19 fibular graft case
DESCRIPTION
The Guide Right Surgical Guide System is a system of components for the fabrication and correction of diagnostic and surgical dental implant guides in 1 or 2 dimensions.TRANSCRIPT
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# 29 and #30
3 mm Guide Posts
3 mm Diagnostic Guide Sleeves
3 mm Magnetic Guide Posts
3.3 and 4 mm Open Guide Sleeves
Generation ll / Guide Post Bending Tool
Software Evaluation
Guide Right™
Fibular Graft Case
Invivo5 Anatomage
Featuring:
KARLS
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This patient had a section of the mandible removed & grafted
with a vascular fibular graft 2 years prior to implant placement.
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Fabrication of DIAGNOSTIC Guide
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3/32” holes were drilled in the cast in the positions of the 2nd bicuspid and 1st molar.
The cast was lubricated with petroleum jelly.
Two straight 3 mm guide posts were placed in the openings.
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3 mm cylindrical guide sleeves were placed on the guide posts
with cleats positioned toward the lingual surface.
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Triad® Gel was added & cured to capture the cleats& form the DIAGNOSTIC
guide which was placed in the patient and a cone beam X-ray was taken.
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Invivo5
Software Evaluation
Pre-op
Anatomage
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The DIAGNAOSTIC guide sleeves viewed in the cone beam images were evaluated.
[ axial, tangential and cross sectional views ]
axial cross sectional
tangential volumetric
Invivo5 Anatomage
# 29
Initial Alignment
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# 29
8° angular correction to the mesial is necessary
axial cross sectional
tangential volumetric
Invivo5 Anatomage
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# 29
▪ close-up showing 8° bend toward the mesial needed ▪
tangential
Invivo5 Anatomage
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axial cross sectional
tangential volumetric
# 29
ANGULAR CORRECTION: 5 ° toward the lingual
LINEAR CORRECTION: 1 mm offset
Invivo5 Anatomage
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5° angular correction 1 mm offset linear correction
cross section tangential # 29
Invivo5 Anatomage
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axial cross sectional
tangential volumetric
# 30
Initial Alignment
Invivo5 Anatomage
Invivo5 Anatomage
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cross sectional
# 30
Shows initial alignment is NOT GOOD
Invivo5 Anatomage
cross sectional view
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axial cross sectional
tangential volumetric
# 30
4.8 mm X 10 mm Straumann Implant (virtual image)
1 mm offset guide post > 15° bend toward lingual
Invivo5 Anatomage
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cross sectional
shows a 15° angular correction is necessary for the
guide sleeve to line up with the position of the virtual implant
Invivo5 Anatomage
tangential view
# 30
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Guide Right™
Generation ll ▪ 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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Preview of Pre-op Corrections
#30
LINEAR CORRECTION
1 mm offset
ANGULAR CORRECTION
1 BEND: 15° toward lingual
#29
LINEAR CORRECTION
1 mm offset
ANGULAR CORRECTION
1ST BEND: 8° toward the mesial
2nd BEND: 5° toward the lingual
Cosine is applied to determine correction data.
* see next 3 slide
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Guide post positioned in the bending tool
with offset positioned forward.
# 29
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BEND
8° toward the mesial
# 29
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The 1 mm offset guide post with an 8 mm correction is rotated 90°
and placed back in the bending tool for the second 5° bend toward lingual.
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# 29 5° correction
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stylus over 1 mm offset guide post bent 15° toward lingual
# 30
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# 29 1 mm offset
5 ° bend
# 29
8° lingual bend
tangential view cross sectional view
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Offset magnetic guide posts in cast
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Buccal view of magnetic guide post with open guide sleeve
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Fabrication of SURGICAL Guide
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Triad® Gel added to open guide sleeves to form the SURGICAL guide.
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SURGICAL Guide
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Ramus plate must be avoided
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Invivo5
Software Verification
Post-op
Anatomage
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axial cross sectional
tangential volumetric
#29
Note: implant placement
with virtual implants positioned over actual implants
Invivo5 Anatomage
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axial cross sectional
tangential volumetric
#30
Post-op Implant Placement
Invivo5 Anatomage
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Custom impression coping due to the depth of the fixture
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Peri-apical X-ray to confirm seating of impression coping.
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Custom Atlantis Abutments
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Final restoration in master cast
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Restoration on master cast
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Atlantis Abutments in place
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Final restoration
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Magnetic Offset 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
3/32” Drill
3 mm Guide Posts
3 mm Diagnostic Guide Sleeves
3 mm Magnetic guide posts
3.3 mm Open Guide sleeves
4 mm Open Guide Sleeves
1.0 mm Offset Magnetic Guide Sleeve
Triad® Gel
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
DéPlaque