CrystalGuide guided surgery protocol for Bicon and Quantum implants with use of bone harvesting drills as hand reamers, with ratchet or motor driven. Also standard protocol for other implant systems. CrystalGuide premium CoCr laser sintered surgical guides more info in facebook http://www.facebook.com/groups/212785608852432/

1. CrystalGuide
Quantum
Protocol for guided surgery with
Quantum bone harvesting drills
Clinical case Dr. Igor Kaplansky
1

2. CrystalGuide Quantum
• Three different possibilities regarding
indication:
1. Optical scan protocol
1. Patient is scanned using a CBCT without scan
appliance intraorally
2. Master model is optically scanned in the laboratory
and delivered as stl-file, aligned to visible tooth
structure on patient scan
Indication: only partially edentulous cases with almost no
metal artifacts and at least 5 teeth remaining
Optional: second optical scan of same model with wax-up
to visualize planned tooth positions
2

3. CrystalGuide Quantum
• Three different possibilities regarding
indication:
2. Dual scan protocol (classical for edentulous)
1. Patient is scanned with a CBCT with scan appliance
intraorally
2. Scan appliance is scanned alone on the CBCT
Indication: totally edentulous cases
3

4. CrystalGuide Quantum
• Three different possibilities regarding
indication:
3. Triple scan protocol (Dr. Gross)
1. Patient is scanned with CBCT with Miratray clear
impression tray (Hager) and PVS medium material
intraorally; patient should not apply bite pressure
on it
2. The same Miratray impression is positioned on the
model and CBCT scanned (previously fit on model
has to be checked)
3. Master model and antagonist cast are optically
scanned as stl-file in occlusion
4. Optional: second optical scan of same master cast
with wax-up to visualize planned tooth positions
Indication: main protocol for partially edentulous case
4

5. CrystalGuide Quantum
• Dual scan protocol
Step 1
CT or CBCT scan of patient wearing the scan
appliance with radiographic markers
5

6. CrystalGuide Quantum
• Dual scan protocol
Step 2
CT or CBCT scan of scan appliance alone
6

7. CrystalGuide Quantum
• Dual scan protocol
Step 3
Alignment of these both datasets and planning in
relation to scan appliance
7

8. CrystalGuide Quantum
• Dual scan protocol
The current denture can be modified and utilized as the scan appliance or a
replica can be fabricated.
Round holes are created in specific points on the denture or replica using a #6
round bur then filled with gutta percha creating radiographic alignment markers.
Current denture with markers
Replica denture with markers
8

9. CrystalGuide Quantum
• Dual scan protocol
Easier is the use of Visionmark radiographic markers. They are just taped to
the prosthesis (6 markers, positions like in the left picture)
http://www.suremark.com/catalog/visionmark. Recommended size is V-20.
Current denture with markers
Visionmark V-20 marker
9

10. CrystalGuide Quantum
• Triple scan protocol (Dr. Gross)
Good impression with medium PVS
material and Miratray impression
tray, model poured and fit of
impression checked both on model
and intraorally
The Miratray impression trays are
available in US as clear impression
trays. These trays have to be used
as they have a special surface
geometry which is used for
alignment
http://www.hagerworldwide.com/pages/dentalproducts/impressiontrays/cleartrays.html
10

11. CrystalGuide Quantum
• Triple scan protocol (Dr. Gross)
Optical scan of the master
model and antagonist in bite
relation
11

12. CrystalGuide Quantum
• Triple scan protocol
Step 1
CT or CBCT scan of patient wearing the Miratray
impression
12

13. CrystalGuide Quantum
• Triple scan protocol
Step 2
CT or CBCT scan of Miratray on model
13

14. CrystalGuide Quantum
Planning with excellent
and free software
BlueSkyPlan, download
under
https://blueskybio.com/pa
ges/overview_3
Loaded CBCT dataset

15. CrystalGuide Quantum
Model aligned to CBCT
dataset

16. CrystalGuide Quantum
Model aligned to CBCT
dataset

17. CrystalGuide Quantum
Model and antagonist
aligned to CBCT dataset

18. CrystalGuide Quantum
Model and antagonist
aligned to CBCT dataset

19. CrystalGuide Quantum
Panoramic overview

20. CrystalGuide Quantum
Panoramic sum image with
planned implants

21. CrystalGuide Quantum
Quantum implant planned
subcrestal, outline of model and
antagonist visible

22. CrystalGuide Quantum
Quantum implant
planned subcrestal,
outline of model and
antagonist visible

23. CrystalGuide Quantum
Quantum implant planned
subcrestal, outline of model
and antagonist visible

24. CrystalGuide Quantum
Quantum implant planned
subcrestal, outline of model
and antagonist visible

25. CrystalGuide Quantum
Planned implant
positions on model in
occlusion

26. CrystalGuide Quantum
Planned implant
positions on model in
occlusion

27. CrystalGuide Quantum
CrystalGuide designed with
lateral access openings and
tubes adapted to Quantum
guiding system developed
by Dr. Michael Gross

28. CrystalGuide Quantum
CrystalGuide designed with
lateral access openings and
tubes adapted to Quantum
guiding system developed by
Dr. Michael Gross

29. CrystalGuide Quantum

30. CrystalGuide Quantum
Quantum components for guided surgery
30

31. CrystalGuide Quantum
CrystalGuide, Quantum bone harvesting drill, tube insert and stopper

32. CrystalGuide Quantum
CrystalGuide, Quantum bone harvesting drill, tube insert and stopper

33. CrystalGuide Quantum

34. CrystalGuide Quantum

35. CrystalGuide Quantum

36. CrystalGuide Quantum

37. CrystalGuide Quantum

38. CrystalGuide Quantum

39. CrystalGuide Quantum

40. CrystalGuide Quantum

41. CrystalGuide Quantum

42. CrystalGuide Quantum