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Guide Right™ Surgical Guide System

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Presentation on theme: "Guide Right™ Surgical Guide System"— Presentation transcript:

1 Guide Right™ Surgical Guide System
INTRODUCTION use of Guide Right™ COMPONENTS use with a SINGLE IMPLANT CASE verification with PA X-ray includes: mesio-distal correction only (not bucco-lingual) 2.3013

2 Challenges with Current 3D Surgical Guides
Most require off-site fabrication Costly and time delay, several days to two weeks May result in difficulty fitting the patient when placed at the time of surgery May require a 2nd cone beam X-ray of cast

3 Best Practices for Implant Success
Implants should be placed within the envelope of available bone to increase clinical success. Pre-surgical radiographs facilitate evaluation of the proposed angle of the long axis of the guide sleeve and proposed implant placement. 3D Radiographs allow us to determine if planned implant placement conflicts with the adjacent roots, the maxillary sinuses, nerves, and if it is within the envelope of available bone.

4 A System of Components for the fabrication and correction of diagnostic & surgical guides in one or two dimensions In-office or lab fabrication Evaluate with 2D & 3D imaging Allows linear and angular correction Enables precision implant placement Cost effective

5 Basic Fabrication & Correction of DIAGNOSTIC and SURGICAL Guides
Featuring GUIDE RIGHT COMPONENTS standard & magnetic guide posts cylindrical & open guide sleeves GUIDE POST BENDING TOOL angular correction linear correction PERIAPICAL X-RAYS FABRICATION OF DIAGNOSTIC guide SURGICAL guide

6 Guide Right™ COMPONENTS used in Fabrication of DIAGNOSTIC & SURGICAL Guides
Guide Posts: standard · magnetic offset Guide Sleeves: cylindrical · open Drills Pin-vice Guide Post Bending Tool

7 Standard Guide Posts Short Guide Post 18 mm x 9 mm x 3/32 in.
Straight Guide Post 30 mm x 2.9 mm x 3/32 in.

8 Magnetic Guide Posts 3.0 mm od Offset 3.0 od X 0.5 mm os
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 3.0od X 2.5 mm os 3.0 od X 3.0 mm os

9 Cylindrical Guide Sleeves
Anterior Straight Cut 3.0 mm x 10 mm Posterior Angle Cut 3.0 mm x 10 mm Large Diameter 4.5 mm id x 5.0 mm 5.3 mm id x 5.0 mm

10 Magnetic Guide Post & Open Guide Sleeve Set
4.0 mm Open Guide Sleeve (short) 4.0 mm x 10 Magnetic Guide Posts 4.0 mm x 1 mm Offset Magnetic Guide Post 2.0 mm x 5.0 mm Pilot Drill 2.0 mm x 10.0 mm Pilot Drill

11 Magnetic Guide Post & Open Guide Sleeve Set
3.0 mm Open Guide Sleeve 3.3 mm Open Guide Sleeve 3.7 mm Open Guide Sleeve 4.0 mm Open Guide Sleeve 3.0 mm Straight Magnetic Guide Posts 3.0 mm Offset Magnetic Guide Post 2.0 mm Pilot Drills (to start the osteotomy) Other Drill Sizes Available on Request

12 Drills used with straight hand piece
3/32”

13 Pin vice may be used for more accurate placement

14 Magnetic Offset Guide Post
3.0 X 0.5 offset

15 Magnetic Offset Guide Post
3.0 X 1.0 offset

16 Magnetic Offset Guide Post
3.0 X 1.5 offset

17 Magnetic Offset Guide Post
3.0 X 2.0 offset

18 Magnetic Offset Guide Post
3.0 X 2.5 offset

19 Magnetic Offset Guide Post
3.0 X 3.0 offset

20 Single Bend corrections in one plane
Guide Right™ Generation ll / Guide Post Bending Tool

21 Guide Right™ Single Implant Case
single bend use of protractor use of bending tool ALB

22 Fabrication of DIAGNOSTIC Guide

23 long axis of the implant into the cast with a 3/32” drill.
A pencil line can be drawn on the cast to guide a proposed osteotomy axis. (Not shown) A hole is drilled through the prostheticly planned long axis of the implant into the cast with a 3/32” drill.

24 The drill is removed from 3/32” hole, the cast is lubricated with petroleum jelly for easy removal and, if necessary, undercuts are blocked out.

25 A 3 mm guide post is placed in the hole

26 A 3 mm guide sleeve is placed on the post and Triad® Gel is added to capture the cleats on the sleeve and to lingual & incisal surfaces of several of the adjacent teeth. After curing the DIAGNOSTIC guide & securely seating it in the patient an X-ray is taken.

27 The radiograph taken with the initial DIAGNOSTIC guide indicates a
correction is needed to avoid hitting the root of the adjacent tooth with the osteotomy / implant.

28 The Guide Right™ protractor is placed over the pre-op
DIAGNOSTIC X-ray to indicate the proposed correction of 9°. NOTE the relationship between the proposed guide sleeve with the adjacent root.

29 Guide Right™ Generation ll Bending Tool
A straight 3 mm magnetic guide post is placed in the block of the bending tool. The 3 mm stylus is placed over the post. Pressure is applied to point of stylus moving it to the 9° correction indicated according to the protractor reading.

30 Guide Right™ Generation ii / guide post Bending Tool
SINGLE BEND review 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.

31 The magnetic guide post is placed in the initially planned prosthetic axis prior to correction.

32 The planned prosthetic axis is changed by bending a straight magnetic guide post 9°.

33 Fabrication of SURGICAL Guide

34 To fabricate the final SURGICAL guide, a 3
To fabricate the final SURGICAL guide, a 3.3 mm open guide sleeve is placed over the corrected guide post which was bent 9°.

35 Triad® Gel is added to capture the cleats
to form the final SURGICAL guide.

36 Pre-op DIAGNOSTIC guide
Corrected SURGICAL guide An X-ray of the altered guide sleeve angle noting the implant position farther away from the root of the adjacent tooth.

37 Prior to surgery the final SURGICAL guide with the 3
Prior to surgery the final SURGICAL guide with the 3.3 mm open guide sleeve securely seated in the patient.

38 Clinical view of the 2 mm pilot drill with 3. 0 mm stop shaft in the 3
Clinical view of the 2 mm pilot drill with 3.0 mm stop shaft in the 3.3 mm open guide sleeve

39 After the 2 mm drill is used the alignment is checked with a 2 mm Direction Indicator placed in the 2 mm osteotomy and post-op X-ray is taken.

40 Note the X-ray of the 2 mm Direction Indicator in place to check the alignment of the 2 mm osteotomy indicates a satisfactory placement Now the use of successive larger drills can proceed.

41 A 2.5 mm drill is centered in the 3.3 mm open guide sleeve.

42 The next larger (2.7 mm) drill is used.

43 A 3.2 mm drill is centered in 3.3 mm open guide sleeve.

44 Finally, the implant is placed with the carrier using the guide sleeve.

45 A final X-ray is taken to view accuracy of implant placement.

46 Products used in this presentation
Guide Right™ Products used in this presentation (1) 3/32” drill (1) 2 mm pilot drill with / 8.5 long / 3 mm stop (1) 3 mm Straight Stainless Guide Post (1) 3 mm Cylindrical Guide Sleeve (1) mm Open Guide Sleeve (1) 3 mm Magnetic Guide Post (1) Generation ll / Guide Post Bending Tool & 3 mm Stylus (1) Direction Indicator Guide Right™ Protractor Triad® Gel

47 Guide Right™ Generation ii Bending Tool
SINGLE BEND review 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.

48 Guide Right™ Generation ii Bending Tool
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.

49 Guide Right™ Surgical Guide System
Start With Precision. Place With Confidence.


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