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COMPOUND BEND
    featuring: Guide Right™
                          Guide Post Bending Tool
                          Magnetic Guide Post
                          Open Guide Sleeve




KLEIS 2.2013
Fabrication of DIAGNOSTIC Guide
An impression is taken and a cast is made, a hole is drilled in the
cast at the #19 site planned for implant placement with a 3/32” drill.
A 3 mm guide post is placed in the hole.
A 3 mm X 8 mm guide sleeve is placed over the guide post. The angle of the
guide post is not critical as this is for a DIAGNOSTIC guide which will be
evaluated and corrected using information from a cone beam X-Ray.
Under cuts are blocked out and petroleum gel is used to lubricate the cast. Triad®
Gel is added to the brackets of the guide sleeve and the adjacent teeth to form the
body of the DIAGNOSTIC guide. The guide is placed in the patient for the Cone
Beam X-ray.
PRE-OPERATIVE
GALAXIS Cone Beam Software
        Evaluation
Preview of Pre-op Corrections


                         #19
               ANGULAR CORRECTION
                  in 2 dimensions

1st BEND: 14° toward the mesial   in the cross sectional plane
2nd BEND: 18° toward the buccal   in the tangential plane
GALAXIS                    #19 panoramic view

              CBVI X-rays were taken with the Sirona Galileos
The location of the mandibular nerve is mapped out on the panoramic view.
A virtual implant is superimposed in line with the radio-opaque guide sleeve
to evaluate the planned implant trajectory.
14°
                mesial
                alteration

      GALAXIS                     tangential view

A virtual implant of the size & length planned for placement is superimposed on the
CBVI image. Preference: align the implant parallel to the axis of the adjacent
bicuspid. This requires a change in the angle of the guide sleeve by 14°
18°
                               lingual
                               alteration

                                   cross sectional view
The virtual implant is ideally placed in the center of the alveolar ridge.
The angle formed by a line superimposed on the long axis of the virtual implant and the
long axis of the diagnostic guide sleeve and the long axis virtual implant is 18° measured
with the GALAXIS software.
making corrections




The guide post used in correcting the         The guide post is placed in the bending block
angle has four flat slides representing the   attached to the bending tool plate with a 35° scale
mesial, distal, buccal & lingual surfaces.    and a set screw.
                                              The set screw is tightened against one of the four flat
An orientation dot is designed to mark        sides of the guide post with the orientation dot in view.
the buccal surface.                           The purpose of the set screw is to prevent rotation
                                              while the guide post is being bent.
Close up of stylus over post in bending
                                                  block after bend is made.




A guide post with 4 flat surfaces
is placed in the bending tool.
The set screw is tightened with a hex driver.
A stylus is placed over the guide post.
The stylus is moved to the right to the appropriate
degree according to the CBVI.
After the 1st bend is complete, the set screw is released and the guide post is rotated
90° counter clockwise until the next flat surface (representing the buccal surface of the
guide post) is aligned with the set screw.
The set screw is retightened.
When rotated the stylus raises up off the plate and points to the 0 degrees.
A stylus support bar is moved down to support the stylus to maintain the angle of the
first bend while the second bend is being made.
corrected guide post
          viewing
   the buccal orientation




                                       The post is placed back in the cast.

The orientation dot is positioned on the buccal surface to maintain the buccal
surface of the guide post to the buccal.
A superimposed line on the cast indicates the angle of the original hole made
with the 3/32” drill.
Fabrication of SURGICAL Guide
lingual view                           buccal view


A 4 mm open guide sleeve has been placed back
on the 4 mm corrected magnetic corrected guide post.
open guide sleeve




                           SURGICAL guide
Triad® Gel has been added to the adjacent teeth of the lubricated cast and to the
brackets on the 4 mm open guide sleeve.
The SURGICAL guide securely seated in the patient.
The osteotomy was started using a 2 mm pilot drill with drill stop slightly smaller
(3.9 mm) diameter than the inside diameters of the 4 mm guide sleeve.
A open guide sleeve of 4 mm diameter was used for the surgery.
The 4 mm open guide sleeve will accommodate drills up to 4 mm diameter.
The diameter of the osteotomies were enlarged by visually
 centering the increasing size drills in the 4 mm guide sleeve.
Final Implant Placement
Final Restoration
2 Years Later
Guide Right™
Products used in this presentation


     1 - 3/32” drill
     1 - 3 mm Guide Post
     1 - 3 mm X 8 mm Guide Sleeve
     1 - 4 mm Magnetic Guide Post
     1 - 4 mm Open Guide Sleeve
     Triad® Gel
     Guide Post Bending Tool


   1.800.314.0065      •   www.deplaque.com
Guide Right™
                   GUIDE POST BENDING TOOL

                              SINGLE BEND review
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 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 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 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.

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.
Guide Right™
                   GUIDE POST 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 2   The 1st bend can be made to the right or left direction.
Step 3   The set screw is loosened and the guide post is rotated 90 ° next flat surface.
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 6   The second 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 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.
DéPlaque


Guide Right™ Surgical Guide System
 fabricate ▪ evaluate ▪ correct ▪ verify ▪ place




Start With Precision. Place With Confidence.™

      1.800.314.0065 •     www.deplaque.com

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6 correction using bending tool

  • 1. COMPOUND BEND featuring: Guide Right™ Guide Post Bending Tool Magnetic Guide Post Open Guide Sleeve KLEIS 2.2013
  • 3. An impression is taken and a cast is made, a hole is drilled in the cast at the #19 site planned for implant placement with a 3/32” drill.
  • 4. A 3 mm guide post is placed in the hole.
  • 5. A 3 mm X 8 mm guide sleeve is placed over the guide post. The angle of the guide post is not critical as this is for a DIAGNOSTIC guide which will be evaluated and corrected using information from a cone beam X-Ray.
  • 6. Under cuts are blocked out and petroleum gel is used to lubricate the cast. Triad® Gel is added to the brackets of the guide sleeve and the adjacent teeth to form the body of the DIAGNOSTIC guide. The guide is placed in the patient for the Cone Beam X-ray.
  • 7. PRE-OPERATIVE GALAXIS Cone Beam Software Evaluation
  • 8. Preview of Pre-op Corrections #19 ANGULAR CORRECTION in 2 dimensions 1st BEND: 14° toward the mesial in the cross sectional plane 2nd BEND: 18° toward the buccal in the tangential plane
  • 9. GALAXIS #19 panoramic view CBVI X-rays were taken with the Sirona Galileos The location of the mandibular nerve is mapped out on the panoramic view. A virtual implant is superimposed in line with the radio-opaque guide sleeve to evaluate the planned implant trajectory.
  • 10. 14° mesial alteration GALAXIS tangential view A virtual implant of the size & length planned for placement is superimposed on the CBVI image. Preference: align the implant parallel to the axis of the adjacent bicuspid. This requires a change in the angle of the guide sleeve by 14°
  • 11. 18° lingual alteration cross sectional view The virtual implant is ideally placed in the center of the alveolar ridge. The angle formed by a line superimposed on the long axis of the virtual implant and the long axis of the diagnostic guide sleeve and the long axis virtual implant is 18° measured with the GALAXIS software.
  • 12. making corrections The guide post used in correcting the The guide post is placed in the bending block angle has four flat slides representing the attached to the bending tool plate with a 35° scale mesial, distal, buccal & lingual surfaces. and a set screw. The set screw is tightened against one of the four flat An orientation dot is designed to mark sides of the guide post with the orientation dot in view. the buccal surface. The purpose of the set screw is to prevent rotation while the guide post is being bent.
  • 13. Close up of stylus over post in bending block after bend is made. A guide post with 4 flat surfaces is placed in the bending tool. The set screw is tightened with a hex driver. A stylus is placed over the guide post. The stylus is moved to the right to the appropriate degree according to the CBVI.
  • 14. After the 1st bend is complete, the set screw is released and the guide post is rotated 90° counter clockwise until the next flat surface (representing the buccal surface of the guide post) is aligned with the set screw. The set screw is retightened. When rotated the stylus raises up off the plate and points to the 0 degrees. A stylus support bar is moved down to support the stylus to maintain the angle of the first bend while the second bend is being made.
  • 15. corrected guide post viewing the buccal orientation The post is placed back in the cast. The orientation dot is positioned on the buccal surface to maintain the buccal surface of the guide post to the buccal. A superimposed line on the cast indicates the angle of the original hole made with the 3/32” drill.
  • 17. lingual view buccal view A 4 mm open guide sleeve has been placed back on the 4 mm corrected magnetic corrected guide post.
  • 18. open guide sleeve SURGICAL guide Triad® Gel has been added to the adjacent teeth of the lubricated cast and to the brackets on the 4 mm open guide sleeve.
  • 19. The SURGICAL guide securely seated in the patient. The osteotomy was started using a 2 mm pilot drill with drill stop slightly smaller (3.9 mm) diameter than the inside diameters of the 4 mm guide sleeve.
  • 20. A open guide sleeve of 4 mm diameter was used for the surgery. The 4 mm open guide sleeve will accommodate drills up to 4 mm diameter.
  • 21. The diameter of the osteotomies were enlarged by visually centering the increasing size drills in the 4 mm guide sleeve.
  • 25. Guide Right™ Products used in this presentation 1 - 3/32” drill 1 - 3 mm Guide Post 1 - 3 mm X 8 mm Guide Sleeve 1 - 4 mm Magnetic Guide Post 1 - 4 mm Open Guide Sleeve Triad® Gel Guide Post Bending Tool 1.800.314.0065 • www.deplaque.com
  • 26. Guide Right™ GUIDE POST BENDING TOOL SINGLE BEND review 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 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 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 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. 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.
  • 27. Guide Right™ GUIDE POST 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 2 The 1st bend can be made to the right or left direction. Step 3 The set screw is loosened and the guide post is rotated 90 ° next flat surface. 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 6 The second 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 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.
  • 28. DéPlaque Guide Right™ Surgical Guide System fabricate ▪ evaluate ▪ correct ▪ verify ▪ place Start With Precision. Place With Confidence.™ 1.800.314.0065 • www.deplaque.com