Post on 11-Jul-2015
transcript
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