IMPLANT PLACEMENT

Drilling Techniques
The internally irrigated tooling requires a specific technique to prevent the irrigation holes from becoming plugged with bone. When drilling with the rosette drill, pilot drills, and depth drills, use an in-and-out motion. Drill in the bone, then move the drill up and out of the bone, without stopping the handpiece motor, to allow the irrigation to wash away bone chips. Proceed with this method until the desired depth reference line is reached. Should a drill become plugged, remove the drill from the handpiece and clear the irrigation hole utilizing A 22-gauge needle. Maximum recommended drill speed varies, depending on bone density. Thread tap the bone at a maximum speed of 50 rpm.

1. 8 Round Bur
Notch the crest of the bone with an 8 round bur at the implant site. Copious external irrigation should be used during this procedure. The 8 round bur is especially helpful when drilling in dense bone.

2. 2 mm Diameter Pilot Drill
Drill to the appropriate depth reference line with the 2 mm diameter pilot drill. Check orientation of the osteotomy using a parallel pin. When placing more than one implant, place a parallel pin into the completed pilot hole and proceed to the next implant site. Align the pilot drill parallel to the previous pin when available bone permits and drill the next hole. A radiograph may be taken with the pilot drill in place to analyze the location of the drill relative to available bone.

3. Implant Drill for Osteotomy
Select appropriate drill diameter and length to enlarge implant site.

4. Thread Former Drill
Place the tip of the thread former into the drilled implant site. Apply firm pressure and begin rotating the thread former slowly (50 rpm maximum). When the threads engage, allow the thread former to feed without pressure. Thread the osteotomy to the desired depth reference line. Irrigate the site with sterile water or sterile saline and suction to remove any tissue and bone debris that may be left from the drilling procedure. Switch the handpiece to the reverse mode and back the thread former out. Do not pull on the thread former. If desired, the implant site may be threaded by hand by attaching the ratchet assembly to the thread former. If larger implants are to placed, perform the same drilling procedure with the proper implant diameter.

Implant Placement
Remove the implant and carrier from the sterile package. Be careful not to touch the implant. Screw the implant into the prepared site using the implant carrier until the threads engage the bone on the implant. If the implant does not seat to the desired level, remove the implant, place it in a sterile ceramic dish, drill, and thread form to the desired depth by repeating steps 3 and 4 above. Reinsert the implant into the osteotomy. Place the neck portion of the PerioSeal Implant at bone crest. Proper placement of the implant relative to the soft tissue crest will ensure better esthetics and simplicity for restorative procedures.

Healing Cap
Empty the healing cap from the carrier onto a sterile field. Suction implant area to remove any blood left inside the implant. Insert the .050 hex driver into the socket of the healing cap and lock it into place in the implant. To minimize the potential for infection, the clinician may elect to dip the healing screw threads into antibiotic ointment prior to placing it into the implant.

Closure
Close and suture the tissue flap using desired technique. A radiographic check of implant position should be taken at this time for a base line.