Guide Right

by DPlaque

a precision implant planning, correction and placement technique

2011 Product Catalog

www.deplaque.com 1.800.314.0065

The

Guide Right Story

As with many beginner dental implant cases, Dr. Sean Meitner experienced less than desirable implant placement often discovered in the post surgical x-ray. It wasnt long before he made a trip to the hardware store to collect material to create a makeshift guide system to assist him in better placment. From his innovative discoveries he has designed and developed Guide Right, a Universal Precision Implant Placement System that has resulted in significantly more accurate implant placement.

What is

Guide Right ?

Guide RightTM is a doctor-developed, prosthetically generated precision implant template planning

and correction system that can be made in the office or by a lab. The template enables dental professionals to communicate the desired location of an implant placement by using radiopaque stainless steel or ceramic guide sleeves to locate the exact position of the implant. Guide sleeves are captured in a light cured resin gel on a plaster cast, removed, and then indexed to the patients adjacent teeth. The Guide RightTM technique requires a diagnostic wax-up, or set-up utilizing set-up disks to determine the position and angle of the osteotomy sites. The fabricated template is placed in the patients mouth and a radiograph is taken to determine if the path of insertion is in conflict with the adjacent teeth or other anatomic structures. If a conflict exists, the components can be removed and the template can be remade using angled or offset guideposts that can be bent for your required application. Guide RightTM component parts work with 2D and 3D X-Rays, and all major implant systems and are reusable.

How to order
Order online at www.deplaque.com, or call DPlaque customer service at 800-314-0065 (US) 585-924-3190 (International) between 9am and 4pm EST Monday through Friday. Closed some holidays. Orders may also be faxed to 585-924-3378.

Limitation of liability
Purchaser assumes all risks and liability resulting from the use of these products, whether used separately or in combination with other products not sold by DPlaque. DPlaque recommends completion of formal postgraduate implant education and adherence to recommended implant procedures. U.S. law restricts the sale of medical devices to licensed or certified medical/ dental professionals.

Shipping information
All US orders are shipped via USPS priority mail. Alternative carriers upon request. International orders will be shipped FedEx or UPS; customs and taxes will be added to the order and billed to the receiver.

Trademark information
Guide RightTM is a trademark of DPlaque, Inc. All rights reserved.

Return policy
Customers may return unopened and undamaged DPlaque product in its original packaging within 30 days of date of invoice to be eligible for full credit or replacement. Customers must contact DePlaque prior to a return to receive an RMA (customer return number). A 15% restocking fee will be charged for returns without a customer return number. All return inquiries should be sent to customerservice@ deplaque.com. No credits, exchanges or refunds will be provided on discontinued product or product with a shelf life of less than six months. Credit or refund for returned items will be issued upon receipt and inspection of goods by DPlaque.
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Product development updates

Product development updates can be viewed on our website: www.deplaque.com

DPlaque
1-800-314-0065

Table of Contents
Guide RightTM Template Component Kits
Stainless Ceramic Magnetic Set 3 5 6

Guide RightTM Components

Guide Posts Guide Sleeves Guide Sleeve Inserts 7 9 11

Guide RightTM Accessories

Generation II Guide Post Bending Tool Protractor Autoclavable Instrument Tray Insert Removal Tool Fabrication Insert Depth Gauge/Direction Indicator Setup Disks 13 13 13 14 14 14 14 16

Drills

Oral Hygiene
Interproximal Brushes Oral Hygiene Products 20 20

Educational
Use of the Bending Tool 23-26 Set-up Disk Technique 19 Universal Template Technique 17-18 Open Guide Sleeve/Magnetic Post Technique 15 Helpful Advice 21 Comparison Chart for Drill Size with Guide Sleeves 27-28

Index

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Guide Right Kits

Guide RightTM Kits
are designed to provide the necessary components used to create a template for guiding the implant placement process. Choose the kit that best suits your implant type and size. Parts are autoclavable and reuseable, and may also be purchased separately.
3.0 Pilot Kit 4.5 Kit

Contains the necessary components for using a template to guide the initial pilot drill. Contains the necessary components to step through drill sizes beginning with the pilot drill and up to 4.4 mm. Intended for placing wide diameter implants. Contains the necessary components to step through drill sizes beginning with the pilot drill and up to 5.2 mm. Contains all components found in the 3.0 , 4.5 , and 5.3 kits. Recommended when using CT scans and/or cone beam x-ray technology to avoid the x-ray scatter that often occurs while using metal. Ceramic kits vary by sleeve size. The Deluxe Ceramic Kit incorporates all sizes.

5.3 Wide Diameter Kit

Complete Stainless Kit Ceramic Kits

3.0 Stainless Pilot Kit

3.0 PK
2 2 1 1 2 1 1 1 1 1 1 5 1 1 CONTENTS PGS 3.0 - Posterior Angle Cut Stainless Guide Sleeves 3.0 mm AGS 3.0 - Anterior Straight Cut Stainless Guide Sleeves 3.0 mm Insert 2.0 i.d. Insert 2.3 i.d. GP 3.0 - Straight Guide Posts OGP 0.5 - Offset Guide Post 0.5 mm OGP 1.0 - Offset Guide Post 1.0 mm OGP 1.5 - Offset Guide Post 1.5 mm OGP 2.0 - Offset Guide Post 2.0 mm Depth Gauge 2.0 mm IRT - Insert Removal Tool 1 Temp Tabs Sample* D 3/32 Plaster Drills 1 Protractor* #46 Stone/Plaster Drill 1 Autoclave Jar* ASL Brush Sample 1 BSL Brush Sample

4.5 Stainless Kit

4.5 SK
2 2 1 1 1 1 1 1 1 1 1 2 1 1 1 1 1
3

CONTENTS SGS 4.5 - 4.5 i.d. Stainless Guide Sleeves FABIN 4.5 - Fabrication Inserts for 4.5 Sleeve Insert 2.0 i.d. Insert 2.25 i.d. Insert 2.5 i.d. Insert 2.75 i.d. Insert 3.0 i.d. Insert 3.25 i.d. Insert 3.5 i.d. Insert 3.75 i.d. 1 Autoclave Jar* Insert 4.0 i.d. 1 Protractor* GP 3.0 - Straight Guide Posts 1 Temp Tabs Sample* Offset Guide Post 0.5 mm 5 D 3/32 Plaster Drills Offset Guide Post 1.0 mm 1 #46 Stone/Plaster Drill Offset Guide Post 1.5 mm 1 ASL Brush Sample Offset Guide Post 2.0 mm 1 BSL Brush Sample Depth Gauge 1 IRT - Insert Removal Tool
* Not pictured 1-800-314-0065

Guide Right Kits

5.3 Stainless Wide Diameter Kit
5.3 WDK
2 2 1 1 1 1 1 1 1 1 2 1 1 1 1 CONTENTS WGS 5.3 - 5.3 i.d. Wide Diameter Stainless Guide Sleeves FABIN 5.3 - Fabrication Inserts for 5.3 Sleeves Insert 2.25 i.d. Insert 2.6 i.d. Insert 2.75 i.d. Insert 3.0 i.d. Insert 3.6 i.d. 1 Temp Tabs Sample* Insert 4.0 i.d. 1 Protractor* Insert 4.2 i.d. 1 Autoclave Jar* Insert 4.6 i.d. 1 IRT - Insert Removal Tool GP 3.0 - Straight Guide Posts 1 D 3/32 Plaster Drills Offset Guide Post 0.5 mm 1 #46 Stone/Plaster Drill Offset Guide Post 1.0 mm 1 ASL Brush Sample Offset Guide Post 1.5 mm 1 BSL Brush Sample Offset Guide Post 2.0 mm 1 Depth Gauge

Complete Stainless Kit

CSK
2 2 2 2 2 6 1 1 1 1 1 1 2 1 1 1 1 1 1 1 1 1 2 2 1 1 1 1 1 1 1 1 2 1 5 2 1 1 1 1 1 1 1 CONTENTS AGS 2.0 - Anterior Straight Cut Stainless Guide Sleeves 2.0 mm AGS 2.3 - Anterior Straight Cut Stainless Guide Sleeves 2.3 mm GP 2.0 - Striaght Guide Posts 2.0 mm AGS 3.0 - Posterior Angle Cut Guide Sleeves 3.0 mm AGS 3.0 - Anterior Straight Cut Guide Sleeves 3.0 mm GP 3.0 - Straight Guide Posts 3.0 mm Offset Guide Post 0.5 mm Offset Guide Post 1.0 mm Offset Guide Post 1.5 mm Offset Guide Post 2.0 mm 2.0 i.d. Insert for 3.0 Sleeve 2.3 i.d. Insert for 3.0 Sleeve SGS 4.5 - 4.5 i.d. Stainless Guide Sleeves 2.0 i.d. Insert for 4.5 Sleeve 2.25 i.d. Insert for 4.5 Sleeve 2.5 i.d. Insert for 4.5 Sleeve 2.75 i.d. Insert for 4.5 Sleeves 3.0 i.d. Insert for 4.5 Sleeves 3.25 i.d. Insert for 4.5 Sleeve 3.5 i.d. Insert for 4.5 Sleeve 3.75 i.d. Insert for 4.5 Sleeve 4.0 i.d. Insert for 4.5 Sleeve FABIN 4.5 - Fabrication Inserts for 4.5 Sleeve WGS 5.3 - 5.3 i.d. Stainless Guide Sleeves 2.25 i.d. Insert for 5.3 Sleeve 2.6 i.d. Insert for 5.3 Sleeve 2.75 i.d. Insert for 5.3 Sleeve 3.0 i.d. Insert for 5.3 Sleeve 3.6 i.d. Insert for 5.3 Sleeve 4.0 i.d. Insert for 5.3 Sleeve 4.2 i.d. Insert for 5.3 Sleeve 4.6 i.d. Insert for 5.3 Sleeve FABIN 5.3 - Fabrication Inserts for 5.3 Sleeve AGP - Set of Angled Guide Posts D 3/32 Plaster Drills #46 Stone/Plaster Drills IRT - Insert Removal Tool Depth Gauge ASL Brush Sample BSL Brush Sample Temp Tabs Sample* Protractor* Autoclave Jar*
* Not pictured

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Guide Right Kits

3.0 mm Ceramic Kit
CERAMIC 3.0
CONTENTS
1 1 1 1 1 1 5 1 1 1 2 1 1 2 CGS 3.0-6 - Ceramic Guide Sleeve (Short) CGS 3.0-8 - Ceramic Guide Sleeve CBGS 3.0-6.2X6 - Ceramic Sleeve CGSI 2.0 for 3.0 Insert for Ceramic Guide Sleeve GP 3.0 - Guide Post 30 mm GPS 3.0 - Guide Post 18 mm D3/32 - Plaster Drill for Lab Handpiece #46 Stone Drill 2.06mm 2.0mm Depth Gauge IRT - Insert Removal Tool Interproximal Brushes; 1 size A and 1 size B Protractor* Autoclave Jar* Temp Tabs Samples*

4.0 mm Ceramic Kit

CERAMIC 4.0
CONTENTS
1 1 1 1 1 1 1 5 1 1 1 2 1 1 2 CGS 4.0-6 - Ceramic Guide Sleeve CGSI 2.0 for 4.0 Ceramic Guide Sleeve CGSI 2.5 for 4.0 Ceramic Guide Sleeve CGSI 3.0 for 4.0 Ceramic Guide Sleeve CGP 4.0 - Guide Post 4.0 COGP 4.0-1 - Offset Guide Post COGP 4.0-2 - Offset Guide Post D3/32 - Plaster Drill for Lab Handpiece #46 Stone Drill 2.06 mm 2.0mm Depth Gauge IRT - Insert Removal Tool Interproximal Brushes; 1 size A and 1 size B Protractor* Autoclave Jar* Temp Tabs Samples*

5.0 mm Ceramic Kit

CONTENTS

CERAMIC 5.0

1 1 1 1 1 1 1 1 1 1 1 5 1 1 1 2 1 1 2

CGS 5.0-6 - Ceramic Guide Sleeve CGSI 2.0 for 5.0 Ceramic Guide Sleeve CGSI 2.25 for 5.0 Ceramic Guide Sleeve CGSI 2.5 for 5.0 Ceramic Guide Sleeve CGSI 2.75 for 5.0 Ceramic Guide Sleeve CGSI 3.0 for 5.0 Ceramic Guide Sleeve CGSI 3.25 for 5.0 Ceramic Guide Sleeve CGSI 3.5 for 5.0 Ceramic Guide Sleeve CGSI 3.75 for 5.0 Ceramic Guide Sleeve CGSI 4.0 for 5.0 Ceramic Guide Sleeve COGP 5.0-1 - Offset Guide Post D3/32 - Plaster Drill for Lab Handpiece #46 Stone Drill 2.06mm 2.0mm Depth Gauge IRT - Insert Removal Tool Interproximal Brushes; 1 size A and 1 size B Protractor* Autoclave Jar* Temp Tabs Samples*
* Not pictured 1-800-314-0065

Guide Right Kits

Deluxe Ceramic Kit
DELUXE
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 1 1 1 2 1 1 2

CONTENTS
CGS 3.0-6 - Ceramic Guide Sleeve (Short) CGS 3.0-8 - Ceramic Guide Sleeve CBGS 3.0-6.2X6 - Ceramic Sleeve CGSI 2.0 for 3.0 Insert for Ceramic Guide Sleeve GP 3.0 - Guide Post 30 mm GPS 3.0 - Guide Post 18 mm CGS 4.0-6 - ceramic Guide Sleeve CGSI 2.0 for 4.0 Ceramic Guide Sleeve CGSI 2.5 for 4.0 Ceramic Guide Sleeve CGSI 3.0 for 4.0 Ceramic Guide Sleeve CGP 4.0 - Guide Post 4.0 COGP 4.0-1 - Offset Guide Post COGP 4.0-2 - Offset Guide Post CGS 5.0-6 - Ceramic Guide Sleeve CGSI 2.0 for 5.0 Ceramic Guide Sleeve CGSI 2.25 for 5.0 Ceramic Guide Sleeve CGSI 2.5 for 5.0 Ceramic Guide Sleeve CGSI 2.75 for 5.0 Ceramic Guide Sleeve CGSI 3.0 for 5.0 Ceramic Guide Sleeve CGSI 3.25 for 5.0 Ceramic Guide Sleeve CGSI 3.5 for 5.0 Ceramic Guide Sleeve CGSI 3.75 for 5.0 Ceramic Guide Sleeve CGSI 4.0 for 5.0 Ceramic Guide Sleeve CGP 5.0 - Guide Post 30 mm COGP 5.0-1 - Offset Guide Post CGS 6.0-6 - Ceramic Guide Sleeve CGP 6.0-20 - Guide Post D3/32 - Plaster Drill for Lab Handpiece #46 Stone Drill 2.06mm 2.0mm Depth Gauge IRT - Insert Removal Tool Interproximal Brushes; 1 size A and 1 size B Protractor* Autoclave Jar* Temp Tabs Samples*

Magnetic Set
MAGNETIC
CONTENTS
1 1 1 1 1 1 MGP 4.0 Magnetic Guide Post OMGP 4.0 - 1.0 mm Offset Guide Post OGS 4.0 - 5 mm Open Guide Sleeve OGS 4.0 - 8 mm Open Guide Sleeve OGS Drill - 2 mm drill x 3.92 mm shaft x 5 mm length to stop OGS Drill - 2 mm drill x 3.92 mm shaft x 10 mm length to stop

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* Not pictured

Guide Right Guide Posts

Guide RightTM Guide Posts are made of stainless steel with various upper shaft diameters and
heights available with lower shaft always a 3/32 diameter. The posts are used to orient guide sleeves to the axis of the holes which have been drilled in the template cast. The guide sleeve is placed over the guide post while gel is applied to form the body of the template. There are several available guide post styles, including:
Straight Guide Posts Short Guide Posts Angled Guide Posts Offset Guide Posts Magnetic Generation II Guide Posts Standard post for sleeve orientation. Used when articulating upper and lower casts to check registration of occlusal tables of the opposing teeth. Used to assist in the correction of the angulation of the guide sleeve after viewing an x-ray indicating an unsatisfactory angle of a guide sleeve. Designed to hold the guide sleeve in an offset position to adjust the center of the guide sleeve and osteotomy site when rotating the guide post. Contains a magnet which attracts the open guide sleeve and holds it in place while the template is being made. The 3.0 mm and 4.0 mm Magnetic Guide Post GII shafts - both straight and offset - are designed with 4 flat surfaces (representing mesial, distal, buccal, and lingual surfaces) configured 90 degrees apart, for the purpose of tightly securing the post in the Guide Right Generation II Bending Plate when bending the offset guide post.

Straight Guide Posts

GP 2.0 Straight Guide Post, 2.0 mm diameter X 25 mm total height
The Straight Guide Post is used to orient the guide sleeve to the axis of the hole which has been drilled into the cast. The guide sleeve is placed over the guide post while gel is applied to form the body of the template.

GP 3.0

Straight Guide Post, 3.0 mm diameter X 30 mm total height

The Straight Guide Post is used to orient the guide sleeve to the axis of the hole which has been drilled into the cast. The guide sleeve is placed over the guide post while gel is applied to form the body of the template.

GPS 3.0

Straight Guide Post Short, 3.0 mm diameter X 16 mm total height

The Short Straight Guide Post is used when articulating upper and lower casts to check registration of occlusal tables of the opposing teeth.

Angled Guide Posts

AGP Angled Guide Post 3.0 mm diameter X 30 mm total height
The Angled Guide Posts are used to assist in the correction of the angulation of the guide sleeve after viewing an x-ray indicating an unsatisfactory angle of a guide sleeve. Available individually in 2, 3, 4, 6, 8, 10, 12, and 14 or in a set of 7.

1-800-314-0065

Guide Right Posts

Offset Stainless Guide Posts
OGP Offset Guide Post
The Offset Guide Posts are designed so that the long axis of the upper shaft holds the guide sleeve in an offset position from the axis of the lower 3/32 shaft. This allows adjustment of the center of the guide sleeve and osteotomy site when rotating the guide post. Available in 0.5, 1.0, 1.5, and 2.0 mm offset.

Magnetic Guide Posts Generation II

MGP Straight Magnetic Guide Post GII 3.0 o.d. x 22 mm height Straight Magnetic Guide Post GII 4.0 o.d. x 22 mm height
The Magnetic Guide Post Generation II contains a magnet which attracts the open guide sleeve and holds it in place while the template is being made. This post is configured to work with the 5 and 8 mm high Open Magnetic Guide Sleeves. The Magnetic Guide Post GII shafts are designed with 4 flat surfaces (representing mesial, distal, buccal, and lingual surfaces) configured 90 degrees apart, for the purpose of tightly securing the post in the Guide Right (TM) Generation II Bending Plate when bending the offset guide post.

OMGP

Offset Magnetic Guide Post GII

3.0 mm Offset Magnetic GP GII comes in 0.5, 1.0, 1.5, 2.0, and 3.0 mm Offsets 4.0 mm Offset Magnetic GP GII comes in 1.0, 2.0, and 3.0 mm Offsets The Offset Magnetic Guide Post GII contains a magnet which attracts the open guide sleeve and holds it in place while the template is being made. This post is configured to work with the 5 and 8mm high Open Magnetic Guide Sleeves. The offset allows adjustment of the center of the guide sleeve and osteotomy site when rotating the guide post. The Magnetic Guide Post Generation II shafts are designed with 4 flat surfaces (representing mesial, distal, buccal, and lingual surfaces) configured 90 degrees apart, for the purpose of tightly securing the post in the Guide Right (TM) Generation II Bending Plate when bending the offset guide post.

Ceramic Guide Posts

CGP Guide Post for Ceramic Guide Sleeve
Ceramic is recommended for CT scans and/or cone beam x-ray machines in order to avoid the x-ray scatter that often occurs while using metal. The stainless Guide Post for Ceramic Guide Sleeves is used to orient the guide sleeve to the axis of the hole which has been drilled in the cast. The ceramic guide sleeve is placed over the guide post while Triad gel is applied and cured to form the body of the template. Available in 4.0 mm, 5.0 mm, and 6.0 mm o.d.

COGP

Offset Guide Post for Ceramic Guide Sleeve

Stainless Offset Guide Posts are designed with the long axis of the upper shaft to hold the Ceramic Guide Sleeve in an offset position from the axis of the lower shaft to adjust the center of the ceramic guide sleeve and osteotomy site when rotating the guide post. Ceramic 4.0 Guide Post is available in 1.0 mm offset and 2.0 mm offset. Ceramic 5.0 Guide Post is available in 1.0 mm offset.

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Guide Right Guide Sleeves

Guide RightTM Guide Sleeves are surgical diagnostic components constructed with securely fastened brackets for attaching the guide sleeve to the acrylic body of the surgical template. They are available in surgical stainless steel for periapical and panoramic x-rays, and ceramic for use with CT scans or cone beam x-ray machines. The longer straight cut guide sleeve (8.0 mm) is used mainly for anterior areas where access is unlimited. The shorter guide sleeves can be used both in the anterior or posterior areas (for easier accessibility).

Stainless Guide Sleeves

Anterior Sleeves
AGS 2.0 2.0 mm Anterior Straight Cut Guide Sleeve
The Anterior Straight Cut Guide Sleeve (2 mm id X 2.9 mm od X 8 mm height) is used for anterior areas where access to the implant area is unlimited.

AGS 2.3

2.3 mm Anterior Straight Cut Guide Sleeve

The Anterior Straight Cut Guide Sleeve (2 mm id X 2.9 mm od X 8 mm height) is used for anterior areas where access to the implant area is unlimited.

AGS 3.0

3.0 mm Anterior Straight Cut Guide Sleeve

The Anterior Straight Cut Guide Sleeve (3 mm id X 3.7 od X 10 mm height) is used for anterior areas where access to the implant area is unlimited.

3.0 mm Posterior Sleeve

PGS 3.0 3.0 mm Posterior Angle Cut Guide Sleeve
The Posterior Angle Cut Guide Sleeve (3 mm id X 3.7 od X 10 mm height) is cut at an angle for easier access for use in the posterior areas of the mouth. The drill can be inserted from the side at the lower end of the angle cut and therefore does not require the patient to open as wide. This sleeve can be used for either posterior or anterior sites. It can be reversed and used to access drill depth.

4.5 mm Sleeves
SGS 4.5 Serial Guide Sleeve
The Serial Guide Sleeve (4.5 mm id X 6 od 5 mm height) is used with Serial Guide Sleeve Inserts ranging from 2.0 mm to 4.0 mm. See 4.5 mm Guide Sleeve Inserts. Measure the drill diameter before ordering inserts. Inserts are press-fit and require the Insert Removal Tool (IRT), the Fabrication Insert (FABIN 4.5 mm), and the 3 mm Guide Post (GP 3.0).

WDGS 5.3

5.3 Wide Sleeves

Wide Diameter Guide Sleeve
The Wide Diameter Guide Sleeve (5.3 mm id X 6.4 od X 5 mm height) is the widest guide sleeve and is to be used with 5.3 mm inserts. See 5.3 mm Guide Sleeve Inserts. Inserts are press-fit and require the Insert Removal Tool (IRT), the Fabrication Insert (FABIN 5.3 mm), and the 3 mm Guide Post (GP 3.0).

1-800-314-0065

Guide Right Guide Sleeves

Open Guide Sleeves
Guide RightTM Open Guide Sleeves facilitate access from the side of the template instead of the top
in order to drill in posterior areas where access is limited. The open guide sleeve also allows viewing the drill depth markings and will accommodate drill sizes up to 4 mm. It is indexed to adjacent teeth of the edentulous area with acrylic light-cured resin gel which is registered to the occlusal and lingual surface of the adjacent teeth. The open guide sleeve requires the use of the magnetic guide post to fabricate a template. This sleeve can also be used in the anterior, but is not as accurate as the closed guide sleeve.

OGS - 5 mm

3.0 i.d. x 5 mm Open Guide Sleeve, U-Shape 4.0 i.d. x 5 mm Open Guide Sleeve, U-Shape
Use of a stopped low temperature drill is recommended to start with. (See drills on page 15)

OGS - 8 mm

3.0 i.d. x 8 mm Open Guide Sleeve, U-Shape 4.0 i.d. x 8 mm Open Guide Sleeve, U-Shape
Use of a stopped low temperature drill is recommended to start with. (See drills on page 15)

Ceramic Guide Sleeves

Ceramic Sleeves are recommended for CT scans and cone beam x-ray machines in order to avoid the x-ray scatter that often occurs when using metal. Like its stainless counterparts, ceramic parts are autoclavable and reuseable. The longer ceramic guide sleeve is used for anterior areas where access is unlimited. The shorter guide sleeves can be used in both anterior and posterior areas. Due to the nature of the material there is a slight variation in the od of ceramic sleeves. The ceramic guide sleeves have a fused at 1700 bracket with undercuts on the side surface which attach and hold to the acrylic body of the template. Use extra care when handling the ceramic sleeves. They may break if dropped to a hard surface. Thin walled sleeves are fragile. Ceramic Guide Sleeves are offered in straight cut configurations in the following dimentions:

CGS 3.0

3.0 mm Ceramic Guide Sleeves

3.0 mm Ceramic Guide Sleeves
CGS 3.0-6 CGS 3.0-8 (3 mm id X 4.80 mm od X 6 mm height) (3 mm id X 4.75 mm od X 8 mm height)

CGSTW 3.0-8 3.0 mm Thick Wall Ceramic Guide Sleeve CGSTW 3.0-6 (3.2 mm id X 6.25 mm od x 6 mm height) Thick Wall Ceramic Guide
Sleeves are used for wider, larger teeth, usually in the posterior areas.

4.0

5.0

6.0 mm Ceramic Guide Sleeves

CGS 4.0 - 6 (4 mm id X 6.45 mm od X 6 mm height) CGS 5.0 - 6 (5 mm id X 8.12 mm od X 6 mm height) CGS 6.0 - 6 (6 mm id X 9.50 mm od X 6 mm height)
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Guide Right Press-Fit Inserts

Guide Sleeves dictate the direction of the drill preparing the osteotomy. All inserts press fit into the guide sleeves to prevent spinning while drilling. The use of the graduated size inserts for increasing drill sizes produces more accurate results. Inserts are available in 2.0 mm - 4.6 mm inside diameter increments and are compatible with the various drill sizes used with many implant systems. See the implant drill sequence chart (pages 23, 24) Some surgeons prefer to use inserts for each drill size; others do not. Measurements below are for the inside diameter (id) of the sleeve.

Stainless Sleeve Inserts

Inserts for 3.0 mm Sleeve

GSSI 2.0 2.0 mm Press Fit Stainless Insert
The 2.0 mm Press Fit Stainless Insert, in conjunction with various drill sizes, is used with many implant systems. It is designed to press-fit into the stainless steel 3.0 mm Straight Guide Sleeve and is removable with the Insert Removal Tool (IRT).

GSSI 2.3

2.3 mm Press Fit Stainless Insert

The 2.3 mm Press Fit Insert, in conjunction with various drill sizes, is used with many implant systems. It is designed to press-fit into the stainless steel 3.0 mm straight guide sleeve and is removable with the Insert Removal Tool (IRT).

Inserts for 4.5 mm Sleeve

SGSI 4.5 mm Guide Sleeve Inserts
All 4.5 mm Guide Sleeve Inserts are designed to be placed in the 4.5 mm serial guide sleeves and are to be used progressively in order to acommodate greater control when drilling the osteotomy. Remove the insert wth the Insert Removal Tool (IRT). Available sizes include: 2.0, 2.25, 2.5, 2.75, 3.0, 3.25, 3.5, 3.75, and 4.0 mm.

FABIN 4.5

4.5 mm Fabrication Insert

The 4.5 mm Fabrication Insert (FABIN) is required to keep acrylic gel from entering inside sleeve inserts during the gel and curing stage. Place the FABIN inside the 4.5 mm wide diameter guide sleeve with correlating size guide post, place the FABIN over the guide post and then apply gel.

Inserts for 5.3 Sleeve

WDGSI 5.3 mm Wide Diameter Inserts
5.3 Wide Diameter Guide Sleeve Inserts are used when large implants and larger diameter drills are required. The various id diameters are designed to be used progressively in order to acommodate greater placement control when drilling the osteotomy. Available sizes include: 2.25, 2.6, 2.75, 3.0, 3.6, 4.0, 4.2 and 4.6 mm.

FABIN 5.3

5.3 mm Fabrication Insert

The 5.3 mm Fabrication Insert (FABIN) is required to keep acrylic gel from entering inside sleeve inserts during the gel and curing stage. Place the FABIN inside the 5.3 mm Wide Diameter Guide Sleeve with correlating size guide post, place the FABIN over the guide post and then apply gel.

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Guide Right Press Fit Inserts

Titanium Sleeve Inserts
GSTI 2.0

Inserts for 3.0 mm Sleeve

2.0 mm Press Fit Titanium Insert
The 2.0 mm Press Fit Insert, in conjunction with various drill sizes, is used with many implant systems. It is designed to press fit into the stainless steel 3.0 mm Straight Guide Sleeve and is removable with the insert removal tool (IRT).

Ceramic Sleeve Inserts

Ceramic Sleeve Inserts are made of stainless steel and are designed to press-fit into the Ceramic Sleeves which are recommended for CT scans and cone beam x-ray machines in order to avoid the x-ray scatter that often occurs when using metal. Like its stainless counterparts, ceramic parts are autoclavable and reuseable.

Inserts for 3.0 mm Ceramic Sleeve

CGSI 2.0 mm Stainless Insert
The 2.0 mm Insert, in conjunction with various drill sizes, is used with many implant systems. It is designed to press-fit into the ceramic 3.0 mm Straight Guide Sleeve and is removable with the Insert Removal Tool (IRT).

Inserts for 4.0 mm Ceramic Sleeve

CGSI 4.0 mm Ceramic Guide Sleeve Inserts
4.0 mm Ceramic Guide Sleeve Inserts are offered in press-fit, straight cut configurations. Drill diameter should measure less than 2.0 mm. The insert is removed from the sleeve with the Insert Removal Tool (IRT). Available sizes include: 2.0, 2.5 and 3.0 mm.

CGSI

Inserts for 5.0 mm Ceramic Sleeve

5.0 mm Ceramic Guide Sleeve Inserts
5.0 Ceramic Guide Sleeve Inserts are offered in press fit, straight cut configurations. The insert is removed from the sleeve with the Insert Removal Tool (IRT). Available sizes include: 2.0, 2.25, 2.5, 2.75, 3.0, 3.25, 3.5, 3.75 and 4.0 mm.

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Guide Right Accessories

Generation II Guide Post Bending Tool and Stylus
The Generation II Bending Tool is used to bend the guide
BT
post in all directions. It is calibrated in 1 increments. The guide post is placed in the bending tool and can easily be bent with the bending stylus. A surgical template using the Guide Right Surgical Components can be fabricated and evaluated with a periapical or 3D X-Ray prior to surgery. The difference in the actual angle of the guide sleeve and the desired angle of the guide sleeve can be determined by laying the Guide Right Protractor over an X-Ray or by measuring the angle with the cone beam software. The correction of the angle can then be made by bending the guide post in the bending tool and remaking the template. If the direction of the guide post is corrected but the bodily alignment is off, an offset guide post can be used. See page 17 for Bending Tool Technique. There are three Bending Stylus available to be used with the bending tool to bend 3.0 mm, 4.0 mm and 5.0 mm guide posts. Using the Guide RightTM Bending Tool to bend the guide posts accurately alters the angle of the guide sleeve. This is based on the angle determined by the 3D scan image. If the angles need to be changed, a new template needs to be made with the corrected guide posts. Generation II guide posts must be used when making multiple bend corrections. The G II guide posts have 4 flats on the lower shaft.

Stylus

GII Guide Post

Protractor
PROTRACTOR
If a Guide RightTM Surgical Template is made and guide sleeve placement is prosthetically driven, an x-ray must be taken prior to use to verify that the angulation/position is correct and not violating the roots of the adjacent teeth or other anatomical structures. If the angle of the guide sleeve is incorrect, the Guide RightTM Protractor is used to indicate the difference between the existing angle and the correct angle. Set the protractor on the periapical x-ray. Locate the guide sleeve in the x-ray and draw a line through the center of the existing guide sleeve. Now draw another line through the desired placement of the guide sleeve and measure the angle between them. That difference is noted and is used to correct the guide post either by using the Guide RightTM Bending Tool or a pre-bent angled guide post, available in 2, 4, 6, 8, 10, and 12 degrees.

Autoclavable Instrument Tray

TRAY
The Autoclavable Instrument Tray is a convenient autoclavable container to not only sterilize your Guide RightTM Components in, but to securely organize the components individually for easy access. Translucent lid included. Two sizes: 2.5 X 6.0 X 0.75 2.5 X 3.0 X 0.75
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Guide Right Accessories

Insert Removal Tool
IRT
The Insert Removal Tool (IRT) is required to push the insert out of the guide sleeve. This tool is a one-size-fits-all, and can be used with all insert sizes. Guide sleeve inserts are pressed down into a sleeve to obtain a press fit to prevent inserts from spinning while drilling. The surgeon (or assistant) will need to use the Insert Removal Tool (IRT) to release the insert before placing the next larger size insert in a multi drill sequence. Inserts release easier when fabricated in an acrylic template than if gripped between your fingers.

Fabrication Insert
The Fabrication Insert (FABIN) is required to keep acrylic gel from entering inside the guide sleeve during the gel and curing stage while fabricating a template. It also serves to hold the guide sleeve and guide post in place for the template. Instructions for use of the FABIN: 1. Place the 3.0 mm guide post into the proposed osteotomy location determined by the drilled hole through the center of the waxup on the cast. 2. Place the the correlating size guide sleeve over the post. 3. Place the appropriate size FABIN over the guide post and press-fit it into the sleeve. 4. Apply acrylic gel to the seeve cleats and up over the adjacent teeth. (see Application of Acrylic, page 20) Available sizes include: 4.5 and 5.3 mm. (see page 11)

FABIN

2mm Depth Gauge / Direction Indicator

DEPTH GAUGE
The Guide Right Depth Gauge/Direction Indicator (2 mm diameter) is inserted into the 2 mm osteotomy and an x-ray is taken to re-check the alignment of the osteotomy with the roots of the adjacent teeth. If the alignment is satisfactory, proceed with the increasing drill sizes. If not, minor changes in the angulation should be made at this time with the 2 mm or a lindeman drill. The depth of the osteotomy can also be checked with the depth gauge and measured at this time. The depth is determined by examining the markings on the depth gauge visible in the x-ray. The width of the top of the depth gauge (4.0 mm) is usually desired for the minimal width of an abutment.

Set-up Disks
SUD
The Guide Right Set-up Disks are used in place of a prosthetic wax setup or a plastic prosthetic tooth. One or more setup disk(s) is chosen to set on a cast to space the center of the implants appropriately. The setup disks allow one to drill through the disk into the cast of a patient with a partially edentulous arch with a 3/32 drill. The guide posts are placed in the 3/32 hole(s) in the cast after the setup disk(s) are removed. Sizes available: 5.5, 6.5, 7.5, 8.5, 9.5, 10.5, and 11.5 mm. Set-up disks may be purchased separately or as a complete series.
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Guide Right Open Guide Sleeve Technique

The Guide RightTM Open Guide Sleeve facilitates access from the side of the template instead of the top in order to drill in posterior areas where access is limited. The open guide sleeve also allows viewing the drill depth markings. It will accommodate drill sizes up to 4 mm in diameter. The Open Guide Sleeve is indexed to the teeth adjacent to the edentulous area with acrylic that is applied to the occlusal and lingual surface of the adjacent teeth. The use of the Magnetic Guide Post to fabricate a template is recommended with this sleeve. The sleeve can also be used in the anterior, but is not as accurate as the closed guide sleeve.
The Open Guide Sleeve is conducive in completely edentulous cases with cone beam X-Rays using a duplication of the patients denture.

Using Magnetic Guide Posts & Open Guide Sleeves to fabricate a surgical template
1

Step 1 Drill hole(s) in the dental cast with (O) D3/32 plaster drill for lab handpiece, block out undercuts and lubricate the cast with petrolium jelly. Insert magnetic guide post into cast.

Step 2 Place open guide sleeve with cleats on the convex side against the magnetic guide post.
3

Step 3 Apply acrylic/light cured resin gel to the open guide sleeve cleats of the lingual occlusal surface and adjacent teeth.
4

Steps 4 & 5
5

The Pilot drill is then placed into the open guide sleeve from the side - Fig. 4 & 5. Verify the position.

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Guide Right Drills

Important note when using drills: A drill manufacturers labeled size may not be the actual size of the drill. To insure proper fit with the guide sleeve inserts, measure the actual outside diameter (od) of the drill shaft then use the next size larger guide sleeve insert. Example: if your drill size measures 2.25 mm outside diameter (od), use a 2.5 mm inside diameter (id) guide sleeve insert to prevent binding of the drill.

D3/32 Plaster Drill

3/32/2.38 mm drill for dental lab handpiece. Available in single or package of 12.

D46

D 2.0 Stone Drill

The 2.0 mm lab drill measures 2.05 mm (#46) and is used in the lab handpiece for drilling hard dental stone or plaster.

OGS DRILL

Open Guide Sleeve Pilot Drill

Four sizes available for 3.0 mm Open Guide Sleeve: 2 mm x 2.92 mm x 5 mm length to stop 2 mm x 2.92 x 8.5 mm length to stop 2 mm x 2.92 x 10 mm length to stop 2 mm x 2.92 x 11.5 mm length to stop Two sizes available for 4.0 mm Open Guide Sleeve: 2 mm drill x 3.92 mm shaft x 5 mm length to stop 2 mm drill x 3.92 mm shaft x 10 mm length to stop

BURR

Acrylic Removal Burr

The trispade Acrylic Burr is recommended for easily and carefulling removing acrylic from Guide RightTM surgical guide sleeves without damage to the sleeve so that it may be reused.

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Guide Right Universal Template Technique

Impressions
Accurate alignment impressions of both arches are taken and poured in plaster. Plaster is preferred over stone as casts poured in stone are very hard and result in the rapid dulling of the 3/32 drill. A bite registration is taken and the casts are then articulated.

Diagnostic Set-up
A set-up is made of the missing teeth to be replaced in wax or by plastic denture teeth on the ridge to determine the ideal position desired for the replacement teeth. (Figs. 1,2)

Fig. 1

Fig. 2

Registration
The long axis of the fixture must be registered or oriented to the portion of the cast which represents the edentulous alveolar ridge. A 3/32 drill is used in a laboratory handpiece to drill through the diagnostic wax set-up or plastic teeth into the plaster cast to a depth of at least 10 mm. (Fig. 3) This hole in the cast represents the osteotomy site in the alveolar ridge. This orientation is captured and transferred to the guide sleeve in the template. When the surgical drill is placed in the guide sleeve, the osteotomy that is prepared in the bone is in the same orientation. The wax or plastic teeth are now removed from the cast and the smallest end of the short 18 mm guide posts are then set into the 3/32 holes prepared in the cast. The models are again articulated to check that the guide posts are properly located in relation to the cusp fossa relationship of the teeth of the opposing arch (Figs. 4,5).

Fig. 3

Fig. 4

Fig. 5

Block Out Undercuts

Block out wax is used to fill all undercuts on at least two teeth on either side of the edentulous areas. The lingual and/or occlusal surfaces of the cast are coated with a lubricant. The short 18 mm guide posts are replaced with the longer 30 mm guide posts to accomodate easier access for removal (Fig. 6). Fig. 6

Guide sleeves are placed over the guide post in contact with the crest of the ridge with the cleat placed lingual. (Fig. 7)

Fig 7

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Guide Right Universal Template Technique

Application of Acrylic
Triad gel or other suitable acrylic is applied to the lingual and/or occlusal surfaces of the adjacent teeth and the lingual surface of the posterior guide sleeves. (Fig. 8) The guide posts are removed from the guide sleeves prior to removing the template from the cast except with offset or angled posts. (Fig. 9) The acrylic template is then removed from the cast and any sharp edges are trimmed with an acrylic burr. Any acrylic extending over the edge of the guide sleeve should be trimmed so as not to contact the surgical drill used in the preparation of the osteotomy site. (Fig. 10) The guide sleeves are cleaned of any acrylic with a DPlaque Interrproximal Brush.
Fig. 8 Fig. 9 Fig. 10

Checking Fit and Accuracy

The template is placed in the patients mouth to see that it fits accurately, and for radiographic evaluation. A periapical, panorex or linear tomography or a volumetric 3-D scan can be taken to determine the projected position of the osteotomy site. By extending the line of the edge of the guide sleeve on the radiographic image in the facial view or the cross sectional view, one can determine the projected location of the osteotomy site (Figs. 11, 12). If the proposed trajectory is not correct, the guide sleeves are removed from the acrylic material, the necessary corrections are made, and the template is remade. The template again should be placed in the patients mouth and a new radiograph taken. Fig.13 demonstrates the final result of the accurate placement of the fixture.
Fig. 11 Fig. 12 Fig. 13

Use of Serial Guide Sleeve Inserts

1. Insert the Fabrication Insert (Fabin) / (X) into the Guide Sleeve (R). 2. Place the Fabrication Insert with the nested 4.5 mm guide sleeve over the 3.0 mm Guide Post (G) already in the cast. The Fabrication Insert will keep the acrylic gel out of the guide sleeve while building your surgical template/stent. 3. When you build up the template be sure the sleeve-cleats are on the lingual/palatal side and are firmly imbedded in the acrylic 4. The Guide Sleeve Inserts should be firmly pressed down for the press fit design to keep inserts from spinning while drilling the osteotomy.

Releasing the Insert

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The surgeon (or assistant) will need to use the Insert Removal Tool (IRT) / (Y) to release the insert before placing the next larger size insert in a multi drill sequence.
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Guide Right Set-up Disk Technique

Guide RightTM Set-up Disks
(Fig. 1) Fig. 1 In lieu of a wax up set up disks can be used to determine spacing placement for adjacent implants. Available in sizes 5.5 to 11.5 mm in 1 mm intervals. Fig. 2

Step 1
Wax rope is placed on the ridge of the edentulous area and an approximate size set-up disk is placed on the wax. (Fig. 2) The opposing cast is articulated to check the relationship to the opposing teeth. (Fig. 3)

Step 2
A 3/32 drill, in a straight handpiece, is used to drill through the center of the set-up disk into the cast to a depth of 10mm. (Fig. 4) Fig. 3

Step 3
The set-up disk is removed from the cast and the narrow end of the guide post is placed into the 3/32 hole. A posterior angle-cut guide sleeve is placed over the guide post with the brackets on the lingual surface. (Fig. 5)

Step 4
The undercuts are blocked out on the lingual surfaces of the teeth. The teeth and body of the cast are lubricated. A light-cured acrylic gel, such as TriadTM, is placed on the surface of the guide sleeve where the brackets are located. Gel is extended over the surfaces of the adjacent two or three teeth to index the template to the patients teeth. (Fig. 6)

Fig. 4

Step 5
The gel material is built up in layers with a curing light or in a curing oven. If there is any material extending over the edge of the guide sleeve opening, it should be trimmed back with an acrylic burr.

Fig. 5

Step 6
The guide sleeve should be cleaned with a brush to remove any loose acrylic particles. The template is removed from the cast and seated on the patients teeth for a radiographic evaluation. Fig. 6

Step 7
The template should be placed in betadine prior to use in the surgical procedure.

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Oral Hygiene Products DPlaque Interproximal Brushes

Our Interproximal Brushes were created to help patients keep areas clean which cannot be cleaned with a standard tooth brush. This includes gaps between teeth as well as areas around implants. Doctors may request samples of our brushes so as to prescribe the correct size to their patients. We provide order forms free of charge so patients may order directly from us.

SL

Silverline Brushes
Silverline Brushes are made with durable dupont nylon bristles and stainless steel stem wire. The brushes are tapered and graduated in size (C, S, A, B, D and E) from 1/8 inch to 5/8 inch in diameter. The two largest brushes (D, E) are for spaces where a tooth or several teeth have been lost, leaving the adjacent proximal surfaces very difficult to clean with a traditional brush. Use the largest size that fits between the teeth without forcing it. Do not force between teeth!

GL

Goldline Brushes
Goldline Brushes are made with durable dupont nylon bristles and plastic coated stainless steel stem wire. Designed to prevent scratching, clinicians have recommended that plastic coated brushes be used by patients with dental implants or by those with sensitive teeth. The brushes are tapered and graduated in size (c, s, a, b), from 1/8 inch to 5/16 inch in diameter. Use the largest size that fits between the teeth without forcing it. Do not force between teeth!

Brush Handle
PRECISION Precision Brush Handle
The DPlaque Precision Adjustable Handle is made with a stainless steel tip and knurled collar with a blue anodized aluminum alloy handle to easily secure and accommodate DPlaque interproximal brushes sizes C, S, A, and B. It is designed for durability and longevity.

Brushes
200 Periodontic Brush #200
The Periodontic Toothbrush has soft textured nylon, multi-tufted bristles with polished tips and features a V-trim design on a small brush head for gentle gumline cleaning.

308

Butler Tapered End Tuft #308

The Butler Tapered End Tuft Brush features soft, textured nylon bristles with polished tips on a compact head for better access to difficult areas. The v-trim design on a small brush head allows for gum line cleaning.

FLOSSBRUSH

FLOSSBRUSH The Flossbrush comes in boxes of 90. This brush consists of a soft, fluoride-treated gauze material mounted on a small plastic handle. Its primary function is for easy reaching and cleaning of interproximal areas. The FlossBrush is ideal for cleaning plaque between teeth, around implants and bridges, and between braces.
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Helpful Advice
To insure proper alignment ...
Schedule an appointment with the patient for a template try-in before the surgery date. Take an x-ray with the template in the patients mouth to insure the alignment of the sleeve is where you want it. If the alignment is incorrect, break it apart by placing the template into 1/4 cup of boiling water, remove from hot water with forcepts to carefully break the softened acrylic away from the guide sleeve with your fingers. Remake it using the correct offset and/or angled guide posts. Disinfect and retry the new template in the patients mouth. Take another verifying x-ray.

Components Reusable ...

All guide sleeves and inserts are reusable and autoclavable. The autoclaving should be at 135 degrees C for at least 10 minutes. Regular guide sleeves are made of 303 stainless steel. The open guide sleeves are made of 410 stainless steel and can also be autoclaved, but they will show some signs of rusting unless you use some of the surgical milk* pre rinse to prevent rusting when autoclaved. Alumina ceramic guide sleeves are fired at 1600 degrees when they are made so they can also be autoclaved at 135 degrees C for 10 minutes with no problems To reuse the guide sleeves, place the fabricated template in 1/4 cup of boiling water for 1 minute to soften the acrylic. Remove it from the hot water with forcepts. Immediately and carefully break the softened acrylic away from the guide sleeve with your fingers.

The surgical template cannot be autoclaved or it will melt. It should be placed in Betadyne for 10 minutes at room temperature, then rinsed or placed in sterile water or saline for 3 seconds. Rinse once more prior to use. At the time of surgery the flap can be reflected to the palatal and the template placed on the teeth (the template will hold the palatal tissue out of the way.) A 3 mm hybrid drill is placed in the guide sleeve of the template. The hybrid drill is recommended because it determines precision guidance for the drill within the 3 mm guide sleeve and follows the 2 mm pilot hole in the same trajectory. After drilling approximately 2 mm into the bone, the template should be removed and the location of the pilot hole checked, to see that it is located where it should be in relation to the mesio-distal and bucco-lingual dimension of the alveolar crest. If there is a concavity on the buccal or lingual aspect below the crest of bone, a perforation may occur. If this happens, one has to decide whether or not to change the angle of the drill which would change the angle of the fixture, thus changing the long axis of the implant body and position of the head of the implant. The original orientation can be followed, but augmentation may be necessary. The area of perforation may be augmented with a bone graft and gortex membrane. However, if the inadequacy is too severe, the ridge may have to be augmented, the site closed, and the surgeon may have to return at a later date to place the implant.

Disinfecting and use ...

Complications ...

A drill manufacturers labeled size may not be the actual size of the drill. To insure proper fit with any guide sleeve insert, measure the actual outside diameter (od) of the drill shaft, then order the next size larger guide sleeve insert to prevent binding of the drill.

Important note when ordering Guide Sleeve Inserts ...

Alternative applications ...

Consider Guide Right Kits, which contain a variety of insert sizes, to further insure accuracy of the drill position, which will ultimately result in more accurate implant placement. S Speak

to a consultant...

For advice call 585.924-3190 / 800.314.0065

* Surgical Milk is available through Henry Schein Gallon - $46.99 (8893280) 32oz. - $20.99 (9972049)
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Helpful Advice
A conflict will exist if more than one guide post is used for the placement of more than one implant and the two corrected posts are at different angles or if the path of insertion is not parallel to the long axis of the corrected guide post the guide post or template will be impossible to remove from the cast. If cylindrical guide sleeves are used, the second surgical guide cannot be removed from the cast. The only way the template can be removed is to use guide sleeves that have one open side. Regardless of divergent guide posts or path of insertion, templates with guide sleeves open to the buccal surface can be removed in a medial direction, lingually or palatally. The Triad gel must not be extended beyond the occlusal surface onto the buccal surface of the adjacent teeth or, likewise, the template will not be removable from the cast. If the cast is not lubricated or the under cuts blocked out the same problem will occur.

Solving Guide Post Conflicts using Open Guide Sleeves ...

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Guide Right Generation ll Bending Tool

The Generation ll BendingTool,

an innovative system of components for the planning and positioning of guide posts and guide sleeves in surgical templates with the use of three dimensional cone beam X-Ray imaging for precision implant placement. This is a technique that allows you to fabricate, evaluate, correct and position implants precisely right in your office or by your lab. It is designed to be used with the Guide Right Generation ll Guide Posts. Guide sleeves are fabricated into a diagnostic template, evaluated with 3D X-Ray imaging, the angles of the guide post corrected and the implant placed. The GENERATION ll Bending Tool is used to bend the guide post both mesio-distally, and bucco-linqually. It is calibrated in 1 increments. The guide post is placed in the bending tool and can easily be corrected with the bending stylus. A Diagnostic Template using the Guide Right Surgical Components is fabricated and evaluated with a periapical or 3D X-ray prior to surgery. The difference in the actual angle of the guide sleeve and the desired angle of the guide sleeve can be determined by laying the Guide Right Protractor over an X-ray or measuring the angle with the cone beam software. The correction of the angle can then be made by bending the guide post in the bending tool and reusing the cast to fabricate the Surgical Template. If the direction of the guide post is corrected but the bodily alignment is off, an offset guide post is used. The Generation ll Bending Tool has three Bending Stylus available to be used with the bending tool to bend 3.0 mm, 4.0 mm, and 5.0 mm guide posts. Using the Bending Tool to bend the guide posts accurately corrects the angle of the guide sleeve. This is based on the angle determined by the 3D scan image. If the angles need to be changed a new template needs to be made with the corrected changes. The complete Generation ll Bending Tool System allows the implant placing surgeon, restorative doctor, and lab technician to efficiently and effectively communicate and execute a precisely placed implant from the osteotomy to the prosthetic restoration. This system is simply and cost effectively a tried and true method to get it right, as Guide Right by DPlaques slogan advises. (See pages 17 - 18 for detailed instruction)

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Guide Right Generation ll Bending Tool

Single Bend
One Dimensional Mesio-Distal Correction
In cases where the Diagnostic Guide needs to be corrected in one plane a simple bend is reqired.

ANALYZE
Evaluate the X-ray by placing the protractor over the guide post to determine the number of degrees to bend the guide post. In this case a 10 bend is necessary to make the correction.

CORRECT
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.

3 4

Locate 3/32 hole in the center of the v-cut and position the bottom half of the guide post into the hole with the marker dot facing you/up. Tighten the set screw. Fit the stylus over the top half of the guide post. If a straight, not offset guide post is used the stylus point should be at the zero degree mark and the bottom of the stylus in contact with the block.

5
10

guide post bent 10

Using the stylus as a lever, bend the guide post to the degrees indicating the angle you desire either right or left. (In this case 10) IF you are working in the patients left side the bend to the left is toward the mesial and a bend to the right is to the distal. IF you are working in the patients right side the bend to the left is toward the distal and a bend to the right is to the mesial. This procedure changes the angle of the guide post which in turn changes the angle of the guide sleeve and a new template is made at the corrected angle. (You may need to ease the point of the stylus 3 or 4 degrees beyond the point of the desired degree so that the point of the stylus rests on the chosen increment.) Loosen the thumb screw and remove the stylus.

6
direction indicator 10

REMAKE

The corrected guide post is now ready to be placed back in the cast and a new template must be made at the corrected angle. (not pictured)

7 8

RE-EVALUATE ?
If necessary, place the Surgical Guide in the patient, take another periapical X-ray to verify accuracy.

PLACE
Prepare the osteotomy and place the implant.
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final placement

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Guide Right Generation ll Bending Tool

Compound Bend
Two Dimensional Mesio-Distal & Buccal-Lingual Corrections
A compound bend refers to two corrective bends, one in the mesio-distal plane and one in the buccallingual plane. A compound bend requires a guide post with four flat surfaces on the lower half representing mesio, distal, bucco, lingual surfaces. The upper portion of the post aligned with one flat surface of the lower half is marked with a round indentaion (dot) representing the bucco surface. Position the guide post with the dot facing toward you. Tighten the thumb screw.

ANALYZE
1
In this case, two corrections are necessary. The angles of the corrections are determined from the cone beam images. Some software programs (Galaxis by Sirona) allow this calculation to be made on the computer images. References and lines super imposed on the images make them easier to read. The green line represents the long axis of the planned implant. The yellow line represents the long axis of the guide sleeve. The angle formed by the intersecting angles are used to make the corrections with the bending tool.

10

CORRECT with 1st bend

2 3
Place Bending Tool Plate securely on a flat surface and move the Stylus Support Bar off the top off the plate.

dot set screw

Position a straight or offset guide post in the block on the bending tool with the dot facing you. Using the screw driver tighten the set screw to secure the post against one of the flat surfaces on the lower half of the guide post.

4
10

Make the first bend to the right or left direction. In this case, 10 to the right. Review step 5 in single bend instructions page 24

PREPARE for 2nd bend

5
The Stylus Support Bar is required for the 2nd bend. Loosen the set screw and rotate the guide post 90 to the next flat surface, up and away from the surface of the bending plate to register the stylus point back to zero degrees. The shadows of the stylus are visible on the surface of the plate indicating the stylus is lifted 10 degre angle from the surface. Slide the support bar down until it supports the stylus. Tighten the set screws before making the second bend.
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Guide Right Generation ll Bending Tool

Compound Bend
Two Dimensional Mesio-Distal & Buccal-Lingual Corrections

ANALYZE
Evaluate the view in the cross sectional image to determine the angle of the 2nd bend and make the bend in either direction. The example to left is a cross-sectional image. (in this case 20)

20

7
20

CORRECT with 2nd bend

With the bending plate securely on a flat surface andthe stylus support bar supporting the stylus make the 2nd bend in the second plane.

REMAKE
Remove the stylus and place the guide post back in the original hole in the cast with the appropriate side oriented to the buccal. Be sure the post is in the correct position. You are now ready to make the new Surgical Guide.

Guide Post & Sleeve in cast

VERIFY
Seat the completed Surgical Guide securely in the patient. Drill the initial 2 mm pilot hole through the corrected guide sleeve and place a direction indicator in the hole. Take another periapical X-ray to verify the correction in a mesiodistal plane.

Direction Indicator

10

PLACE
You are now ready to place your implant with confidence.

LINEAR ADJUSTMENT If the guide post needs to be corrected by a linear movement an offset guide post can be used. See page 8 Off sets are available in: 3.0 mm guide post with 0.5, 1.0 ,1.5, 2.0, and 3.0 mm offsets 4.0 mm guide post with 1.0, 2.0 and 3.0 mm offsets. See page 8
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Final Placement
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Comparison Chart

for

Drill Size & Stainless Sleeves and Inserts

The chart below provides an example of possibilities for which Guide Sleeve Insert to use depending on the drill size and guide sleeve size. To insure proper fit with the guide sleeves and inserts, measure the actual outside diameter (od) of the drill you are using. Order the next size larger guide sleeve or insert. Example: If the drill od is 2.25 mm, order 2.5 mm insert for the 4.5 mm guide sleeve. The recommended clearance between drill and sleeve should be greater than or equal to 0.1 mm. REMEMBER, TIGHT DRILLS GENERATE HEAT. Our Template Components are universal and compatible with, but not limited to, the following implant company drills: 3I Anklos Astra Bicon Bio-Horizons Lifecore Mega-Gen Nobel Straumann Thommen XiVE Zimmer

Drill Chart Key:

3.0 GS Insert
Drill Size

Insert

4.5 GS

Insert 5.3 GS

GS = Guide Sleeve

3.0 GS

2.0 Insert

1.6
2.0 GS

2.0 Insert

4.5 GS

3.0 GS

3.0 Insert

2.85

3.0 Insert

4.5 GS

3.0 GS

2.3 Insert

2.0
2.25 Insert 5.3 GS

2.25 Insert

4.5 GS

3.0 GS

3.0 Insert

2.9
3.0 Insert 5.3 GS

3.0 Insert

4.5 GS

2.2
2.25 Insert 5.3 GS

2.25 Insert

4.5 GS

3.0
3.6 Insert 5.3 GS

3.25 Insert

4.5 GS

2.3
2.6 Insert 5.3 GS

2.5 Insert

4.5 GS

3.1
3.6 Insert 5.3 GS

3.25 Insert

4.5 GS

2.5
2.6 Insert 5.3 GS

2.75 Insert

4.5 GS

3.15
3.6 Insert 5.3 GS

3.25 Insert

4.5 GS

3.0 GS

3.0 Insert

2.75
3.0 Insert 5.3 GS

3.0 Insert

4.5 GS

3.2
3.6 Insert 5.3 GS

3.25 Insert

4.5 GS

3.0 GS

3.0 Insert

2.8
3.0 Insert 5.3 GS

3.0 Insert

4.5 GS

3.25
3.6 Insert 5.3 GS

3.5 Insert

4.5 GS

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Implant Drill Sequences

3.3
3.6 Insert 5.3 GS 3.5 Insert 4.5 GS

4.2
4.6 Insert 5.3 GS

4.5 GS

3.35
3.6 Insert 5.3 GS

3.5 Insert

4.5 GS

4.25
4.6 Insert 5.3 GS

4.5 GS

3.4
3.6 Insert 5.3 GS

3.5 Insert

4.5 GS

5.3 GS

4.6 Insert

4.3

4.5 GS

4.4
3.5 insert 4.5 GS 4.6 Insert 5.3 GS

4.5 GS

3.45
3.6 Insert 5.3 GS

4.5
3.75 Insert 4.5 GS 4.6 Insert 5.3 GS

5.3 GS

3.6 Insert

3.5

5.3 GS

4.0 Insert

3.6

3.75 Insert

4.5 GS

4.7
5.3 GS

5.3 GS

4.0 Insert

3.7

3.75 Insert

4.5 GS

3.85
4.0 Insert 5.3 GS

4.9
4.0 Insert 4.5 GS 5.3 GS

5.0 3.8
4.0 Insert 5.3 GS 4.0 Insert 4.5 GS 5.3 GS

5.1
5.3 GS

3.9
4.0/4.2 Insert

4.0 Insert

4.5 GS

5.2
5.3 GS

5.3 GS

4.0
4.2 Insert 5.3 GS

4.5 GS

5.25
5.3 GS

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