ILLUSTRATED SURGICAL PROCEDURE


Buccal view of missing mandibular right 2nd premolar area.
Mid-crestal incision with full mucoperiosteal flap reflection exposing the alveolar crestal bone. Smooth the bone ridge crest as needed.
At the predetermined implant site, use a number eight round bur to notch the cortical bone.

Place the 2mm pilot drill into the notched area of bone and drill to the predetermined depth.
After selecting the proper diameter and length of the implant drill, complete the osteotomy to the predetermined depth.
Thread-tap the recipient implant site with the corresponding thread former, if needed.

Remove healing cap from implant carrier with .050 hex wrench and set aside. Insert the implant into the recipient site with the pre-loaded implant carrier and tighten with hand pressure.
Remove the implant carrier and insert the implant driver to take the implant to the final depth. The implant is seated when the apical portion of the implant neck is flush with the crestal bone.
The nut must be unlocked to set flush with the top of the implant. Note: when healing cap is in locked position it will not seat. Turn healing cap 1-2 turns counterclockwise with .050 hex wrench to unlock.

Place the cap into the top of the implant until the healing cap is level with the top of the implant. Tighten the cap with hand pressure.
Suture the gingival tissue around the implant neck with 4-0 plain gut suture. The top of the implant should be flush with the gingival tissue. The implant may also be completely submerged below the soft tissue if desired. It is the clinician's choice.		 Adjust provisional prostheses as needed and provide the necessary post-op instructions and medications.

SURGICAL PROCEDURE

  1. Site identification with surgical stent and administer anesthetic.
  2. Isolate and clean the surgical area.
  3. Mid-crestal incision with full mucoperiosteal flap reflection exposing the alveolar crestal bone; smooth the bone ridge crest as needed. (Locate and note vital structures e.g. nerves, sinus, etc.)(Figures 1 & 2)
  4. At the predetermined implant site, use a number eight round bur to notch the cortical bone. (Figure 3)
  5. Place the 2mm pilot drill into the notched area of bone and drill to the determined depth. (Figure 4)
  6. Place color coded spacing pins to verify proper implant diameter, location and distance between the implants and teeth. Adjust the implant location and size as needed (1 1/2 mm of bone is needed between tooth and implant; 3mm between implant and implant; and 2mm of bone on buccal and lingual areas.)
  7. After determining the proper diameter and length of the implant drill, complete the osteotomy with the implant drill to the predetermined depth. (Figure 5)
  8. Thread-tap the recipient implant site with the corresponding bone tap, if needed. (Figure 6)
  9. Insert the implant into the recipient site with the pre-loaded implant carrier and tighten with hand pressure. (Figure 7)
  10. Remove the implant carrier and insert the implant driver to take the implant to the final depth. The implant is seated until the apical rim of the implant neck is flush with the crestal bone. (Figure 8)
  11. Insert the healing cap into the top of the implant until it is level with the top of the implant. Tighten the healing cap with hand pressure. NOTE: When the healing cap is in the locked position it will not seat. Turn healing cap 1-2 turns counterclockwise with the .050 hex wrench to unlock. (Figures 9 & 10)
  12. Suture the gingival tissue around the implant neck with 4-0 plain gut suture. The top of the implant should be flush with the gingival tissue. If needed, a gingival-plasty procedure may be required to remove teh excess gingival tissue. The implant may also be completely submerged below the soft tissue if using a 2-stage procedure. it is the clinician's choice. (Figure 11)
  13. Adjust provisional prosthesis as needed to prevent premature loading and tissue trauma during healing.
  14. Provide written post-op instructions and the necessary post operative medications.