11 case for co axis angled implants
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Transcript of 11 case for co axis angled implants
Guide Right™
CASE FOR ANGLED IMPLANTS
ZHEN 2.2013
# 10 & # 6
Vacuform Shell
Offset Guide Posts
Open Guide Sleeves
Evaluation using Software
Lineal Corrections
Angular Corrections
Invivo5
Featuring:
Vacuform
3 mm guide posts
3 mm guide sleeves
Fabrication of DIAGNOSTIC guide
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.
PREOPERATIVE
Software Evaluation Invivo5 Anatomage
# 6
# 6
INITIAL ALIGNMENT of guide sleeve with implant
axial cross sectional
tangential view volumetric
Invivo5 Anatomage
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
Invivo5 Anatomage
Cone beam image showing the axial alignment of the virtual implant
in the # 6 position..
# 6
Utilizing 12º Angled Southern Implant ▪
axial cross sectional
tangential view volumetric
Invivo5 Anatomage
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
tangential view Invivo5
Anatomage
Southern Implant & Guide Right™ Guide Sleeve in Place
▪ 12º facial correction needed to place implant ▪
cross sectional view
#6
Invivo5
Anatomge
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
tangential view Invivo5
Anatomage
Southern Implant & Guide Right™ Guide Sleeve in Place
▪ 12º facial checking the correction with actual bent guide post on image ▪
cross sectional view
#6
Invivo5
Anatomge
PREOPERATIVE
Software Evaluation Invivo5 Anatomage
# 10
Invivo5
Anatomage ▪ Initial Alignment ▪
occlusal cross sectional
tangential view volumetric
Invivo5
Anatomage
#10
Showing virtual implant and the guide sleeve in two planes.
#10 A Southern 12° Co-axis Implant will be used, Angular Correction for guide sleeve: 12º toward the facial
Invivo5
Anatomage
cross sectional
#10 A Southern 12° Co-axis Implant will be used, Checking the correction: 12º toward the facial
Invivo5
Anatomage
cross sectional
Invivo5
Anatomage
▪ Southern Implant 12º co-axis virtual image ▪
Linear Correction:
1 mm offset guide post > moving closer to root of # 11
# 10
tangential view Invivo5
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
Final X-rays of implant placement
# 10 # 6
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
For more information on use of the bending tool go to
www.deplaque.com ▪ Guide Right™ Generation ll Bending Tool
10 ° example
Close up of Offset Guide Posts in bending block
Guide Right™
Guide Post Bending Tool
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 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 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 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.
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.
Guide Right™
GUIDE POST BENDING TOOL
SINGLE BEND review
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 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 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.
Step 3 The set screw is loosened and the guide post is rotated 90 ° next flat surface.
Step 2 The 1st bend can be made to the right or left direction.
Step 6 The second bend can be made in either direction according to the x-ray.
Guide Right™
GUIDE POST BENDING TOOL
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
In-office or lab fabrication
Evaluate with 2D & 3D imaging
Allows linear and angular correction
Enables precision implant placement
Cost effective
A System of Components
for the fabrication and correction of DIAGNOSTIC & SURGICAL guides
in one or two dimensions
1.800.314.0065 • www.deplaque.com
Guide Right™ Surgical Guide System
Start With Precision. Place With Confidence.™
1.800.314.0065 • www.deplaque.com
fabricate ▪ evaluate ▪ correct ▪ verify ▪ place