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Guide Right™
                  CASE FOR ANGLED IMPLANTS


          Featuring:

              # 10 & # 6
             Vacuform Shell
             Offset Guide Posts
             Open Guide Sleeves
             Evaluation using Invivo5 Software
             Lineal Corrections
             Angular Corrections




ZHEN 2.2013
Fabrication of DIAGNOSTIC guide

          Vacuform
          3 mm guide posts
          3 mm guide sleeves
Cast of the patient as he presented at initial exam.
Temporary partial denture
Impression and cast with partial denture in place.
Vacuform shell on cast marked to indicate
 the planned axis holes for the implants.
Holes are drilled through the plastic shell into the incisal edge with 3/32” drills.
Vacuform shell on cast with holes drilled indicating
    the proposed axis holes for the implants.
The vacuform shell removed.
The drills are removed and replaced
with two short 3 mm straight guide posts.
3 mm diagnostic guide sleeves (with 1 cleat) are placed
on the guide posts with cleats positioned on the palatal surface.
Triad® Gel is applied capturing the cleats on the guide posts
     and adjacent teeth to form the DIAGNOSTIC guide
         which is used for the cone beam imaging.
#6     PREOPERATIVE
Invivo5 Software Evaluation
Anatomage
#6
INITIAL ALIGNMENT of guide sleeve with implant

     axial                            cross sectional




                            Invivo5
                        Anatomage




     tangential view                       volumetric
#6
       Utilizing 12º Angled Southern Implant ▪

       axial                                          cross sectional




                                       Invivo5
                                      Anatomage




       tangential view                                     volumetric

Cone beam image showing alignment of the guide sleeve in the # 6 position.
                 A 12 º bend is required for this site.
#6
              Utilizing 12º Angled Southern Implant ▪

               axial                                         cross sectional




               tangential view                                      volumetric

            Cone beam image showing the axial alignment of the virtual implant
                                in the # 6 position..
 Invivo5
Anatomage
#6




      Invivo5
     Anatomage                 tangential view

The guide sleeve is in line with the virtual implant, but close to root of #5.
So a 1.5 mm offset post will be used to move the position of the guide
sleeve to the mesial.
Southern Implant & Guide Right™ Guide Sleeve in Place
  #6 ▪ 12º facial correction needed to place implant   ▪




                      cross sectional view
Invivo5
Anatomge
#6




      Invivo5
     Anatomage                 tangential view

The guide sleeve is in line with the virtual implant, but close to root of #5.
So a 1.5 mm offset post will be used to move the position of the guide
sleeve to the mesial.
#6         Southern Implant & Guide Right™ Guide Sleeve in Place
▪ 12º facial checking the correction with actual bent guide post on image ▪




                             cross sectional view
Invivo5
Anatomge
# 10   PREOPERATIVE
Invivo5 Software Evaluation
Anatomage
Invivo5
#10                ▪ Initial Alignment ▪
                               Anatomage

      Showing virtual implant and the guide sleeve in two planes.

       occlusal                                 cross sectional




                                    Invivo5
                                   Anatomage




       tangential view                               volumetric
#10 A Southern 12° Co-axis Implant will be used,
   Angular Correction for guide sleeve: 12º toward the facial




                          cross sectional
 Invivo5
 Anatomage
#10 A Southern 12° Co-axis Implant will be used,
             Checking the correction: 12º toward the facial




                              cross sectional
 Invivo5
 Anatomage
Invivo5
# 10  ▪ Southern Implant 12º co-axis virtual image ▪
                           Anatomage
                    Linear Correction:
   1 mm offset guide post > moving closer to root of # 11




Invivo5                 tangential view
Anatomage
Fabrication of SURGICAL guide

        Magnetic Guide Posts
        Open Guide Sleeves
Corrected magnetic offset guide posts in place:
# 6 > 1.5 mm offset guide post to move mesially, away from # 5
#10 > 1.0 mm offset guide post to move distally, closer to # 11
3.3 mm open guide sleeves positioned over the magnetic guide posts
     with cleats positioned toward the palatal surface.
Triad® Gel is added to form the completed SURGICAL guide.
POST-OPERATIVE
  Final X-rays
#6                            # 10

Final X-rays of implant placement
RESTORATION
Axis indicator (3 mm guide posts) in place
Posts indicating the long axis of the abutments
Atlantis abutments
Final Restoration
Final Restoration
Atlantis Abutment
Final Restoration
Final Restoration
Guide Right™
               Guide Post Bending Tool


                                                10 ° example




  For more information on use of the bending tool go to
www.deplaque.com ▪ Guide Right™ Generation ll Bending Tool
Guide Right™
               Guide Post Bending Tool


Close up of Offset Guide Posts in bending block
Guide Right™
                   GUIDE POST BENDING TOOL

                              SINGLE BEND review
Step 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 set crew and remove guide post and the stylus to find the guide post
       bent to the desired angle.
Guide Right™
                   GUIDE POST BENDING TOOL

                           COMPOUND BEND overview
Step 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.
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
Guide Right™
    Products shown in this case

 2 - 3/32” Drill
   2 - 3 mm Straight Guide Posts (short)
 2 - 3 mm Guide Sleeves
 1 - 3 mm X 1.0 mm Offset Magnetic Guide Post
 1 - 3 mm X 1.5 mm Offset Magnetic Guide Post
 2 - 3 mm Open Guide Sleeve
 Guide Post Bending Tool
 Triad® Gel
A System of Components
for 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


                 1.800.314.0065 •   www.deplaque.com
Guide Right™ Surgical Guide System
fabricate ▪ evaluate ▪ correct ▪ verify ▪ place




Start With Precision. Place With Confidence.™


     1.800.314.0065 •     www.deplaque.com

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11 case for co axis angled implants

  • 1. Guide Right™ CASE FOR ANGLED IMPLANTS Featuring:  # 10 & # 6  Vacuform Shell  Offset Guide Posts  Open Guide Sleeves  Evaluation using Invivo5 Software  Lineal Corrections  Angular Corrections ZHEN 2.2013
  • 2. Fabrication of DIAGNOSTIC guide  Vacuform  3 mm guide posts  3 mm guide sleeves
  • 3. Cast of the patient as he presented at initial exam.
  • 5. Impression and cast with partial denture in place.
  • 6. Vacuform shell on cast marked to indicate the planned axis holes for the implants.
  • 7. Holes are drilled through the plastic shell into the incisal edge with 3/32” drills.
  • 8. Vacuform shell on cast with holes drilled indicating the proposed axis holes for the implants.
  • 10. The drills are removed and replaced with two short 3 mm straight guide posts.
  • 11. 3 mm diagnostic guide sleeves (with 1 cleat) are placed on the guide posts with cleats positioned on the palatal surface.
  • 12. Triad® Gel is applied capturing the cleats on the guide posts and adjacent teeth to form the DIAGNOSTIC guide which is used for the cone beam imaging.
  • 13. #6 PREOPERATIVE Invivo5 Software Evaluation Anatomage
  • 14. #6 INITIAL ALIGNMENT of guide sleeve with implant axial cross sectional Invivo5 Anatomage tangential view volumetric
  • 15. #6 Utilizing 12º Angled Southern Implant ▪ axial cross sectional Invivo5 Anatomage tangential view volumetric Cone beam image showing alignment of the guide sleeve in the # 6 position. A 12 º bend is required for this site.
  • 16. #6 Utilizing 12º Angled Southern Implant ▪ axial cross sectional tangential view volumetric Cone beam image showing the axial alignment of the virtual implant in the # 6 position.. Invivo5 Anatomage
  • 17. #6 Invivo5 Anatomage tangential view The guide sleeve is in line with the virtual implant, but close to root of #5. So a 1.5 mm offset post will be used to move the position of the guide sleeve to the mesial.
  • 18. Southern Implant & Guide Right™ Guide Sleeve in Place #6 ▪ 12º facial correction needed to place implant ▪ cross sectional view Invivo5 Anatomge
  • 19. #6 Invivo5 Anatomage tangential view The guide sleeve is in line with the virtual implant, but close to root of #5. So a 1.5 mm offset post will be used to move the position of the guide sleeve to the mesial.
  • 20. #6 Southern Implant & Guide Right™ Guide Sleeve in Place ▪ 12º facial checking the correction with actual bent guide post on image ▪ cross sectional view Invivo5 Anatomge
  • 21. # 10 PREOPERATIVE Invivo5 Software Evaluation Anatomage
  • 22. Invivo5 #10 ▪ Initial Alignment ▪ Anatomage Showing virtual implant and the guide sleeve in two planes. occlusal cross sectional Invivo5 Anatomage tangential view volumetric
  • 23. #10 A Southern 12° Co-axis Implant will be used, Angular Correction for guide sleeve: 12º toward the facial cross sectional Invivo5 Anatomage
  • 24. #10 A Southern 12° Co-axis Implant will be used, Checking the correction: 12º toward the facial cross sectional Invivo5 Anatomage
  • 25. Invivo5 # 10 ▪ Southern Implant 12º co-axis virtual image ▪ Anatomage Linear Correction: 1 mm offset guide post > moving closer to root of # 11 Invivo5 tangential view Anatomage
  • 26. Fabrication of SURGICAL guide  Magnetic Guide Posts  Open Guide Sleeves
  • 27. Corrected magnetic offset guide posts in place: # 6 > 1.5 mm offset guide post to move mesially, away from # 5 #10 > 1.0 mm offset guide post to move distally, closer to # 11
  • 28. 3.3 mm open guide sleeves positioned over the magnetic guide posts with cleats positioned toward the palatal surface.
  • 29. Triad® Gel is added to form the completed SURGICAL guide.
  • 31. #6 # 10 Final X-rays of implant placement
  • 33. Axis indicator (3 mm guide posts) in place
  • 34. Posts indicating the long axis of the abutments
  • 41. Guide Right™ Guide Post Bending Tool 10 ° example For more information on use of the bending tool go to www.deplaque.com ▪ Guide Right™ Generation ll Bending Tool
  • 42. Guide Right™ Guide Post Bending Tool Close up of Offset Guide Posts in bending block
  • 43. Guide Right™ GUIDE POST BENDING TOOL SINGLE BEND review Step 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 set crew and remove guide post and the stylus to find the guide post bent to the desired angle.
  • 44. Guide Right™ GUIDE POST BENDING TOOL COMPOUND BEND overview Step 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.
  • 45. 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
  • 46. Guide Right™ Products shown in this case  2 - 3/32” Drill  2 - 3 mm Straight Guide Posts (short)  2 - 3 mm Guide Sleeves  1 - 3 mm X 1.0 mm Offset Magnetic Guide Post  1 - 3 mm X 1.5 mm Offset Magnetic Guide Post  2 - 3 mm Open Guide Sleeve  Guide Post Bending Tool  Triad® Gel
  • 47. A System of Components for 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 1.800.314.0065 • www.deplaque.com
  • 48. Guide Right™ Surgical Guide System fabricate ▪ evaluate ▪ correct ▪ verify ▪ place Start With Precision. Place With Confidence.™ 1.800.314.0065 • www.deplaque.com