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1 introduction to guide right compnents single implant

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Guide Right Surgical Guide System is a system of components for the fabrication and correction of diagnostic and surgical guides in one or two dimensions.

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1 introduction to guide right compnents single implant

  1. 1. Guide Right™ Surgical Guide System INTRODUCTION  use of Guide Right™ COMPONENTS  use with a SINGLE IMPLANT CASE  verification with PA X-ray includes: mesio-distal correction only (not bucco-lingual) 2.3013
  2. 2. Challenges with Current 3D Surgical Guides Most require off-site fabrication Costly and time delay, several days to two weeks May result in difficulty fitting the patient when placed at the time of surgery May require a 2nd cone beam X-ray of cast
  3. 3. Best Practices for Implant Success Implants should be placed within the envelope of available bone to increase clinical success. Pre-surgical radiographs facilitate evaluation of the proposed angle of the long axis of the guide sleeve and proposed implant placement. 3D Radiographs allow us to determine if planned implant placement conflicts with the adjacent roots, the maxillary sinuses, nerves, and if it is within the envelope of available bone.
  4. 4. A System of Componentsfor the fabrication and correction of diagnostic & surgical guides in one or two dimensions  In-office or lab fabrication  Evaluate with 2D & 3D imaging  Allows linear and angular correction  Enables precision implant placement  Cost effective
  5. 5. DéPlaque Guide Right™ Surgical Guide SystemComparison with ▪ without guide used in implant placement planning implant placed WITHOUT a guide implant placed WITH a guide #19 #30 #29 #21 Start With Precision. Place With Confidence.™ WEB
  6. 6. Basic Fabrication & Correction ofDIAGNOSTIC and SURGICAL Guides Featuring GUIDE RIGHT COMPONENTS standard & magnetic guide posts cylindrical & open guide sleeves GUIDE POST BENDING TOOL angular correction linear correction PERIAPICAL X-RAYS FABRICATION OF DIAGNOSTIC guide SURGICAL guide
  7. 7. Guide Right™ COMPONENTS used inFabrication of DIAGNOSTIC & SURGICAL Guides  Guide Posts: standard · magnetic offset  Guide Sleeves: cylindrical · open  Drills  Pin-vice  Guide Post Bending Tool
  8. 8. Standard Guide Posts Short Guide Post 18 mm x 9 mm x 3/32 in. Straight Guide Post 30 mm x 2.9 mm x 3/32 in.
  9. 9. Magnetic 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 3.0od X 2.5 mm os 3.0 od X 3.0 mm os
  10. 10. Cylindrical Guide Sleeves Anterior Straight Cut 3.0 mm x 10 mm Posterior Angle Cut 3.0 mm x 10 mm Large Diameter 4.5 mm id x 5.0 mm Large Diameter 5.3 mm id x 5.0 mm
  11. 11. Magnetic Guide Post & Open Guide Sleeve Set 4.0 mm Open Guide Sleeve (short) 4.0 mm x 10 Magnetic Guide Posts 4.0 mm x 1 mm Offset Magnetic Guide Post 2.0 mm x 5.0 mm Pilot Drill 2.0 mm x 10.0 mm Pilot Drill
  12. 12. Magnetic Guide Post & Open Guide Sleeve Set 3.0 mm Open Guide Sleeve 3.3 mm Open Guide Sleeve 3.7 mm Open Guide Sleeve 4.0 mm Open Guide Sleeve 3.0 mm Straight Magnetic Guide Posts 3.0 mm Offset Magnetic Guide Post 2.0 mm Pilot Drills (to start the osteotomy) Other Drill Sizes Available on Request
  13. 13. Drillsused with straight hand piece 5/64” drill 3/32”
  14. 14. Pin vicemay be used for more accurate placement
  15. 15. Magnetic Offset Guide Post3.0 X 0.5 offset
  16. 16. Magnetic Offset Guide Post 3.0 X 1.0 offset
  17. 17. Magnetic Offset Guide Post 3.0 X 1.5 offset
  18. 18. Magnetic Offset Guide Post 3.0 X 2.0 offset
  19. 19. Magnetic Offset Guide Post 3.0 X 2.5 offset
  20. 20. Magnetic Offset Guide Post 3.0 X 3.0 offset
  21. 21. Single Bend corrections in one plane Guide Right™Generation ll / Guide Post Bending Tool
  22. 22. Guide Right™ Single Implant Case  single bend  use of protractor  use of bending toolALB 2.2013
  23. 23. Fabrication of DIAGNOSTIC Guide
  24. 24. A pencil line can be drawn on the cast to indicate a proposed osteotomy location. A hole is drilled through the planned long axis into the cast with a 3/32” drill.
  25. 25. The drill is removed from 3/32” hole, the cast is lubricated withpetroleum jelly for easy removal and, if necessary, undercutsare blocked out.
  26. 26. A 3 mm guide post is placed in the hole
  27. 27. A 3 mm guide sleeve is placed on the post and Triad® Gel is added tocapture the cleats on the sleeve and to lingual & incisal surfaces ofseveral of the adjacent teeth. After curing the DIAGNOSTIC guide &securely seating it in the patient and X-ray is taken .
  28. 28. The radiograph taken with the initial DIAGNOSTIC guide indicates acorrection is needed to avoid hitting the root of the adjacent tooth withthe osteotomy / implant.
  29. 29. The Guide Right™ protractor is placed over the pre-op DIAGNOSTIC X-ray to indicate the proposed correction of 9°.NOTE the relationship between the proposed guide sleeve with the adjacent root.
  30. 30. Guide Right™ Guide Post Bending Tool• A straight 3 mm magnetic guide post is placed in the block of the bending tool.• The 3 mm stylus is placed over the post.• Pressure is applied to point of stylus moving it to the 9° correction indicated according to the protractor reading.
  31. 31. Guide Right™ GENERATION II / GUIDE POST BENDING TOOL SINGLE BEND reviewStep 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 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 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 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.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.
  32. 32. The magnetic guide post is placed in the initiallyplanned prosthetic axis prior to correction.
  33. 33. The planned prosthetic axis is changed by bendinga straight magnetic guide post 9°.
  34. 34. Fabrication of SURGICAL Guide
  35. 35. To fabricate the final SURGICAL guide, a 3.3 mm open guidesleeve is placed over the corrected guide post which was bent 9°.
  36. 36. Triad® Gel is added to capture the cleats to form the final SURGICAL guide.
  37. 37. Pre-op DIAGNOSTIC guide Corrected SURGICAL guideAn X-ray of the altered guide sleeve angle noting the implantposition further away from the root of the adjacent tooth.
  38. 38. The final SURGICAL guide with the 3.3 mmopen guide sleeve securely seated in the patient.
  39. 39. 2 mm pilot drill with 3.0 mm stop shaftin the 3.3 mm open guide sleeve
  40. 40. After the 2 mm drill is used the alignment is checkedwith a 2 mm Direction Indicator placed in the 2 mmosteotomy and post-op X-ray is taken.
  41. 41. Note the X-ray of the 2 mm Direction Indicator in place to check thealignment of the 2 mm osteotomy indicates a satisfactory placement. Now the use of successive larger drills can proceed.
  42. 42. A 2.5 mm drill is centered in the 3.3 mm open guide sleeve.
  43. 43. The next larger (2.7 mm) drill is used.
  44. 44. A 3.2 mm drill is centered in 3.3 mm open guide sleeve.
  45. 45. Finally, the implant is placed with the carrier using the guide sleeve.
  46. 46. A final X-ray is taken to view accuracy of implant placement.
  47. 47. Products used in this presentation (1) 3/32” drill (1) 2 mm pilot drill with / 8.5 long / 3 mm stop (1) 3 mm Straight Stainless Guide Post (1) 3 mm Cylindrical Guide Sleeve (1) 3.3 mm Open Guide Sleeve (1) 3 mm Magnetic Guide Post (1) Generation ll / Guide Post Bending Tool & 3 mm Stylus (1) Direction Indicator Guide Right™ Protractor Triad® Gel 1.800.314.0065 • www.deplaque.com
  48. 48. Guide Right™ GENERATION II BENDING TOOL SINGLE BEND reviewStep 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 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 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 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.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.
  49. 49. Guide Right™ GENERATION II BENDING TOOL COMPOUND BEND overviewStep 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 2 The 1st bend can be made to the right or left direction.Step 3 The set screw is loosened and the guide post is rotated 90 ° next flat surface.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 6 The second 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 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.
  50. 50. Guide Right™ Surgical Guide System Start With Precision. Place With Confidence. 1.800.314.0065 • www.deplaque.com

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