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Single guided implant surgery #8 9.2016 z

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Single guided implant placement #8 Featuring: Corrections
1 mm offset toward buccal, 10° correction buccal, 6° correction mesial, using 2-Piece Offset Guide Posts, Invivo5 Software, Guide Right Bending Too, 4.5 MM Serial Guide Sleeves,Guide Sleeve Insert Handles,Versah Condensing Drills to enlarge the osteotomy, Astra Implant,

Published in: Health & Medicine
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Single guided implant surgery #8 9.2016 z

  1. 1. Site # 8 Zug 2016 Single Guided Implant Placement Corrections • 1 mm offset toward buccal • 10° correction buccal • 6° correction mesial Featuring 2-Piece Offset Guide Posts Invivo5 Software Bending Tool 4.5 MM Serial Guide Sleeves Guide Sleeve Insert Handles Versah Condensing Drills to enlarge the osteotomy Astra Implant
  2. 2. Start With Precision. Place With Confidence.™ 1.800.314.0065 • www.deplaque.com DéPlaque A Geometric Approach to Guided Surgery Guide Right™ Surgical Guide System fabricate ▪ evaluate ▪ correct ▪ verify ▪ re-fabricate ▪ place
  3. 3. Guide Right™ Surgical Guide System DéPlaque ▪ fabricate DIAGNOSTIC guide ▪ evaluate ▪ correct ▪ re-fabricate surgical guide ▪ verify ▪ place
  4. 4. Planned implant position made at the site # 8 with a 3/32” drill
  5. 5. 3/32” hole in cast
  6. 6. 3 mm straight guide post in hole
  7. 7. Articulated models with 3 mm short guide post
  8. 8. 3 mm guide post
  9. 9. 3 mm guide sleeve positioned on the 3 mm guide post with cleat to the palatal surface.
  10. 10. Triad® gel is added to the guide sleeve & adjacent teeth on either side of the site to form the DIAGNOSTIC guide
  11. 11. DéPlaque ▪ fabricate diagnostic guide ▪ evaluate ▪ correct ▪ re-fabricate surgical guide ▪ verify ▪ place Guide Right™ Surgical Guide System
  12. 12. Invivo5 Anatomage Cone Beam Analysis
  13. 13. HOME POSITION Invivo5 Anatomage
  14. 14. Using Invivo5 Software CHANGES in the proposed implant position can be made Changing the LINEAR POSITION… … in either mesio-distal plane or bucco-lingual plane is made by selecting an offset guide post to alter the position of the guide sleeve Changing the ANGLE of the TRAJECTORY by measuring the angle of the proposed implant location & bending the guide post to the corrected angle. After making a correction (angle or linear) in one plane YOU MUST RETURN TO THE HOME POSITION To measure and make the correction needed in the other plane.
  15. 15. Use of Invivo5 Software The HOME POSITION WARNING: Measuring or making angle or linear corrections from any other positions (cross sectional or tangential) will lead to errors, & the corrections recorded will not be accurate BECAUSE the angle is not measured from the HOME POSITION
  16. 16. # 8 HOME POSITION axial cross sectional tangential volumetric
  17. 17. axial cross sectional # 8 tangential volumetric LINEAR CORRECITON: 1 mm offset buccal ANGULAR CORRECTION: 10° buccal
  18. 18.  Measure the angle formed by the 2 intersecting lines  use the angle tool in invivo5 to measure & correct the angle of the guide post/sleeve When … the long axis of the sleeves & the virtual implants are not parallel.
  19. 19. # 8 LINEAR CORRECITON: 1 mm offset buccal ANGULAR CORRECTION: 10° buccal
  20. 20. # 8 LINEAR CORRECITON: none ANGULAR CORRECTION: 10° buccal & 6° mesial
  21. 21. DéPlaque ▪ fabricate [diagnostic guide] ▪ evaluate ▪ correct ▪ re-fabricate [surgical guide] ▪ verify ▪ place Guide Right™ Surgical Guide System
  22. 22. LINEAR CORRECTIONS are made with the 1 mm offset guide post Guide Right™ Offset Guide Posts LINEAR CORRECTION The bottom half of the offset guide posts are designed with 8 flat sides so they can be rotated 45° & corrected half way between the buccal & mesial surface, allowing corrections in 8 directions: mesial, mesio-buccal, buccal, mesio-lingual, distal, disto-lingual, lingual, mesio-lingual
  23. 23. DéPlaque Guide Right™ Surgical Guide System Offset Guide Posts
  24. 24. 2-Piece Guide Post Straight Lower Piece with Upper Removable Piece The bottom half of the straight Lower Pieces of the 2-Piece Guide Post are designed with 4 flat sides corresponding with the mesial, distal, buccal & lingual surfaces of the tooth.
  25. 25. Guide Right™ Bending Tool 1 mm offset Guide Post Bent 1st time to 10° Stylus 1st BEND 10° 1 mm Offset Guide Post
  26. 26. Guide Right™ Bending Tool 1 mm Offset Guide Post Bending Sequence 1 mm Offset Guide Post Stylus positioned on 1 mm Offset Guide Post Stylus positioned on 1 mm Offset Guide Post & bent 10° 1 mm Offset Guide Post Shown with 10° bend Steps to Bending Tool use at end of slideshow
  27. 27. Guide Right™ Bending Tool with Support Bar 1 mm offset Guide Post with a 10° bend rotated back to 0° 0° • 1 mm offset guide post with a 10° bend rotated 90° in block hole • stylus support bar moved into place to support the 10° angle of the 1st bend Before 2nd BEND • stylus removed & guide post rotated 90° pointing to 0° before 2nd bend is made
  28. 28. Guide Right™ Bending Tool with Support Bar 1 mm offset Guide Post with 10° bend bent a 2nd time to 6° stylus 6° • 1 mm offset guide post with 10° angle rotated 90° in block hole & stylus replaced 2nd BEND • stylus removed & the guide post rotated 90° before 2nd bend is made • stylus support bar moved into place to support the angle of the 1st bend
  29. 29. DéPlaque ▪ fabricate [diagnostic guide] ▪ evaluate ▪ correct ▪ re-fabricate [surgical guide] ▪ verify ▪ place Guide Right™ Surgical Guide System
  30. 30. Angle corrected lower-half of 2-Piece 1 mm offset guide post placed in the reference hole in the cast
  31. 31. 2-Piece 1 mm offset guide post with 3 mm upper piece facial view
  32. 32. 1 mm offset guide post with fabrication insert used to center the 4.5 mm guide sleeve 4.5 mm fabrication insert 4.5 mm guide sleeve with cleat to palatal 1 mm offset guide post
  33. 33. 4.5 Fabrication Insert (FABIN) Purposes & Use: • To center the 4.5 mm guide sleeve on the 3 mm guide post • To prevent acrylic gel from entering inside sleeve during guide fabrication by placing the FABIN inside the 4.5 mm diameter guide sleeve with 3 mm guide post. • Place the FABIN over the guide post, then apply gel. • 5.3 mm FABIN available for the 5.3 guide sleeve
  34. 34. Triad® gel is added to the lubricated cast to form the corrected SURGICAL GUIDE
  35. 35. The fabrication insert has been removed leaving the 4.5 mm guide sleeve centered on the lower-half of the 2-Piece guide post.
  36. 36. Facial View • Corrected SURGICAL GUIDE
  37. 37. SURGICAL GUIDE is trimmed to be sure no acrylic is occluding the surface of the guide sleeve.
  38. 38. In this case, the anterior insert handle with inserts were used to position the increasing diameter drills in the surgical guide sleeve without changing the SURGICAL GUIDE for the placement of a 4 mm X 11 mm implant. Anterior Insert Handles with 2.2 & 3.0 mm inserts used with the 4.5 mm guide sleeves
  39. 39. Versah Densah Bur Kit used to prepare & widen the osteotomy
  40. 40. Guide Right™ Surgical Guide System DéPlaque ▪ fabricate [diagnostic guide] ▪ evaluate ▪ correct ▪ re-fabricate [surgical guide] ▪ verify ▪ place Guide Right™ Surgical Guide System
  41. 41. 4.0 mm Astra Implant Placement
  42. 42. Guide Right™ GUIDE POST BENDING TOOL Steps to SINGLE BEND Step 1 Place bending tool plate on a secure flat surface with the degree increments at the top & the stainless steel bar at the bottom. Step 2 Locate the two 3/32” holes in the top of the stainless steel bar. The hole closest to the plate is used for all guide posts up to 3.0 mm offsets. The front hole is used for offsets 3.5 mm or larger. Place the bottom half of the guide post to be bent into the appropriate hole. Position the offset guide post in the hole determined by the planned direction of the correction. Tighten the set screw. Step 3 Select the appropriate stylus to fit over the top half of the guide post. Step 4 Fit the stylus over the guide post securely with the point directed at 0 ° & the bottom of the stylus in contact with the platform of 2-piece guide post or if no platform on post, in contact with block. 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 Remove the stylus. Loosen screw to remove the guide post bent to the desired angle.
  43. 43. Steps to COMPOUND BEND Guide Right™ GUIDE POST BENDING TOOL Step 1 Position a straight or offset guide post in the bending plate, tightening the set screw against one of the 8 flat surfaces on the lower half of the guide post. Step 2 The 1st bend can be made to the right or left direction. Step 3 The set screw is loosened & the guide post is rotated 90° next flat surface. Step 4 The 2nd bend in the 2nd plane is made after rotating the guide post up away from the surface of the bending plate to register the stylus point back at 0º. Step 5 Slide the stylus support bar down under the stylus until it supports the stylus. Tighten the side screws before making the 2nd bend. Step 6 The 2nd bend can be made in either direction according to the X-ray. Step 7 Remove the stylus and place the guide post back in the cast with the appropriate side indicated by a mark with a felt tip pen facing the buccal or lingual surface. Be sure the post is in the correct position. Linear Corrections, using an offset guide post, must be determined & made before Angle Corrections. Offset 2-Piece Guide Posts available in the 3 mm guide post: 0.5,1, 1.5, 2.0, 2.5 & 3.0 mm.
  44. 44. view Guide Right™ VIDEO Case KZ for actual site preparation & implant placement www.deplaque.com Featuring 4.5 MM Serial Guide Sleeves Guide Sleeve Insert Handles Versah Condensing Drills used to enlarge the osteotomy Astra Implant
  45. 45. Guide Right™ Surgical Guide System Start With Precision. Place With Confidence.™ 1.800.314.0065 • www.deplaque.com fabricate ▪ evaluate ▪ correct ▪ verify ▪ re-fabricate ▪ place DéPlaque A Geometric Approach to Guided Surgery

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