This document describes the fabrication of diagnostic and surgical guides for dental implant placement in two patients. Guides were made using 3mm and 4mm guide posts, ceramic and magnetic guide sleeves, and Triad gel. For each patient, a diagnostic guide was made and evaluated using CBCT imaging software to determine needed angular corrections. Surgical guides were then made incorporating the corrections by bending the guide posts using a bending tool. The guides will help precisely place the implants.

1. Case Corrections in 2 Planes
mesio▪distal & bucco▪lingual
Featuring
#18 ▪ #19
DIAGNOSTIC Guide SURGICAL Guide
ANAN 2.2013

2. Fabrication of DIAGNOSTIC Guide
 3 mm Guide Posts
 3 mm Ceramic Guide Sleeves
 Generation ll Bending Tool

3. An impression was taken and a cast was made.
Two holes are drilled in the cast with a Two 3 mm guide posts are placed in
3/32” drill. the holes.

4. Ceramic guide sleeves are placed on the Triad® Gel was used to capture the
3 mm guide post. cleat on the ceramic guide sleeve
and adjacent teeth to fabricate the
DIAGNOSTIC guide.
The DIAGNOSTIC guide is ready to be securely seated in the patient for the cone
beam X-ray so that the long axis of the proposed osteotomies can be evaluated.

5. GALAXIS
Pre-op Software Evaluation
with DIAGNOSTIC Guide securely seated in patient

6. GALAXIS #18 panoramic view
A better position appears to be angled mesially from the
existing axis of the ceramic guide sleeve in the DIAGNOSTIC guide.

7. # 18
L B
tangential view cross sectional view
GALAXIS
11° bend to the mesial 14° bend to the lingual

8. #18
11°
FIRST BEND 11°.
The stylus is placed over the straight 3 mm guide post.
The set screw is tightened and the guide post is bent 11°
WHY to the LEFT? Easier to follow when bending to the mesial as in slide above.

9. #18
11°
Guide post in bending tool block with 11° bend.

10. #18
PREPARATION for 2nd BEND
With the stylus still on the guide post, the set screw is loosened
and the stylus on the guide post is rotated 90° back to the 0° mark.
This causes the stylus to raise up off the bending plate.
NOTE the shadows on both sides of the stylus

11. #18
stylus support bar
wing
screw
The sliding support bar is positioned beneath the stylus
to maintain the 11° angle of the 1st bend.

12. #18
14°
SECOND BEND
The wing screws are tightened to secure the stylus for the 2nd bend of 14°
toward the lingual (left) to avoid hitting the root of the distal tooth.

13. #19 panoramic view
GALAXIS
A better position appears to be angled toward the mesial from the
existing axis of the ceramic guide sleeve in the DIAGNOSTIC guide.

14. # 19
L B
tangential view cross sectional view
GALAXIS
9° bend to the mesial 15° bend to the lingual

15. #19
9°
1st BEND 9°.

16. With the stylus still on the guide sleeve it is rotated back to the 0° mark.

17. The SECOND bend for #19 guide post is 15°.

18. Review of Pre-op Corrections
# 18 #19
ANGULAR CORRECTIONS ANGULAR CORRECTION
1st bend: 11° bend to the mesial 9° bend to the mesial
2nd bend: 14° bend to the lingual 15° bend to the lingual
Cosine is applied to determine correction data.
* see Pythagorean Theorem - COSINE CALCULATION slideshow

19. Fabrication of SURGICAL Guide
 4 mm Magnetic Guide Posts
 4 mm Open Guide Sleeves
 Adding Triad® Gel in Layers

20. Wax added to buccal surface to stabilize position of 4 mm open guide sleeves
and guide posts prior to adding gel to the cleats on lingual surface.

21. Occlusal view of 4 mm magnetic guide sleeves stabilized with red wax.
Then 4 mm open guide posts are removed.

22. First layer of clear Triad® Gel added to adjacent tooth on lingual surface.

23. Second layer of Triad® Gel extended to adjacent teeth in arch for
greater stability and cured to form the SURGICAL guide.

24. Last layer of clear Triad® Gel added to capture
occlusal surface of teeth and cured

25. Completed SURGICAL guide
ready for cold sterilization and placement.

26. Guide Right™
Products shown in this case presentation
 2 - 3 mm Stainless Guide Posts
 2 - 3 mm Ceramic Guide Sleeves
 2 - 4 mm Magnetic Guide Posts
 2 - 4 mm Open Guide Sleeves
 1 - 3/32” drill
 Generation ll ▪ Bending Tool
 Triad® Gel
Not shown but used: 2 mm pilot drill / 4mm stop shaft
NOTE: either stainless or ceramic guide sleeves could be used
1.800.314.0065 • www.deplaque.com

27. Guide Right™
GENERATION II ▪ 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 screw and remove guide post and the stylus to find the guide post
bent to the desired angle.

28. Guide Right™
GENERATION II ▪ 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.

29. 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

30. DéPlaque
Guide Right™ Surgical Guide System
fabricate ▪ evaluate ▪ correct ▪ verify ▪ place
Start With Precision. Place With Confidence.™
1.800.314.0065 • www.deplaque.com