking at it from the front view. So I want to look at it from the front and make sure I'm not angle too Buccally or too lingually. I actually want that, that drill to be coming up. Almost through, like the central groove, and if you, and in this case, I actually prefer to error a little bit on the side of a little bit to Lingual. So instead of having it exit exactly the central groove, I might have it, exit the midway between the central groove in the lingual cusp. So that way, I'm sure that I'm not going to come out the buccal. You can always correct things with the angled abutment, but I like to do a screw retained abutments or screw retained crowns, sorry.

So anyway, I'm going to go ahead and position the pilot drill right in the middle. And I put a good pressure on it just to make sure that it's like kind of like stuck into into the bone a little bit so it doesn't move on me. And I start running the drill at nine hundred RPM. I use an up-and-down motion. Until I get to that third marking. I'm just going up and down, slowly. No rush here. Just trying to make sure that I I keep that that same pathway that I'm following, the long axis of those teeth. And I'm not going to be hitting any of those roots. And so after I do that, I'm going to inspect it and you want to look at it from the occlusal view, and make sure you're where you want to be.

You can still make changes because you haven't drilled too much yet. I take the drill off of the handpiece and I put it into that hole and I just compare. Does that fall the long axis of the teeth? And then I look at it from the front view. Does that is that follow buccal lingually, where I wanted to be coming out the central groove or maybe a little bit lingual to that? All right, so you can see that it's kind of slightly towards the Buccal a little bit slightly leading towards the buccal. I'm still okay with that. But if possible, I can straighten it up, just a little bit. When you look at it from the side view. I guess, at what, at what I'm looking at is a long axis of those crowns. You know you see that canine if you look real carefully that Canine, looks like that root kind of like goes towards our implant site so that's why I want to make sure to take an x-ray in a little bit, but that's the first step.

So I'll show you now, how to move on to the next step where you start your twist drills.

Lesson Summary

In this video, the presenter explains how to get started with making the first initial pilot drill for implants. The first step is to evaluate the bone by examining the buccal and lingual width and using two fingers to pinch the area. This helps determine the thickness of the tissue and locate the boundaries of the bone. Flapping is recommended for the first 50 cases to ensure comfort and accuracy.

Once the boundaries are identified, the presenter suggests using a round pilot drill to create a dimple in the bone. This round burr helps set up the future drills and prevents slipping. The next step is to use a Lance pilot drill placed in the middle of the bone, between the teeth, ensuring it follows the long axis of the teeth. It's important to check the angle from both the buccal and front view, aiming for the drill to come up near the central groove or slightly lingual.

The presenter prefers a slightly lingual exit point to avoid coming out the buccal and to allow for screw-retained abutments or crowns. The drill is inserted with pressure and run at 900 RPM, using an up-and-down motion until reaching the third marking. It's important to inspect the drill placement from the occlusal and front view and make any necessary adjustments before proceeding.

Note: The presenter mentions evaluating the long axis of the teeth and suggests taking an x-ray to confirm the implant site location.

The video ends with a preview of the next step, which involves using twist drills.