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Navigator

®

 CT Guidance: Steps to Success  ................................................................................................................................... 1

Getting Started ............................................................................................................................................................................... 3

Introduction And Treatment Planning ............................................................................................................................................. 4

Instrumentation Overview ............................................................................................................................................................. 5

Surgical Plan Overview ................................................................................................................................................................... 9

Tips And Techniques ................................................................................................................................................................... 10

Immediate Provisionalization Option ............................................................................................................................................ 12

Fabrication Of A New Denture Or Partial Denture And CT Scanning Appliance ........................................................................... 13

Fabrication Of CT Scanning Appliance Using An Existing Denture ................................................................................................. 15

Pre-Surgical Fabrication Of An Edentulous Fixed Provisional Restoration ........................................................................................ 16

Pre-Surgical Fabrication Of A Partially Edentulous Fixed Provisional Restoration ............................................................................. 17

Cement-Retained PreFormance

®

 Post .......................................................................................................................................... 18

Cement-Retained Provide

®

 Abutment And Temporary Cylinder ................................................................................................... 20

Screw-Retained Low Profile Abutment And Temporary Cylinder  ................................................................................................. 22

Screw-Retained PreFormance Temporary Cylinder ....................................................................................................................... 24

Combination Cement / Screw-Retained QuickBridge

®

 Restoration And Low Profile Temporary Cylinder Multiple-Unit Only ..........26

Table Of Contents

Summary of Contents for Navigator

Page 1: ...The Parallel Walled Navigator System For Guided Surgery Procedure Manual ...

Page 2: ......

Page 3: ...Using An Existing Denture 15 Pre Surgical Fabrication Of An Edentulous Fixed Provisional Restoration 16 Pre Surgical Fabrication Of A Partially Edentulous Fixed Provisional Restoration 17 Cement Retained PreFormance Post 18 Cement Retained Provide Abutment And Temporary Cylinder 20 Screw Retained Low Profile Abutment And Temporary Cylinder 22 Screw Retained PreFormance Temporary Cylinder 24 Combin...

Page 4: ... to step 8 6 The master cast is poured into the guide or the implant analogs are placed in the preoperative cast on a partially edentulous case using the guide 7 The abutments are selected and the provisional prosthesis is fabricated and sent to the clinician 8 The surgical guide and surgical plan are sent to the surgeon and used in conjunction with the Parallel Walled Navigator Surgical Kit 9 The...

Page 5: ...Voorhees NJ NO YES TRADITIONAL PROCEDURE IMMEDIATE PROVISIONAL 10 6 7 9 11 12 14 15 IMMEDIATE PROVISIONAL DESIRED 13 Dr Baumgarten and Dr Meltzer have financial relationships with BIOMET 3i LLC resulting from speaking engagements consulting engagements and other retained services ...

Page 6: ...abricating a scanning appliance from an existing denture a newly fabricated denture or a diagnostic wax up A page with tips from clinicians who evaluated the system prior to market release is also included in this manual on pages 10 11 These tips will help to ensure a smooth process from CT scan to the day of surgery and provisional delivery when using the system and may reduce the learning curve ...

Page 7: ...ive outcome Pre Operative Planning Proper treatment planning includes selection of appropriate implant lengths diameters and locations The number of implants is a fundamental consideration for the long term success of an implant supported restoration Before an implant is placed the anatomical foundation of the treatment area must be carefully assessed During the presurgical restorative planning ph...

Page 8: ...o fabricate a provisional prosthesis prior to implant placement by creating a master cast using the surgical guide The system allows clinicians to place dental implants in predetermined locations with proper hex orientation This feature is especially beneficial for single tooth and cement retained provisionals It offers clinicians the option to deliver a provisional prosthesis the day of surgery a...

Page 9: ...es four complete sets of Analog Mounts are available in the kit for a total of 48 Analog Mounts The Analog Mounts feature a mechanical locking system to hold the implant analog in place vertically laterally and rotationally within the Master Tube A peg on the side of the Analog Mounts is aligned with one of the slots on the Master Tube to ensure accurate transfer of the hex orientation from the pr...

Page 10: ... the osteotomy The Starter Drills are available in five diameters 3 4 3 4 4 4 5 and 5mm to countersink different implant collar shapes These contain depth markings of 1 2 3 and the top of the Starter Drill body 4 to correspond with the surgical plan protocols for use during surgery The recommended drill speed is 1200 1500rpm DRILL POSITIONING HANDLES The handles contain drill guide tubes that are ...

Page 11: ...OTE Drill lengths do not necessarily correspond to implant lengths rather these are dictated by the surgical plan protocols based on the prolongation distance between the position of the Master Tubes and implant seating surface BONE TAPS Bone Taps are used through the Master Tubes in the surgical guide to thread a 5 5mm section of the osteotomy prior to implant placement The Bone Taps are availabl...

Page 12: ...icate the proper depth to which these instruments should be used through the Master Tubes Figure 1 There are three lines on each instrument the first line represents depth line 1 while the top of the instrument represents depth line 4 The instruments pass through the Master Tube until the center of the specified line on the instrument reaches the top of the Master Tube Figure 2 The depth lines als...

Page 13: ... and position relative to the restoration Preparation Inspect the surgical guide for imperfections and reinforce potential weak areas of the surgical guide with acrylic Try in the Drill Positioning Handles in case the guide may need adjustments to allow the Drill Positioning Handles to fully seat Clear the Master Tubes of any material remaining from the surgical guide manufacturer Score the Master...

Page 14: ...ntacts the Master Tube It is recommended to use the WR150 Ratchet Wrench with extension for final rotations of these instruments Once seated do not continue to rotate these instruments as this can cause damage to the instrumentation or osteotomy Figure 3 The Implant Mounts must be fully engaged within the implant prior to tightening the Implant Mount Screw Sequence the placement of implants in an ...

Page 15: ...T 3i Provisional Components These components and manual guidelines were developed to provide an easy to use way to deliver an accurately fitting provisional restoration on the day of surgery regardless of potential error from CT scan data cast fabrication or implant placement When selecting the provisional component to use it is important to identify the type of definitive prosthesis and the abutm...

Page 16: ...illary and mandibular impressions in die stone Fabricate baseplate s and wax occlusal rim s on the cast s 3 CLINICIAN Place the wax occlusal rim s in the mouth contour appropriately and make an interocclusal registration 4 LABORATORY Articulate the maxillary and mandibular casts using the interocclusal registration Set denture teeth on the baseplate s and wax for try in ...

Page 17: ...w the duplication material to set per the manufacturer s instructions Apply a separator to the surface Mix the duplication material and place it into the other side of the flask and close the flask over the denture Allow the duplication material to set Separate the flask and remove the denture 7 Create a mixture of 30 barium sulfate and cold cure acrylic resin Pour the mixture into the tooth areas...

Page 18: ...re Allow the duplication material to set Separate the flask and remove the denture 2 Create a mixture of 30 barium sulfate and cold cure acrylic resin Pour the mixture into the tooth areas only Allow the acrylic resin to set per the manufacturer s instructions Create a mixture of 10 barium sulfate and cold cure acrylic resin Pour the mixture into the flask Close the flask tightly Allow the acrylic...

Page 19: ...ft tissue material around the analogs approximately 2mm apical from the interface of the Analog Mount Pour stone into the Surgical Guide to create the master cast and allow it to set Unscrew the thumb screws and remove the Analog Mounts Carefully separate the Surgical Guide from the master cast 3 Place the scanning appliance on the master cast and verify the fit and tooth position Articulate the m...

Page 20: ...rill through the guide Insert the Implant Analogs attached to the Surgical Guide into the holes and seat the guide onto the remaining teeth on the cast Fixate the analogs in the cast using stone or pattern resin Unscrew the thumb screws and remove these Remove the Surgical Guide from the master cast 3 If a scanning appliance was fabricated on the cast place it on the master cast and verify the fit...

Page 21: ...e the margin of each PreFormance Post following the gingival contour at soft tissue level or slightly below and prepare the post area for the proper draw of single or multiple units A rough diamond bur is recommended Number each abutment with the tooth position on the buccal side with a bur Seal the abutment screw access openings with wax or putty PROVISIONAL RESTORATION FABRICATION 8 Place the va...

Page 22: ...adiograph Torque the abutment screws to 20Ncm using the Large Hex Driver Tip and a torque device Seal each screw access opening with a temporary filling material Try in the provisional restoration over the PreFormance Posts and verify it fits to the margins properly Adjust the occlusion as indicated and remove the provisional restoration 12 If the provisional restoration did not fit passively plac...

Page 23: ...t of interfacing components Number each abutment with the tooth position on the flat side with a bur Seal the abutment screw access openings with wax or putty PROVISIONAL RESTORATION FABRICATION 8 Select the appropriate Provide Temporary Cylinder for single or multiple units Place the temporary cylinders on each abutment and verify complete seating at the margin Place a small amount of wax at the ...

Page 24: ...rfaces or by taking a radiograph Torque the abutment screws to 20Ncm using the Large Hex Driver Tip and a torque device Seal each screw access opening with a temporary filling material Place a small amount of temporary cement inside each Provide Temporary Cylinder and seat it on the Provide Abutment Try in the provisional restoration over the temporary cylinders and verify it fits to the margins p...

Page 25: ...ace a Low Profile Temporary Cylinder on each of the abutments Secure the cylinders into place using the Low Profile Titanium Screw and the Large Hex Driver 8 Drill holes in the vacuum formed template in the areas of the Low Profile Temporary Cylinders Place the vacuum formed template on the master cast over the temporary cylinders Reduce the cylinders as necessary so that these fit within the temp...

Page 26: ...e of the arch from the selected lab processed cylinder Secure the cylinder into place using the Low Profile Titanium Screw and the Large Hex Driver Seal the screw access opening with impression material Try in the provisional restoration over the Low Profile Temporary Cylinder and secure it into place by threading a retaining screw through the lab processed cylinder Verify that it fits to the cyli...

Page 27: ...crew access openings with wax or putty Select one cylinder in an area with dense bone to process it into the provisional restoration Block out the retention facets on all other cylinders with wax Place the cast back on the articulator Add acrylic resin into the retention facets on the selected cylinder and fill the tooth portion of the template with acrylic resin Fully seat the template on the cas...

Page 28: ...Formance Temporary Cylinder and into the cylinder area on the provisional restoration Seat the provisional restoration over the cylinder and secure it into place by threading an abutment screw through the lab processed cylinder Have the patient close into centric occlusion Allow the acrylic resin to set per the manufacturer s instructions Remove the abutment screws and remove the provisional resto...

Page 29: ...nium Screws and the Large Hex Driver Thread a Low Profile QuickBridge Titanium Cylinder on each of the remaining abutments using the Large Hex Driver Place a Low Profile QuickBridge Cap on each cylinder and press down firmly until fully seated Block out the retention facets on the Low Profile QuickBridge Caps and one of the temporary cylinders with wax 8 Drill holes in the vacuum formed template i...

Page 30: ...Place each Low Profile Abutment into the implants one by one in the proper locations Press firmly until feeling and or hearing a click Thread the Low Profile Abutment Screws into the implants using the Abutment Driver Verify an accurate fit of each abutment by visualizing the interfaces or by taking a radiograph Torque the abutment screws to 20Ncm using the Abutment Driver Tip and a torque device ...

Page 31: ...mporary cylinders Have the patient close into centric occlusion Allow the acrylic resin to set 13 Remove the retaining screws and the provisional restoration Fill in any voids Remove any excess acrylic resin and polish 14 Line the Low Profile QuickBridge Cylinders with temporary cement Seat the provisional restoration on the Low Profile Abutments and snap it over the Low Profile QuickBridge Titani...

Page 32: ...duct information including indications contraindications warnings precautions and potential adverse effects see the product package insert and the BIOMET 3i Website Not Available In All Markets Please Contact Your Local BIOMET 3i Sales Representative For Availability Or Visit www biomet3i com Looking For The Latest In Accurate Implant Treatment Then Navigator Is For You Global Headquarters 4555 Ri...

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