VIP Partner Laboratory (PL) Process Flow

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2 VIP Partner Laboratory (PL) Process Flow 1. VIP Software 2. CT Scan Appliance 3. CT Scan Clinician purchases VIP for PL fabricates CT Scan Appliance Patient submitted for scans treatment planning purposes and invoices clinician If Compu-Guide is requested for case 4. VIP Treatment Plan Clinician virtually plans case VIP case and CT Scan Appliance shipped to BioHorizons from PL 5. Compu-Guide BioHorizons mills Compu- Guide and invoices PL 6. Implant Procedure Compu-Guide shipped to clinician from PL for Implant Procedure 1

3 purpose of CT Scan Appliance Radiographic Guide that provides visualization of optimal implant placement and prosthetic outcome custom fabricated to patient s tooth anatomy radiopaque material used to indicate edentulous space fabricated by BioHorizons Partner Laboratories 2

4 CT Scan Appliance Prescription Completed CT Scan Appliance Prescription (F0369) and CT Scan Appliance requirements are provided to the Partner Laboratory from the clinician CT Scan Appliance Prescription can be downloaded from BioHorizons website 3

5 CT Scan Appliance Step 1 Prepare dental stone model from impression or duplicate master cast provided by clinician. The dental stone model will be used as a mold to fit the wax clinical teeth, fabricate the barium / acrylic teeth and form the CT Scan Appliance. 4

6 block undercuts Step 2 Identify inter-proximal undercuts around edentulous spaces and block with block-out / molten wax. 5

7 prepare diagnostic wax set-up Step 3 At the discretion of the technician, prepare wax teeth or select prefabricated denture teeth based on position on the diagnostic model. 6

8 index teeth Step 4a Place uniformly mixed putty onto model and adapt to the prefabricated/wax teeth. Prepared diagnostic wax set-up ready for indexing. Step 4b Once putty is cured, remove from the diagnostic cast. Clean any loose debris. 7

9 index teeth Step 4c Using a trimming knife, trim putty index to form a good fit to the diagnostic cast. Inspect the putty index for voids, fit, and impression accuracy. Step 4d Using a spatula mix the barium / acrylic resin (1:3) and apply into the index cavity. Ensure that the index is filled completely and place on model. Remove any excess acrylic. 8

10 trim teeth Step 5a Using an acrylic bur, trim the barium tooth / teeth of excess trim and flash after cured. On multiple unit cases use a separating disk to enhance inter-proximal spaces. Step 5b Inspect the barium teeth for proper fit to the diagnostic model. Note: Depending on the depth of undercuts, the barium teeth may come off with the index, this is not unusual. 9

11 rope wax prep Step 6 Hold the diagnostic model and wrap the mid-facial surface of the teeth with the rope wax. Hand press the rope wax, such that it tacks to the model. Using the small spatula, press the rope wax into the spaces between the teeth to ensure good contact. 10

12 wax undercuts Step 7 Apply a coat of molten wax to the outer perimeter of the teeth, containing the rope wax. Inspect to ensure all spaces / undercuts between teeth are sealed. Once the outer perimeter is coated, proceed to coat the inner teeth perimeter with the molten wax. When finished, all model teeth, both exterior and interior surfaces are coated with the molten wax, and the rope wax has a sufficient ridge to form the border for the acrylic. 11

13 separating media application Step 8 Using a small brush, liberally apply separating media to the inside portion of the diagnostic model except where the pre-fabricated or wax tooth / teeth are located. Allow the separating media to dry as per manufacturer s instructions. Lute the fabricated barium tooth / teeth into proper position. 12

14 form appliance / pressure treatment Step 9 Apply the acrylic resin to the facial and occlusal of the teeth above the rope wax border. When all the front teeth surfaces are covered, apply the acrylic resin to the interior tooth surfaces and process resin covered cast in pressure pot. Insert patient identifier along the palatal / lingual surface using standard laboratory procedures. 13

15 CT Scan Appliance Plates CGS-CTMED Part# CGS-CTSM CGS-CTLG Based on patient arch size CT Scan Appliance Plates - Small, Medium or Large can be used to fabricate the CT Scan Appliance Note: CT Scan Appliance Plates to be stored in provided foam padded boxes to protect plates. Worn Fiducial mounts may prevent the appliance from fitting CT Scan Appliance plates. 14

16 CT Scan Appliance Plate preparation Step 10 Select the appropriately sized CT Scan Appliance Plate and place modeling clay around the inner perimeter of plate. 15

17 fiducial markers Part# CGS-FDMKR Fiducial Marker Step 11 Place the Fiducial Markers into the CT Scan Appliance Plate and review for horizontal alignment to the appliance. Apply the acrylic to the appliance and form a bridge to connect the Fiducial Markers. Ensure that adequate acrylic is applied to secure the Fiducial Marker to the appliance. Once the Fiducial Markers and appliance are properly affixed with the acrylic resin, place the assembly into the pressure pot to cure. 16

18 appliance finishing Step 12 After material has set, smooth out excess acrylic around Fiducial Markers with deburring tool. Note: Fiducial Markers are used to secure CT Scan Appliance during milling, ensure adequate acrylic around the Fiducial Markers to stabilize CT Scan Appliance. Avoid deburring tool from hitting tip of Fiducial Markers. 17

19 appliance finishing Step 13 Finish the edges with the deburring tool so that when the appliance sits on the diagnostic model, it seats firmly in place and removes easily. 18

20 polish appliance Step 14 Continue to polish until the surface is smooth to touch. Steam clean the appliance to remove any polishing agent and wax. 19

21 bite block placement Step 15 Locate on the appliance where the bite-blocks will be placed and apply a thin coating of the bonding agent to that area. Affix the biteblocks to the adhesive applied areas on the appliance. Note: Bite blocks to be not more than 5mm in thickness 20

22 CT Scan Appliance Step 16 Inspect the assembled appliance for bond and residual bonding agent and clean if necessary. Ensure occlusal surface is flat and fits passively to the diagnostic model. Completed CT Scan Appliance with Fiducial Marker. 21

23 CT Scanning Protocol CT Scan Appliance is then returned to clinician CT Scanning Protocol (L01012) is also returned with CT Scan Appliance CT Scan Protocol instructs scanning site to ensure proper scan for VIP CT Scanning Protocol can be downloaded from BioHorizons website 22

24 Pilot Compu-Guide If a Compu-Guide is requested for case: Clinician completes Pilot Compu-Guide Prescription (F0370) and includes necessary contents Pilot Compu-Guide Prescription and components are then shipped to: BioHorizons Attention: VIP Laboratory 2300 Riverchase Center Birmingham, AL Pilot Compu-Guide Prescription can be downloaded from BioHorizons website 23

25 Pilot Compu-Guide The following is returned with Pilot Compu-Guide: Pre-surgical Planning Report Drilling Report* Contents received for milling Compu-Guide BioHorizons mills Compu-Guide according to submitted Pilot Compu-Guide Prescription and VIP s virtual treatment plan *BioHorizons 2.0 CGS Pilot Drill Set ( ) is required for the Pilot Compu-Guide 24

26 re-order items Item Number Description CGS-CTFS CT Scan Appliance Fabrication Set* CGS-FDMKR Fiducial Marker (pack of 100) CGS-CTSM CT Scan Appliance Plate - Small CGS-CTMED CT Scan Appliance Plate - Medium CGS-CTLG CT Scan Appliance Plate - Large *CT Scan Appliance Fabrication Set includes: CT Scan Appliance Plates (small, medium, and large) and Fiducial Markers (pack of 100) 25

27 contact information VIP Laboratory 2300 Riverchase Center Birmingham, AL phone: fax: L03001 REV A JAN

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