CADCAM Pilot Only Surgical Guide – Missing Lateral

The Implant Concierge provides different types of surgical guides.  For different reasons, a Pilot only guide is requested by dentists.  Some of those reasons could be due to inter-dental space concerns, instrumentation concerns or due to dentists preferences.  The case below, submitted by periodontist Takanari Miyamoto in Omaha, NE, is a great example of a tight inter-dental space.  This case also illustrates the requirements and ease of use of using Implant Concierge Virtual Treatment Plan coordinator to order, track and plan the ideal case when time is short and patient demands are high!  Please enjoy this case and thank you Dr. Miyamoto for allowing us to use your case to showcase the Implant Concierge.  

Pilot Guide for tight Inter-dental space

Dr. Miyamoto

Takanari Miyamoto,


Diplomates of the American Board of Periodontics 

La Vista, NE 68128



Patient referred for implant consultation to replace missing lateral incisor

Patient Profile

68 year old male with no significant health history with congenital missing tooth number 7.

Doctor quote

“I truly enjoyed the service of Implant Concierge! It took only 5 days from the day I ordered the Implant Concierge guide to the time I received in my office. Guide fits very well and the cost was only $225. It was a wonderful experience. – Takanari Miyamoto, DDS PhD CAGS MSD PC

lo 007[1] Pre OP Photo. Congenitally missing tooth 7





Sagital view of DENTSPLY 3.5 x 11mm


Implant #7 (DENTSPLY AstraTech 3.5 x 11mm) virtually placed by Implant Concierge 3D Case Coordinator and then placement was finalize during brief online meeting with Dr. Miyamoto.  The image is very powerful due to the ability to overlay the patient’s soft tissue onto the CBCT dicom scan.  This allows us to place the implant in the ideal restorative B/L, M/D and vertical position to ensure a beautiful restoration. 



Picture Miyamoto

Splitting the upright

Splitting the uprights!

Coronal slice with measurements showing the space between the implant edge and the adjacent roots of #8 and #6.  Having the ability to plan with Dr. Miyomoto during an online session, we were able to quickly position the implant as well as determine which type of surgical sleeve we could utilize.  In this case, a Facilitate compatible guide was not an option due to the tight inter-dental space.





Here is another stunning image of the virtual surgery with Dr. Miyomoto.  You can see the DENSPLY Astra 3.5mm x 11 mm implant and the master sleeve in the CAD 3D model.




Implant Concierge CAD/CAM Pilot Surgical Guide in surgery.           surgical guide pic 2







Post Op x-ray showing the precision and accuracy of the 3.3mm x 11mm implant.  Not only did Dr. Miyamoto succesfully split the uprights in a challenging surgical space, but he also maximized the surface to bone ratio with the 11mm implant as it snuggles up to the base of the nasal cavity. 




How did Implant Concierge services make a difference in this case?

This patient wanted to schedule the implant surgery right away. I had a confidence that we can get a guide on time because I knew that IC has their own scanner in San Antonio and they can do overnight shipping. IC guide is simple to use and easy to order. “

Thank you Dr. Miyamoto for this great case and congratulations on a successful surgery!  To learn more about the Implant Concierge and our flat rate prices surgical guides, please visit us at or call us at 866-977-2228 to schedule a demo!