How to Navigate the Simpler iGuide LADDI Instrument Kit

How to navigate:
The
iGuide LADDI ™ Instrument Kit
www.simplerimplants.com
To properly place implants,
it is imperative that the surgeon place the implant at the correct:
LADDI ™
It is well documented that the distance between the cervical margins of a neighboring tooth or implant be 3.0 mm to ensure maintainence of the papilla.
Many techniques have been suggested to accomplish these ends including the use of lab fabricated Stents, ConeView,
Tomograms, etc. All these procedures are time consuming and costly for the patient. Although using these tools gives the
much information to guide the surgeon in the proper placement of an implant, it does not remove the ultimate clinical
decision from the surgeon.
The Simpler iGuide LADDI ™ Instrument System allows the operator to determine the Site, Angulation, Depth, Diameter and Inter-implant Separation Distance in a simple, step by step, chairside procedure for any patient.
The Simpler iGuide LADDI ™ Instrument Kit (S1002 IG) contains the following instruments and is laid out as follows:
•
The top row contains three Centering Guides (S7041, 2, 3) which determine the correct Location of the entry or
pilot hole. As well, it provides an initial guide to determining the correct diameter implant to be placed in each site.
•
In the middle right of the kit is the double row of four each Alignment Jigs (S7045,6,7,8). These are used to
establish the correct Angulation of the proposed implant. They are 6.0 mm in height, have a 2.1mm diameter
alignment hole in the center and have different outside diameters, (3.25, 4.0, 5.0, 6.0 mm).
The central hole in the guide allows the operator to use either a 1.5 mm or 2.0 mm drill to start the osteotomy hole
through the cortical plate.
A narrow groove runs around the periphery of each guide which accepts the Alignment Jig Holder.
•
Next to the Alignment Guides is the Alignment Jig Holder (S7050). The expandable beaks of the Holder fit
snugly into the narrow groove of the Alignment Guide allowing the operator to firmly hold the Alignment Guide in
whatever angle and position they choose. This is especially valuable when placing an implant using the extraction
site technique.
The other end of the Holder is 3.0 mm in width. By placing this end between the edge of the Alignment Guide and
the neighboring tooth/implant, the operator can confirm the precise 3.0 mm Inter-Implant Separation Distance.
The Jig Holder also has a millimeter ruler etched on its surface to measure any object.
•
•
The far right middle row contains four 2.0 mm Depth Guides (S7020). These are used with a radiograph during
the initial Provisional Depth stage to ensure that the operator stays well away from any vital structure.
At the far right are two each of 1.5 mm Twist Drill (S6015 ST) and the 2.0 mm (S6020 ST) Twist Drills.
Copyright by Harold Bergman
2009.05.24
How to navigate the
iGuide LADDI
™ Instrument Kit
www.simplerimplants.com
Steps:
1.
For Crown & Bridge cases, the ideal placement site is centered between teeth /implants with 3.0 mm between the
edges of the implant. This is the ideal intra-proximal distance for papilla maintenance.
2.
Using either the one, two or three implant Centering Guide, place the template into the space between the neighboring
teeth or implants and pull it toward you until it fits snugly between the teeth. This will help determine whether there is
space for one, two or three implants.
3.
Note the different sizes marked on the surface which indicate the recommended correct diameter of the implant that
fits in that space. Using a cold laser, periodontal probe, explorer or 1.5 mm drill, mark the center of the surgical site.
4.
Note the diameter of the proposed implant and select the appropriate sized Alignment Jig.
5.
Insert the 1.5 mm Drill through the selected Alignment Jig there is 3 mm of space between the edge of the Alignment
Jig and the cervical margin of the neighboring tooth/implant.
6.
Using the end of the Alignment Jig Holder, check that there is 3 mm of space between the edge of the Alignment Jig
and the cervical margin of the neighbouring tooth/implant.
7.
If the width is not 3mm, replace the Alignment Jig with another size until satisfied of the correct Inter-Implant Separa
tion Distance . This helps determine the diameter of the implant to be used.
8.
Using the 2.0 mm Drill through the selected Alignment Guide, drill through the soft tissue into the bone to a depth of
4 – 5 mm to form the “provisional working length”
.
9.
Remove the drill from the jig and insert the 2.0 mm Depth Guide into the osteotomy site until the gauge bottoms out.
10.
With the Jig/Guide combination in place, take a radiograph to determine the “provisional working length”
lation of the osteotomy site.
11.
Evaluate the amount of available bone between the bottom of the “provisional working length” tures. This evaluation will be the “correct depth” of the proposed osteotomy site.
12.
Using the 2.0 mm Drill, alter the angulation of the site as required and drill to the pre-determined implant depth.
13.
Remove the drill from the osteotomy site and insert the 2.0 mm Depth Guide into the osteotomy site until the gauge
bottoms out.
14.
With the 2.0 mm Depth Guide in place, take a radiograph to verify the depth and angulation of the osteotomy site.
15.
You have now determined the Location, Angulation, Depth, Diameter
and Inter-implant Separation Distance
of
the proposed osteotomy site. The next stage for implant placement is to “widen the site” to establish the final
diameter for implant placement.
16.
Use your Surgical Instrument Kit for all instruments and drills needed to widen the site and place the implant.
Copyright by Harold Bergman
-
and angu-
and any vital struc-
April 4, 2011