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Guide Right ™
       Use of Pythagorean Theorem in #9 Single Implant Case

             Featuring: LINEAR CORRECTIONS


             DIAGNOSTIC Guide
               3 mm X 30 mm guide post
               3 mm guide sleeve

             SURGICAL Guide
                 3 mm X 1.5 mm offset guide post
                 3 mm open guide sleeve
                 Pythagorean Theorem ► Cosine
                 Invivo5 software analysis
                  Anatomage



BEL 2.2013
Fabrication of DIAGNOSTIC guide
facial view


Line marked on teeth to position original axis
for initial 3/32” drill mm & 3 mm guide post.
3 mm X 30 mm guide post in 3/32” hole
3 mm guide sleeve placed on the 3 mm guide post
     and cast lubricated with petroleum jelly
Initial layer of Triad® Gel added to the guide sleeve cleats
and cured to stabilize the guide sleeve.
DIAGNOSTIC Guide
showing the 3 mm guide sleeve attached to the cured acrylic
ready to be placed for cone beam X-ray.
Additional and final layer of Triad® Gel
extended to lingual and incisal surfaces of adjacent teeth
PRE-OPERATIVE
     Invivo5
      Anatomage

Software Evaluation
INITIAL EVALUATION
       of DIAGNOSTIC guide sleeve position

               axial plane              cross sectional plane · buccal-lingual
#9




                                         Invivo5
                                         Invivo5
                                         Anatomage
                                         Anatomage




     tangential plane · mesial-distal                3D volume
Axial Plane

  Greater accuracy in implant placement is achieved when the line representing
  the bucco-lingual plane is set at 90° to the buccal surface of the arch.

Yellow line passing through the axis of the implant creates the
view seen in the cross sectional view (next slide).
                                                           Dragging the yellow line in the software will
                                                           change the cross sectional view as the line
                                                           rotates about the axis of the implant.

                                                                         The markings on the concentric
                                                                         circles are 5 mm apart allowing
                                                                         measurements to be calculated.




                                                                         virtual implant

                                                                                             Invivo5
 #9                                                                                          Anatomage
#9           preferred implant placement
               cross sectional plane · bucco-lingual
Images from software evaluated in 3 planes: axial, mesio-distal & bucco-lingual

                  axial plane             cross sectional plane · bucco-lingual




                                           Invivo5
                                           Anatomage




        tangential plane · mesio-distal                3D Volume
#9                         LINEAR CORRECTION
             Illustrating preferred implant placement position (bucco-lingual)


                      The virtual implant is moved parallel & facial 1.3 mm
                      to the location of the DIAGNOSTIC guide sleeve.

                         Yellow line passing through the axis of the implant.




   virtual implant
                                                                                5 mm grid intervals
                                                                                to allow measurements
                                                                                to be calculated.
actual guide sleeve


                                                                                      Invivo5
                                                                                      Anatomage
                                     cross sectional view.
#9                     LINEAR CORRECTION
           Illustrating preferred implant placement position (mesio-distal)


          Illustrating the preferred implant placement in the tangential view

               The center of the virtual implant is located 1 mm mesial
                 to the center of the DIAGNOSTIC guide sleeve.


  virtual implant
                                                                  5 mm grid intervals
                                                                  to allow measurements
                                                                  to be calculated.


actual guide sleeve


                                                                                Invivo5
                                                                                Anatomage
                                  tangential view
preferred implant placement
                   tangential plane · mesio-distal
Images from software evaluated in 3 planes: axial, mesio-distal & bucco-lingual

                  axial plane             cross sectional plane · bucco-lingual




                                           Invivo5
                                           Anatomage




        tangential plane · mesio-distal                3D Volume
Review of Pre-op Corrections


                           #9
                   LINEAR CORRECTION
1.5 mm offset guide post rotated 45º toward the mesial & facial.

        Cosine is applied to determine correction data.
                       * see next 3 slide
Pythagorean Theorem
COSINE Calculations for Guide Right™ Guides



                   The cosine of 45°
        is recommended for Guide Right corrections

                         BECAUSE
           rotating the offset guide post half way
       between 2 adjacent planes (90° apart) is 45°.
Correction          based on the calculations
              from the   Pythagorean Theorem



To move the position of the guide sleeve 1 mm both mesially & buccally:

               ► use a 1.5 mm offset guide post

      ► and rotate the offset guide post 45º to a mesio-buccal position.

     Cosine of 45° X 1.5 mm = 0.71 X 1.5 mm = 1.06 mm
A= cosine of 45º X 1.5
                                                (0.707 X 1.5 mm = 1.06 mm
        mesial 1.06 mm




                         45°


        45°
                               facial 1.06 mm

guide post center
A= cosine of 45º X 1.5
(0.707 X 1.5 mm = 1.06 mm
Fabrication of SURGICAL guide
palatal view

1.5 mm offset guide post rotated 45º toward the mesial & facial.
Initial application of Triad® Gel
to capture the cleats on the open guide sleeve to form the SURGICAL guide.
Additional Triad® Gel added to adjacent teeth
Final SURGICAL guide
SURGICAL guide (facial view)
POST-operative RESULTS
Invivo5 Software Analysis
Anatomage
# 9 POST-OP RESULTS
        showing actual implant placement.


          axial plane             cross sectional plane · bucco-lingual




                                   Invivo5
                                   Anatomage




tangential plane · mesio-distal                3D Volume
# 9 POST-OP results
                                          Axial Plane
  Greater accuracy in implant placement is achieved when the line representing
  the bucco-lingual plane is set at 90° to the buccal surface of the arch.

Yellow line passing through the axis of the implant creates the
view seen in the cross sectional view (next slide).

                                                                         virtual implant

                                                                         The markings on the concentric
                                                                         circles are 5 mm apart allowing
                                                                         measurements to be calculated.



                                                          Dragging the yellow line in the software will
                                                          change the cross sectional view as the line
                                                          rotates about the axis of the implant.


                                                                                              Invivo5
                                                                                             Anatomage
# 9 POST-OP results
                           Cross Section (bucco-lingual)


                                Yellow line passing through the axis of the implant.




 virtual implant
 superimposed over
 actual implant
                                                                                       5 mm grid intervals
                                                                                       to allow measurements
                                                                                       to be calculated.


       actual
  open guide sleeve

     Only one wall of
                                                                                                Invivo5
                                                                                                Anatomage
open guide sleeve is visible.
# 9 POST-OP result

                      Tangential   (mesio-distal)




virtual implant
superimposed over                                   5 mm grid intervals
actual implant.                                     to allow measurements to
                                                    be calculated.

actual guide sleeve


                                                                  Invivo5
                                                                  Anatomage
Guide Right™
  Products shown in this case


 1 - 3/32” drill
 1 - 3 mm X 30 mm Guide Post
 1- 3 mm Guide Sleeve
 1 - 3 mm x 1.5 mm Offset Magnetic Guide Post
 1 - 3 mm Open Guide Sleeve
 Guide Post Bending Tool
 Triad® Gel


        1.800.314.0065 •   www.deplaque.com
A System of Components
for the fabrication and correction of diagnostic & surgical templates
                       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

                1.800.314.0065 •   www.deplaque.com
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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8 use of pythagorean theorem # 9 single implant case

  • 1. Guide Right ™ Use of Pythagorean Theorem in #9 Single Implant Case Featuring: LINEAR CORRECTIONS DIAGNOSTIC Guide  3 mm X 30 mm guide post  3 mm guide sleeve SURGICAL Guide  3 mm X 1.5 mm offset guide post  3 mm open guide sleeve  Pythagorean Theorem ► Cosine  Invivo5 software analysis Anatomage BEL 2.2013
  • 3. facial view Line marked on teeth to position original axis for initial 3/32” drill mm & 3 mm guide post.
  • 4. 3 mm X 30 mm guide post in 3/32” hole
  • 5. 3 mm guide sleeve placed on the 3 mm guide post and cast lubricated with petroleum jelly
  • 6. Initial layer of Triad® Gel added to the guide sleeve cleats and cured to stabilize the guide sleeve.
  • 7. DIAGNOSTIC Guide showing the 3 mm guide sleeve attached to the cured acrylic ready to be placed for cone beam X-ray.
  • 8. Additional and final layer of Triad® Gel extended to lingual and incisal surfaces of adjacent teeth
  • 9. PRE-OPERATIVE Invivo5 Anatomage Software Evaluation
  • 10. INITIAL EVALUATION of DIAGNOSTIC guide sleeve position axial plane cross sectional plane · buccal-lingual #9 Invivo5 Invivo5 Anatomage Anatomage tangential plane · mesial-distal 3D volume
  • 11. Axial Plane Greater accuracy in implant placement is achieved when the line representing the bucco-lingual plane is set at 90° to the buccal surface of the arch. Yellow line passing through the axis of the implant creates the view seen in the cross sectional view (next slide). Dragging the yellow line in the software will change the cross sectional view as the line rotates about the axis of the implant. The markings on the concentric circles are 5 mm apart allowing measurements to be calculated. virtual implant Invivo5 #9 Anatomage
  • 12. #9 preferred implant placement cross sectional plane · bucco-lingual Images from software evaluated in 3 planes: axial, mesio-distal & bucco-lingual axial plane cross sectional plane · bucco-lingual Invivo5 Anatomage tangential plane · mesio-distal 3D Volume
  • 13. #9 LINEAR CORRECTION Illustrating preferred implant placement position (bucco-lingual) The virtual implant is moved parallel & facial 1.3 mm to the location of the DIAGNOSTIC guide sleeve. Yellow line passing through the axis of the implant. virtual implant 5 mm grid intervals to allow measurements to be calculated. actual guide sleeve Invivo5 Anatomage cross sectional view.
  • 14. #9 LINEAR CORRECTION Illustrating preferred implant placement position (mesio-distal) Illustrating the preferred implant placement in the tangential view The center of the virtual implant is located 1 mm mesial to the center of the DIAGNOSTIC guide sleeve. virtual implant 5 mm grid intervals to allow measurements to be calculated. actual guide sleeve Invivo5 Anatomage tangential view
  • 15. preferred implant placement tangential plane · mesio-distal Images from software evaluated in 3 planes: axial, mesio-distal & bucco-lingual axial plane cross sectional plane · bucco-lingual Invivo5 Anatomage tangential plane · mesio-distal 3D Volume
  • 16. Review of Pre-op Corrections #9 LINEAR CORRECTION 1.5 mm offset guide post rotated 45º toward the mesial & facial. Cosine is applied to determine correction data. * see next 3 slide
  • 17. Pythagorean Theorem COSINE Calculations for Guide Right™ Guides The cosine of 45° is recommended for Guide Right corrections BECAUSE rotating the offset guide post half way between 2 adjacent planes (90° apart) is 45°.
  • 18. Correction based on the calculations from the Pythagorean Theorem To move the position of the guide sleeve 1 mm both mesially & buccally: ► use a 1.5 mm offset guide post ► and rotate the offset guide post 45º to a mesio-buccal position. Cosine of 45° X 1.5 mm = 0.71 X 1.5 mm = 1.06 mm
  • 19. A= cosine of 45º X 1.5 (0.707 X 1.5 mm = 1.06 mm mesial 1.06 mm 45° 45° facial 1.06 mm guide post center
  • 20. A= cosine of 45º X 1.5 (0.707 X 1.5 mm = 1.06 mm
  • 22. palatal view 1.5 mm offset guide post rotated 45º toward the mesial & facial.
  • 23. Initial application of Triad® Gel to capture the cleats on the open guide sleeve to form the SURGICAL guide.
  • 24. Additional Triad® Gel added to adjacent teeth
  • 28. # 9 POST-OP RESULTS showing actual implant placement. axial plane cross sectional plane · bucco-lingual Invivo5 Anatomage tangential plane · mesio-distal 3D Volume
  • 29. # 9 POST-OP results Axial Plane Greater accuracy in implant placement is achieved when the line representing the bucco-lingual plane is set at 90° to the buccal surface of the arch. Yellow line passing through the axis of the implant creates the view seen in the cross sectional view (next slide). virtual implant The markings on the concentric circles are 5 mm apart allowing measurements to be calculated. Dragging the yellow line in the software will change the cross sectional view as the line rotates about the axis of the implant. Invivo5 Anatomage
  • 30. # 9 POST-OP results Cross Section (bucco-lingual) Yellow line passing through the axis of the implant. virtual implant superimposed over actual implant 5 mm grid intervals to allow measurements to be calculated. actual open guide sleeve Only one wall of Invivo5 Anatomage open guide sleeve is visible.
  • 31. # 9 POST-OP result Tangential (mesio-distal) virtual implant superimposed over 5 mm grid intervals actual implant. to allow measurements to be calculated. actual guide sleeve Invivo5 Anatomage
  • 32. Guide Right™ Products shown in this case  1 - 3/32” drill  1 - 3 mm X 30 mm Guide Post  1- 3 mm Guide Sleeve  1 - 3 mm x 1.5 mm Offset Magnetic Guide Post  1 - 3 mm Open Guide Sleeve  Guide Post Bending Tool  Triad® Gel 1.800.314.0065 • www.deplaque.com
  • 33. A System of Components for the fabrication and correction of diagnostic & surgical templates 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 1.800.314.0065 • www.deplaque.com
  • 34. DéPlaque Guide Right™ Surgical Guide System fabricate ▪ evaluate ▪ correct ▪ verify ▪ place Start With Precision. Place With Confidence.™ 1.800.314.0065 • www.deplaque.com