Fixation Base

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Do I have to buy the Fixation Kit, or can I use my own pins and drills?

  • You’ll have to purchase our kit. It is specifically made for our guide and the software plans the position exactly to place the pin in the lingual cortex.
  • They are now al a carte items that are based on the number of pins and drills needed for the case.
  • They are multi-case use.

Do I have to buy two Fixation Kit for a double arch?

You can complete both arches because you’re just going to do one at a time.

Does the CHROME loc’s engage? What if the plunger does not plunge?

  • CHROME Loc’s are carefully checked. Guides may be going in crooked. Inspect the CHROME Loc Box for material. Might be clear, broken Pin Guide plastic that is hard to see. Perhaps the case was heat cleaned and warped. Carefully adjust the hold on the insertion part that is going in the box, until the plunger plunges.
  • Taper the end of the plunger tip, round off the edge.
  • Rongeurs twist and pull. Be delicate, full removal is not terrible, just inconvenient because it will not work as designed for the rest of the surgery.
  • NO Autoclave, only 20 minutes cold sterilization

What if the plunger pulls out?

The pin can be re-seated. It will not function as the others. It will pull out every time, so please use care when pulling so as not to drop in the mouth. The plunger will still work. Clinical chairside support may have extra plastic sleeves to replace the damaged one. CHROME is on the 3rd generation CHROME Loc design and a new design is being rolled out Q1 2019.

What if the Fixation Base contacts bone in the posterior? What could that mean?

  • Exostosis that we missed. Lab may have trimmed the model and missed it. Inspect, a flap and adjust bone, or adjust metal with a disc, if possible – do not cut off a CHROME Loc or pin site.
  • Pin Guide may have seated crooked. This is BAD. If the teeth are still in, remove the Fixation Base and re-insert with the Pin Guide FULLY seated.
  • Mobile teeth may exist and the Pin Guide moved the teeth. If the Pin Guide has an integrated bite, re-start the case using the bite for seating the Pin Guide. Next time, inform the CHROME team of mobile teeth, especially of most or all are mobile. We will design a Pin Guide that seats against the opposing teeth.

What if it contacts labial bone?

Pin Guide is not seated correctly. Perhaps the bone is very soft and the malleting pushed the fixation base and oblonged the holes. This is bad. Suggest pulling the Fixation Base back out to mimic the GSI report images, pack gauze plugs between the Fixation base and the bone and be gentile during the surgery. Or, just use the Fixation Base for bone reduction and then freehand the implants using the Carrier Guide as just a guide for close implant location. These are just suggestions for a case that is not aligned correctly. This is not a surgical recommendation! These suggestions can lead to very unpredictable surgery and results.

If the fixation base wobbles?

Do not drill to depth. Drill ½ into the bone and use a surgical mallet to force the pins in. If it is too late and all the pins are in, this is bad. Suggest pulling the Fixation Base back out to mimic the GSI report images, pack gauze plugs between the Fixation base and the bone and be gentile during the surgery.

The fixation drill breaks?

If you cannot back it out or easily remove, and you have an extra 2mm, leave it in place and use the other drill. Length can be measured by setting it next to a pin and using a sharpie. If this is the only drill, it must be removed. Remove the Pin Guide and the other pins and remove the drill. This is a last resort, as the removed pins will not fit the same as the initially did, and can be detrimental to the stability of the Fixation Base.

Do I have to buy two Fixation Kit for a double edentulous arches surgery?

Now the only time that you would need more pins is if you were going to do a double edentulous arch. In this situation, we often ask the doctor to do both Fixation Bases at the same time because the Pin Guides are duplicates of the denture, but are not the same teeth as the long term temps. In other words, the Pin Guides put the fixation base in the exact position using the teeth of BOTH dentures. You’ll need ALL the pins on these cases.

Further, the Pin Guide is a duplicate of the patient’s denture. So if there are dual pin guides, we want both of those in the mouth at the same time and at the right occlusion, everything fits perfectly, just like their old denture did, then you drill everything.

If you just do the maxillary, for example, and you go through the whole procedure and three hours later the patient’s wearing their future maxillary teeth, it doesn’t match up with the old denture lower Pin Guide. In this situation, we would have to make a pin guide that’s designed for the lower for the second surgery of the day. We would have to design it so that it meets the patient’s new prosthetic.

So instead of this, we encourage you to put both pin guides in, drill all the facial sites, put the pins in, load both metals, and you could take the lower metal out and put it back in in a few hours. It doesn’t have to be in there for three hours, but at least the sites are drilled in the right position.

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