40
Guide Right™ Immediate Placement & Immediate Load WHITEHO 2.2013 Correction using Guide Right Components 15° bend toward the facial Guide Post Bending Tool Pre-op evaluation using software I nvi vo5 Anatomage Featuring:

17 immediate placement immediate load angular correction

Embed Size (px)

Citation preview

Page 1: 17  immediate placement immediate load angular correction

Guide Right™

Immediate Placement & Immediate Load

WHITEHO 2.2013

■ Correction using Guide Right Components

• 15° bend toward the facial

■ Guide Post Bending Tool

■ Pre-op evaluation using software

Invivo5 Anatomage

Featuring:

Page 2: 17  immediate placement immediate load angular correction

#11 has internal root resorption on palatal surface.

An implant was recommended.

Page 3: 17  immediate placement immediate load angular correction

Fabrication of DIAGNOSTIC Guide

3 mm Guide Post

3 mm Diagnostic Guide Sleeve (1 cleat)

Page 4: 17  immediate placement immediate load angular correction

Treatment Plan:

Replacement of #11 with immediate placement & temporary restoration

Page 5: 17  immediate placement immediate load angular correction

3/32” drill through the existing tooth on the cast

Page 6: 17  immediate placement immediate load angular correction

3 mm guide post & 3 mm diagnostic guide sleeve (1 cleat)

with existing tooth remaining for the DIAGNOSTIC guide

Page 7: 17  immediate placement immediate load angular correction

Red wax added to tooth if cast should break when drilling

to allow the DIAGNOSTIC guide to fit for the cone beam X-ray

Page 8: 17  immediate placement immediate load angular correction

Palatal view of beading wax added

Page 9: 17  immediate placement immediate load angular correction

Triad® Gel applied to capture guide sleeve cleats and adjacent teeth

to form the DIAGNOSTIC guide

Page 10: 17  immediate placement immediate load angular correction

Invivo5

Anatomage

Pre-op

Software Evaluation

Page 11: 17  immediate placement immediate load angular correction

Invivo5

Anatomage

Initial Alignment

axial cross sectional

tangential view volumetric

Invivo5

Anatomage

# 11

NOTE:

Each time a change is made in the software go back to the

initial line up view and calculate the angle in the 2nd plane.

Page 12: 17  immediate placement immediate load angular correction

Initial Alignment of guide sleeve with virtual implant

Invivo5

Anatomage

cross sectional view

# 11

Page 13: 17  immediate placement immediate load angular correction

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

Page 14: 17  immediate placement immediate load angular correction

# 11 CLOSE UP

If the implant is placed with the guide sleeve in this position

the facial wall of the bone will be violated.

Therefore the axis of the guide sleeve needs to be changed

Page 15: 17  immediate placement immediate load angular correction

Invivo5

Anatomage

# 11 indication ANGULAR CORRECTION: 15º bend toward the facial

axial cross sectional

tangential volumetric

Invivo5 Anatomage

Page 16: 17  immediate placement immediate load angular correction

cross sectional tangential

Invivo5 Anatomage

CLOSE UP

ANGULAR CORRECTION: 15° to the facial

# 11

Page 17: 17  immediate placement immediate load angular correction

ANGULAR CORRECTIONS are made with the

Guide Right™

Guide Post Bending Tool

Step by step instructions at end of slideshow

Page 18: 17  immediate placement immediate load angular correction

Guide Right™

Guide Post Bending Tool

For more information on use of the bending tool go to

www.deplaque.com ▪ Guide Right™ Generation ll Bending Tool

10 ° example

Page 19: 17  immediate placement immediate load angular correction

3 mm stylus placed over 3 mm guide post to make the 15° bend

One bend to correct # 11

15°

Page 20: 17  immediate placement immediate load angular correction

Image showing 15° difference in virtual implant correction

Invivo5

# 11

cross sectional views

Before After

Page 21: 17  immediate placement immediate load angular correction

# 11 actual guide post placed on image of virtual guide post and corrected guide in place

▪ to verify 15º magnetic guide post correction ▪

Invivo5 Anatomage

One method of checking the

guide post after the bend is to

place the bent guide post over

a print out of the view observed

in the software.

Page 22: 17  immediate placement immediate load angular correction

Review of Pre-op Corrections

#11

ANGULAR CORRECTION

15º bend toward the facial

Page 23: 17  immediate placement immediate load angular correction

Fabrication of SURGICAL Guide

3 mm Magnetic Guide Post

3 mm Open Guide Sleeve

Page 24: 17  immediate placement immediate load angular correction

Existing restoration removed from cast before making SURGICAL guide

Page 25: 17  immediate placement immediate load angular correction

Straight magnetic 3 mm guide post in planned osteotomy hole

Page 26: 17  immediate placement immediate load angular correction

Corrected 3 mm magnetic guide post with 15° bend toward facial

Page 27: 17  immediate placement immediate load angular correction

3 mm bent magnetic guide post showing 15° correction

Page 28: 17  immediate placement immediate load angular correction

Occlusal view of corrected 3 mm magnetic guide post and open guide sleeve

Page 29: 17  immediate placement immediate load angular correction

Initial Triad® Gel applied to capture the cleats of

the open guide sleeve to form the SURGICAL guide.

Page 30: 17  immediate placement immediate load angular correction

Final application of gel to form the SURGICAL guide

Page 31: 17  immediate placement immediate load angular correction

Clinical view of implant placement

Page 32: 17  immediate placement immediate load angular correction

Final implant placement

Page 33: 17  immediate placement immediate load angular correction

Placement of 15° angled abutment for temporary restoration

Page 34: 17  immediate placement immediate load angular correction

Temporary restoration

Page 35: 17  immediate placement immediate load angular correction

Temporary restoration 2 days later

Page 36: 17  immediate placement immediate load angular correction

Guide Right™

Products shown in this case

1 - 3/32” drill

1 - 3 mm Guide Post

1 - 3 mm Diagnostic Guide Sleeve (1 cleat)

1 - 3 mm Magnetic Guide Post

1 - 3 mm Open Guide Sleeve

Guide Post Bending Tool

Triad® Gel

1.800.314.0065 • www.deplaque.com

Page 37: 17  immediate placement immediate load angular correction

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

Page 38: 17  immediate placement immediate load angular correction

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 2nd bend can be made in either direction according to the x-ray.

Guide Right™

GUIDE POST BENDING TOOL

Page 39: 17  immediate placement immediate load angular correction

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

1.800.314.0065 • www.deplaque.com

Page 40: 17  immediate placement immediate load angular correction

Guide Right™ Surgical Guide System

Start With Precision. Place With Confidence.™

1.800.314.0065 • www.deplaque.com

fabricate ▪ evaluate ▪ correct ▪ verify ▪ place