Immediate Placement Using Guide Right 2-Piece Guide Post

Guide Right™ Surgical Guide System

Use of 2-Piece Guide Post

DéPlaque

Guide Right™

2-Piece Guide Posts

DéPlaque

2-Piece Guide Post

Straight Lower Piece with Upper Removable Piece

The bottom half of all Lower Pieces

of the 2-Piece Guide Post are designed with

4 flat sides corresponding with the mesial,

distal, buccal & lingual surfaces of the tooth.

2-Piece Guide Post

Offset Lower Piece

The Offset Lower Piece is constructed in a series of offsets to allow corrections

in 0.5 mm intervals in any direction to change the linear position of the surgical

guide sleeve.

2-Piece Guide Post

Upper Removable Piece

2.7 mm

Purpose & Use of the 2-Piece Guide Post

The 2-piece guide post is designed to facilitate the correction & removal of surgical guides

made with cylindrical guide sleeves even when the 3-D planned implant sights are not parallel.

Angular Corrections:

The lower piece of the 2-piece guide post can be altered for angular corrections by bending the 1/16th shaft up

to 35º to the desired degree with the Guide Right Bending Tool. After the bend is made the upper piece/post is

selected to coordinate with the guide sleeve dimension and placed over the 1/16” shaft for the fabrication of the

surgical guide.

Linear Corrections

Offset guide posts are designed for linear corrections that reposition the implant in either bucco-linqual or

mesio-distal plane with or without necessarily changing the angle of the guide post.

Use with Guide Sleeves

Guide Sleeves made for 2-Piece Guide Posts are designed to match the diameter (0.05 mm or larger) of the

upper piece of the 2-piece guide posts and are available in many dimensions:

2.7 mm id X 5.0 mm long • 3.0 mm id X 5.0 mm long • 4.2 mm id X 5.0 mm long • 5.3 mm id X 5.0 mm long.

The 2-piece 3 mm Guide Post can be used with any of the original 3 mm cylindrical guide sleeves plus

4.5 & 5.3 mm Serial Kits.

When to Use the 2-Piece Guide Post

1. WHEN the path of withdrawal of the guide sleeve & the adjacent teeth are not parallel,

SOLUTION

• A closed cylindrical sleeve is selected

• An angle correction is made by bending the guide post,

• Triad® gel is added to both the guide sleeve and the adjacent teeth to form the surgical guide

• The path of withdrawal of the guide sleeve and the adjacent teeth are not parallel,

2. WHEN 2 adjacent guide posts are not parallel the surgical guide will be mechanically locked

on the cast.

SOLUTION: A two piece guide post, allows the removal of the upper piece of the guide post & the removal

of the completed surgical guide with cylindrical guide sleeves from the cast.

• The surgical guide is made with the upper piece of the 2-piece guide post which has the axis of the

geometrically corrected implant trajectory

• The axis of the lower piece of the guide post has the bucco-lingual and mesio-distal axis of the originally

prostheticly planned implant trajectory of the diagnostic guide.

Guide Right

OPTIONS for Fabrication of Surgical Guide

with NON-PARALLEL Adjacent Guide Posts

OPTIONS

1 Magnetic Guide Post with coordinating Open Guide Sleeve

2 2-Piece Guide Post with Cylindrical Guide Sleeves

are selected for the surgical guide.

OPTION 1

for Non-parallel Adjacent Guide Posts

Open Guide Sleeve with the coordinating Magnetic Guide Post

PURPOSE: used in posterior areas where access is limited

HOW: • facilitates access from the open side of the guide sleeve

• allows viewing the drill depth markings

• accommodates drill sizes equal to guide sleeve id

• indexed to adjacent teeth of edentulous area

• registered to the occlusal & lingual surface of the adjacent teeth

with light-cured resin

REQUIRES: coordinating magnetic guide post to fabricate the guide

OPTION 2


Cylindrical Guide Sleeve with the coordinating 2- Piece Guide Post

PURPOSE: • used in areas where access & visibility are limited

HOW: • facilitates access from the top of the SURGICAL guide

• may require drills with drill stops to determine drill depth.

• accommodate surgical drill sizes which fit inserts of serial guide sleeves

• indexed to adjacent teeth of edentulous area with light-cured resin

• used in the anterior or posterior areas

• more accurate than the open guide sleeve / less chance of error.

REQUIRES: the use of the 2- piece Guide Post to fabricate and correct the guide.

Why the 2-Piece Guide Post is a Better Option

When an angle correction is made by bending the guide post, light cured resin is

added to the guide sleeve & the adjacent teeth to form the surgical guide

as a result…

The surgical guide may be mechanically locked on the cast

IF the path of withdrawal of the guide sleeve & the adjacent teeth are not parallel,

OR

IF there are 2 adjacent guide posts that are not parallel.

“a must use”


OPTION 2 (continued)

2-Piece Guide Post

HOW: Use of the 2-piece guide post allows easy removal of the surgical guide when

the upper piece of the guide post is removed leaving the lower piece in the cast.

WHY: The cylindrical guide sleeve & the corrected SURGICAL guide are

made with the upper piece of the 2-piece guide post which has the axis of

the geometrically corrected implant trajectory. The axis of the lower piece

of the guide post has the axis of the originally prosthetically planned

implant trajectory of the DIAGNOSTIC guide sleeve which is based on the

original 3/32” hole drilled in the cast.

Design & Specifications

Lower Piece STRAIGHT

The 2-Piece Guide Post Design is comprised of 2 compatible parts:

Lower Piece & the Upper Piece which can be removed one from the other.

LOWER PIECE STRAIGHT guide post

PURPOSE: Configured with 1/16” od X 5.0 mm length shaft extending up from

the platform of the lower piece on which various sized upper removable posts

can be placed to hold the SURGICAL guide sleeve.

Allows multiple SURGICAL guides with different diameter guide sleeves

SPECIFICATIONS:

• 3/32” outside diameter fits in the 3/32” diameter hole drilled in the cast

• The lower shaft has 4 equal flat sides representing mesial, distal buccal or

lingual surfaces


Lower Piece OFFSET

LOWER PIECE OFFSET guide posts

PURPOSE:

• Offsets are designed for linear corrections that reposition the implant in

either bucco-lingual or mesio-distal planes with / without changing the angle

for the surgical guide.

SPECIFICATIONS:

3/32” outside diameter

The lower post has 8 flat sides and the platform having 4 flat sides

rectangular platform with various size offsets > 0.5 mm, 1.0 mm 1.5 mm,

2.0 mm, 2.5 mm & 3.0 mm

UPPER PIECE guide post

PURPOSE:

Compatibility: to fit the keys of other implant companies

Benefit: Allows removal of the surgical guide from the cast even when multiple posts for

multiple implants sites are not parallel.

More than one surgical guide can be made with a larger or smaller diameter upper piece

& larger or smaller diameter guide sleeves.

SPECIFICATIONS:

Length: 10 mm

Options > od: 2.7 mm, 3.0 mm, 4.2 mm, 5.3 mm & others with 1/16 inch hole in shaft.

Hole size: 1/16” hole id which fits over the 1/16” shaft of the Lower Piece of the 2-piece

guide post


Upper Piece

ACESSORIES for 2-Piece Guide Post

Stylusfor 2-Piece Guide Post

PURPOSE: Used with the Guide Right™ Bending Tool to make anglular corrections

• to the lower piece of the 2-piece guide post

• the shaft of the magnetic guide post

Opening: 1/16” or 3 mm to fit over a guide post

Fabrication & Correction of a SURGICAL GuideImmediate Placement

Using the 2-Piece Guide Post

jensen


DéPlaque

▪ fabricate diagnostic guide

▪ evaluate

▪ correct

▪ re-fabricate surgical guide

▪ verify

▪ place

The maxillary right lateral incisor will be removed and an implant placed.

3/32” Drill is used

to drill the initial hole through the singulum of # 7 into the base of the cast.

3 mm guide post with DIAGNOSTIC sleeve

positioned in the hole of # 7 on the cast

Clear Triad® gel has been applied to the guide sleeve & adjacent teeth after

lubricating the cast and blocking our undercuts to form the DIAGNOSTIC guide.

After the cone beam X-ray is taken the tooth is removed from the cast.


DéPlaque

▪ fabricate diagnostic guide

▪ evaluate ▪ correct

▪ re-fabricate surgical guide

▪ verify

▪ place

Invivo5

AnatomageCone beam

Analysis

axial cross section

A cone beam X-ray provides the correction information

to assure guide sleeve was placed at a 4º angle toward the buccal

tangential volumetric

Invivo5

Anatomage

axial cross section

Home position slide

step by step….

tangential volumetric

Invivo5

Anatomage

Indicates guide sleeve is placed at a 4º angle toward the buccal

& is the preferred position to place the virtual implant away from the buccal wall.

cross section view

Invivo5

Anatomage

tangential view

Indicates no correction is needed in the mesio-distal plane.

Evidenced by the alignment of the axis of the implant

with the radiolucent center of the DIAGNOSTIC guide sleeve.

Invivo5

Anatomage

Indicates the plane of the slice being evaluated in the cross sectional view

is (& should always be) 90º to the mesio-distal plane.

Axial View

Invivo5

Anatomage


DéPlaque

▪ fabricate [diagnostic guide]

▪ evaluate

▪ correct ▪ re-fabricate [surgical guide]

▪ verify

▪ place

ANGULAR CORRECTIONS are made with the

Guide Right™

Generation ll Bending Tool

Step by step instructions at end of slideshow

Single Bendcorrections in one plane

Guide Right™

Generation ll Bending Tool

Lower piece of guide post in the Bending Tool block

Bending tool with stylus moved 4º to make angular correction to the guide post

Close up view: bending tool block with guide post bent 4º

The 4º angular correction of the guide post is made with the Bending Tool

Lower Piece of 2-piece guide post in site where tooth is removed

Palatal view: lower piece of guide post with 4º correction is placed in the cast

Buccal flat of the offset portion of the lower piece

was marked with black magic marker

to assure placement with bend toward the buccal.


DéPlaque


▪ evaluate

▪ correct

▪ re-fabricate [surgical guide]

▪ verify

▪ place

3 mm diameter Upper Piece of post added to the corrected lower piece

Buccal view

corrected lower piece with the upper piece in position

A 3 mm upper post placed on corrected lower piece

ready for the 3 mm guide sleeve to be placed over it.

A 3 mm guide sleeve placed on the upper piece

will be be used with a 2.3 mm hybrid drill.

3 mm open guide sleeve

3.80 mm guide post with 3.85 mm guide sleeve is used for the

final larger diameter drill to place 4.1 mm implant.

Triad® Gel applied to capture cleats of the 3.9 mm guide sleeve & adjacent teeth

to form the DIAGNOSTIC guide

The upper piece of the post has been removed.

NOW the SURGICAL guide can be removed,

placed in cold sterilization & place in patient for surgery.


DéPlaque


▪ evaluate

▪ correct


▪ verify▪ place

Post-op Verification of accurate implant placement

Invivo5

Anatomage


DéPlaque


▪ evaluate

▪ correct


▪ verify

▪ place

Final X-ray with implant in place to verify accurate position.

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™

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™

BENDING TOOL

Close up of Offset Guide Posts in bending block

Guide Right™

Bending Tool


Start With Precision. Place With Confidence.™

1.800.314.0065 • www.deplaque.com

fabricate ▪ evaluate ▪ correct ▪ verify ▪ place

DéPlaque

Immediate Placement Using Guide Right 2-Piece Guide Post

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Transcript of Immediate Placement Using Guide Right 2-Piece Guide Post