18 maxillary edentulous case

Guide Right™

Edentulous Maxillary Arch

6 implants

magnetic guide post

3 mm open guide sleeves

2 mm guide sleeves

HOO 2.2013

Invivo5Anatomage

software evaluation comparison

GALAXIS

Duplication & Conversion of Complete Denture

into DIAGNOSTIC Guide

Duplicate, trim and try the denture in to be sure it still fits etc.

View into the mucosal side of the denture base where 10

shallow holes have marked the center of the alveolar ridge.

Holes are drilled through the denture base with a 3/32” drill from the mucosal

side of the denture centered in the middle of the concavity of the alveolar ridge.

3 mm holes are drilled in the denture

where the proposed implant sites

are possible.

3 mm od X 2 mm id aluminum guide sleeves

(0 cleats)

Clear Triad® Gel has be added to

secure them on the oral side of the

denture.

6 to 8 sites will be chosen based on the

cone beam X-ray.

At this point the patient and denture are

ready for the cone beam volumetric X-ray.

Several screws (13 - 15 mm) will be placed

in 2 or more of the sites to stabilize the

denture during the surgery.

Lab putty has been mixed and molded into the

denture base with 3 mm od X 2 mm id guide sleeves guide sleeves in place

and removed leaving an indentation in the lab putty.

2 mm drills have been used

to index the guide sleeves

by drilling through them

into the Lab Putty at least

10-12 mm

The denture and drills have been removed leaving the registration holes

of the long axis of the guide posts in the lab putty.

PREOPERATIVE

Evaluation

GALAXISGalileos

panoramic tangential cross sectional

Invivo5Anatomage

Software

Software

Preview of Pre-op Corrections

# 9

ANGULAR CORRECTION

31º bend toward the palatal

#8

ANGULAR CORRECTION

17º bend toward the palatal

# 11

ANGULAR CORRECTION

33º bend toward the palatal

# 4 NO CORRECTION

# 6

ANGULAR CORRECTION

28 bend toward the palatal

# 13

LINEAR CORRECTION

1 mm offset toward the buccal

A B

There is not one specific angle that is the absolute angle of placement.

The range varies by 20 between the buccal and lingual plates.

The position nearest the guide sleeve with the smallest angle should be selected

depending on the closest to the opposing restoration. [ In this case position (B) ]

Invivo5Anatomage

Selecting the Corrective Angle

#4 Initial Alignment

axial

volumetric

cross section

tangential

Invivo5Anatomage

cross section tangential

#4 ANGULAR CORRECTION: 12 toward the facial

GALAXIS

#4 ANGULAR CORRECTION: 15

cross sectional views

Invivo5Anatomage

GALAXIS

#6 ANGULAR CORRECTION: 28 toward the palatal

axial

volumetric

cross section

tangential

Invivo5Anatomage

# 6 ANGULAR CORRECTION: 28 to 31 to the buccal

cross sectional view

GALAXISInvivo5Anatomage

# 8 ANGULAR CORRECTION: 24º indicated

Invivo5Anatomage

axial

volumetric

cross section

tangential

Invivo5Anatomage

Invivo5Anatomage

GALAXIS

# 8 ANGULAR CORRECTION: 24 toward facial

cross section

# 9 ANGULAR CORRECTION: 31º Indicated

axial

volumetric

cross section

tangential

Invivo5Anatomage

# 9 31º Angle is Measured

cross sectional view

Invivo5Anatomage

GALAXIS

#11 ANGULAR CORRECTION: 24º indicated

axial

volumetric

cross section

tangential

Invivo5Anatomage

Invivo5Anatomage

Invivo5Anatomage

#11 ANGULAR CORRECTION: 24º to the facial

GALAXIS

#11 ANGULAR CORRECTION: 28 to 31

software comparison

cross sectional views

Invivo5Anatomage

#13 LINEAR CORRECTION: 1 mm offset toward the buccal

axial

volumetric

cross section

tangential

Invivo5AnatomageInvivo5Anatomage

#13 LINEAR CORRECTION: 1.5 mm toward the buccal

cross section

Invivo5Anatomage

GALAXIS

#13 LINEAR CORRECTION: 1.5 mm toward the buccalSoftware Comparison

GALAXISInvivo5Anatomage

Review of Pre-op Corrections

# 9

ANGULAR CORRECTION

31º bend toward the palatal

#8

ANGULAR CORRECTION

17º bend toward the palatal

# 11

ANGULAR CORRECTION

33º bend toward the palatal

# 4 NO CORRECTION

# 6

ANGULAR CORRECTION

28 bend toward the palatal

# 13

LINEAR CORRECTION

1 mm offset toward the buccal

Guide Right™

GENERATION II BENDING TOOL

If the angle needs to be corrected a guide post is bent in the Guide Right™ Bending Tool.

A guide post is placed in the bending tool

and a set screw tightened.

The bending stylus is placed over the

guide post and the post is bent in the first

plane.

If a second bend is indicated by a scan the

bent post in loosened and rotated 90

degrees and the set screw retightened.

The slide support bar is moved down in

contact with the stylus and the second

bend is made in the second plane. Bending tool step by step

guide at end of this slideshow.

Fabrication of SURGICAL Guide

• 3 mm magnetic guide posts with smaller diameter 3/32” lower half

have been inserted into the 2 mm holes in the Lab Putty.

• They have not been corrected yet with the information from the volumetric

scan.

• After bending the posts to the correct angles, according to the cone beam X-ray,

the posts are marked on the facial surface to orient them to be placed back in the

Lab Putty.

• Posts should also be marked sequentially (1-6) to keep them in order.

Note the offset guide post in the right most distal #13

site used to correct the linear position of the implant.

Open guide sleeves are used for the

best visibility during surgery .

The acrylic sides of the denture have been

removed with acrylic burrs to form slots

where the guide sleeves have been

removed for the placement of the angle

corrected open guide sleeves on the

magnetic guide posts

Open guide sleeves have been added to the magnetic guide posts with the

cleats positioned on the palatal surface without interference from the acrylic

of the duplicated denture.

Triad® Gel is added to the remaining denture base

to capture the open guide sleeves and the cleats.

After incorporating the open guide sleeves two additional 3 mm holes

are used in the #7 and #10 positions

to accommodate 2 mm guide sleeves

for 2 mm x 15 mm screws (Salvin) to stabilize the denture.

2 mm X 15 mm screws will be used to stabilize the

Denture while the osteotomies are being prepared.

Open guide sleeves allow visibility of drill depth markings.

A milled bar with locator

attachments is made to

support the prosthesis

Final Prosthesis

Milled bar with locator attachments

Intraoral view of attached bar

Insertion of milled bar.

Intraoral view of final prosthesis.

Final Prosthesis

Guide Right™

Products shown in this Presentation

(2) 3/32” drill

(10) 3 mm od X 2 mm id guide sleeves (0 cleats) special phone order

(6) 2 mm Drills

(5) 3 mm Magnetic Guide Posts

(1) 1 mm Offset Magnetic Guide Posts

(6) 3 mm Open Guide Sleeves

(1) Generation ll Bending Tool & 3mm Stylus

Acrylic Burrs

Triad® Gel from your dental products supplier

1.800.314.0065 • www.deplaque.com

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 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 BENDING TOOL

Guide Right™ Surgical Guide System

Start With Precision. Place With Confidence.™

1.800.314.0065 • www.deplaque.com

fabricate evaluate correct verify place

DéPlaque