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Guide Right™                 Fibular Graft Case    Featuring:   # 29 and #30   3 mm Guide Posts   3 mm Diagnostic Guide...
This patient had a section of the mandible removed & graftedwith a vascular fibular graft 2 years prior to implant placeme...
Fabrication of DIAGNOSTIC Guide
 3/32” holes were drilled in the cast in the positions of the 2nd bicuspid and 1st molar. The cast was lubricated with p...
3 mm cylindrical guide sleeves were placed on the guide postswith cleats positioned toward the lingual surface.
Triad® Gel was added & cured to capture the cleats& form the DIAGNOSTICguide which was placed in the patient and a cone be...
Pre-op    Invivo5    AnatomageSoftware Evaluation
# 29                               Initial Alignment           axial                                                  cros...
# 298 angular correction to the mesial is necessary axial                              cross sectional                    ...
# 29    close-up showing 8 bend toward the mesial needed                        tangential Invivo5Anatomage
# 29        ANGULAR CORRECTION: 5 toward the lingual          LINEAR CORRECTION: 1 mm offsetaxial                         ...
# 29         cross section            tangential   5 angular correction          1 mm offset linear correction Invivo5Anat...
# 30             Initial Alignmentaxial                             cross sectional                      Invivo5          ...
# 30            Shows initial alignment is NOT cross sectional                                           GOOD             ...
# 304.8 mm X 10 mm Straumann Implant (virtual image)1 mm offset guide post > 15 bend toward lingualaxial                  ...
# 30   shows a 15 angular correction is necessary for the   guide sleeve to line up with the position of thecross sectiona...
Guide Right™              Generation ll Bending Tool                                               10 example  For more in...
Preview of Pre-op Corrections               #29                                    #30   LINEAR CORRECTION                ...
# 29       Guide post positioned in the bending tool            with offset positioned forward.
# 29            BEND       8 toward the mesial
The 1 mm offset guide post with an 8 mm correction is rotated 90and placed back in the bending tool for the second 5 bend ...
# 29   5 correction
# 30 stylus over 1 mm offset guide post bent 15 toward lingual
tangential view   cross sectional view     # 29                 # 298 lingual bend        1 mm offset                     ...
Offset magnetic guide posts in cast
Buccal view of magnetic guide post with open guide sleeve
Fabrication of SURGICAL Guide
Triad® Gel added to open guide sleeves to form the SURGICAL guide.
SURGICAL Guide
Ramus plate must be avoided
Post-op   Invivo5   AnatomageSoftware Verification
#29               Note: implant placementwith virtual implants positioned over actual implants   axial                    ...
#30             Post-op Implant Placementaxial                                 cross sectional                           I...
Custom impression coping due to the depth of the fixture
Peri-apical X-ray to confirm seating of impression coping.
Custom Atlantis Abutments
Final restoration in master cast
Restoration on master cast
Atlantis Abutments in place
Final restoration
Magnetic Offset Guide Posts Straight 3.0 mm od Offset 3.0 od X 0.5 mm os 3.0 od X 1.0 mm os 3.0 od X 1.5 mm os 3.0 od...
Guide Right™Products shown in this case 3/32” Drill   3 mm Guide Posts   3 mm Diagnostic Guide Sleeves   3 mm Magnetic...
DéPlaqueGuide Right™ Surgical Guide System fabricate   evaluate   correct   verify   placeStart With Precision. Place With...
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19 fibular graft case

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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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19 fibular graft case

  1. 1. Guide Right™ Fibular Graft Case Featuring: # 29 and #30 3 mm Guide Posts 3 mm Diagnostic Guide Sleeves 3 mm Magnetic Guide Posts 3.3 and 4 mm Open Guide Sleeves Generation ll Bending Tool Invivo5 Software Evaluation AnatomageKARLS
  2. 2. This patient had a section of the mandible removed & graftedwith a vascular fibular graft 2 years prior to implant placement.
  3. 3. Fabrication of DIAGNOSTIC Guide
  4. 4.  3/32” holes were drilled in the cast in the positions of the 2nd bicuspid and 1st molar. The cast was lubricated with petroleum jelly. Two straight 3 mm guide posts were placed in the openings.
  5. 5. 3 mm cylindrical guide sleeves were placed on the guide postswith cleats positioned toward the lingual surface.
  6. 6. Triad® Gel was added & cured to capture the cleats& form the DIAGNOSTICguide which was placed in the patient and a cone beam X-ray was taken.
  7. 7. Pre-op Invivo5 AnatomageSoftware Evaluation
  8. 8. # 29 Initial Alignment axial cross sectional Invivo5 Anatomage tangential volumetricThe DIAGNAOSTIC guide sleeves viewed in the cone beam images were evaluated. [ axial, tangential and cross sectional views ]
  9. 9. # 298 angular correction to the mesial is necessary axial cross sectional Invivo5 Anatomage tangential volumetric
  10. 10. # 29 close-up showing 8 bend toward the mesial needed tangential Invivo5Anatomage
  11. 11. # 29 ANGULAR CORRECTION: 5 toward the lingual LINEAR CORRECTION: 1 mm offsetaxial cross sectional Invivo5 Anatomagetangential volumetric
  12. 12. # 29 cross section tangential 5 angular correction 1 mm offset linear correction Invivo5Anatomage
  13. 13. # 30 Initial Alignmentaxial cross sectional Invivo5 Invivo5 Anatomage Anatomagetangential volumetric
  14. 14. # 30 Shows initial alignment is NOT cross sectional GOOD cross sectional view Invivo5Anatomage
  15. 15. # 304.8 mm X 10 mm Straumann Implant (virtual image)1 mm offset guide post > 15 bend toward lingualaxial cross sectional Invivo5 Anatomagetangential volumetric
  16. 16. # 30 shows a 15 angular correction is necessary for the guide sleeve to line up with the position of thecross sectional virtual implant tangential view Invivo5Anatomage
  17. 17. Guide Right™ Generation ll Bending Tool 10 example For more information on use of the bending tool go towww.deplaque.com ▪ Guide Right™ Generation ll Bending Tool
  18. 18. Preview of Pre-op Corrections #29 #30 LINEAR CORRECTION LINEAR CORRECTION 1 mm offset 1 mm offset ANGULAR CORRECTION ANGULAR CORRECTION1ST BEND: 8 toward the mesial 1 BEND: 15 toward lingual2nd BEND: 5 toward the lingual Cosine is applied to determine correction data. * see next 3 slide
  19. 19. # 29 Guide post positioned in the bending tool with offset positioned forward.
  20. 20. # 29 BEND 8 toward the mesial
  21. 21. The 1 mm offset guide post with an 8 mm correction is rotated 90and placed back in the bending tool for the second 5 bend toward lingual.
  22. 22. # 29 5 correction
  23. 23. # 30 stylus over 1 mm offset guide post bent 15 toward lingual
  24. 24. tangential view cross sectional view # 29 # 298 lingual bend 1 mm offset 5 bend
  25. 25. Offset magnetic guide posts in cast
  26. 26. Buccal view of magnetic guide post with open guide sleeve
  27. 27. Fabrication of SURGICAL Guide
  28. 28. Triad® Gel added to open guide sleeves to form the SURGICAL guide.
  29. 29. SURGICAL Guide
  30. 30. Ramus plate must be avoided
  31. 31. Post-op Invivo5 AnatomageSoftware Verification
  32. 32. #29 Note: implant placementwith virtual implants positioned over actual implants axial cross sectional Invivo5 Anatomage tangential volumetric
  33. 33. #30 Post-op Implant Placementaxial cross sectional Invivo5 Anatomagetangential volumetric
  34. 34. Custom impression coping due to the depth of the fixture
  35. 35. Peri-apical X-ray to confirm seating of impression coping.
  36. 36. Custom Atlantis Abutments
  37. 37. Final restoration in master cast
  38. 38. Restoration on master cast
  39. 39. Atlantis Abutments in place
  40. 40. Final restoration
  41. 41. Magnetic Offset Guide Posts Straight 3.0 mm od Offset 3.0 od X 0.5 mm os 3.0 od X 1.0 mm os 3.0 od X 1.5 mm os 3.0 od X 2.0 mm os 3.0 od X 2.5 mm os 3.0 od X 3.0 mm os
  42. 42. Guide Right™Products shown in this case 3/32” Drill 3 mm Guide Posts 3 mm Diagnostic Guide Sleeves 3 mm Magnetic guide posts 3.3 mm Open Guide sleeves 4 mm Open Guide Sleeves 1.0 mm Offset Magnetic Guide Sleeve Triad® Gel 1.800.314.0065 • www.deplaque.com
  43. 43. 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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