Work Instruction GUIDE-SYSTEM

Guide System 13 X-RAY DIAGNOSIS AND IMPLANT POSITION PLANNING A. USING AN X-RAY TEMPLATE The x-ray template is placed on the residual teeth and/or on the temporary implants. The implants must exhibit adequate primary stability. The x-ray tomography (CT/DVT) is performed with the template accurately and secu- rely attached. After this, the data acquired from the CT or DVT is transfer- red to the 3D planning software. B. BY SUPERIMPOSING OPTICAL AND RADIOLOGICAL SCANS By means of selected reference points, the surface data of the wax-up/ set-up scan, the scan of the real oral situation or a virtual tooth configu- ration can be overlaid with the volume data of the x-ray tomography. Both methods allow implant planning to be carried out according to anatomi- cal, surgical and prosthetic requirements. Once planning of the implant positions in the 3D software is complete, the data is available for positioning and alignment of the guiding sleeves in the drilling template. WARNING: During planning, the surgeon must maintain an appropriate safety margin from teeth and vital structures. Maintain a safety margin of 1.5 mm from the mandibular nerve or inferior alveolar nerve. Other- wise permanent injury may be caused to nerves or other vital structu- res. Implant diameters and lengths must be sized to leave adequate bone (at least 1.0mm exists around the implant). Maintain a minimum distance of 1.5 mm to an adjacent natural tooth and 3.0 mm to an ad- jacent implant. The dimensions to be considered in the planning software (if not yet implemented by the manufacturer of the software): The total height (vertical distance from the implant shoulder to the up- per rim of the guiding sleeve) is 7.5 mm. A guiding sleeve height of 3 mm allows a maximal gingival thickness of 4.5 mm. The total height must not be altered otherwise there is a risk of incor- rect drilling depth and implant positioning! If planning shows that the basal rim of the guiding sleeve lies in the soft tissue, then the gingiva is to be folded out until correct intraope- rative positioning of the template is ensured. Overall height: 7.5 mm Distance from the lower end of the guide sleeve to the implant shoulder supporte: 4.5 mm Guide sleeve height: 3.0 mm