Yes I have reviewed the data and it seems like bone density is really high.

I am worried because the guide may not fit as ti has been such a long time since printed (on our record it says it is from 11/21/2018.

Please check the fit first prior to surgery and also as it was still soaked inside the saline it may have gone bad. It would be much better if refabricated to be honest.

For the implants, I would recommend 800 rpm for all osteotomy drills with cold saline irrigation. Also it would be better if you go for 1 size wider diameter drilling (same as fixture diameter)

You can also use in-bone anchor pin right after point drill on #19 and start for #18 implant.