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Blue Sky Plan® - BlueSkyBio.com

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1. ccccecccececeeceeeceeeceeeceeecueecueceeecaueceecaeesueseuesauesseeseess 46 6 13 Angular MEASUEMENN ccccccceccceeeceeeeceeeceeeceueecseeceeceueesseeseeeseeenseeseeeseanens 46 2 Blue Sky Plan 614 TENS MICAS UNC HIG sicartosicctenscaientiantinavanctlaetiansieationslcakionrtateougsdeuaensiansenensey 46 6 15 Measurement correction and number POSITION ccceecceeeceeeeeeeeeeeeeeeeeeeeeees 46 6 16 Deleting a measurement ccccccsecceececeeeceeeceueeceeecueceueesseeseeeseuseneeeseeeseeens 46 OAF COV STAY renen EErEE E E EEEE EE EE O EE EE EEEE EEEE EEE 47 OS PANO MG crae E 47 7 Importing the Scan Appliance ccccccccccseececeeeeeceeeeceeeeeseeeeeseeeesseeeessaeeesaaeeesaaes 50 Al G tapercha makers COMMING sesioni ni EEEE 51 7 2 Gutta percha markers do not coincide ccccceeeeeceeeeeeeeeeeeeeeesseeeesaeeeesseeeeeas 52 o TEMOM Gee E ee 53 S o EE CU its eared E A E E 56 IL Menn COW e EN EAEE 56 9 2 Positioning the crown and manipulating It nannannnannennannnnnnnnnennnnnnnnnnnnnrennnnne 57 9 3 Aligning an implant and further Operations cccceecseeeeseeeeeeeeeeeeneeeseeeeeeeens 58 9 4 Context 00 gt 010 eee 60 10 TOOR SSCS A AUN ON ests cesareereteec tetra E EE ERS 61 11 Data EOE ceersseraeerceniexenaceneenanctansnacateaunaqunteaacenunteanncatenslenchecunceuhauenauehaqanaachGauxaaaxeusnds 62 TZ OOO ATCS EO ea E A E S 63 Boe S aO TES E E E 65 13 1 Guide fabrication
2. BlueSky Bio Blue Sky Plan 2 3 Hardware requirements General requirements e Monitor 14 inch resolution of at least 1440 X 900 e Hard Disk 500MB of free space Minimum requirements e Processor dual core e RAM 3 GB e Video card NVidia or AMD 512MB of video RAM or Intel HD Graphics 4000 Recommended e Processor quad core e RAM gt 4GB e Mid range dedicated video card NVidia or AMD 1024MB of video RAM E g NVidia GeForce GTX 650 AMD Radeon HD 7750 2 4 Operating system Windows 7 Home Professional or Mac OS X Lion Mountain Lion BlueSky Bio Blue Sky Plan 10 3 Loading the patient s CT or CBCT scan into Blue Sky Plan Blue Sky Plan can load uncompressed DICOM images exported by all CT scanners into the software Blue Sky Plan is self processing allowing the user to directly import the DICOM images in a few easy steps A complete scanning protocol is available via the Blue Sky Bio website and can be sent to the scan site 3 1 Selecting the DICOM images location To import the patient s CT or CBCT images follow these steps 1 Click the File gt New Project menu option 2 Anew window will appear Desktop Documents Network VE 3rdParty File Folder 3 9 2012 10 21 04 boost File Folder 19 10 2012 9 35 24 data File Folder 15 1 2013 14 01 44 n BSBData File Folder 122 2013 15 47 16 p CT and model File Folder 3 9 2012 13 24 10 n DICOM Merge File Folder 12 2 2013 15 46 12
3. BlueSkyBio 59 Blue Sky Plan 9 4 Context menu some operations can also be performed via the context menu We invoke this by clicking the right mouse button on the tooth geometry Besides the operations described previously such as aligning the implant removing the tooth or replacing it with another type it is also possible here to choose the point of rotation of the draggers the Pivot as described in chapter 5 2 TIN Show properties Align new implant Align existing implant Remove Replace 4 mee i 60 BlueSky Bio Blue Sky Plan 10 Tooth segmentation Blue Sky Plan makes it possible to segment and remove individual teeth from the data The following two segmentation methods are supported With a correctly set dental curve it is possible to select a tooth by clicking 1 on the data in one of the orthogonal slices The result of the selection will be colored in 7 in all the slices The result of the automatic segmentation can be corrected with the Height Limit parameter 2 which determines the distance from the slice up to which the program should attempt to detect the tooth By reducing this it is possible to compensate for erroneous detection in an area where the tooth is difficult to differentiate from the bone automatically y A oy sili La Wig S z Order Implants f iki yu Tooth Segmentation Segmentation Select Tooth Height Limit q l Manual Segm
4. merget File Folder 3 9 2012 13 23 47 pn Appliance File Folder 3 9 2012 13 73 41 BB 2eaf0bg03000 dem tt S oe 14 12 2010 14 15 BS 2edf0bg03001 dem dem File 14 12 2010 19 56 BB 2edf0bg03002 dem dem File 14 12 2010 13 59 W 2edfbg03003 dcem dem File 14 12 2010 19 27 Ej Zed bg03004 dcm dem File 14 12 2010 20 5 j Zedfbg03005 dcm dem File 14 12 2010 14215 Ej Zedfbg03006 dcm dem File 14 12 2010 14 58 j edfbg03007 dem dem File 14 12 2010 16 44 Ej Zed bg03008 dcm dem File 14 12 2010 19256 BS 2edf0bg03009 dem dem File 14 12 2010 15 58 Note that there are several shortcut buttons that appear on the top of the window The leftmost button is a shortcut to your desktop and the next button is a shortcut to My Documents These buttons allow quick navigation to the folder containing the DICOM images select the directory that contains the DICOM images and click OK Images must be stored in DICOM format from your Imaging Center in order to load them into Blue Sky Plan C 11 BlueSky Bio Blue Sky Plan 3 2 Selecting the series A list of available series that can be loaded will appear 1 Ideally each series should be saved in a separate folder and only one series will appear 512 x 512 x 192 voxels 0 32 x 0 32 x 0 62 mm ORIGINAL 20110217 CT AXIAL MODE 1 3 3 Enhancing performance In the case that the computer does not have sufficient system or video memory and possibly also if th
5. 3 5 Positioning the panoramic curve The panoramic curve the middle of the three curves which appear in the axial view should be positioned to pass through the middle of the patient s ridge Blue Sky Plan Anonymous Patient C inst manual data default c io Se File Edit Tools View Panels Filtering Model Implants Virtual Teeth Help aN OSS Bina i en ai INTA aT Density Level 1000 This can be done by using the slider 1 to identify an axial slice which shows the complete arch ridge of the patien s jaw If necessary it is possible to switch the display mode of the axial slice to an X ray display by clicking button 2 The curve as a whole can be shifted by dragging point 4 and the local form can be adjusted by dragging any yellow square 5 Dragging the yellow circle within the curve decreases increases the curve Alternatively the entire curve can be redrawn by pressing the Edit Dental Curve button 3 The user can left click periodically as the mouse moves around the arch from left to right placing dots The software will connect the dots to draw the panoramic curve Be sure not to double back over a section of the curve which is already drawn as this will create inconsistencies in the curve When the curve is complete just click on the Edit Dental Curve button 3 again or press Esc 14 Blue Sky Plan 4 Software interface Blue Sky Plan allows seamless interaction among the vario
6. Create Report 4 remaining Drill Report Show Data Properties Exit marker 2 In the coordinates export settings panel select the corresponding type of scan appliance A schematic preview of the template currently selected 7 can by displayed by clicking on the help button 6 In the 3D window view the model from above 3 and adjust the display with the slider so the markers are clearly visible Click button 4 to activate marker display mode and designate markers by clicking on them 8 The order in which the markers are designated must correspond to the order marked on the schematic template 7 If no order is prescribed then markers can be selected in any order The markers can be designated in all available views and their position is automatically adjusted for the best fit lf you make a mistake when entering a marker the most recently entered point or all points can be removed by clicking the corresponding buttons 5 or with a right click on a marker when the marker selection mode is active 4 The coordinates are actually exported when you click the Create Report button 9 For a license with a limited number of exports the number of remaining exports is indicated on button 9 the 63 lue Sky Bio Blue Sky Plan number of exports is only reduced once each time the project is opened gt Blue Sky Plan BlueSkyBio Patient Name DateOfBirth ae ae Model 3 0mm A E mpat ERF pla
7. DICOM coordinates alignment File Edit Tools View Panels Filtering Model Implants Virtual Teeth Help on Perey H eke ie pez PE l Vat OJ NF 4 AT b N ae S y D Haal ull is N OW N Lt Order Implants Cy ths a Model Alignment lt gt Model n ais ay Barron_1602_Mandibular ie gt S F gt ae J J D Visible D Model outline Alignment 3 Direct yw Center DICOM coordinates Auto F u P Points am 2a 4 F Align 5 Adjust Model Position Manually 6 Density Level 1000 lt is essential that the dental curve is set correctly in order for the automatic alignment of the model to the teeth to work correctly After setting it in the Alignment section 2 of the Model Alignment panel select Auto in the Orientation section 4 Then select the corresponding jawbone and perform alignment with the Align button 5 Because automatic alignment is usually not precise enough Blue Sky Plan also makes it possible to perform the alignment by entering a pair of points corresponding to each other If you select Points 3 and click Align 5 in the Alignment section a dialogue appears for entering points manually The surface model displayed in the left hand window of the dialogue is created on the basis of the settings of the currently selected density surface You can also significantly influence the time it takes to create 53 ue
8. a cross 8 By dragging the cross it is possible to move the model in the plane of view The model can be rotated using the blue circle 9 Hold SHIFT and click the mouse button to position the pivot at a different position in 2D views In the 3D window the pivot can be repositioned using the small dragger arrows 7 55 BlueSky Bio Blue Sky Plan 9 Virtual teeth Blue Sky Plan makes it possible to insert virtual teeth into the project Using pre prepared models of crowns inserted into the data we can show the patient the possible result after all planned procedures have been performed Virtual teeth also make it possible to align either a new or an existing implant and thus easily visually inspect the respective position of the resulting crown with respect to the position of the implant and to plan any abutment 9 1 Inserting crowns lt is a good idea to first have a correctly specified dental curve since the inserted crown will be rotated automatically with respect to it We insert the individual crowns either by clicking on the i icon in the toolbar or by using the button in the side panel indicated below if necessary choosing the Virtual Teeth gt Add Tooth menu item A dialogue for selecting crown then opens Clicking on the associated tooth 1 selects it and a text description of the crown appears in 2 It is also possible to select from three sizes 3 The dimensions of the tooth can subsequently be modifie
9. exact image position of one window in relation to the images in the other windows 26 Blue Sky Plan 4 2 1 Sagittal window The sagittal image is a vertical plane that divides the skull into a right and left side It is located in the bottom left window of the software 1 and is marked in yellow When the user moves the scrollbar of the sagittal window 2 the whole sequence of images in this group will be shown The indicator line of the sagittal slice appears in the coronal 3 axial 4 and 3D images Blue Sky Plan Anonymous Patient P Anonymous Patient bsb n ee ol oem File Edit Tools View Panels Filtering Model Implants Virtual Teeth Help CS Bina Bo va NWS ao oO Volume Renderir COE Density Level 1000 42 2 Coronal window The coronal image is a vertical plane that divides the skull into a front and back part This image is located in the top right hand window of the application and is marked in pink When the user moves the scrollbar in the coronal window the whole sequence of images in this group will be shown The indicator line of the coronal slice appears in the axial sagittal and 3D images 2 BlueSkyBio Blue Sky Plan 5 Placing implants and pins Blue Sky Plan allows virtual implant planning via the patients CT or CBCT images It is possible to add exchange move and rotate the implant and abutment or pin in the different views 5 1 Adding an implant or pin 5 1 1 Implant from
10. gt Save Image menu option then choose the folder where you want to save the images or PDF file 6 6 Saving screenshots and generating a Drill Report Screenshots can also be captured individually using the Screenshot button 1 located on the right side of each view Captured screenshots are inserted into the list in the Screenshots panel 3 which can be accessed from the Panels menu For most slices this makes it possible to extract not only the current view but also all further possible slice positions with the current settings Snapshots are captured in the 40 BlueSky Bio Blue Sky Plan size corresponding to the current window size and the setting 2 in the Screenshots panel Blue Sky Plan Anonymous Patient P Anonymous Patient bsb File Edit Tools View Panels Filtering Model Implants Virtual Teeth Help gt e m eo EE a weed 1 4 Mar mA ra iit A A A Me a emg 100 2 Panoramic 0 0 mm 446x377 Drill Report 4 save 5 PDF O Tae 7 Density Level 1000 x E 3D Axial XY Coronal XZ Sagittal YZ Cross sections Panoramic Implant Tangential Using the context menu options in the list of screenshots 3 it is possible to copy the selected screenshot to the clipboard save it to disk or remove it from the list The screenshot can be displayed in its original size by double clicking on the preview Snapshots can be saved individually in the selected bitmap format 5 a PDF doc
11. possible to replace the implant with the selected variant Epico Visibility Settings 2 Transparency Implant outline C Implant IJH3508 3 Apical Diameter 50 mm lu liu oo CI 3 3 d Ocdusal Diameter 3 50 mm pee ste several properties of the implant can be changed quickly in the list of implants One is the ID 6 which is a short description of the implant It is possible to change the visibility of the ID by double clicking on it and to toggle its visibility in the windows with the check box The check box under the implant 7 changes the visibility of the implant the check box under the abutment icon 8 toggles the visibility of the abutment and the check box under the drill guide 9 changes the visibility of the drill guide Abutment ASJHRO2 4 Length cS p p Beis Gs 8s ib db db Replace Outer Diameter Height SG G ske SEEE All the visibility settings are independent of each other and the following rules control whether the implant can be seen in the windows 1 If the implant is active red color it is always visible The abutment and drill 34 BlueSky Bio Blue Sky Plan guide are controlled by the check boxes 2 If the mouse cursor is positioned over the implant its abutment or the drill guide the draggers and the implant are displayed The abutment and drill guide are controlled by the check boxes 3 In all other cases the v
12. similarly as in the side panel General 1 Implant ID Implant IJH3508 2 Abutment ASIHRO2 Length Length in Heb Bo mE _ Apical Diameter a Diameter Outer Diameter Ocdusal Diameter EM Angle Height Implant Visible 4 Abutment Visible Offset Customize Ll Drill Guide Visible All dimensions are in mm OK 5 7 Validating implants All implants are validated on the background That means that their positions with respect to each other and to the nerves are checked If an implant is evaluated as invalid the icon appears next to it The first criterion considered is the distance between implants If two implants are too close to each other both are evaluated as invalid which is represented by the appearance of icons over both implants BlueSky Bio Blue Sky Plan The second criterion is the angle between implants If this angle is too large the implants are again evaluated as invalid despite the fact that they are relatively far apart To fulfill the validation criteria we must reduce the angle between the implants and if necessary to increase the distance between the implants again The third criterion is the distance from the nerve The same considerations apply here as for the distance between implants lf you are not certain why the validation had failed you may open a panel with the validation results via Panels gt Implant Validation In this panel it is also possibl
13. the catalogue Before positioning the implant it is recommended to first measure the dimensions of the bone In this way it is possible to estimate what dimensions the implant should have Clicking on the 1 icon in the toolbar opens a dialogue for adding an implant 3 7 x8mm 3 7x10mm 3 70 mm 3 7x11 5mm 3 70 mm 3 7x13mm 3 70 mm 3 7x16mm 3 70 mm 41x8mm 4 10 mm 41x10mm 4 10 mm 41x11 5mm 4 10 mm 41x13mm 4 10 mm 4 1x16mm 4 10 mm In this dialogue it is possible to modify the implant parameters abutment and drill guide The corresponding parts can be selected in the individual tabs 1 Select Implant 2 is selected by default which makes it possible to select an implant from the catalogue on the basis of its type 3 and platform 4 and then according to parameters 5 It is also possible to specify the orientation of the implant 6 The currently selected implant can be viewed in the preview 7 A short description of the implant 8 is also located in the lower part of the dialogue 5 1 2 Custom implant lf none of the implants fulfills the particular requirements it is possible to create a simplified but fully parameterized implant This is achieved by clicking on the Custom Implant option 1 The individual parameters 2 can be modified with the 28 BlueSky Bio Blue Sky Plan corresponding fields These changes appear immediately in the preview Implant Abutment Drill Guide Customi
14. the view but also along the axis of the tooth As in the other views it is necessary to move the cursor onto the tooth and display the draggers The blue arrows above and below the tooth serve to shift it along the axis We change the position of the tooth by moving the cursor to the arrow clicking the left mouse button and dragging As for implants three differently colored circles appear in the 3D view for rotating the tooth around the corresponding axes of the local coordinate system In addition to the position and rotation the size of the crown can also be modified in the 3D view The purple arrow displayed along the axis of the tooth serves to change the size We change the size of the tooth by moving the cursor to it clicking the left mouse i 57 BlueSky Bio Blue Sky Plan button and dragging 9 3 Aligning an implant and further operations The side panel which can be opened with the Panels gt Tooth List menu option provides further operations on the tooth A list containing a description of the tooth 1 a check box 2 for turning the visibility of the individual tooth on and off and a button to remove the given tooth 3 appear in this panel The currently selected tooth is displayed in red in the sequence and the associated row is highlighted in the list As for implants it is also possible to set the transparency 4 or outline display 10 for teeth There is also an Add Tooth button here for adding a t
15. to Maila T 1 change selection 1 manually When generating the ia re model the application then asks whether you really ee o want to fabricate this type of surgical guide Draw curve JEF L r J The Remove undercuts checkbox 2 is used to set the method of working with areas that run under the surgical guide and might prevent mounting on teeth Edit curve in the case of a surgical guide fabricated from stiff a material These areas can be removed automatically when generating the surgical guide Differences between individual outputs can be compared on the following pair of images On the left is a guide without undercuts on the right all details are preserved Clear curve Fabricate on model The slider and corresponding spin box 3 are used to set the thickness of the resulting surgical guide in millimeters Before actually fabricating the surgical guide it is necessary to specify the area that should be covered This is done by drawing and then editing border curves directly on the surface of the input model using the three buttons 4 6 Clicking the first button 4 activates drawing mode The state of the button is indicated by a change in color If we are in curve drawing mode it is possible to manipulate the model without pressing any keys and for the actual drawing it is necessary to press and hold down the Shift key The mouse cursor changes shape from an arrow to a cross and a st
16. to indicate its status In this mode the model can be manipulated in the usual way Surface smoothing mode is activated when the Shift key is pressed The effect is then applied by pressing the left mouse button while simultaneously dragging the mouse cursor over the model surface i 69 BlueSky Bio Blue Sky Plan 13 4 Label tool The surgical guides fabricated can be supplemented with one or more labels with a 3D profile This is done with the Label tool Y Label tool lt is first necessary to check whether the correct BB Surgical Guide m model is selected 1 If the model is set as invisible at this point in time the user is notified of this when he or she tries to insert a label on it The text is inserted into the editing field 2 At this point an auxiliary display of the text entered is also shown in the 3D display window The text will be located on the model at the location at which it is displayed in this window Therefore it is necessary to position the model in the 3D window in such a way that the text will be at the right position on its surface Then press the Apply button The auxiliary display of the text in the 3D window is hidden and the text is pressed into the surface of the surgical guide The auxiliary display in the 3D window can be reactivated with the Show label checkbox 3 F C 70 BlueSky Bio Blue Sky Plan 14 Preferences Blue Sky Plan makes it possible to save u
17. to select what should be exported from the project Selection is limited to data that are currently visible in the 3D view of the application Nerves 2 imported models 3 implants 4 and density surfaces 5 can be selected It is possible to export either to a file or directly to the installed VRMesh application 6 For a license with a limited number of exports the number of remaining exports is indicated on button 6 and in the title of the window within the project currently open the number of exports is only reduced once Export Quality 1 Standard Ti Implants O TT iL aala ag a ma a m 2 62 BlueSky Bio Blue Sky Plan 12 Coordinates Export For the purpose of producing a surgical guide the program has a function for exporting the coordinates of implants on the basis of markers that are part of the scan appliance It is necessary to first designate markers which are visible in the data From the menu option File gt Export Coordinates 1 open the panel with the coordinates export functions 2 Blue Sky Plan fae File Edit Tools View Panels Filtering Model Implants Virtual Teeth Help My New Project Ctl N FES H Q 2 z N Ao N THE 124 t gt la w O Order Iniekants mA z EN A Be Open Project Ctrl O 5 y Open Projec rl Special Features EE DHS rw Wi Y Coordinates Export 2 Ee Recent Projects Guide type BitePlateFox i oe i oH
18. 2 Positioning and manipulating the implant nannannnnnnennennnnnnnnnnnennnnnnnnnernennenne 31 5 3 Further operations on the implant cccccecccseeeseeeceeeeeeeeseeeseeeeeeeeneeeseeeeeeeens 32 aA de PANE ene E eee ree eee eee 34 5 5 Dialogue with parameters of all implants n nnannnnnnennannnnnnnnnennnnennnnnnnnnennnnne 35 5 6 Dialogue with the parameters of the selected implant ccccsseeeseeeeeeeeees 36 5 7 Validating implants ccccccccsecccececeeeceeeeneeeseeeeeeeeseeeseueeeeeeseeeseeeeeeeenseeseeesaeeess 36 S9 Enn P e E 38 TOONS AET EE ET EA EAA TEE 39 or TOODI a E E E 39 62 61 gt a1 12 fc al 0 OL eea ee 40 6 3 SAVING a project 20 eee ccecccceeececeeeeeceeeeeceeeeeseeeeeseeeesseeesseeessaeeessaeeesseeeesaeeeeas 40 CA 8 9 0 a POCO meeeeeee ene eee er ee ee ee eee ee 40 6 5 Saving images in JPG fOrmMa ccccecccceeceeceeeeeceeeeeseeceseeeeeseeeeessaeeeseeeeeseeeeeas 40 6 6 Saving screenshots and generating a Drill Report eee ceeceeeeeeeeeeeeeees 40 6 7 Modifying window and level cccccceeceeeeeceeeeeeeeseeeseeeceueeseeeseeeeeeeeseeeseeeseeeess 44 0S ZOOMMMG e 44 6 9 MOVING the IMAQE cccccceccceeeeceeeceeeeeeeeeeeeseueeeeeeseesueeseeeseeeseueeseeeseeeseeeseneens 44 ONO MOVIN TODE eea a E atceaees 45 6 11 Measurements and overlays ccccccccsececeeeeeeeeeeeeeeseeeeseeeeseaeesseesseeesaeeeeseeeeas 45 6 12 Linear measurement
19. BlueSkyBio Blue Sky Plan USER MANUAL Manual Revision 10 mdi Europa GmbH Langenhagener Strae 71 D 30855 Langenhagen CE 0297 BlueSky Bio Blue Sky Plan Contents i 2 3 4 5 BlueSky Bio NA OGUIGTION serer E A eee esee eee 4 Installing Blue Sky Plan eecccceccseececeeeeceeeeseseeseeeeseeeeseeeeseueeseeeeseueeseueeseeeeseeeenees 6 Ar AASA IO 6S 55 1 VVING OWS oeae EEE 6 2 2 Installation process Mac OS X ccccccsscccseecceseeeeeeeeseeeeeeeseeeseeeseeeeseeeeseeeesnes 8 20 MAWE TOUI ONTOS eraai E E E E E E 10 24 QODErAing SVG eee EEEE EEEE EEEE EEEE EEA 10 Loading the patients CT or CBCT scan into Blue Sky Plan cccecsceeeeeeeees 11 3 1 Selecting the DICOM images locatiOn ccccccceccseseeeeeeeeseeeeeeeeeeesaeseeseeeeeas 11 Ie OPCI TNC Se CS e S 12 3 3 Enhancing performance cccccccsccceseccececseeceucccececseeceueeeeeecseeseuseeeeeseeeseeess 12 3 4 Scan alignment and defining the range of slices cccececeeeeseeeeeeeeeeeeeeeaeeeens 12 S9 FosStoOnNNg iNe panoramic CUIVC sacacseccacecsxctsanconctausetactensaeueiecsseveiactqeredaansaxcteaeds 14 DOMWAlE IMC ACS E E E A ANE A E E E E E E 15 4 1 Screens and VIEWS cccceecccceececceececceececseeceeeeueesseueessacesseeeessaueesseeesseeeeseeeeeeas 16 Ae NUDE SEOS a 26 Placing implants and PINS nannnennennannnnnnennennnnrnnrnrnenrrenrsnrnrrrrrrsrrnnrrnrrnrrsnrnnrnnrennene 28 S ANAMDA OF D eee E E 28 5
20. D M naal MOLN T 4 7mm eile hie i ee eT Tyr a i rT 2 Density Level 1006 16 BlueSky Bio Blue Sky Plan 4 1 1 Axial window The axial images are horizontal slices of the volume and can be seen in the top right hand view in the application 1 They are marked in blue All the other images are generated from the sequence of axial images By moving the axial scrollbar 2 it is possible to view the whole sequence of axial images The indicator line of the axial slice appears in the cross sectional 3 panoramic and 3D images r s n A pe lt Blue Sky Plan Anonymous Patient P Anonymous Patient bsb File Edit Tools View Panels Filtering Model Implants Virtual Teeth Help Cy eye DO N p ONPE Do O eee T E ine r ee a a s Density Level 1009 NS 17 BlueSkyBio Blue Sky Plan 4 1 2 Cross sectional window The cross sections view displays vertical slices going around the patient s ridge As the user moves through the slices using the up and down arrows 2 the corresponding multi color lines in the axial and panoramic views 3 and 4 will move accordingly identifying the location of the five images being displayed in the cross sectional views These images are used to evaluate the bone height and thickness in planning When implants are placed they are often placed into one of the images in the cross sectional view The distance separating the images can be modi
21. Sky Bio Blue Sky Plan the model and the visibility of appropriate reference points by setting the thresholds of the density surface appropriately vere Nt dill iii I e Surface model Points 5 PM gt Imported model K Refine using ICP Points can be added by clicking on the button with the eyedropper Ea or by pressing the Shift key If Refine using ICP is activated the program attempts to perform an additional automatic alignment after the alignment based on the points entered lt is also possible to align the model manually in the 3D window using the dragger 7 that appears when you press the Adjust Model Position Manually button 6 Clicking this same button closes the manual alignment mode and the dragger disappears 54 Blue Sky Plan File Edit Tools View Panels Filtering Model Implants Virtual Teeth Help Plugins oh fe H O E Af MON OEE a i i im B PA iii A G ay a DE 3 J fy i Order Implants a A i w Model 6s Model Alignment Barron_1602_Maxillar XI Visible C Mode outline Alignment eB Direct Center DICOM coordinates JUaWUBYy japow Sy 3811 4j00 Auto Points Orientation 4 Maxilla Mandible Align 5 Adjust Model Position Manually O Density Level 1000 When aligning manually 6 it is possible to define a fixed point a so called pivot around which the model rotates In 2D views the pivot is represented by
22. a different view the plane displayed in the window 1 automatically changes to the rotated plane of the implant Thanks to the option of rotating the plane passing through the implant it is possible to easily check and correct the tilt of the implant s position when viewing from any angle Blue Sky Plan Anonymous Patient P Anonymous Patient bsb File Edit Tools View Panels Filtering Model pon Virtual Teeth ag Ga 8 im ra p c r EE 5 L wi DC Order Implants Density Level 840 BlueSky Bio Blue Sky Plan 4 1 5 3D View The 3D image is located in the bottom left hand view of the application 1 To rotate the 3D image click the left mouse button in the model and to zoom click the right mouse button XD Blue Sky Plan Anonymous Patient P Anonymous Patient bsb File Edit Tools View Panels Filtering Model nee Virtual Teeth Help fe De DaM naa E LE T 4416mm iit Volume Renderir qo Density Level 1015 4 1 6 3D Shortcut buttons The 3D view has several valuable shortcut buttons on the right side of the view The first button 2 maximizes the window The second button 3 allows the user to change the positioning of the view The user can click on the button to open a fly out menu The orientation of the patients anatomy will adjust according to the option chosen The third button 4 allows the user to take advantage of different volume rendering options It is possible to set the rendering
23. ake to generate it and the slower manual edits with tools such as the Brush Tool will take A model with the Normal setting should be sufficiently detailed for most input data Y Scan apokance o Fabnicate on scan After entering and checking all settings in the Fabrication panel it is possible to proceed to automatic fabrication of the surgical guide Clicking the Fabricate on scan button 1 in the Scan Appliance section runs this A progress bar is then displayed and once this runs out the resulting surgical guide is displayed automatically 13 2 Guide fabrication based on scanned surface models lt is necessary to have an input STL model open in this case as well First check whether all the settings in the Fabrication panel are correct i e whether the correct input model is selected whether or not automatic model alignment is used above the guide tubes and what level of detail is selected for the resulting surgical guide Further settings specific to fabricating a surgical guide from a surface model are found in the Model settings section When opening a project the program tries to guess whether it contains maxillary or 2 66 BlueSky Bio Blue Sky Plan mandibular data and automatically makes the selection 1 The same test is then also conducted when initiating generation of a surgical guide If the program s guess does Y Model settings not agree with the actual situation it is possible
24. based on scan appliance oannonnoonnoannonnnsnnnnnrnnennrennenne 65 13 2 Guide fabrication based on scanned surface MOEIS cccseeeeeneeeeeeeeeeneees 66 We DU IOO eer E E E EE 69 13 4 Label tool ccrccsciccrectecectetiiecseniecemnerateesumancecinneancecienteeadiednniesaceceemenceeaiaenciedentenceceeucadateseeacees 70 ta PECOS e ee ee 71 ge a gt cc een er ee ee en ere 71 A FTO JOC e E E E E 72 AS PAINS e e E EE E E E A E E E 72 1o AUO 00 2 tt hee te ee 73 BlueSky Bio Blue Sky Plan 1 Introduction Blue Sky Plan is Windows and Mac based computer software intended for 3D virtual surgical implant placement giving clinicians a more accurate way to treat patients Blue sky Plan is precise and can help the clinician determine the ideal position for implant placement for the best esthetic and functional results Blue Sky Plan can be used for diagnostic purposes and can aid in the fabrication of surgical guides for computer guided surgery Using Blue Sky Plan is the way to give your patients the best care available Blue Sky Plan converts a Computer Tomography CT or Cone Beam Computer Tomography scan into a format that allows the dentist to assess the anatomic topography of the maxilla and mandible as well as the location of important structures The patient s CT or CBCT images will be stored in DICOM format from an Imaging Center The software converts these images and makes it possible to view the pat
25. bles advanced scene manipulation gestures in Leap viewing mode A Leap controller is required Zoom with circle gestures toggle the effect of the circle gesture between slider control and zoom control 14 2 Project Autosave project automatically saves the project at the time interval entered 14 3 Advanced Rendering mode the multi threaded mode provides somewhat better display performance but may lead to program instability with inappropriate graphics card drivers Logging allows information about the execution of the program to be stored in a log The log can be displayed by clicking the Show Log button and its content can make it easier for the program manufacturer to solve problems that arise when running the program on specific hardware configurations Automatically check for updates every day when it first starts up the application checks whether you are using the newest release and if not offers to install the update for you J 72 BlueSky Bio Blue Sky Plan 15 Automatic Updates Blue Sky Plan supports the option of automatically checking the availability of a newer version of the program It does this once a day when it first starts up this can be turned off in the program settings dialogue in the Advanced tab with Automatically check for updates This feature can be invoked manually with the menu selection Helo gt Check For Updates gt Blue Sky Plan New version New ve
26. d You can display or hide the Scan Appliance model with button 3 The top left hand box contains the gutta markers from the patient s scan The top right hand box contains the gutta markers of the Scan Appliance The bottom left hand box contains an image of the Scan Appliance The bottom right hand box displays both sets of gutta markers if they coincide 7 1 Gutta percha markers coincide If the two sets of markers do coincide we continue as follows If they do not coincide proceed to section 7 2 Scan Appliance Ali Patient markers Provisorymarkers Provisory model 4 Confirm the data alignment by pressing OK 5 The Scan Appliance will appear in the 3D image of the patient s jaw The properties of the Scan Appliance can be changed in the Surfaces panel in the Imported Surfaces table 9 51 BlueSky Bio Blue Sky Plan 7 2 Gutta percha markers do not coincide gt Scan Appliance Alig n 0O Patient gutta percha markers f m Provisory gutta percha markers gt AS 8 351 E Patient markers Provisory markers Provisory model LJ Align points only Update Cancel 4 BlueSkyBio In the top right hand box use the zoom tool right mouse button the 3D density slider and the rotation tool left mouse button to clearly view at least four gutta markers Identify the gutta markers by clicking the Ea button or pressing the Shift key followed by left mouse clicks on the gutta mar
27. d directly in the sequence We confirm the selection by clicking the OK button 4 the Cancel button closes the dialogue without making a selection Add tooth Preview PmseeHesAht EELE G cer Fr rire sees Small Medium Large 3 56 Blue Sky Plan 9 2 Positioning the crown and manipulating it The mouse cursor changes to a cross when the dialogue closes We can then position the crown by clicking on the slice and if necessary on the 3D visualization in any window The crown is positioned in a vertical position according to the type of the simulated tooth and rotates with respect to the dental curve It is up to the user to fine tune its position The tooth can be moved in all the windows This is achieved by positioning the mouse on the tooth geometry clicking the left mouse button and dragging The tooth always moves in the plane of the view The tooth can also be rotated using the so called draggers These appear again when the mouse cursor is positioned on the tooth We can subsequently grab the dragger by clicking the left mouse button the dragger changes color and we modify the rotation of the tooth by dragging The rotation point the so called Pivot can either be in the center of the tooth geometry or at the beginning of the local coordinate system This is located in the same place as the head of the aligned implant In the 3D view the tooth can be dragged not only in the plane of
28. e to set the validation parameters 1 There is a list here of all invalid implants 2 and the reasons the validation of the selected implant failed 3 Implant Validation Validation Settings Implants minimum distance Implants ma Nerve minimum distance Invalid Implants Validation Results 3 Implant is too close to implant 0 Angle between this implant and implant 5 is too big Note pins are not validated either against themselves or implants or against nerves 2 ST BlueSky Bio Blue Sky Plan 5 8 Ordering implants Implants can be ordered directly from the application by selecting Order Implants 1 in the toolbar File Edit Tools View Panels Filtering Model Implants Virtual Teeth Help Plugins g Am 1 a mm lt EES Oo f i ses Ta D m tH 4 i g s y X H Order Implants i J 4 j 21 8 mm The Blue Sky Bio website will load automatically and the implants which were used in the treatment plan will be added automatically to the shopping cart Additional implants and items can be added to the shopping cart by continuing to shop via the website lf custom implants were used implants that were not selected from the Blue Sky Bio catalog in the treatment plan those implants will not be added automatically to the shopping cart BlueSky Bio Blue Sky Plan 6 Tools This chapter explains the properties of each Blue Sky Plan tool and the
29. e to your hard drive simply execute the file and follow the steps to proceed Choose the language and click OK instalace Cestina English Francais Italiano Portugu s Portugal Click Next Welcome to the Blue Sky Plan 3 Setup Wizard This will install Blue Sky Plan 3 19rc16 on your computer It is recommended that you close all other applications before Click Next to continue or Cancel to exit Setup Carefully read the license agreement License Agreement 1 Please read the folowing important information before continuing select one of the options and click Please read the following License Agreement You must accept the terms of this N ex t agreement before continuing with the installation CAUTION READ THIS AGREEMENT CAREFULLY BEFORE INSTALLING THE SOFTWARE ICENSE AGREEMENT FOR USE OF BLUE SKY PLAN SOFTWARE is License Agreement is provided for your reference To complete the installation and to use the Blue Sky Plan software package you will need to agree to the following terms and conditions 1 Contracting Parties The parties in this License Agreement are ue Sky Bio LLC Licensor and the user of the software I do not accept the agreement BlueSky Bio Blue Sky Plan BlueSkyBio Setup Blue Select Destination Location Where should Blue Sky Plan 3 be installed A Setup will install Blue Sky Plan 3 into the following folder To continue dick Nex
30. e video card is not sufficiently powerful the program makes it possible to reduce downsample the input data the user may set this manually for each axis or choose one of the available settings 2 The software will automatically compensate for the skipped slices and the quality of the treatment plan and Surgical Template will not be compromised 3 4 Scan alignment and defining the range of slices In this step you align volumetric data and delimit the area of interest in the data It is possible to crop the data in all directions by dragging the yellow lines 1 or by directly setting the dimension of the slice for the individual axes 2 The data display mode can be changed by selecting Imaging Mode 3 12 BlueSky Bio Blue Sky Plan Options Imaging Mode MIP Alignment 5 ange x Angle Y Nae a 000 Reset Rotation Volume of Interest 2 Min X lo sd Max X Min Y r MaxY Min Z O MaxZ 227 n Cancel The data can be aligned using the blue circles 4 it is also possible to enter values for rotation around the individual coordinate axes manually 5 The transformation performed then applies correctly for importing and exporting data as well Given the significant memory and performance requirements for visualizing 3D medical data it is advisable to crop the input data to the actual area of interest this allows the program to run much more smoothly 13 BlueSky Bio Blue Sky Plan
31. ed to the list on the Surfaces panel where its parameters can be changed in the standard way The surgical guide can be regenerated with edited parameters and the same curve the curve is merely hidden and can be displayed with selection 7 edited again and used to create a modified model 13 3 Brush tool The application provides a basic tool for manually smoothing the resulting surgical guide the Brush Tool This tool smooths the surface i e It lowers Diameter i i bulging parts and evens out depressions Before Sirenath ammm E using it ensure that model you really want to edit is selected in 1 If the model is not visible at that given point in time the program notifies you when you turn on editing mode Y Brush too W Surgical Guide Brush The diameter of the circular area that the brush tool will edit can be adjusted in the associated section 2 of the panel Correctly adjusting the size significantly alters the behavior of the tool it is necessary to set the diameter somewhat larger than the area we want to even out The selection for Strength 3 adjusts the strength of the resulting smoothing effect For significant unevenness it is a good idea to first work with a lower tool strength and smaller diameter until surface smoothing occurs and only then use a greater strength and larger diameter and press down the entire area with it The Brush button starts editing mode and changes color
32. entation Use Active Tooth Model Tooth Removal Create Surface Remove Tooth Model Neighbourhood C lf automatic delimitation of the tooth fails it can be selected in the data using the virtual tooth manually positioned in the data via the Virtual Teeth gt Add Tooth option from the main menu After positioning the model perform the Use Active Tooth Model action 3 for the designated data on the basis of the tooth model entered Using the Model Neighbourhood Parameter 4 you can perform a slight correction of the area around the positioned model which is selected lt is possible to transfer the area of the tooth marked in the data into the model by clicking Create Surface 5 The model created in this way appears in the Surfaces panel in the Imported Surfaces table The tooth can be removed from the data by clicking Remove Tooth 6 If you are not satisfied with the result the action performed can be reversed with the Undo button and the tooth selection parameters can be modified 61 ie Sky Bio Blue Sky Plan 11 Data Export Most of the project data can be exported from the application in the form of an STL model The menu selection File gt Export Data is used to export data The quality of the export 1 can be set in the dialogue which influences the quality of the resulting model but also the time necessary to generate the export With the check boxes it is possible
33. es of items can also be changed in the Notes List panel by clicking on the Color field 6 18 Panoramic A panoramic image is a panoramic slice of the mouth and teeth It is a perpendicular plane of the axial image 47 BlueSky Bio Blue Sky Plan 6 18 1 Creating a panoramic line Refer to Section 3 3 6 18 2 Mandibular canal The mandibular canal can be added in the panoramic image and viewed in all of the images 6 18 3 Adding a mandibular canal Adjust the panoramic curve to fit the patient s arch as described in section 3 2 1 Click on the Tools gt Add Nerve menu item 1 The Nerves panel 3 will appear to show default properties for the nerve 2 Click on portions of the nerve in the panoramic window and follow the canal to the mental foramen When entering nerve points the position of the slice can be changed with the scroll bar on the right side of the window and the last added point can be removed with the Edit gt Undo action Blue Sky Plan Anonymous Patient C inst manual data default File Edit BORE View Panels Filtering Model Implants Virtual Teeth Help Gt QO ye a Aad Marker A ere Add Text Add Scale Edit Nerve Order Implants Edit curve gt ke Density Value Measure Hu W Distance Measure mm 3 Angular Measure Clear Notes Clear Measurements r Preferences Add Neve C Show Nerves Density Level 1000 You can fine tune the buccal l
34. faces mode each density surface is cropped independenily of the others The first non deletable surface shares its cropping area with the other visualization modes Shaded Bones MIP X Ray etc Density Surfaces Cropping serves to Original Name Visible Hint Color e remove noise e remove superfluous anatomy Adi Duplicate Reset to Defaults e isolate anatomy Surface Definition The cropping tools are in the lower part of the Surfaces panel 1 It is possible to crop data with the Cut button to delete a previously Rijs performed crop with the Clear button and to iam isolate the selected anatomic portion It is also possible to invert the current cropping Maximum 3 3 Shininess epep TE TETE Transparency Surface Culling Dp After the user clicks the Cut button the Mmi application switches to drawing mode At this point by clicking on the left mouse button in the 3D window and dragging the cursor it is possible to draw an area which is cut out of the selected surface after when the mouse button is released Drawing can also be invoked at any point by pressing the Shift key and holding it down during the whole drawing period lf we want to isolate a particular part of the anatomy we must first ensure that it is not connected to any other parts We can ensure this using the cropping function described above We can isolate anatomy in this way with the solate button a
35. fied by clicking on the icon 5 and a new value can be selected from the drop down menu By default the distance between images is set to 1mm A tl T TF L Blue Sky Plan Anonymous Patient P Anonymous Patient bs File Edit Tools View Panels Filtering Model Implants Virtual Teeth Help Ga 8 m p a A I iA cs DIE y Order Implants T 41 6 mm T 39 4 mm Ja EE Density Level 978 BlueSky Bio Blue Sky Plan 4 1 3 Panoramic window The panoramic image is located in the bottom right hand window of the application 1 and is marked with light green D Blue Sky Plan Anonymous Patient P Anonymous Patient bsb m 7 s n o x File Edit Tools View Panels Pilani Model ne Virtual Teeth wigs W w E rm g i mee N A Ws i De Order Implants Density Level 1000 The indicator line of the panoramic slice appears in the cross sectional 2 and axial 3 views As the user flips through the panoramic images the panoramic curve will move along the horizontal axial plane to indicate the location of the specific slice represented by the location of the panoramic curve The range of the field of view reachable by the panoramic curve can be adjusted by clicking on the offset distance icon a 4 and by choosing an appropriate step The change in the range of slices reachable by the panoramic curve will be represented by a change in the distance between the inner and outer pano
36. for fabricating a surgical guide The combo box 1 is used to select the input model some input models may be damaged they are composed of several parts and their internal structure may not be correct Fabrication of the surgical guide may fail in these cases lf the input model is damaged it is possible to try to correct the input geometry using the correction Fadricaten Input model o tool 2 and run model fabrication again When I 2375 without teeth x manipulating the model it is a good idea for the J Lockimplants option of working with implants to be turned off so F Use automatic brush that they are not moved unintentionally for example Brush diameter i 10 00mm h24 The Lock Implants checkbox 3 locks them Implants are also locked automatically when using E O certain tools for fabricating surgical guides In order to be able to work conveniently with the resulting surgical guide and so that protruding parts do not prevent you from working with the tools it is possible to select automatic alignment of the areas above and around the guide tubes Select Use automatic brush 4 for this purpose and then use setting 5 to set the diameter of the free area If these selections are not checked only an area of the same diameter as the given guide tube is enabled above the guide tubes The detail of the resulting model is adjustable 6 The general rule is that the more detailed the model is the longer it will t
37. format for printing Clicking the Print button 2 then prints it or saves it to a PDF file gt Print Preview documentl Blue Sky Pan Repoz Anonymous PR em Fetent Name Anopmous Fatient Dae 13 hoa B13 11 2812 Sqect Name EAnopmous Fatet b ipet Coming impian DsTee aar iai AbimetHegi Imgrtdbiret Ange Ori Secth So ea a 1 1 ae 1 E z o os s z 3 43 a ww BlueSky Bio Blue Sky Plan 6 7 Modifying window and level The display brightness and contrast of density data can be changed in the Brightness Contrast panel 2 which can be accessed from the Panels menu 1 The brightness and contrast can also be changed with a special mouse mode 2 in which movement along the horizontal axis while pressing the left mouse button changes the brightness and movement along the vertical axis changes the contrast Blue Sky Plan Anonymous Patient C inst manual data default a File Edit Tools View ree Filtering Model Implants Virtual Teeth Help N eh e ee E ai ERI E mE 8 H o ESERE NO Ne BO O SB oeme HH Ortho Slices f 3 ry Brightness Contrast G r 4 Volume Rendering gt Current Settings xX 2 gt S E5 j urface Brightness Sn HD 200 ad m Implant List S w Contrast Smmm GD coo E gt n gt N ry Presets Notes List 7 r y D Nerve List Tar Soft Tissue 4 B v Y Implant Validation us amp Tooth List Screenshots Model Align
38. he individual parameters 2 Implant Abutment Drill Guide Customization No Abutment Select Abutment Custom Abutment Q Abutment 2 Description BIO Internal Hex implants are compatible with Zimmer Dental s Tapered Screw Vent implant system Cover screw and 3mm healing abutment induded 5 1 5 Drill guide The implant has an auxiliary drill guide added by default If we want to modify it it is necessary to switch to the Drill Guide 1 tab Its parameters can be changed in the corresponding fields 2 If we want to display it or hide it in the preview we can use the check box 3 Description BIO nts are compa Dental s Tapered Screw Vent implan t and 3m i tr induded BlueSky Bio Blue Sky Plan 5 1 6 Pin from the catalogue Instead of an implant it is possible to add a pin This is a special implant for positioning a template more firmly In contrast to an implant it cannot have an abutment but only a drill guide 5 1 7 Your own pin lt is also possible to adjust your own pin similarly as for previous parts Length O sets the length of the blue part of the pin length 1 then sets the length of the green part 5 2 Positioning and manipulating the implant We confirm the choice of implant in the dialogue by pressing OK The mouse cursor then changes to Yn We can then position the implant by clicking on the slice and if necessary on the 3D visualization in any wi
39. he windows by its red coloring The other implants are colored light blue 5 3 Further operations on the implant 5 3 1 Toolbar In the upper menu bar it is possible to display a toolbar of further operations on the implant by selecting View gt Toolbars gt Implants Toolbar Here there are icons for removing the implant 1 replacing the implant 2 and displaying information about the implant 3 All of these operations are used in the same way we click on the icon move the cursor onto the implant and click on it For the option of replacing the implant the same dialogue appears as when adding the implant in which we choose which implant we want to replace the selected implant with 2 32 BlueSky Bio Blue Sky Plan 5 3 2 Context menu lt is also possible to perform several operations on the implant via the context menu which we can invoke by clicking the right mouse button on the implant Show Properties E ee ell m mi z m m m mi a a m a Replace Abutment Duplicate Align with Replace Remove Pivot Visibility lt is possible to display the implant ID a short editable description of the implant or its properties It is also possible to lock the implant against edits The locked implant has a padlock icon displayed next to it It is similarly possible to replace and if necessary add an abutment The entire implant can be duplicated or aligned with another implant That means that al
40. ient s anatomic structures These data can be used for accurate pre surgical treatment planning The dentist can use the program to carry out pre surgical planning help fabricate an accurate surgical guide decrease the risks of surgical complications create realistic simulations of the treatment plan assist in selecting the type and size of implants asses results of prior bone grafting procedures store the patient data allow visual communication with patients and the implant team e demonstrate knowledge credibility and safety help provide advanced patient care Blue Sky Plan software can be downloaded from http www blueskybio com A user license must be obtained for each installation During the installation process the software will prompt the user to request a license via the internet BlueSky Bio Blue Sky Plan The DICOM data can be used to do the following 1 make a scale 3D model of the jaw with the planned implant according to the illustrations below The files with three dimensional positioning of implants and the file of the three dimensional guide can only be generated in Blue Sky Plan BlueSky Bio Blue Sky Plan 2 Installing Blue Sky Plan Blue Sky Plan software supports both Windows and Mac OS X operating systems Installation packages are available for the systems indicated 2 1 Installation process Windows After downloading the Blue Sky Plan softwar
41. ingual aspect by adjusting the nerve point in the cross sectional view later Add another nerve by clicking the Add Nerve button 4 on the Nerves panel and repeat on the other side All images should show the nerve with a default diameter in yellow 48 BlueSky Bio Blue Sky Plan BlueSky Bio Blue Sky Plan 6 18 4 Changing mandibular canal parameters Clicking on the color of the nerve in the list 8 opens color selection window After choosing confirm your selection by pressing OK The width of the nerve is displayed in the adjacent column This can be changed either by clicking on the window and entering new values or by repeatedly clicking on the arrows beside it to change the value in increments of 0 1 mm 6 18 5 Deleting the mandibular canal select the Panels gt Nerve List menu option and click on the letter X beside the nerve to be deleted PR ig 6 18 6 Canal display in different panoramic view modes As described in Section 6 18 within panoramic view it is possible to switch between composite mode and slice display mode In composite mode the entire mandibular canal is displayed in the form of an outline including all control points see image In slice mode only the control points near the panoramic plane are visible The mandibular canal itself is only displayed in the form of slices of the same plane 49 7 Importing the Scan Appliance The Blue Sky Plan Scanning Protocol calls for
42. irtual Teeth E z ik T5 M Views p Toolbars Perspectives 3D a Coronal Projection on the 3D image d sagittal Projection Reset Zoom a i Cross section Projection Load Default Layout possible to enable the indicators D images Click View gt 3D in the Axial Projection d choose the projection type to be To change the visibility of objects such as implants or teeth it is possible to use the associated panels the buttons in the main menu bar or the View gt Objects option After switching the visibility of the dental curve and slice indicators in the 2D views it is now possible to use the All projections icon E in the main menu bar BlueSky Bio Blue Sky Plan 25 4 2 Multi planer screen To access the multi planar screen click the View gt Perspectives gt MPR menu option The multi planar screen makes it possible to view coronal axial sagittal and 3D images This screen is generally used for applications such as oral and maxillofacial lesions and defects removal of impacted teeth and treatment of temporomandibular joint pathology Blue Sky Plan Anonymous Patient P Anonymous Patient bsb a File Edit Tools View Panels Filtering Model Implants Virtual Teeth Help D M naal MO Sv mo NWR Do O oem Volume Renderir Density Level 1000 To locate the desired image move the slide bar located next to the windows Indicator lines show the
43. isibility of the individual parts is controlled by the check boxes Finally for every implant there is an icon for removing it 10 and locking it between drill guide and deletion 5 5 Dialogue with parameters of all implants A dialogue with the parameters of all the implants can be invoked from the menu via Implants gt All Implant Properties If we want to change an implant in the list 1 to its fully parameterized version it suffices to double click on its Label or the grayed out parameters 3 The same applies to an abutment 4 In the dialogue it is possible to change the visibility for all implants 2 If the associated box is checked visibility is turned on for all implants If it is unchecked visibility is turned off If it is partially checked the visibility remains unchanged BlueSky Bio Blue Sky Plan 5 6 Dialogue with the parameters of the selected implant The parameters of the implant can be displayed from the context menu If the side panel is displayed then the associated implant is selected in this panel and its parameters appear If this panel is hidden a special dialogue appears when the user attempts to display the parameters It again displays the implant ID 1 the parameters of the implant 2 the parameters of the abutment 3 and the parameters of the drill guide 4 For a pin the parameters of the pin appear here instead of the parameters of the implant and abutment
44. kers An erroneous identification of one marker can be reversed with button 2 If necessary all identifications can be canceled with button 3 Repeat the previous step for the top left box to identify the patient s markers Perform the alignment on the basis of the gutta markers identified by pressing the Update button 4 If the result noes not roughly correspond to what is desired identify more points for alignment or for data with gutta markers that are hard to discern check Align points only 5 Under this setting the program aligns the points identified without reference to dimensional data The alignment can also be corrected manually using the dragger in the lower right hand window The Scan Appliance will appear in the 3D image of the patient s jaw The properties of the Scan Appliance can be changed in the Surfaces panel in the Imported Surfaces table 52 Blue Sky Plan 8 STL model import Existing STL models are imported into Blue Sky Plan by selecting File gt Import STL Model After the model has loaded the Model Alignment panel 2 opens in addition to the aligned model in the 3D window 1 Using this panel the model can be positioned in the desired location lf the model is already aligned with respect to the data the Direct alignment should correspond to the correct position of the model For STL models created with different software than Blue Sky Plan use the
45. ment an Segmentation Shows the density window adjusting panel Density Level 1000 6 8 Zooming To zoom in press and hold down the right mouse button and drag the mouse up or down A second option is to select the zoom icon Q as shown below and hold down the left mouse button while moving the mouse forward or backward LLA Bing GRADE TL OE 6 9 Moving the image Click on the Move Image icon and drag the image as desired An image can also be 44 BlueSky Bio Blue Sky Plan moved by holding down the mouse wheel pressing it not scrolling it and dragging the image Order Implants 6 10 Moving objects In the default mouse mode left clicking changes the position of the slice If the mouse cursor is positioned over an object that can be manipulated the mouse cursor changes and the object can be moved and if necessary its angle of rotation or size can be changed using the displayed dragger Order Implants 6 11 Measurements and overlays Users can perform any measurement of density 1 length 2 or angle 3 in 2D images They can also insert arrows 4 text descriptions or rulers 5 D Blue Sky Plan Anonymous Patient C inst manual data default File Edit oe View Panels Filtering Model Implants Virtual Teeth Help EY ea ee z wea 1 hy A Add Nerve cs Order Implants Add Marker n 6 Notes List E e Add Scale Note Note Type Color Viey
46. nd by clicking on it in the 3D window All parts of the anatomy are then removed except for the selected part As soon as we have a cropped part of the anatomy that we want to display it is possible to invert the cropping with the Invert check box Any cropping actions can be reversed using the Undo function The following is an example of working with the Surface Culling function 23 BlueSky Bio Blue Sky Plan BlueSkyBio 1 D After the data has loaded the 3D visualization contains a certain amount of unwanted information We press the Isolate button and click on the lower jawbone A portion of tissue continuous with the lower jawbone has now been isolated The vertebrae and other small parts have been removed However the upper jawbone remains in the visualization because it is connected to the lower jawbone in some location We press the Cut button and cut away part of the tissue on both sides After cutting we again press the Isolate button and click on the lower jawbone Only the lower jawbone now remains visible Blue Sky Plan 24 4 1 8 Indicators The indicators are reference lines that indicate the positioning between the images shown on the screen Usually the indicators are already enabled in the windows of 2D images To disable them click View gt 2D in the menu and choose the indicator to be disabled Panels Filtering Model Implants V
47. ndow After being added the implant is always positioned perpendicular to the selected orientation It is up to the user to fine tune the position and rotation lt is possible to move the implant in all of the windows This is achieved by moving the cursor onto the implant clicking the left mouse button and dragging The implant always moves in the plane of the view E j j Besides moving it it is also possible to rotate it using the so called draggers These are displayed when you position the cursor on the implant its abutment or the drill guide If we move the mouse curser onto the dragger and click the left mouse button the dragger changes color and by dragging the mouse we can modify the rotation of the implant i 31 BlueSky Bio Blue Sky Plan lf the implant has a parameterized abutment it is possible to change the angle of the abutment with the spherical blue green dragger In the 3D window the situation is a little more complicated because unlike the other windows the implant is manipulated in space Three circles of different colors appear around the implant which rotate it around the associated axes of the local coordinate system Besides these arrows appear both above and below the implant by means of which it is possible to move the implant on its axis lt should be added that clicking on the implant makes the implant active and all the slices move onto it It is possible to recognize it in t
48. nt Mpa Interface Orientation V stra Compatible Blue Sky Plan 64 13 Surgical Guides lt is possible to fabricate surgical guides in the program on the basis of imported STL models or a so called scan appliance It is also possible to edit the surgical guide fabricated The surface can be smoothed with the Brush Tool and text labels can be created on the surface with the Label Tool Surgical guides are fabricated using the functions located on the Guide Fabrication panel which you can open by clinking on the File gt Guide Fabrication menu item 1 The tools are divided into groups according to their purpose Ede Took View Panel Filtering Model molts Virtual Teeth Help WW aM RNA O owe The first group 2 combines elements used together for both model types The second 3 contains a button for fabricating surgical guides on the basis of a scan appliance model The third 4 contains all elements for fabricating an offset surgical guide from a surface model of the oral cavity These are followed by panels for manually editing the resulting model 5 and creating labels 6 The method of fabrication differs according to the type of model being processed 13 1 Guide fabrication based on scan appliance lt is first necessary to import a scan appliance model and correctly align it with CT data Then open the Guide Fabrication panel The first section Fabrication contains all 65 common settings
49. ooth 5 which functions the same way as the toolbar button described above optionally via a menu item i 58 BlueSky Bio Blue Sky Plan Right Maxillary Central Incisor 9 visibility Settings Transparency Tooth Outline L 10 Tooth Add Tooth 5 Rep ace Tooth 7 Remove To oth B O The result of clicking the Remove Tooth button 6 depends on whether a tooth is designated as selected If so if one of the teeth is designated the action is performed directly on the designated tooth If not the selected tooth is removed from the sequence by clicking the mouse The button for changing the geometry of the tooth is Replace Tooth 7 The dialogue for selecting the new geometry works analogously if one of the teeth is selected the new geometry is set to it if none is selected the mouse cursor changes to a selection cross and the geometry changes to that of the tooth selected by clicking on it The Align New Implant button 8 first opens a dialogue for selecting the implant see chapter 5 and after the selection is confirmed with the OK button the new implant is added to the project with the position setting corresponding to that of the selected tooth The button for aligning an existing implant 9 works analogously When it is pressed the mouse cursor changes to a selection cross and when one of the existing implants is clicked on its position with respect to the tooth is modified
50. options and click the associated button To continue installing the software you must agree to the terms of the software license agreement 8 Int Lic Click Agree to continue or click Disagree to cancel the installation and quit the Installer De oi Read License Disagree Agree Ins lo agree to the following terms and conditions ih TD Va aa g 1 Contracting Parties The parties in this License Agreement are Blue Sky Bio LLC Licensor and the user of the software Licensee TO Wan aa a 2 License Grant The Licensor grants the Licensee a single non exclusive and non transferable license to use the Software provided Licensee complies with all terms and conditions of this Agreement 3 Accession to the Agreement Installing copying or otherwise using the software signifies that you are expressly agreeing and are Print Save GoBack Continue BlueSky Bio Blue Sky Plan Click Install Standard Install on Macintosh HD Introduction License This will take 134 7 MB of space on your computer Click Install to perform a standard installation of this software on the disk Macintosh HD Change Install Location Install Click Close The installation was completed successfully 8 Introduction License The installation was successful The software was installed Go Back
51. os oe Edit curve Density od ke Density Value Measure Hu Density Distance Measure mm Scale Angular Measure Distance Clear Notes i Ea Tyr Angle Clear Measurements lt Preferences Marker Bn ai 2136 Hu Marker z a Esite H e Wie TO E ia fered PT ore OE 5 om RS es Bete ae 3D Axial XY Coronal XZ Sagittal YZ Cross sections Panoramic Implant Tangential Clear Notes Clear Measurements Density Level 1005 45 BlueSky Bio Blue Sky Plan 6 12 Linear measurement Click the Tools gt Distance Measure menu option 6 in order to perform any 2D measurements 2 Click the left mouse button with the pointer on the image to mark the start point of the distance to be measured and click again on the image to mark the end point of the measured distance To correct the measurement you can grab one of the end points and move them 6 13 Angular measurement Click Tools gt Angular Measure menu option 6 Click the left mouse button with the pointer on the image and repeat the process twice to get an angle 3 To correct the measurement you can grab the points specifying the angle 6 14 Density measurement Click the Tools gt Density Measure menu option 6 The value of the density measurement is obtained from the information contained in the patient s image and can vary for each CT or CBCT scan The measurements are given in Hounsfield units 6 15 Measu
52. ramic curves The view mode button 5 will change the panoramic view into a composite image representing an image similar to an X ray In such a situation the panoramic curve in the axial view will disappear as no individual slices are being represented and instead a composite image of all the slices within the relevant range is displayed Selecting the view mode button again will return the panoramic view to the standard section view 19 BlueSky Bio Blue Sky Plan 4 1 4 Tangential implant window The tangential view is located in the upper right hand part 1 of the window and is marked in green It works in two modes If no implant is active it displays the view orthogonal to the cross section view tangential to the curve The plane displayed can be rotated with the scroll bar in the tangential view window 1 or by dragging the line displaying the intersection of the plane with the axial slice in the axial view window 2 The direction of view on the plane of the tangential slice is indicated in the axial view with a green triangle lf an implant is active the view orients itself in a tangential position to the curve when switching to the implant Nonetheless it does not display the perpendicular plane but rather the plane passing through the implant In this mode the orientation of the plane is indicated not only in the axial view but also on the associated implant in the 3D window 3 lf the implant is rotated in
53. rement correction and number position The user can correct the measurement and all the overlays in the default mouse mode lt is possible to correct a measurement by clicking at the edge of the measurement with the left mouse button and dragging It is also possible to position the numerical value of the measurement outside of the image 6 16 Deleting a measurement lt is possible to erase a measurement in two ways a Click the measurement edge or click on the number with the right mouse button A menu will appear with the deletion option b Click the Panels gt Notes List menu option A panel will appear 7 with a list of all measurements their types values and colors To erase a measurement click the X beside the measurement D 46 BlueSky Bio Blue Sky Plan 6 17 Overlays To add text or other types of overlays select the corresponding action from the Tools menu Specify the position of the item in the selected window by clicking on it The inserted overlay is bound to a specific position in the slice it will not be visible for other positions Orthogonal slices and the normal slice can be positioned in the location of an overlay by double clicking on the Note Type field 1 or View field 2 of the associated item The text of an overlay can be changed by clicking on the Note field in the Notes List panel 7 or via the context menu on the item in the associated slice The color of several typ
54. roke can be drawn by pressing the left mouse button and dragging the mouse along the surface of the model The individual lines do not need to be connected but the relationship of the orientation of the individual sections must be maintained see the pair of images i 67 BlueSky Bio Blue Sky Plan BlueSkyBio Blue Sky Plan After sketching the basic shape of the surgical guide switch to border curve editing mode by pressing 6 The shape of the curve can be edited using individual control points on it Before actually generating a surgical guide it is a good idea to check its shape in this mode As a consequence of fragmentation errors in some input models and in some cases local unevenness in the surface it can happen that the curve does not correspond to the intended shape exactly In this case it is necessary to move the nearest points of the erroneous section so that the resulting outline aligns see the following images After you finish editing you can run generation of the surgical guide with button 8 The now unnecessary cropped curve is hidden automatically at this point This is indicated by the Show curve checkbox 7 which can be used to redisplay the curve lf the curve entered and thus the resulting surgical guide do not contain all the planned 68 implants the user is notified and has the option of halting generation Once it is completed the model surgical guide fabricated is displayed and also add
55. rsion brings new features and bugfixes Remind me later Download Skip this version lf a new version is available the program offers the user the options of postponing the update till later downloading and installing the update immediately or skipping this update completely The update download runs directly in the application environment and to install it Blue Sky Plan must shut down and then start the installation so please close open projects before checking for a new version and installing the update RETON E ON ag A es ee gt Blue Sky Plan New version New version brings new features and bugfixes CLICK FOR MORE INFORMATION 73 BlueSky Bio Blue Sky Plan
56. ser settings for the program and its environment You mark the settings selection with the Tools gt Preferences menu option Preferences Project Advanced sno cde glish Language nglish Interface Dark Background Color Drill Depth Correction 1 OO mm A Big Icons x Hide Window Titles LJ Synchroni Restore Defaults 14 1 General Dragger delay the time until the dragger disappears after the mouse cursor moves away from the implant or tooth Big icons sets the size of the icons in the tool bars Hide window title sets the visibility of the titles of windows with visualization data Synchronize cross sections zoom if this option is turned on moving and changing the ruler in any cross section of the slice also changes the ruler in the other cross sections of the slice Maximum intensity projection slice mode this button for switching the slice display 71 BlueSkyBio Blue Sky Plan mode offers two variants MIP maximum intensity projection and X ray Always show selected implant tooth ensures visibility of the active implant when implants teeth are fully transparent Drill Depth Correction a correction factor for the distance of the Drill Guide from the implant when exporting Move slices to selected implant s position clicking on the implant sets the positions of the orthogonal and normal slices on the selected implant Advanced gestures in Leap viewing mode ena
57. t If you would like to select a different folder dick Browse Program Files x86 BlueSkyPlan3 At least 111 6 MB of free disk space is required Select Start Menu Folder Where should Setup place the program s shortcuts i Setup will create the program s shortcuts in the following Start Menu folder To continue dick Next If you would like to select a different folder dick Browse asw E Don t create a Start Menu folder Select Additional Tasks Which additional tasks should be performed Select the additional tasks you would like Setup to perform while installing Blue Sky Plan 3 then dick Next Setup is now ready to begin installing Blue Sky Plan 3 on your computer Click Install to continue with the installation or dick Back if you want to review or change any settings Destination location C Program Files x86 BlueSkyPlan3 Start Menu folder Blue Sky Plan 3 Click Next Click Next Click Next Click Install Blue Sky Plan Click Finish Completing the Blue Sky Plan 3 Setup Wizard Setup has finished installing Blue Sky Plan 3 on your computer The application may be launched by selecting the installed icons Click Finish to exit Setup eoo Install Blue Sky Plan for Mac OS X Click Continue Welcome to the Blue Sky Plan for Mac OS X Installer Blue Sky Plan is a FREE full featured treatment planning software for 8 Introduction s
58. though the implant remains in its position it turns in the space in sucha way that its axis is parallel to the axis of another implant A complex implant replacement can also be performed from the context menu The implant can also be removed Besides this it is possible to change the point around which the implant rotates during manipulation the so called Pivot Finally it is possible to cancel selection of the active implant via the context menu Pivot set to Center The implant rotates around its center Pivot set to Head The implant now rotates around its head BlueSky Bio Blue Sky Plan Finally the visibility of individual parts of the implant can be changed Visibility gt Implant Abutment Drill Guide 5 4 Side panel To make it easier to find our way among implants the side panel can be displayed via Panels gt Implant List lt contains a list of all the implants 1 unas o settings for the transparency and visibility of Label o aa OT outlines 2 the parameters of the active implant 3 its abutment 4 and the drill guide 5 For a pin the properties of the pin are displayed instead of the properties of the implant and abutment For the implant and abutment sections there are also Customize and Replace buttons The Customize button replaces the implant with its fully parameterized variant Replace opens the same dialogue as for adding an implant and makes it
59. toolbar that contains the most used tools in the application 6 1 Toolbar 1 Menu bar access to all the software tools 2 Icon bar fast access to the main tools 3 3D view icons view rotation volume rendering settings and visibility of slices 4 Panoramic icons offset step X ray mode etc W Blue Sky Plan Anonymous Patient C inst manual data default o x File Edit Tools View Panels Filtering Order Implants Density Level 1000 Further toolbars can be displayed by means of the context options in the main bar or via the option View gt Toolbars i 39 BlueSky Bio Blue Sky Plan 6 2 Opening a project Edit Tools View i gt Open Project 1 menu option Select the project New Project Ctrl N file to open and click Open Open Project Ctri 0 Recent Projects d Save Project Ctri 2 Save Project As 3 Close Project Import Scan Appliance Import STL Model Export Data Ss Print Save Image Show Data Properties Exit 6 3 Saving a project To save a modified project click the File gt Save Project 2 menu option To save a project under a new name click the File gt Save Project As 3 menu option 6 4 Closing a project To close a project file click the File gt Close project 4 menu option 6 5 Saving images in JPG format To save the currently visible screen images in jpg format click on the File
60. two CT scans The first scan should be of the patient wearing a Scan Appliance and the second scan should be of just the scan Appliance Since the Scan Appliance is made of mosily radiolucent material the Scan Appliance does not appear in the patient s scan It does however appear when scanned alone since the relevant density of the Scan Appliance is greater than the density of air causing it to appear in the scan The software allows the two scans to be merged in order to have the Scan Appliance appear in the scan of the patient Merging the Scan Appliance assists with proper treatment planning as it shows the position of the future teeth and removes any artifacts which may have previously appeared in the area of the teeth Follow the steps below to import the Scan Appliance 1 Load the DICOM set of the patient into the Blue Sky Plan application 2 Choose File gt Import Scan Appliance Follow the prompts to identify the location of the Scan Appliance DICOMs and select the relevant region of interest selecting only the range containing the Scan Appliance r Scan Appliance Align 9 r 4 _ h e 0 x Patient gutta percha markers s 338 JR Patient markers Provisory markers Provisory model LJ Align points only Update 3 In the process of alignment you can use the buttons 1 2 to toggle simultaneous display of the patient data gutta markers white and Scan 50 Blue Sky Plan Appliance re
61. type and quality using the contextual menu options or the Volume Rendering panel which can be accessed from the Panels menu The Presets option opens a selection of different 3D volume rendering presets with different coloring schemes 4 21 BlueSky Bio Blue Sky Plan J Fv Rendering a a ce rh Presets b eben tera MIP es Surfaces d Quality gt s n X ray Shaded bones Air pockets Transparent Bones Skin Surfaces Volume Renderir B In Surfaces mode differential surfaces density surfaces are depicted that are defined in the Surfaces panel which can be accessed from the main menu under the Panels option or by double clicking in the 3D window The user can assign a name to each density surface and set threshold values the color or the transparency In the Imported Surfaces table located on the same panel users can find created or imported models for which it is possible to set the color visibility and transparency The visibility of imported models unlike that of density surfaces is not limited by the chosen volume rendering mode The fourth button 5 turns on the visibility of the vertical slices in the 3D window The fifth button 6 inserts a current snapshot of the 3D window into the Screenshots panel 22 BlueSkyBio Blue Sky Plan 4 1 7 Surface culling 3D cut A 3D visualization can be cropped with the Moe Surface Culling function 1 In Sur
62. ument of all the windows can be created 6 and the document can be printed out directly 7 6 6 1 Drill report A set of screenshots can also be created with the Drill Report button 4 which creates a set of snapshots containing the 3D view the panoramic view and a pair of the normal and tangential view for each planned implant 41 BlueSky Bio Blue Sky Plan l el Fa Biu Ie Sky R EDIC JNYy EP 6 6 2 PDF export and print settings When exporting to a PDF file and printing the layout of the images on the page can be selected in the Page layout section 1 In Downsize only mode the program will not enlarge the images and will attempt to maintain their actual size Screenshot Export Settings Page layout One image per page Custom x Downsize only prefer real size Project Name Header Implant List Font Font Arial Blue Sky Plan Report Anonymous Patient Image Title Font Arial Colour Footer eae m Align to top Align to bottom O Show slice position Show scale Cancel The document created can be supplemented with a user header 2 and footer 3 basic information about the patient and project 4 a table of implants 5 and a description of each image inserted in the image 6 42 j Blue Sky Plan 6 6 3 PDF export and printing Once the settings are confirmed the document created appears in the preview window The Page setup button 1 can be used to set the page
63. urgical implant planning and computer guided surgery License For more information see https blueskybio com Destinatiog saadi pus This installer guides you through the steps necessary to install Blue Sky Plan 3 for Mac OS X To get started click Continue C 2012 Blue Sky Bio LLC All rights reserved nuji Go Back Continue S EEEE Carefully read the license agreement English and click Continue 8 Introduction CAUTION READ THIS AGREEMENT CAREFULLY BEFORE INSTALLING THE SOFTWARE License LICENSE AGREEMENT FOR USE OF BLUE SKY PLAN SOFTWARE This License Agreement is provided for your reference To complete the installation and to use the Blue Sky Plan software package you will need to agree to the following terms and conditions 1 Contracting Parties The parties in this License Agreement are Blue Sky Bio LLC Licensor and the user of the software Licensee 2 License Grant The Licensor grants the Licensee a single non exclusive and non transferable license to use the Software provided Licensee complies with all terms and conditions of this Agreement 3 Accession to the Agreement Installing copying or otherwise using the software signifies that you are expressly agreeing and are Print Save GoBack Continue eoo Install Blue Sky Plan for Mac OS X Choose one of the
64. us windows displaying the axial sagittal coronal cross sectional tangential panoramic and 3D images Depending on the intended use it is possible to select the active windows for multi planar functions cross sectional sagittal coronal and 3D or implant functions cross sectional axial panoramic and 3D gt Blue Sky Plan Anonymous Patient P Anonymous Patient bsb File Edit Tools View Panels Filtering Model Implants Virtual Teeth Help et oe BS Kyy f oT a 7 3 j YY i im re M A 1 al o 6 5 5 5 Order Implants Implant Cross sections 2 z kaale ain Sr able min Implant Tangential 3 Implant Tangential 5 MPR B fy 3D Tabs The following information and tools can be viewed in each active window individual colors for each cross section of images indicators showing the current position of the images label of the image rulers 15 BlueSky Bio Blue Sky Plan 4 1 Screens and views The implant screen allows visualization of the cross sectional tangential axial panoramic and 3D images All implant planning tools can be accessed through the menu bar 1 below The main toolbar and the toolbar of the panoramic image 2 and 3 respectively in the following illustration show the most used tools E Blue Sky Plan Anonymous Patient P Anonymous Patient bsb lt a cs n File Edit Tools View Panels Filtering Model Implants Virtual Teeth Help
65. zation Implant Orientation Select Implant Maxilla Custom Implant 4 Mandible Implant Length 3 00 mm Occlusal Diameter Description Fully customizable implant 5 1 3 Abutment from the catalogue By default the implant is loaded without an abutment If we want to add an abutment it is necessary to first switch to the Abutment tab 1 and then select the Select Abutment option 2 A list of abutments that are compatible with the selected implant appears in the table 3 Once we have chosen a parameterized implant a table for selecting the type and platform will be displayed here similarly as for the implant Implant Abutment Drill Guide Customization No Abutment Select Abutment 2 Custom Abutment Abutment 3 3 5mm Angled 4 20 mm 00 9 10 mm 3 5mm Angled 4 30 mm 00 9 10 mm 3 5mm 4 50 mm 00 8 80 mm 3 5mm 4 50 mm 00 8 80 mm KISS 3 5mm 3 50 mm 00 5 10 mm KISS 3 5mm 3 50 mm 00 6 10 mm KISS 3 5mm 3 50 mm 00 7 10 mm UCLA Titanium 2 10 mm 00 11 70 mm MPA 3 5mm 4 00 mm 00 11 40 mm Description BIO Internal Hex implants are compatible with Zimmer Dental s Tapered Screw Vent implant system Cover screw and 3mm healing abutment induded Cancel 29 BlueSky Bio Blue Sky Plan 5 1 4 Custom abutment The abutment can also be fully parameterized in the same way as the implant We first select Custom Abutment 1 it is then possible to set t

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