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19 fibular graft case

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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.

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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 / Guide Post 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 ▪ Guide Post 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 90°and 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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