Fully Edentulous Mandibular Arch

Guide Right™ SURGICAL GUIDE SYSTEM Start With Precision. Place With Confidence. ™ DéPlaque

In-office or lab fabrication
Evaluate with 2D & 3D imaging
Allows linear and angular correction
Enables precision implant placement
Cost effective

FULLY EDENTULOUS MANDIBULAR ARCH
4 Implants
Stainless Guide Sleeves
Magnetic Guide Posts & Open Sleeves
3D Cone Beam Imaging
Generation ll Bending Tool
Richt

The denture is duplicated in clear acrylic.
Holes are drilled with a 3/32” drill just lingual to the anterior teeth
and through the occlusal surface of the posterior teeth and center
of the ridge from the under side of the denture.

A pencil line is drawn indicating where to add additional acrylic to the denture.
2 mm id thin walled guide sleeves are inserted into the 3/32” holes.
Boxing wax is added to indicate to the lab where the denture needs to be built up.

Boxing wax will be replaced with clear acrylic where the denture is to be reinforced.

The duplicated denture reinforced on the lingual with the additional acrylic.

A lab putty matrix is made and the denture is pressed into the lab putty base.
A putty matrix allows some flexibility necessary to remove the denture after
guide sleeves are captured in the acrylic.

Occlusal view with a 2 mm drill marking registered in the lab putty.

Four of the sites were selected for the implants from the X-rays.
Holes were drilled through the putty.
The holes in the Lab putty matrix captures the long axes of the
guide sleeves of the duplicated denture.

Panorex view with a virtual 6 mm implant # 19 high lighted position.
A short implant will be placed to avoid the mandibular nerve.

Image on the right indicates the guide sleeve should be corrected 18°
to avoid penetrating the lingual plate.
The implant will also need to be moved to the buccal 2 mm
(half the thickness of the 4 mm diameter implant.)
#19 tangential cross sectional

Making Corrections Using Gll Guide Post The guide post used in correcting the angle has four flat slides representing the mesial, djstal, buccal and lingual surfaces. An orientation dot is present to orient the flat surface on the buccal. The guide post is placed in a block attached to a bending tool plate with a degree scale indicator and a set screw. The set screw is tightened against one of the four flat sides of the guide to prevent rotation while it is being bent.

A 4 mm X 2 mm offset guide post is placed in the bending tool.
The set screw is tightened against the mesial flat, so the offset will be
toward the buccal surface.

The 4 mm X 2 mm offset magnetic guide post with a is bent 18° (by gently moving the stylus tip to the left)

The stylus is removed leaving the guide post bent 18°

Panorex view with a virtual implant in the # 22 site highlighted.

tangential cross sectional
These images indicate a 3 mm X 1 mm offset magnetic guide post bent 7 ° is needed to move the guide post buccally and correct the 7 ° angle. #22

A 7 ° correction with a 1.0 mm offset 3 mm guide post for the #22 site.

Close up of the corrected 3 mm guide post with 1 mm offset
with the 7 degree bend after stylus is removed.

Panorex view with the implant in the # 27 position highlighted

#27 A virtual implant in the # 27 position , tangential and cross sectional views look , no changes are needed.

Panorex view with a 4 X 8 mm virtual implant in the # 30 position is highlighted.

# 30 These images show a 13 ° bend is needed with a 2 mm offset guide post the length of the 4.0 mm diameter implant will be changed to 6.0 mm.

Each guide post is corrected according to the information obtained from the cone
beam volumetric imaging.
Open guide sleeves are placed on corrected 3mm and 4 mm magnetic guide
posts.

A frontal view of the placement of the open guide sleeves on the magnetic guide posts with the brackets positioned on the lingual surface of the guide posts.

The denture has had slots cut out of the buccal surface to allow the denture to be placed back on the guide posts with room for the guide sleeves to sit passively.

Guide Right™ Generation ll Bending Tool

A post operative CBVI scan from a completed case.

Post op X-ray shows the placement of a 6.0 mm implant in the # 19 position.

Guide Right™ Products Used in this Presentation
3/32” drill
(1) 2 mm drill
2 mm Straight Stainless Guide Post
(2) 4 mm X 2 mm Offset Magnetic Guide Post
(2) 4 mm Open Guide Sleeve
(2) 3 mm X 1 mm Offset Magnetic Guide Post
3 mm X Open Guide Sleeve
(1) Generation ll Bending Tool & 4 mm Stylus
Triad® Gel

Guide Right™ by DéPlaque 1.800.314.0065 • www.deplaque.com Start With Precision. Place With Confidence. ™

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Fully Edentulous Mandibular Arch

by DePlaque on Oct 19, 2011

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Fully Edentulous Mandibular Arch — Presentation Transcript