16 immediate placement immediate load #11

Immediate Placement ■ Immediate Load

Linear & Angular Corrections

Featuring

CROSS SECTION of CAST

FABRICATION of

DIAGNOSTIC Guide: straight guide posts · ceramic guide sleeves

SURGICAL Guide: magnetic offset guide post · open guide sleeve

COMPARING: GALAXIS & Software Evaluations

SMIT 3..2013

Invivo5 Anatomage

Guide Right™

Using:

3 X 30 mm straight guide posts

3 mm cylindrical ceramic guide sleeve

Fabrication of DIAGNOSTIC GUIDE

An impression was taken and a cast was made

with the existing deciduous tooth in place

A cast is made of patient to replace

the deciduous maxillary left cuspid.

A hole is drilled through the deciduous

tooth with a 3/32” drill.

#11

The deciduous tooth was removed from

the cast leaving the previously drilled hole.

A 3 mm x 30 mm guide post is placed in the

hole in the cast.

A ceramic guide sleeve is placed

on the 3 mm guide post.

Triad® Gel was used to capture the cleat on the ceramic guide sleeve and

adjacent teeth to fabricate the DIAGNOSTIC guide. It is now ready to be

securely seated in the patient for the cone beam X-ray so that the long axis

of the proposed osteotomy can be evaluated.

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PREview of Pre-op Corrections

ANGULAR CORRECTION

10° toward the distal

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LINEAR CORRECTION

1st : 1 mm toward the buccal

2nd: 1 mm toward the distal

Accomplished by using a 1.5 mm offset guide post rotated 45° in the

bending tool block

Cosine is applied to determine correction data.

See slide show:

Pythagorean Theorem: COSINE Calculations for Guide Right™ Guides

PRE-OPERATIVE

GALAXIS Cone Beam Images

Software Calculations

A better position appears to be a 21° angular correction

toward the buccal with linear movement of the guide sleeve

1.5 mm toward the buccal from the present axis of the

ceramic guide sleeve in the DIAGNOSTIC guide.

The mesio-distal axis can also be

corrected 10° - 11° toward the distal

according to the image.

Yellow planned axis of guide sleeves Green: ideal axis of virtual implant in bone.

tangential view cross sectional view #11

Magnetic Offset Guide Post

3.0 X 1.5 offset

A 1.5 mm offset guide post is placed in the bending tool. The offset

positioned toward the buccal is rotated in the bending tool block with the

depression mark positioned toward the right.

Preparing for 1st BEND

The stylus is placed over the guide post and bent 20° - 21°

which will reposition the guide sleeve angle

away from the apex of the adjacent distal tooth.

1st BEND

The slide support bar is positioned beneath the stylus

to maintain the 20° angle of the 1st bend.

The 2nd bend will be 10° toward the distal

to avoid hitting the root of the distal tooth.

2nd BEND

Fabrication of SURGICAL Guide Illustrated with cross-sectioned models

The DIAGNOSTIC guide sleeve shows

the original planned axis of the DIAGNOSTIC SLEEVE

Cast showing the guide removed

Straight magnetic guide post in place first.

1.5 mm offset magnetic guide post with 20° bend toward the buccal

Facial view of 20° corrected 1.5 mm magnetic offset guide post

bent toward the buccal with open guide sleeve.

Occlusal / axial view of corrected guide post and sleeve in actual case model.

Fabrication of the SURGICAL Guide

Triad® Gel has been added to capture the cleat on the ceramic

guide sleeve & adjacent teeth to fabricate the SURGICAL guide.

Invivo5 Anatomage

SOFTWARE

#10 Evaluation using:

#10

▪ Virtual implant initial alignment ▪

Invivo5 Anatomage

axial cross section

tangential volumetric

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▪ Applying the grid allows you to make more accurate measurements ▪

Invivo5 Anatomage

axial cross section

tangential volumetric

tangential

SOFTWARE GRID

each square: 5 X 5 mm

each side of the square: 5 mm

center mark is 2.5 mm

Understanding Grid Measurements Invivo5

cross sectional

tangential

axial

volumetric

Invivo5 Anatomage

#11

21º ANGULAR CORRECTION toward the facial

► measured with the Invivo5 software angle tool ◄

cross sectional view

Invivo5 Anatomage

#11 ANGULAR CORRECTION: 21º bend toward the distal

tangential view evaluation

#11

RETURN TO THE INITIAL ALIGNMENT ► to make angle change in next plane ◄

Invivo5 Anatomage

tangential view

Invivo5 Anatomage

#11

ANGULAR CORRECTION: 10º bend toward the distal

Magnetic Offset Guide Post

3.0 X 1.5 offset

A 1.5 mm offset guide post is placed in the bending tool. The offset post

which will be toward the buccal is rotated in the bending tool with the

depression toward the right.

The stylus is placed over the guide post and bent 20° which will reposition

the guide sleeve angle away from the apex of the adjacent distal tooth.

The slide support bar is positioned beneath the stylus to maintain

The 20° angle of the first bend. The 2nd bend will be 10° toward the distal

to avoid hitting the root of the distal tooth.

REview of Pre-op Corrections

ANGULAR CORRECTION

10° toward the distal

#11

LINEAR CORRECTION

1st : 1 mm toward the buccal

2nd: 1 mm toward the distal

Accomplished by:

using a 1.5 mm offset post rotated 45° in the bending tool block

Cosine is applied to determine correction data.

See slide show:

Pythagorean Theorem: COSINE Calculations for Guide Right™ Guides

Immediately placed temporary restoration

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™

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™

GUIDE POST BENDING TOOL

Guide Right™

Products 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

Guide Post Bending Tool

Triad® Gel

1.800.314.0065 • www.deplaque.com

A System of Components for 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 effective

1.800.314.0065 • www.deplaque.com

Guide Right™ Surgical Guide System

Start With Precision. Place With Confidence.™

1.800.314.0065 • www.deplaque.com

fabricate ▪ evaluate ▪ correct ▪ verify ▪ place

DéPlaque