This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Site # 8
Zug 2016
Single Guided Implant Placement
Corrections
• 1 mm offset toward buccal
• 10° correction buccal
• 6° correction mesial
Featuring
2-Piece Offset Guide Posts Invivo5 Software
Bending Tool4.5 MM Serial Guide SleevesGuide Sleeve Insert Handles
Versah Condensing Drills to enlarge the osteotomyAstra Implant
CHANGES in the proposed implant position can be made
Changing the LINEAR POSITION… … in either mesio-distal plane or bucco-lingual plane is made by selecting an offset guide post to alter the position of the guide sleeve
Changing the ANGLE of the TRAJECTORY by measuring the angle of the proposed implant location & bending the guide post to the corrected angle.
After making a correction (angle or linear) in one plane YOU MUST RETURN TO THE HOME POSITION To measure and make the correction needed in the other plane.
.
Use of Invivo5 Software
The HOME POSITION WARNING:
Measuring or making angle or linear corrections from any other positions (cross sectional or tangential)
will lead to errors, & the corrections recorded will not be accurate
BECAUSE the angle is not measured from the HOME POSITION
# 8 HOME POSITION
axial cross sectional
tangential volumetric
axial cross sectional
# 8
tangential volumetric
LINEAR CORRECITON: 1 mm offset buccalANGULAR CORRECTION: 10° buccal
Measure the angle formed by the 2 intersecting lines
use the angle tool in invivo5 to measure & correct the angle
of the guide post/sleeve
When … the long axis of the sleeves & the virtual implants are not parallel.
# 8 LINEAR CORRECITON: 1 mm offset buccalANGULAR CORRECTION: 10° buccal
The bottom half of the offset guide posts are designed with 8 flat sides so they can be rotated 45° & corrected half way between the buccal & mesial surface, allowing corrections in 8 directions: mesial, mesio-buccal, buccal, mesio-lingual, distal, disto-lingual, lingual, mesio-lingual
DéPlaque
Guide Right™ Surgical Guide System
Offset Guide Posts
2-Piece Guide Post Straight Lower Piece with Upper Removable Piece
The bottom half of the straight 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.
Guide Right™ Bending Tool
1 mm offset Guide Post Bent 1st time to 10°
Stylus
1st BEND
10°
1 mm Offset Guide Post
Guide Right™ Bending Tool
1 mm Offset Guide Post Bending Sequence
1 mm Offset Guide Post Stylus positioned on 1 mm Offset Guide Post
Stylus positioned on 1 mm Offset Guide Post& bent 10°
1 mm Offset Guide Post Shown with 10° bend
Steps to Bending Tool use at end of slideshow
Guide Right™ Bending Tool with Support Bar
1 mm offset Guide Post with a 10° bend rotated back to 0°
0°
• 1 mm offset guide post with a 10° bend rotated 90°
in block hole
• stylus support bar moved into place to support the 10° angle of the 1st bend
Before 2nd BEND
• stylus removed & guide post rotated 90° pointing to 0° before 2nd bend is made
Guide Right™ Bending Tool with Support Bar
1 mm offset Guide Post with 10° bend bent a 2nd time to 6°
stylus
6°
• 1 mm offset guide post with 10° angle rotated 90° in block hole & stylus replaced
2nd BEND
• stylus removed & the guide post rotated 90° before 2nd bend is made
• stylus support bar moved into place to support the angle of the 1st bend
Angle corrected lower-half of 2-Piece 1 mm offset guide post placed in the reference hole in the cast
2-Piece 1 mm offset guide post with 3 mm upper piece
facial view
1 mm offset guide post with fabrication insert used to center the 4.5 mm guide sleeve
4.5 mm fabrication insert 4.5 mm guide sleevewith cleat to palatal
1 mm offset guide post
4.5 Fabrication Insert (FABIN)
Purposes & Use:
• To center the 4.5 mm guide sleeve on the 3 mm guide post
• To prevent acrylic gel from entering inside sleeve during guide fabrication by placing the FABIN inside the
4.5 mm diameter guide sleeve with 3 mm guide post.
• Place the FABIN over the guide post, then apply gel.
• 5.3 mm FABIN available for the 5.3 guide sleeve
Triad® gel is added to the lubricated cast to form the corrected SURGICAL GUIDE
The fabrication insert has been removed leaving the 4.5 mm guide sleeve centered on the lower-half of the 2-Piece guide post.
Facial View • Corrected SURGICAL GUIDE
SURGICAL GUIDE is trimmed to be sure no acrylic is occluding the surface of the guide sleeve.
In this case, the anterior insert handle with inserts were used to position the increasing diameter drills in the surgical guide sleeve without changing the SURGICAL GUIDE for the placement of a 4 mm X 11 mm implant.
Anterior Insert Handles with 2.2 & 3.0 mm inserts used with the 4.5 mm guide sleeves
Versah Densah Bur Kit used to prepare & widen the osteotomy
Step 1 Place bending tool plate on a secure flat surface with the degree increments at the top & the stainless steel bar at the bottom.
Step 2 Locate the two 3/32” holes in the top of the stainless steel bar. The hole closest to the plate is used for all guide posts up to 3.0 mm offsets. The front hole is used for offsets 3.5 mm or larger. Place the bottom half of the guide post to be bent into the appropriate hole. Position the offset guide post in the hole determined by the planned direction of the correction. Tighten the set screw.
Step 3 Select the appropriate stylus to fit over the top half of the guide post.
Step 4 Fit the stylus over the guide post securely with the point directed at 0 ° & the bottom of the stylus in contact with the platform of 2-piece guide post or if no platform on post, in contact with block.
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 Remove the stylus. Loosen screw to remove the guide post bent to the desired angle.
Steps to COMPOUND BEND
Guide Right™
GUIDE POST BENDING TOOL
Step 1 Position a straight or offset guide post in the bending plate, tightening the set screw against one of the 8 flat surfaces on the lower half of the guide post.
Step 2 The 1st bend can be made to the right or left direction.
Step 3 The set screw is loosened & the guide post is rotated 90° next flat surface.
Step 4 The 2nd bend in the 2nd plane is made after rotating the guide post up away from the surface of the bending plate to register the stylus point back at 0º.
Step 5 Slide the stylus support bar down under the stylus until it supports the stylus. Tighten the side screws before making the 2nd bend.
Step 6 The 2nd bend can be made in either direction according to the X-ray.
Step 7 Remove the stylus and place the guide post back in the cast with the appropriate side indicated by a mark with a felt tip pen facing the buccal or lingual surface. Be sure the post is in the correct position.
Linear Corrections, using an offset guide post, must be determined & made before Angle Corrections.Offset 2-Piece Guide Posts available in the 3 mm guide post: 0.5,1, 1.5, 2.0, 2.5 & 3.0 mm.
view
Guide Right™
VIDEO Case KZ for actual site preparation & implant placement
www.deplaque.com
Featuring
4.5 MM Serial Guide SleevesGuide Sleeve Insert Handles
Versah Condensing Drillsused to enlarge the osteotomy