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.

1. Maxillary Posterior Case
 4 Implants: #12 ▪ #13 ▪ #14
 #19 *guide not shown in presentation
 Ceramic & Open Stainless Guide Sleeves
 Magnetic & Offset Open Guide Posts
 3D Cone Beam Imaging
 Utilizing Cosine Rule
 Guide Post Bending Tool
MMEI 2.2013

2. Fabrication of DIAGNOSTIC guide

3. DIAGNOSTIC Guide
3 mm
post & sleeve
4 mm
post & sleeve
 Holes are drilled in the cast in the planned positions of the bicuspids and first molar.
 Two 3 mm guide posts and a 4 mm guide post were placed in the holes in the cast.
 Three ceramic guide sleeves were used to make the initial DIAGNOSTIC guide.

4. Actual Guide Posts Used
3 mm X 30 3 mm X 30 4 mm X 20
Generation ll Guide Post Guide Post Guide Posta

5. PREview of Pre-op Corrections
# 12
NO CORRECTION
#13
LINEAR CORRECTION
2.1 mm toward the bucal + 2.1 mm toward the distal
accomplished by: 3 mm offset guide post rotated 45° disto-buccally
# 19
LINEAR CORRECTION
2 mm toward the buccal
ANGULAR CORRECTION
6.6° toward the lingual
#14
LINEAR CORRECTION
3 mm toward the palatal

6. PRE-OPERATIVE Evaluation
GALAXIS Cone Beam Images

7. #12
GALAXIS
 A cone beam X-ray was taken and the images are viewed for each individual site
to verify or correct the position of the guide sleeve.
 Panoramic views in the GALAXIS (Sirona) software are not very accurate.
Therefore, tangential & cross sectional views are used to verify the sites in next slides.

8. GALAXIS
tangential view cross sectional view
Both views indicate #12 to be well aligned
no need to be corrected

9. GALAXIS
# 13 panoramic view
middle implant highlighted in orange

10. GALAXIS # 13
tangential view cross sectional view
Both views indicate the 3 mm ceramic guide sleeve should be moved to the buccal &
distal to correct the position of the proposed osteotomy.
This means: a LINEAR CORRECTION of 2.1 mm bucally and 2.1 mm distally
made by using a 3 mm offset guide post rotated 45° disto-buccally.
The angle of the guide sleeve is correct. Therefore , NO ANGULAR CORRECTION.
Cosine is applied to determine correction data.
* see next 4 slides

11. DéPlaque
Pythagorean Theorem
COSINE 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°.
See additional slide show: for more information
Pythagorean Theorem
COSINE Calculations for Guide Right™ Guides

12. Cosine for site #13
A = cosine of 45° X 3 mm offset post
(0.707 X 3 mm = 2.12 mm)
distal 2.1 mm
45°
buccal 2.1 mm
guide post center
What is COSINE? See FAQ www.deplaque.com

13. Cosine EXAMPLE
A = cosine of 45° X 2.5 mm offset post
(0.707 X 2.5 mm = 1.8 mm)
distal 1.8 mm
45°
buccal 1.8 mm
guide post center

14. Cosine EXAMPLE
A = cosine of 45° X 1.5 mm offset post
(0.707 X 1.5 mm = 1.06 mm)
distal 1.06 mm
45°
buccal 1.06 mm
guide post center

15. Cosine EXAMPLE
A = cosine of 45°X 2 mm offset post
(0.707 X 2 mm = 1.42 mm)
distal 1.4 mm
45°
buccal 1.4 mm
guide post center

16. GALAXIS
# 14 panoramic view

17. GALAXIS
# 14
A 5 X 9 mm virtual implant is placed on the cone beam image and indicates
 LINEAR CORRECTION: the guide post will need to be moved 3 mm palatally
 by using a 3 mm offset post with no change in the angle of the guide post.

18. GALAXIS
# 19 panoramic view

19. # 19
GALAXIS
tangential view cross sectional view
ANGULAR CORRECTION of 6.6° to the lingual will be needed
and a LINEAR CORRECTION of the guide post >
2 mm to the buccal using a 2 mm offset guide post to avoid perforation of the lingual plate.
The green line indicates the acceptable angle of the guide sleeve in the bucco-lingual plane.

20. REview of Pre-op Corrections
# 12
NO CORRECTION
#13
LINEAR CORRECTION
2.1 mm toward the bucal + 2.1 mm toward the distal
accomplished by: 3 mm offset guide post rotated 45° disto-buccally
#14
LINEAR CORRECTION
3 mm toward the palatal
# 19 *guide not shown in presentation
LINEAR CORRECTION
2 mm toward the buccal
ANGULAR CORRECTION
6.6° toward the lingual

21. Fabrication of SURGICAL guide

22. magnetic guide posts in cast
• # 12 leave as is
• # 13 move buccally 2 mm.
• # 14 No angle correction is necessary

23. Magnetic guide posts with open guide sleeves
showing cleats positioned toward the palatal surface.

24. Triad® Gel applied to open guide sleeve cleats
& adjacent teeth to form the SURGICAL guide.

25. After the initial 2 mm drill a direction indicator was
placed to check the proximity to the adjacent root.

26. POST-OPERATIVE Evaluation
GALAXIS Cone Beam Images

27. GALAXIS
# 12 volumetric view
POST OP results

28. GALAXIS
#13 panoramic view

29. #12 POST-op RESULTS
GALAXIS
tangential view cross sectional view
Alignment of the #12 implant with the SURGICAL guide in place - both views.

30. #13 POST-op RESULTS
GALAXIS
tangential view cross sectional view
Alignment of the #13 implant with open guide sleeve - both views.

31. #14 POST-op RESULTS
GALAXIS
tangential view cross sectional view
Alignment of the #14 implant with guide sleeves – both views.

32. Post-op position of the #19 implant

33. Impressions were made at the time of the surgery and an X-ray
was taken of the impression copings for #12 ▪ #13 ▪ #14
to be sure they were completely seated.

34. A lateral view of the master cast
with prepared abutments.

35. Final restorations.

36. Final restoration.

37. Guide Right™
Products Used in this Presentation
 (1) 3/32” drill
 (2) 3 mm & (1) 4 mm Straight Guide Posts for the DIAGNOSTIC guide
 (2) 3 mm & (1) 4 mm Ceramic Guide Sleeve for the DIAGNOSTIC guide
 (2) 3 mm & (1) 4 mm Open Guide Sleeve for the SURGICAL guide
 (1) 3 mm Straight Magnetic Guide Post
 (1) 3 mm x 3 mm Offset Magnetic Guide Post
 (1) 4 mm x 3 mm Offset Magnetic Guide Post
 Guide Post Bending Tool & 3mm Stylus
 Triad® Gel
 ► See slide show : Use of Pythagorean Theorem with Guide Right System
1.800.314.0065 • www.deplaque.com

38. 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

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