Fabrication of Maxillary Denture Guide 10.12.2016 LUF NEW

Fabrication of

MAXILLARY DENTURE GUIDE

Featuring:

• 2-Piece Guide Posts • Invivo5 Software Analysis• Linear & Angular Corrections• Straumann Implants• Placement of 5 implants to

support Conus abutment prosthesis including one in Incisive Canal

Guide Right™ Surgical Guide System

DéPlaque

LUF

Treatment plan for this case: Conus abutment supported prosthesis

Start With Precision. Place With Confidence.™

1.800.314.0065 • www.deplaque.com

DéPlaque

A Geometric Approach to Guided Surgery

Guide Right™ Surgical Guide Systemfabricate ▪ evaluate ▪ correct ▪ verify ▪ re-fabricate ▪ place


DéPlaque

▪ fabricate Diagnostic GUIDE ▪ evaluate ▪ correct ▪ re-fabricate surgical guide▪ verify▪ place

Duplicated Denture

Oral surface

Occlusal surface

Pre-op Cone beam radiograph with denture guide in patient

PANOREX VIEW

2 mm X 20 mm guide posts inserted through guide sleeves in Lab Putty Base & used for registering corrected guide posts for complete denture guide.

Invivo5 Anatomage

Cone Beam Analysis

PRE-OP

Each site must be evaluated

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.

DéPlaque

▪ fabricate diagnostic guide ▪ evaluate with cone beam images ▪ correct ▪ re-fabricate surgical guide▪ verify▪ place


axial cross sectional

# 3 Pre-op

tangential volumetric

HOME POSITION

Straumann 3.3 mm BLT


# 3 Pre-op


LINEAR CORRECTION: 1 mm offset toward buccal

cross sectional magnified

# 3 Pre-op



# 4 Pre-op


HOME POSITION



# 4 Pre-op

tangential


17 mm VIRTUAL FIXATION SCREW

volumetric

cross sectional

# 4 Pre-op




# 5 Pre-op


HOME POSITION

Straumann 3.3 X 8 mm BLT

cross sectional

# 5 Pre-op

HOME POSITION

Straumann 3.3 X 8 mm BLT


# 7 Pre-op


HOME POSITION: , NO Correction

3.3 X 8 mm Straumann BLT


# 7 Pre-op


NO CORRECTION




INCISIVE CANAL POTENTIAL SITE

Straumann 4.1 X 8 mm BL OUTLINE of VIRTUAL IMPLANT

cross sectional

INCISIVE CANAL CROSS SECTION

Straumann 4.1 X 8 mm BL OUTLINE of VIRTUAL IMPLANT


Pre-op


INCISIVE CANAL

4.1 X 8 mm OPAQUE VIRTUAL IMPLANT


# 10 Pre-op


HOME POSITION

3.3 mm Straumann BLT


# 10 Pre-op


LINEAR CORRECTION: 1 mm offset palatal

2 X17 mm VIRTUAL FIXATION SCREW

cross sectional

# 10 Pre-op

LINEAR CORRECTION: 1 mm offset palatal



# 11 Pre-op


HOME POSITION NO change



# 11 Pre-op


HOME POSITION


# 13 Pre-op


HOME POSITION

Straumann BLT 0.5 mm offset toward buccal


# 13 Pre-op


LINEAR CORRECTION: 0.5 mm offset toward palatal


# 13 Pre-op

LINEAR CORRECTION: 0.5 mm offset toward palatal


cross sectional


# 14 Pre-op


HOME POSITION

3.3 mm Straumann BLT


# 14 Pre-op



cross sectional

# 14 Pre-op



# 14 Pre-op


ANGLE CORRECTION: 14° distal to avoid sinus

# 14 Pre-op

tangential

ANGLE CORRECTION: 14° distal to avoid sinus

X-ray of VIRTUAL FIXATION SCREW in mid-palatal suturePotential site for fixation screw

DéPlaque

▪ fabricate diagnostic guide ▪ evaluate▪ correct ▪ re-fabricate surgical guide▪ verify▪ place


LUF

IMPLANT POSITION & SIZE

# 3 3.3 X 8 mm BLT ••• ••• ••• Linear Correction: 1 mm offset buccal

# 4 17 mm fixation screw ••• ••• ••• Linear Correction: 2 mm offset buccal

# 5 3.3 X 8 mm BLT ••• ••• ••• No Correction

# 7 17 mm fixation screw ••• ••• ••• No Correction:

#10 17 mm fixation screw ••• ••• ••• Linear Correction: 1 mm offset buccal

#11 3.3 x 8 mm BLT ••• ••• ••• No Correction:

#13 17 mm fixation screw ••• ••• ••• Linear Correction: 0.5 mm offset buccal

# 14 3.3 x 8 mm BLT ••• ••• ••• Linear Correction: 1 mm offset buccal Angular Correction: 14° distal

Incisive Canal 4.1 X 8 mm BL ••• ••• •••

NOTE: Implant placement in Incisive Canal was added due to the limited surface area of the four other 3.3 mm X 8 mm implants.

CORRECTIONS

Flap design outlined on Lab Putty matrix

DéPlaque


Offset Guide Posts

LINEAR CORRECTIONS are made with the

offset guide post

Guide Right™ Offset Guide Posts

LINEAR CORRECTION

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.

# 7

# 5

# 4

# 3

# 10

# 11

# 13

# 14

2-Piece offset lower guide post aligned in order they will be placed

Puddy cast with palatal guide post,

corrected lower part offset guide posts positioned in sites with corresponding upper guide post

corrected 2-Piece upper guide posts with guide sleeves

2-Piece upper guide sleeves positioned on guide posts with cleats toward the palatal surface

palatal guide post

DéPlaque

▪ fabricate [diagnostic guide] ▪ evaluate ▪ correct ▪ re-fabricate [surgical guide]▪ verify▪ place


Triad® gel applied to form the corrected DENTURE GUIDE

Additional Triad® gel applied

Guide Posts removed from DENTURE GUIDE

Access view left Access view right

If necessary???, palatal fixation screw: 3.5 x 8 mm

Trimmed DENTURE GUIDE


DéPlaque

▪ fabricate [diagnostic guide] ▪ evaluate ▪ correct ▪ re-fabricate [surgical guide]▪ verify▪ place


Invivo5 Anatomage

Cone Beam Analysis

POST-OP

# Incisive Canal Post-op



4.1 X 8 mm Straumann

# 3 Post-op



Straumann 3.3 X 8 mm Implant Bone has been spread with Densah drills

# 7 Post-op



Straumann 3.3 X 8 mm Implant bone has been spread with Densah drills

# 11 Post-op



Straumann 3.3 X 8 mm Implantbone has been spread using Densah drills

# 14 Post-op



Straumann 3.3 X 8 mm Implant

view

Guide Right™

View VIDEO Lfor actual site preparation & implant placement

www.deplaque.com

For more in-depth instruction & understanding of Guide Right Surgical Guide System view SLIDE SHOWS at www.deplaque.com

“INTRODUCTION to GUIDE RIGHT COMPONENTS with SINGLE IMPLANT”

“2-PIECE GUIDE POST with STEPS to MAKING a SURGICAL GUIDE FEATURING: INVIVO5 SOFTWARE”

Guide Right™

GUIDE POST BENDING TOOL

Steps to SINGLE BENDStep 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 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.

Guide Right™

GUIDE POST BENDING TOOL

Steps to COMPOUND BEND Step1 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.

If necessary,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.

Versah Densah Drill Kit used to prepare & widen the osteotomy

Start With Precision. Place With Confidence.™

1.800.314.0065 • www.deplaque.com

DéPlaque

A Geometric Approach to Guided Surgery

Guide Right™ Surgical Guide Systemfabricate ▪ evaluate ▪ correct ▪ verify ▪ re-fabricate ▪ place

Health & Medicine

Fabrication of Maxillary Denture Guide 10.12.2016 LUF NEW