COMPOUND BEND featuring: Guide Right™

Bending Tool

Magnetic Guide Post

Open Guide Sleeve

KLEIS 2.2013

Fabrication of DIAGNOSTIC Guide

An impression is taken and a cast is made, a hole is drilled in the

cast at the #19 site planned for implant placement with a 3/32” drill.

A 3 mm guide post is placed in the hole.

A 3 mm X 8 mm guide sleeve is placed over the guide post. The angle of the

guide post is not critical as this is for a DIAGNOSTIC guide which will be

evaluated and corrected using information from a cone beam X-Ray.

Under cuts are blocked out and petroleum gel is used to lubricate the cast. Triad®

Gel is added to the brackets of the guide sleeve and the adjacent teeth to form the

body of the DIAGNOSTIC guide. The guide is placed in the patient for the Cone

Beam X-ray.

PRE-OPERATIVE

GALAXIS Cone Beam Software Evaluation

Preview of Pre-op Corrections

#19

ANGULAR CORRECTION

in 2 dimensions

1st BEND: 14° toward the mesial in the cross sectional plane

2nd BEND: 18° toward the buccal in the tangential plane

CBVI X-rays were taken with the Sirona Galileos

The location of the mandibular nerve is mapped out on the panoramic view.

A virtual implant is superimposed in line with the radio-opaque guide sleeve

to evaluate the planned implant trajectory.

#19 panoramic viewGALAXIS

tangential view

A virtual implant of the size & length planned for placement is superimposed on the

CBVI image. Preference: align the implant parallel to the axis of the adjacent

bicuspid. This requires a change in the angle of the guide sleeve by 14

14

mesial

alteration

GALAXIS

18

lingual

alteration

The virtual implant is ideally placed in the center of the alveolar ridge.

The angle formed by a line superimposed on the long axis of the virtual implant and the

long axis of the diagnostic guide sleeve and the long axis virtual implant is 18 measured

with the GALAXIS software.

cross sectional view

making corrections

The guide post is placed in the bending block

attached to the bending tool plate with a 35 scale

and a set screw.

The set screw is tightened against one of the four flat

sides of the guide post with the orientation dot in view.

The purpose of the set screw is to prevent rotation

while the guide post is being bent.

The guide post used in correcting the

angle has four flat slides representing the

mesial, distal, buccal & lingual surfaces.

An orientation dot is designed to mark

the buccal surface.

A guide post with 4 flat surfaces

is placed in the bending tool.

The set screw is tightened with a hex driver.

A stylus is placed over the guide post.

The stylus is moved to the right to the appropriate

degree according to the CBVI.

Close up of stylus over post in bending

block after bend is made.

After the 1st bend is complete, the set screw is released and the guide post is rotated

90° counter clockwise until the next flat surface (representing the buccal surface of the

guide post) is aligned with the set screw.

The set screw is retightened.

When rotated the stylus raises up off the plate and points to the 0 degrees.

A stylus support bar is moved down to support the stylus to maintain the angle of the

first bend while the second bend is being made.

corrected guide post

viewing

the buccal orientation

The orientation dot is positioned on the buccal surface to maintain the buccal

surface of the guide post to the buccal.

A superimposed line on the cast indicates the angle of the original hole made

with the 3/32” drill.

The post is placed back in the cast.

Fabrication of SURGICAL Guide

lingual view buccal view

A 4 mm open guide sleeve has been placed back

on the 4 mm corrected magnetic corrected guide post.

open guide sleeve

Triad® Gel has been added to the adjacent teeth of the lubricated cast and to the

brackets on the 4 mm open guide sleeve.

SURGICAL guide

The SURGICAL guide securely seated in the patient.

The osteotomy was started using a 2 mm pilot drill with drill stop slightly smaller

(3.9 mm) diameter than the inside diameters of the 4 mm guide sleeve.

A open guide sleeve of 4 mm diameter was used for the surgery.

The 4 mm open guide sleeve will accommodate drills up to 4 mm diameter.

The diameter of the osteotomies were enlarged by visually

centering the increasing size drills in the 4 mm guide sleeve.

Final Implant Placement

Final Restoration

2 Years Later

1 - 3/32” drill

1 - 3 mm Guide Post

1 - 3 mm X 8 mm Guide Sleeve

1 - 4 mm Magnetic Guide Post

1 - 4 mm Open Guide Sleeve

Triad® Gel

Generation ll Bending Tool

Guide Right™

Products used in this presentation

1.800.314.0065 • www.deplaque.com

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 screw 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™

GENERATION II 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™

GENERATION II BENDING TOOL

Guide Right™ Surgical Guide System

Start With Precision. Place With Confidence.™

1.800.314.0065 • www.deplaque.com

fabricate evaluate correct verify place

DéPlaque