1. Guide RightImmediate Placement Immediate LoadLinear & Angular Corrections Featuring CROSS SECTION of CASTFABRICATION ofDIAGNOSTIC Guide: straight guide posts ceramic guide sleevesSURGICAL Guide: magnetic offset guide post open guide sleeve COMPARING: GALAXIS & Invivo5 Software EvaluationsAnatomageSMIT 2.2013

2. Fabrication of DIAGNOSTIC GUIDE Using: 3 X 30 mm straight guide posts 3 mm cylindrical ceramic guide sleeve 3. An impression was taken and a cast was madewith the existing deciduous tooth in place#11A cast is made of patient to replace A hole is drilled through the deciduousthe deciduous maxillary left cuspid. tooth with a 3/32 drill. 4. The deciduous tooth was removed fromA ceramic guide sleeve is placedthe cast leaving the previously drilled hole. on the 3 mm guide post.A 3 mm x 30 mm guide post is placed in thehole in the cast. 5. #11Triad Gel was used to capture the cleat on the ceramic guide sleeve andadjacent teeth to fabricate the DIAGNOSTIC guide. It is now ready to besecurely seated in the patient for the cone beam X-ray so that the long axisof the proposed osteotomy can be evaluated. 6. PREview of Pre-op Corrections#11LINEAR CORRECTION1st : 1 mm toward the buccal2nd: 1 mm toward the distalAccomplished by using a 1.5 mm offset guide post rotated 45 in thebending tool block ANGULAR CORRECTION10 toward the distal Cosine is applied to determine correction data.See slide show: Pythagorean Theorem: COSINE Calculations for Guide Right Guides 7. PRE-OPERATIVEGALAXIS Cone Beam ImagesSoftware Calculations 8. Yellow planned axis of guide sleevesGreen: ideal axis of virtual implant in bone.cross sectional viewtangential view #11A better position appears to be a 21 angular correctionThe mesio-distal axis can also betoward the buccal with linear movement of the guide sleeve corrected 10 - 11 toward the distal1.5 mm toward the buccal from the present axis of theaccording to the image.ceramic guide sleeve in the DIAGNOSTIC guide. 9. Magnetic OffsetGuide Post 3.0 X 1.5 offset 10. Preparing for 1st BENDA 1.5 mm offset guide post is placed in the bending tool. The offsetpositioned toward the buccal is rotated in the bending tool block with thedepression mark positioned toward the right. 11. 1st BENDThe stylus is placed over the guide post and bent 20 - 21which will reposition the guide sleeve angleaway from the apex of the adjacent distal tooth. 12. 2nd BENDThe slide support bar is positioned beneath the stylusto maintain the 20 angle of the 1st bend.The 2nd bend will be 10 toward the distalto avoid hitting the root of the distal tooth. 13. Fabrication of SURGICAL GuideIllustrated with cross-sectioned models 14. The DIAGNOSTIC guide sleeve showsthe original planned axis of the DIAGNOSTIC SLEEVE 15. Cast showing the guide removed 16. Straight magnetic guide post in place first. 17. 1.5 mm offset magnetic guide post with 20 bend toward the buccal 18. Facial view of 20 corrected 1.5 mm magnetic offset guide postbent toward the buccal with open guide sleeve. 19. Occlusal / axial view of corrected guide post and sleeve in actual case model. 20. Fabrication of the SURGICAL Guide 21. Triad Gel has been added to capture the cleat on the ceramicguide sleeve & adjacent teeth to fabricate the SURGICAL guide. 22. #10 Evaluation using: Invivo5AnatomageSOFTWARE 23. #10 Virtual implant initial alignmentaxialcross section Invivo5 Anatomagetangential volumetric 24. #10Applying the grid allows you to make more accurate measurementsaxial cross section Invivo5Anatomagetangentialvolumetric 25. Understanding Invivo5 Grid MeasurementsSOFTWARE GRID each square: 5 X 5 mm each side of the square: 5 mm center mark is 2.5 mm tangential 26. #11 21 ANGULAR CORRECTION toward the facial measured with the Invivo5 software angle toolocclusal viewcross sectional view Invivo5 Anatomagetangential viewvolumetric 27. #11ANGULAR CORRECTION: 21 bend toward the distalcross sectional view Invivo5Anatomage 28. #11RETURN TO THE INITIAL ALIGNMENT to make angle change in next planeInvivo5Anatomage tangential view evaluation 29. #11ANGULAR CORRECTION: 10 bend toward the distal tangential view Invivo5Anatomage 30. Magnetic OffsetGuide Post 3.0 X 1.5 offset 31. A 1.5 mm offset guide post is placed in the bending tool. The offset postwhich will be toward the buccal is rotated in the bending tool with thedepression toward the right. 32. The stylus is placed over the guide post and bent 20 which will repositionthe guide sleeve angle away from the apex of the adjacent distal tooth. 33. The slide support bar is positioned beneath the stylus to maintainThe 20 angle of the first bend. The 2nd bend will be 10 toward the distalto avoid hitting the root of the distal tooth. 34. REview of Pre-op Corrections #11 LINEAR CORRECTION 1st : 1 mm toward the buccal 2nd: 1 mm toward the distalAccomplished by:using a 1.5 mm offset post rotated 45 in the bending tool blockANGULAR CORRECTION 10 toward the distalCosine is applied to determine correction data. See slide show:Pythagorean Theorem: COSINE Calculations for Guide Right Guides 35. Immediately placed temporary restoration 36. Guide Right GENERATION II BENDING TOOLSINGLE BEND reviewStep 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 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 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 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.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. 37. Guide Right GENERATION II BENDING TOOL COMPOUND BEND overviewStep 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 2 The 1st bend can be made to the right or left direction.Step 3 The set screw is loosened and the guide post is rotated 90 next flat surface.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 6 The second bend can be made in either direction according to the x-ray.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. 38. Guide RightProducts shown in this case 1 - 3/32 drill 1 - 3 X 30 mm Straight Guide Posts 1 - 3 mm Cylindrical Ceramic Guide Sleeves 1 - 2 mm Guide Post 1 - 3.0 X 1.5 offset Magnetic Offset Guide Post 1 - 3 mm Open Guide Sleeve Generation ll Bending Tool Triad Gel1.800.314.0065 www.deplaque.com 39. A System of Componentsfor the fabrication and correction of diagnostic & surgical guide in two or three dimensions In-office or lab fabrication Evaluate with 2D & 3D imaging Allows linear and angular correction Enables precision implant placement Cost effective1.800.314.0065 www.deplaque.com 40. DPlaqueGuide Right Surgical Guide System fabricate evaluate correct verify placeStart With Precision. Place With Confidence. 1.800.314.0065 www.deplaque.com