Instructions on Creating CEREC® Guide 2

 

Optical impression

CEREC

 

a. Scan the situation in the mouth either intraorally or using a model.
The following applies to all areas, which are intended to later serve as a support 
for the CEREC Guide 2. The surface scan is also used for the overlay of the x-ray volume.

 

b. Design a restoration at the planned implant position. Mark the emergence         profile of the tooth on the gingiva in manual entry mode.

 

c. Export the data record using in *.SSI format.

 

Sirona CBCT

Sirona CBCT

 

A DVT scan can be performed before or after the optical impression.
Make sure that there are no metal artifacts in the scan, as these may hinder the overlay of optical data. Do not scan the patient at the final bite position, but rather with a slightly opened jaw. Remove all removable metal parts in the opposing jaw 
(e.g. prosthetics).

 

If possible, record 3/4 of the arch of the jaw. This increases the likeliness that teeth free from artifacts can be used for registration.

 

 

Implant Planning

To produce a CEREC Guide 2, the import of the previously created *.SSI data record in GALILEOS Implant is necessary. 
The optical surface scan is superimposed over the X-ray volume.

 

Select CEREC Guide 2 as the sleeve system.
You have three sleeves available to choose from, S, M or L respectively.

 

The specification of a depth stop is oriented on the length of the drill used. 
The planned position is reached when the mechanical stop of the drill reaches the guide or the sleeve. 

 

In the GALILEOS Implant software, the depth stop is entered using the D2 value.
The D2 value is defined as the distance from the top of the drilling template to the apical top of the implant.

 

D2 = drill length

 

The statement of the D1 value is to be ignored.
After entering the D2 value, the sleeve is visualized above the implant at the relevant height. 

- Ensure that the sleeve does not collide with neighboring teeth and the drill itself can be introduced without a collision. 

- If the representation of the underside of the sleeve cuts the scan shown as the yellow line, this indicates that the position of the sleeve is at least partially sub-gingival. Multiple implants and sleeve positions are planned in the same way. It is possible to export this as a file. Export the plan “processing by third-party providers by way of optical impressions” as a .CMD.DXD file or a .CMG.DXD file to import into CEREC/InLab. 

 

 

Design and development of the CEREC® Guide 2

By selecting "Import", you can load the *.CMG.DXD file. 

 

Phase ADMINISTRATION 

If the plan contains multiple implants, these will be treated as separate restorations. Select the machine type for 
development. This determines the possibilities for further processing. 

 

Phase MODEL

All areas which are not intended to serve as a support for the CEREC Guide 2 should be cut. This includes, for example, larger areas of gingiva outside the planned implant position. Parts of the residual teeth may also be discarded if they are not required for support. 
Note that a longer template is easier to hold in position with one finger and ensures secure support.

 

Phase DESIGN

The position and shape of the sleeve cannot be changed using general design tools. If a sleeve is shown in red, parts of it are sub-gingival. Determine whether these areas are to be cut away (e.g. to enable the unhindered placement on a model) or are to be left as they are. The color of the sleeve then turns green. Optionally, you can create side access to introduce the drill from the side. After calculating the template element and if necessary orienting it in the block, you have the option of creating viewing panels, which you can use to check the fitting of the template even during the surgical intervention. You can then still adapt the design of the template by cutting away any problematic areas.

 

Phase MILL

Where necessary, ensure that you have activated the option "Milling" in configuration. So that the milling process runs without interruption, ensure where necessary that milling tools with a sufficient service life are used, the water filter has been cleaned and there is sufficient water in the tank. After milling, ensure that no shavings enter into the tank during the cleaning process, as these can quickly clog the water filter. 

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