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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 I nvi vo5 Anatomage Featuring: KARLS
43

19 fibular graft case

Jun 03, 2015

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Health & Medicine

DePlaque

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.
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Page 1: 19 fibular graft case

# 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

Page 2: 19 fibular graft case

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

Page 11: 19 fibular graft case

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

Page 13: 19 fibular graft case

axial cross sectional

tangential volumetric

# 30

Initial Alignment

Invivo5 Anatomage

Invivo5 Anatomage

Page 14: 19 fibular graft case

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

Page 16: 19 fibular graft case

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

Page 33: 19 fibular graft case

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

Page 42: 19 fibular graft case

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

Page 43: 19 fibular graft case

Guide Right™ Surgical Guide System

Start With Precision. Place With Confidence.™

1.800.314.0065 • www.deplaque.com

fabricate ▪ evaluate ▪ correct ▪ verify ▪ place

DéPlaque