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13 mandibular implant case correcting divergent angled diagnostic guide sleeves


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The Guide Right Surgical Guide System is a system of components for the fabrication and correction of diagnostic and surgical dental implant guides in 1 or 2 dimensions.

Published in: Health & Medicine
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13 mandibular implant case correcting divergent angled diagnostic guide sleeves

  1. 1. Mandibular Posterior CaseCorrecting Divergent Angled Diagnostic Guide Sleeves Featuring:  Magnetic Offset Guide Posts  Open Guide Sleeves  Diagnostic Guide Sleeves [to increase diameter of guide sleeve]  GALAXIS Cone Beam Software Evaluation  Generation ll ▪ Guide Post Bending ToolCALHO 2.2013
  2. 2. 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 3.0 od X 2.5 mm os 3.0 od X 3.0 mm os
  3. 3. 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
  4. 4. Fabrication of DIAGNOSTIC Guide
  5. 5. Holes are drilled deliberately accentuating inaccurately initiallyplanned long axis of the implant positions with a 3/32” drill.
  6. 6. Straight 3 mm guide posts are placed in the questionableholes drilled in the positions of #19 and #20.
  7. 7. View of 3 mm straight guide posts in place showing the divergent angles.
  8. 8. 3 mm guide sleeves are positioned on the guide post with the cleat facing thelingual. The cast is lubricated & Triad® Gel added to the guide sleevescapturing the cleats including lingual & incisal surfaces of several of theadjacent teeth. After curing the DIAGNOSTIC guide & securely seatingit in the patient, a cone beam X-ray is taken.
  9. 9. PRE-OPERATIVE Evaluation GALAXIS Cone Beam
  10. 10. Preview of Pre-op Corrections ANGULAR CORRECTIONS #19 9° Bend toward the buccal #20 7° Bend rotated toward the lingual Cosine is applied to determine correction data. * see next 3 slide
  11. 11. DéPlaque Pythagorean TheoremCOSINE Calculations for Guide Right™ Guides The cosine of 45° is recommended for Guide Right corrections BECAUSE rotating the offset guide post half way between 2 adjacent planes (90° apart) is 45°.
  12. 12. Correction based on the calculations from the Pythagorean TheoremTo move the position of the guide sleeve 1.4 mm both mesially & buccally: ► use a 3 mm X 1.5 mm offset guide post ► and direct the offset 45º facially and buccally. Cosine: 1.5 mm X 0.71 = 1.06 mm see slideshow > Use of Pythagorean Theorem in 9 Single Implant Case
  13. 13. A= cosine of 45º X 1.5(0.707 X 1.5 mm = 1.06 mm
  14. 14. GALAXIS Panoramic view #19 highlighted The mandibular nerve is drawn in with the GALAXIS software.
  15. 15. GALAXIS tangential cross sectional # 19 viewed with GALAXIS software
  16. 16. 9° L BGALAXIS tangential cross sectional # 19 evaluated in GALAXIS software and 9° corrected angle drawn in.
  17. 17. L B 9° #19 tangential #19 cross sectionalGALAXIS  A cone beam X-ray is taken with the DIAGNOSIC guide in place.  The images are evaluated with the software.  The cross sectional image on the right will be corrected 9° rotated toward the buccal surface.
  18. 18. GALAXIS Panoramic view #20 highlighted
  19. 19. 9° L BGALAXIS #20 tangential #20 cross sectional The image of the mesial implant will be rotated 7° toward the lingual
  20. 20. 7° L BGALAXIS #20 tangential #20 tangential #20 cross sectional #20 cross sectional The image of the mesial implant will be rotated 7 ° toward the lingual
  21. 21. POST-OPERATIVE verificationGALAXIS Cone Beam Images
  22. 22. # 19 9° bend
  23. 23. # 20 7° 7° bend rotated toward the buccal
  24. 24. Angle corrected 3 mm guide posts in holes
  25. 25. Buccal viewAngle corrected 3 mm guide posts in holes
  26. 26. Buccal view3 mm guide posts with (3 x 2 mm id) diagnostic guide sleeves (1 cleat) serving to increase the diameter of the 3 mm guide sleeve for use with 4 mm open guide sleeve
  27. 27. occlusal view3 mm guide post with 2 mm id diagnostic guide sleeve (1 cleat) serving to increase the diameter of the 3 mm guide sleeve for use with 4mm open guide sleeve
  28. 28. 3 mm diagnostic guide sleeves - 3 mm magnetic guide posts with 4 mm open guide sleeves added
  29. 29. Triad® Gel added & cured to form the SURGICAL guide
  30. 30. GALAXIS Panoramic view # 19 Post-op cone beam shows virtual implant superimposed over placed implant and aligned with the open guide sleeve.
  31. 31. #19 Post-Operative Cone BeamGALAXIS tangential view cross sectional view
  32. 32. 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.
  33. 33. Guide Right™ GENERATION II ▪ Guide Post 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.
  34. 34. Guide Right™ Products used in this presentation  1 - 3/32” drill  2 - 3 mm Guide Post  2 - 3 mm Guide Sleeve  2 - 3 mm x 2 mm id Diagnostic Guide Sleeve [1 cleat]  2 - 4.0 mm Open Guide Sleeve (short)  1 - 2.0 mm x 5.0 mm Pilot Drill  1 - 2.0 mm x 10.0 mm Pilot Drill  Triad® Gel  Generation ll ▪ Guide Post Bending Tool1.800.314.0065 •
  35. 35. 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
  36. 36. Guide Right™ Surgical Guide System fabricate ▪ evaluate ▪ correct ▪ verify ▪ place Start With Precision. Place With Confidence.™ 1.800.314.0065 •