UNI-GuideThe no-nonsense Guide

Dr Luc VrielinckOMFS

Ziekenhuis Oost LimburgGenk, Belgium

Overview

• Introduction• UNI-Guide / clinical examples• Conclusion

What is UNI-Guide?

Cylinder½ cilinder

Planning software

BoneTeethCombinedMucosa

PLAN SUPPORT GUIDING MECHANISM

Which guide to choose?

• Multifactorial decision:– Desired accuracy– Surgical necessity– Production turnovercycle– Experience of the surgeon– Cost € and – No guide is also an option !

Salient points

• Bone supported• One-step drill guide• All implant platforms and implant types• Open system: software independent

provided that the SW allows STL export

User customisable

• 1-2-3 or more supporting points• Guiding groove variability (1.5 ↔ 5 mm)• Allows peroperative surgical modification• Allows ancillary procedures

Overview

• Introduction• UNI-Guide / clinical examples• Conclusion

Lower jaw 4 implantsUpper jaw 4 implants

UNI-Guide Case 3

14071948VJ

Treatment plan• Total extraction in UJ and LJ and healing• Removable dentures (UJ and LJ)• Lower jaw:

– After healing: 4 implants lower jaw with UNI-Guide– Delayed loading– Fixed removable prosthesis in lower jaw

• Upper jaw– 4 implants with UNI-Guide– Delayed loading– Fixed removable prosthesis in upper jaw

Intake

11/05/2009: Intake

Treatment plan

Implant Planning

Residual extraction alveoli

Implant placement (Replace Select)

Drilling according to the markings on the UNI-Guide

Implant placement (Replace Select)

Implant placement (Replace Select)

Implant placement

Upper jaw: All-on-6Lower jaw: 6 parallel implants

UNI-Guide Case 2

29121965DJ

Intake

Treatment plan

Upper jaw: All-on-6 Lower jaw: 6 parallel implants

Use of bone supported saddles

Implant placement in upper jaw (AO6)

Easy positioning of the UNI-Guide with 3

skeletal support points

Postoperative orthopantomogram

Pre/post matching upper jaw: frontal view

Peroperative modification of the implant planThe surgeon elected to change position of implant 23 toward 22

Because of local anatomical reasons, remaining implants were placed according to the planning

Pre/post matching: upper jaw: Occlusal view

Peroperative modification of the implant planThe surgeon elected to change position of implant 23 toward 22

Because of local anatomical reasons, remaining implants were placed according to the planning

Peroperative modification of the implant planThe surgeon elected to change position of implant 23 toward 22

Because of local anatomical reasons, remaining implants were placed according to the planning

Pre/post matching: upper jaw: cranial view

Peroperative modification of the implant planThe surgeon elected to change position of implant 23 toward 22

Because of local anatomical reasons, remaining implants were placed according to the planning

Pre/post matching: upper jaw: sagitaal left and right view

Peroperative modification of the implant planThe surgeon elected to change position of implant 23 toward 22

Because of local anatomical reasons, remaining implants were placed according to the planning

Pre/post matching: upper jaw: Posterior view

Pre/post matching: lower jaw: frontal view

Pre/post matching: lower jaw: apical view

Pre/post matching: lower jaw: posterior view

Pre/post matching: lower jaw: left lateral view

End result

46 44 42 32 34 36

15 12 11 21 22 25

2 implants maxilla frontal

UNI-Guide Case 4

23091958NH

Intake

X X

12 11 21 22

Conebeam scan examination

Treatment plan

X X

An implant was planned on location 21 instead of 22Because of bone volume (see previous slide)

Implant Planning

Bone-planned, teeth-supported UNI-Guide

UNI-Guide

Implant placement with UNI-Guide

Preoperative check of the drill guide

Implant placement with UNI-Guide

Preparation of mucoperiostal flap

mplant placement with UNI-Guide

2 mm twist drilling

Implant placement with UNI-Guide

3 mm twist drilling

The drill can be cooled directly

Implant placement with UNI-Guide

Implant placement under direct view

Implant placement with UNI-Guide

Implant placement under direct view

Implant placement

Final result

22/02/2010: Final result

5 implants Lower jawfor two lateral bridges

UNI-GuideCase 7

28041958JF

Situation• Patient desires:

– Lower jaw: a solution for missing teeth– Upper jaw: recently restored with crown and bridge work

• Diagnosis:– Enough bone volume in the edentulous zones in the lower jaw

• Treatment plan:– 5 implants placed with UNI-Guide in lower jaw– Delayed loading– Solitary crowns

Intake

11/10/2010: Intake

Evaluation of bone volume

46 45 44 34 35

Treatment plan

Implant planning

Implant planning

18/11/2010: Teeth supported UNI-Guide

18/11/2010: Implant placement

3 implants lower jawfor 3 solitary crowns

UNI-Guidecase 8

29101961BH

Situation

• Patient desires: replacement of lost elements 35 36 37

• Diagnosis: limited vertical bone volume on location 35 36 37

• Treatment plan:– Placement 3 ultrashort implants (Bicon) /

Delayed Loading / 3 x solitary crowns

Intake

Intake

Bone analysis

34 35 36 37

Height above alveolar nerve: 9 7 7 mm

Treatment plan

Implant planning

UNI-Guide with simultaneous dental and bone support

UNI-Guide with simultaneous dental and bone support

Implant planning

UNI-Guide with simultaneous dental and bone support

Implant planning

Implant placement Bicon implants

Placement of the crowns

Placement of the crowns

Placement of the crowns

3 standard implants, 1 zygoma implant in maxilla

for All-on-4

UNI-GuideCase 9

20101943BR

Situation• Patient desires: fixed prosthesis in the upper jaw• Diagnosis

– All teeth in UJ are lost

• Treatment– Extraction front teeth: 11 12 13– Implant supported bridge – Placement 3xc standard implant, 1 x zygoma implant, delayed

loading, implant supported bridge

Intake

X X X X X X X

Intake

Implan planning

Implant placement

Use of UNI-Guide for extramaxillary zygoma

implant

UNI-Guide has a combined bone and dental support

Implant placement

Placement of zygoma implantWith extramaxillary trajectory

Coverage of extramxillary trajectory With Isotis and a membrane

postoperative

Preoperative planning versus postoperative position

Deviation at the tip of the zygoma implant less than 2 mm

Frontal sagittal Occlusal

Second stage surgery

Endresult

Endresult

01/06/2010: Endresult

Quad zygomafor overdenture

UNI-GuideCase 11

02031945BG

Intake

Intake

Analytical bone table

Implantplanning

Implantplanning

Implant placement Quad zygoma

UNI-Guideguide for Quad zygoma with

intersecting drill trajectories

Implant placement Quad zygoma

Second stage surgery

Overview

• Introduction• UNI-Guide / clinical examples• Conclusion

No-nonsense

• UNIversal Guide• No prosthetic set-up needed• Diagnostic scan allows treatment planning• No increased failure rate compared to

conventional implantology• Allows simultaneous ancillary procedures

No-nonsense

• Drill guide to solve surgical demands:• E.g.

– simultaneous extractions, – alveolectomy, – augmentation, – Ultrashort implants, ultralong, – modification of treatment plan peroperatively

is possible