11 case for co axis angled implants

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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 I nvi vo5 Featuring:

Transcript of 11 case for co axis angled implants

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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:

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Vacuform

3 mm guide posts

3 mm guide sleeves

Fabrication of DIAGNOSTIC guide

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Cast of the patient as he presented at initial exam.

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Temporary partial denture

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Impression and cast with partial denture in place.

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Vacuform shell on cast marked to indicate

the planned axis holes for the implants.

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Holes are drilled through the plastic shell into the incisal edge with 3/32” drills.

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Vacuform shell on cast with holes drilled indicating

the proposed axis holes for the implants.

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The vacuform shell removed.

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The drills are removed and replaced

with two short 3 mm straight guide posts.

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3 mm diagnostic guide sleeves (with 1 cleat) are placed

on the guide posts with cleats positioned on the palatal surface.

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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.

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PREOPERATIVE

Software Evaluation Invivo5 Anatomage

# 6

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# 6

INITIAL ALIGNMENT of guide sleeve with implant

axial cross sectional

tangential view volumetric

Invivo5 Anatomage

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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

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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

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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

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Southern Implant & Guide Right™ Guide Sleeve in Place

▪ 12º facial correction needed to place implant ▪

cross sectional view

#6

Invivo5

Anatomge

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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

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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

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PREOPERATIVE

Software Evaluation Invivo5 Anatomage

# 10

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Invivo5

Anatomage ▪ Initial Alignment ▪

occlusal cross sectional

tangential view volumetric

Invivo5

Anatomage

#10

Showing virtual implant and the guide sleeve in two planes.

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

Invivo5

Anatomage

cross sectional

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

Invivo5

Anatomage

cross sectional

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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

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Fabrication of SURGICAL guide

Magnetic Guide Posts

Open Guide Sleeves

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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

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3.3 mm open guide sleeves positioned over the magnetic guide posts

with cleats positioned toward the palatal surface.

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Triad® Gel is added to form the completed SURGICAL guide.

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POST-OPERATIVE

Final X-rays

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Final X-rays of implant placement

# 10 # 6

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RESTORATION

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Axis indicator (3 mm guide posts) in place

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Posts indicating the long axis of the abutments

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Atlantis abutments

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Final Restoration

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Final Restoration

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Atlantis Abutment

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Final Restoration

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Final Restoration

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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

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Close up of Offset Guide Posts in bending block

Guide Right™

Guide Post Bending Tool

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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

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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

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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

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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

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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

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Guide Right™ Surgical Guide System

Start With Precision. Place With Confidence.™

1.800.314.0065 • www.deplaque.com

fabricate ▪ evaluate ▪ correct ▪ verify ▪ place