13 mandibular implant case correcting divergent angled diagnostic guide sleeves
DESCRIPTION
The Guide Right Surgical Guide System is a system of components for the fabrication and correction of diagnostic and surgical dental implant guides in 1 or 2 dimensions.TRANSCRIPT
CALHO 2.2013
Featuring:
Magnetic Offset Guide Posts
Open Guide Sleeves
Diagnostic Guide Sleeves [to increase diameter of guide sleeve]
GALAXIS Cone Beam Software Evaluation
Generation ll ▪ Guide Post Bending Tool
Correcting Divergent Angled Diagnostic Guide Sleeves
Mandibular Posterior Case
Magnetic Guide Posts
Straight
3.0 mm od
Offset
3.0 od X 0.5 mm os
3.0 od X 1.0 mm os
3.0 od X 1.5 mm os
3.0 od X 2.0 mm os
3.0 od X 2.5 mm os
3.0 od X 3.0 mm os
Magnetic Guide Post & Open Guide Sleeve Set
3.0 mm Open Guide Sleeve
3.3 mm Open Guide Sleeve
3.7 mm Open Guide Sleeve
4.0 mm Open Guide Sleeve
3.0 mm Straight Magnetic Guide Posts
3.0 mm Offset Magnetic Guide Post
2.0 mm Pilot Drills (to start the osteotomy)
Other Drill Sizes Available on Request
Fabrication of DIAGNOSTIC Guide
Holes are drilled deliberately accentuating inaccurately initially
planned long axis of the implant positions with a 3/32” drill.
Straight 3 mm guide posts are placed in the questionable
holes drilled in the positions of #19 and #20.
View of 3 mm straight guide posts in place showing the divergent angles.
3 mm guide sleeves are positioned on the guide post with the cleat facing the
lingual. The cast is lubricated & Triad® Gel added to the guide sleeves
capturing the cleats including lingual & incisal surfaces of several of the
adjacent teeth. After curing the DIAGNOSTIC guide & securely seating
it in the patient, a cone beam X-ray is taken.
PRE-OPERATIVE Evaluation
GALAXIS Cone Beam
Preview of Pre-op Corrections
#20
7° Bend rotated toward the lingual
ANGULAR CORRECTIONS
#19
9° Bend toward the buccal
Cosine is applied to determine correction data.
* see next 3 slide
Pythagorean Theorem
COSINE Calculations for Guide Right™ Guides
The cosine of 45°
is recommended for Guide Right corrections
BECAUSE
rotating the offset guide post half way
between 2 adjacent planes (90° apart) is 45°.
DéPlaque
Correction based on the calculations
from the Pythagorean Theorem
To move the position of the guide sleeve 1.4 mm both mesially & buccally:
► use a 3 mm X 1.5 mm offset guide post
► and direct the offset 45º facially and buccally.
Cosine: 1.5 mm X 0.71 = 1.06 mm
see slideshow > Use of Pythagorean Theorem in 9 Single Implant Case
A= cosine of 45º X 1.5
(0.707 X 1.5 mm = 1.06 mm
Panoramic view #19 highlighted
The mandibular nerve is drawn in with the GALAXIS software.
GALAXIS
tangential cross sectional
# 19 viewed with GALAXIS software
GALAXIS
tangential
B L
9 °
cross sectional
# 19 evaluated in GALAXIS software and 9° corrected angle drawn in.
GALAXIS
#19 tangential
B L
9 °
#19 cross sectional
A cone beam X-ray is taken with the DIAGNOSIC guide in place.
The images are evaluated with the software.
The cross sectional image on the right will be corrected 9°
rotated toward the buccal surface.
GALAXIS
Panoramic view #20 highlighted
GALAXIS
#20 tangential #20 cross sectional
B L
9°
The image of the mesial implant will be rotated 7° toward the lingual
GALAXIS
#20 tangential #20 cross sectional
B L
7°
The image of the mesial implant will be rotated 7 ° toward the lingual
#20 tangential #20 cross sectional GALAXIS
POST-OPERATIVE verification
GALAXIS Cone Beam Images
9° bend
# 19
7° bend rotated toward the buccal
# 20
7°
Angle corrected 3 mm guide posts in holes
Buccal view
Angle corrected 3 mm guide posts in holes
Buccal view
3 mm guide posts with (3 x 2 mm id) diagnostic guide sleeves (1 cleat)
serving to increase the diameter of the 3 mm guide sleeve
for use with 4 mm open guide sleeve
3 mm guide post with 2 mm id diagnostic guide sleeve (1 cleat)
serving to increase the diameter of the 3 mm guide sleeve
for use with 4mm open guide sleeve
occlusal view
3 mm diagnostic guide sleeves - 3 mm magnetic guide posts
with 4 mm open guide sleeves added
Triad® Gel added & cured to form the SURGICAL guide
Panoramic view # 19
Post-op cone beam shows virtual implant
superimposed over placed implant
and aligned with the open guide sleeve.
GALAXIS
tangential view cross sectional view
#19 Post-Operative Cone Beam
GALAXIS
Step 2 Locate 3/32” hole in the center of the v-cut and place the bottom half of the
guide post into the hole. Tighten the set screw.
Step 1 Place bending tool plate on a secure flat surface with the degree increments
at the top & the stainless steel bar with the v-cut at the bottom.
Step 3 Locate the hole in the bottom of the stylus that you will use that will fit over
the top half of the guide post (3.0 mm, 4.0 mm or 5.0 mm).
Step 5 Using the stylus as a lever, bend the guide post to the degree of angle of
correction. You may need to ease the point of the stylus beyond the
point of the desired degree.
Step 6 Loosen screw and remove guide post and the stylus to find the guide post
bent to the desired angle.
Step 4 Fit the stylus over the guide post securely with the point directed at
zero degrees and the bottom of the stylus in contact with the V block.
Guide Right™
GENERATION II ▪ GUIDE POST BENDING TOOL
SINGLE BEND review
COMPOUND BEND overview
Step 1 Position a straight or offset guide post in the bending plate, tightening the set
screw against one of the flat surfaces on the lower half of the guide post.
Step 4 The 2nd bend in the second plane is made after rotating the guide post up away
from the surface of the bending plate to register the stylus point back at 0 degrees.
Step 5 Slide the stylus support bar down under the stylus until it supports the stylus.
Tighten the side screws before making the second bend.
Step 7 Remove the stylus and place the guide post back in the cast with the
appropriate side indicated by a mark facing the buccal or lingual surface.
Be sure the post is in the correct position.
If the post needs to be corrected by a linear movement an offset guide post can be used.
Off sets available in the 3 mm guide post: 0.5,1,1.5, 2.0 ,or 3.0 mm.
Step 3 The set screw is loosened and the guide post is rotated 90 ° next flat surface.
Step 2 The 1st bend can be made to the right or left direction.
Step 6 The second bend can be made in either direction according to the x-ray.
Guide Right™
GENERATION II ▪ Guide Post BENDING TOOL
Guide Right™
Products used in this presentation
1.800.314.0065 • www.deplaque.com
1 - 3/32” drill
2 - 3 mm Guide Post
2 - 3 mm Guide Sleeve
2 - 3 mm x 2 mm id Diagnostic Guide Sleeve [1 cleat]
2 - 4.0 mm Open Guide Sleeve (short)
1 - 2.0 mm x 5.0 mm Pilot Drill
1 - 2.0 mm x 10.0 mm Pilot Drill
Triad® Gel
Generation ll ▪ Guide Post Bending Tool
In-office or lab fabrication Evaluate with 2D & 3D imaging Allows linear and angular correction Enables precision implant placement Cost effective
A System of Components
for the fabrication and correction of diagnostic & surgical guides
in one or two dimensions
Guide Right™ Surgical Guide System
Start With Precision. Place With Confidence.™
1.800.314.0065 • www.deplaque.com
fabricate ▪ evaluate ▪ correct ▪ verify ▪ place