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14 mandibular anterior case open guide sleeve drill progression

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Guide Right Surgical Guide System: fabrication and correction of Diagnostic & Surgical Guides with 2D & 3D X-ray Images

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14 mandibular anterior case open guide sleeve drill progression

  1. 1. MANDIBULAR ANTERIOR CASE SURGICAL Guide in Place Showing Drill Progression Featuring:  2 Implants: # 27 # 23  Magnetic Guide Posts Open Guide Sleeves  Invivo5 software evaluation SCHA 2.2013
  2. 2. Fabrication of DIAGNOSTIC GUIDE  3 mm straight guide posts  3 x 8 mm cylindrical guide sleeves
  3. 3. Two 3 mm guide posts placed in the holes.
  4. 4. The angles of the guide posts were made semi-parallel to the adjacentnatural teeth. However, the angles are not too critical for theDIAGNOSTIC guide, as they most likely will need to be corrected.
  5. 5. Occlusal view Facial view3 x 8 mm guide sleeves are placed over the guide posts.
  6. 6. Undercuts were blocked out and petroleum jelly was used to lubricate the cast.Triad® Gel was added to the brackets of the guide sleeves and the adjacentteeth to form the body of the DIAGNOSTIC guide.
  7. 7. Facial view of fabricated template.The DIAGNOSTIC guide is now ready to beplaced in the patient for a Cone Beam X-ray.
  8. 8. Preview of Pre-op Corrections #23 LINEAR CORRECTION 10 correction toward the buccal #27 LINEAR CORRECTION 6 correction toward the lingual
  9. 9. PRE-OPInvivo5 Software EvaluationAnantomage
  10. 10. # 23 Initial Alignment Software Evaluation axial cross sectional Invivo5 Invivo5 Anatomage Anatomage tangential volumetricNOTE Each time a change is made in the software go back to the Initial alignment view and calculate the angle in the 2nd plane.
  11. 11. Invivo5Anatomage #23 CLOSE UP with software grid tangential view cross sectional view requires no correction requires a 10 correction toward the distal toward the buccal
  12. 12. Understanding Invivo5 Grid Measurements SOFTWARE GRID each square: 5 X 5 mm each side of the square: 5 mm center mark is 2.5 mm tangential
  13. 13. # 27 Evaluation with Software Grid axial cross sectional Invivo5 Invivo5 Anatomage Anatomagetangential volumetric
  14. 14. #27 Axial view should always be adjusted to the 90 cross sectional plane of the alveolar ridge. axial view occlusal view Bucco-lingual plane Invivo5Anatomage
  15. 15. #27 CLOSE UP LINEAR & ANGULAR Evaluation tangential view cross sectional view guide sleeve requires no correction guide sleeve requires a 6 away from the adjacent tooth correction toward the lingual (left)Invivo5Anatomage
  16. 16. Preview of Pre-op Corrections #27 LINEAR CORRECTION: 1.0 mm to the buccal ANGULAR CORRECTION 6 bend BEND to the lingual. #23 LINEAR CORRECTION 0.5 mm to the lingual
  17. 17. Occlusal view Buccal view#27 correction: 1.0 mm offset guide post to the buccal & bent 6 to the lingual.#23 correction: 0.5 mm offset guide post to the lingual / no change in the angle
  18. 18. Occlusal view Buccal view3.3 mm open guide sleeves placed on offset magnetic guide posts.
  19. 19. SURGICAL guide Occlusal view
  20. 20. Buccal view of 3.3 mm open guide sleeves in SURGICAL guide. Ready to be placed in the patient for surgery.
  21. 21. Surgical site
  22. 22. SURGICAL GUIDE in Place surgical drill sequencewith 3.3 mm open guide sleeves
  23. 23. 2 mm drills placed with 3 mm stop shaft
  24. 24. 2.5 and 2.85 mm drills in place
  25. 25. 3.2 mm and 3.35 mm drills in place
  26. 26. Axial view of implant placement
  27. 27. Final X-rays
  28. 28. # 23 Post-op Cone Beam Evaluation tangential view cross sectional view# 23 virtual implant placed over actual implant to check alignment with guide sleeve
  29. 29. # 26 Post-op Evaluation Invivo5 tangential view Anatomage cross sectional view# 26 virtual implant placed over actual implant to check alignment with guide sleeve
  30. 30. Facial view of Atlantis abutments
  31. 31. Final restoration on master cast
  32. 32. Lingual view
  33. 33. Final Restoration
  34. 34. Guide Right™ Products shown in this case 1 - 3/32” Drill 2 - 3 mm Guide Post 2 - 3 mm cylindrical Guide Sleeve 1 - 3 mm x 0.5 mm Offset Magnetic Guide Post 1 - 3 mm x 1.0 mm Offset Magnetic Guide Post 2 - 3.3 mm Open Guide Sleeves Generation ll Bending Tool Triad® Gel 1.800.314.0065 • www.deplaque.com
  35. 35. DéPlaqueGuide Right™ Surgical Guide System fabricate evaluate correct verify placeStart With Precision. Place With Confidence.™ 1.800.314.0065 • www.deplaque.com

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