Surgical Procedures

Surgical Procedures
o
Contents
Introduction 4
Drilling Sequence Overview 5
Standardanddenseboneprotocol 5
Drilling Sequences
OsseoSpeed
™
3.0S 6
OsseoSpeed
™
3.5S 7
OsseoSpeed
™
4.0S 8
OsseoSpeed
™
4.0S–6mm 9
OsseoSpeed
™
4.5 10
OsseoSpeed
™
5.0 11
OsseoSpeed
™
5.0S 12
Implant Surgery 13
Standardprotocolof
OsseoSpeed
™
4.0Sand4.5 14
One-andtwo-stageprocedures 16
Overview and Considerations 17
Pre-operativeprocedures 17
–Pre-operativeexamination 17
–Pre-operativeplanning 17
–Implant-bonerelationship 18
–Loadingguidelines 18
–Surgicalconsiderations 18
Implantoverview 19
Drilloverview 20
Preparation 22
Implant 22
HealingAbutmentandCoverScrew 23
Surgical Tray and Instruments 24
Cleaning and Sterilization Guidelines 25
References supporting Astra Tech Implant System
™
26
Thismanualisdesignedforuseby
clinicianswhohaveundergoneat
leastbasicsurgicalandin-clinic
implanttraining.Stayingcurrent
onthelatesttrendsandtreatment
techniquesinimplantdentistry
throughcontinuededucationisthe
responsibilityoftheclinician.
^
I nTrODuCTI On
X-Small
Function, beauty and biology
in perfect harmony
Our aim is to provide you with the freedom of unlimited possibilities when it
comes to implant therapy. We develop products and solutions to help make your
job as simple as possible but we never compromise when it comes to reliable
long-term esthetics and function. We always respect the body’s own healing
processes and by our holistic approach to implant therapy, refected in the
Astra Tech BioManagement Complex
™
, the result is function, beauty and biology
in perfect harmony.
The Astra Tech Implant System
™
:
• One system for all indications
• Suitable for both one-stage and two-stage surgery
• Designed for immediate and early loading
• One connection in three sizes
• Carrier-free implant installation
• Color-coded packaging
3.0S Small 3.5S 4.0S Large 4.5 5.0 5.0S
'
Drilling Sequence Overview
OsseoSpeed
™
3.5 S
OsseoSpeed
™
4.0 S
OsseoSpeed
™
5.0
OsseoSpeed
™
5.0 S
OsseoSpeed
™
4.5
OsseoSpeed
™
3.0 S
OsseoSpeed
™
Implants Drilling protocol – standard Drilling protocol – dense bone
Guide
Drill
Twist
Drill
2.0
●
Twist
Drill
2.7
Guide
Drill
Twist
Drill
2.0
●
Twist
Drill
3.2
Guide
Drill
Twist
Drill
2.0
●
Twist
Drill
3.2
●
Twist
Drill
3.7
Guide
Drill
Twist
Drill
2.0
●
Twist
Drill
3.2
●
Conical
Drill
4.5
Guide
Drill
Twist
Drill
2.0
●
Twist
Drill
3.2
●
Twist
Drill
3.7
●
Conical
Drill
5.0
Guide
Drill
Twist
Drill
2.0
●
Twist
Drill
3.2
●
Twist
Drill
3.7
●
Twist
Drill
4.2
●
Twist
Drill
4.7
Guide
Drill
Twist
Drill
2.0
●
Twist
Drill
2.7
●
Cortical
Drill
3.0
●
Twist
Drill
2.85
Guide
Drill
Twist
Drill
2.0
●
Twist
Drill
3.2
●
Cortical
Drill
3.5
●
Twist
Drill
3.35
Guide
Drill
Twist
Drill
2.0
●
Twist
Drill
3.2
●
Twist
Drill
3.7
●
Cortical
Drill
4.0
●
Twist
Drill
3.85
Guide
Drill
Twist
Drill
2.0
●
Twist
Drill
3.2
●
Conical
Drill
4.5
●
Twist
Drill
3.35
Guide
Drill
Twist
Drill
2.0
●
Twist
Drill
3.2
●
Twist
Drill
3.7
●
Conical
Drill
5.0
●
Twist
Drill
3.85
Guide
Drill
Twist
Drill
2.0
●
Twist
Drill
3.2
●
Twist
Drill
3.7
●
Twist
Drill
4.2
●
Twist
Drill
4.7
●
Cortical
Drill
5.0
●
Twist
Drill
4.85
DrI LLI nG SequenCe OvervI ew
Standard and dense bone protocol
c
Guide
Drill
Twist
Drill
2.7
Twist
Drill
2.85
Twist
Drill
2.0
Optional drill
Cortical
Drill
3.0
PilotDrillisavailableas
anoptionalstepwithin
thedrillingsequence.
Ø2.0/2.7mm
OsseoSpeed
™
3.0S
13mm
Drilling protocol – standard
Drilling protocol – dense bone
Guide
Drill
Twist
Drill
2.7
Twist
Drill
2.0
OsseoSpeed
™
3.0S
13mm
OsseoSpeed
™
3.0 S
Drilling Sequences
DrI LLI nG SequenCeS
OsseoSpeed
™
3.0 S
.
Guide
Drill
Twist
Drill
3.2
Twist
Drill
2.0
OsseoSpeed
™
3.5S
13mm
Optional drill
PilotDrillisavailableas
anoptionalstepwithin
thedrillingsequence.
Ø2.0/3.2mm
Guide
Drill
Twist
Drill
3.2
Cortical
Drill
3.5
Twist
Drill
2.0
Twist
Drill
3.35
OsseoSpeed
™
3.5S
13mm
OsseoSpeed
™
3.5 S
Drilling Sequences
DrI LLI nG SequenCeS
OsseoSpeed
™
3.5 S
Drilling protocol – standard
Drilling protocol – dense bone
o
Guide
Drill
Twist
Drill
3.2
Twist
Drill
3.7
Twist
Drill
2.0
Twist
Drill
3.85
OsseoSpeed
™
4.0S
13mm
Drilling protocol – standard
Guide
Drill
Twist
Drill
3.2
Twist
Drill
2.0
OsseoSpeed
™
4.0S
13mm
Drilling protocol – dense bone
Twist
Drill
3.7
Cortical
Drill
4.0
OsseoSpeed
™
4.0 S
Drilling Sequences
DrI LLI nG SequenCeS
OsseoSpeed
™
4.0 S
Optional drills
PilotDrillsareavailable
asanoptionalstepwithin
thedrillingsequence.
Ø2.0/3.2mm
Ø3.2/3.7mm
'
Guide
Drill
Twist
Drill
3.2
Twist
Drill
2.0
OsseoSpeed
™
4.0S
6mm
Drilling protocol – dense bone
Twist
Drill
3.7
Guide
Drill
Twist
Drill
3.2
Cortical
Drill
4.0
Twist
Drill
2.0
OsseoSpeed
™
4.0S
6mm
Twist
Drill
3.85
Twist
Drill
3.7
OsseoSpeed
™
4.0 S – 6 mm
Drilling Sequences
DrI LLI nG SequenCeS
OsseoSpeed
™
4.0 S – 6 mm
Drilling protocol – standard Optional drill
PilotDrillisavailableas
anoptionalstepwithin
thedrillingsequence.
Ø2.0/3.2mm
0
Drilling protocol – standard
Drilling protocol – dense bone
Guide
Drill
Twist
Drill
3.2
Twist
Drill
2.0
OsseoSpeed
™
4.5S
13mm
Conical
Drill
4.5
Guide
Drill
Twist
Drill
3.2
Conical
Drill
4.5
Twist
Drill
2.0
Twist
Drill
3.35
OsseoSpeed
™
4.5S
13mm
OsseoSpeed
™
4.5
Drilling Sequences
DrI LLI nG SequenCeS
OsseoSpeed
™
4.5
Optional drill
PilotDrillisavailableas
anoptionalstepwithin
thedrillingsequence.
Ø2.0/3.2mm

Guide
Drill
Twist
Drill
3.2
Conical
Drill
5.0
Twist
Drill
2.0
Twist
Drill
3.85
OsseoSpeed
™
5.0
13mm
Optional drills
PilotDrillsareavailable
asanoptionalstepwithin
thedrillingsequence.
Ø2.0/3.2mm
Ø3.2/3.7mm
Twist
Drill
3.7
Guide
Drill
Twist
Drill
3.2
Twist
Drill
2.0
OsseoSpeed
™
5.0
13mm
Conical
Drill
5.0
Twist
Drill
3.7
OsseoSpeed
™
5.0
Drilling Sequences
DrI LLI nG SequenCeS
OsseoSpeed
™
5.0
Drilling protocol – standard
Drilling protocol – dense bone
2
Optional drills
PilotDrillsare
availableasan
optionalstep
withinthedrilling
sequence.
Ø2.0/3.2mm
Ø3.2/3.7mm
Ø3.7/4.2mm
Drilling protocol – standard
Drilling protocol – dense bone
Guide
Drill
Twist
Drill
3.2
Twist
Drill
2.0
OsseoSpeed
™
5.0S
13mm
Twist
Drill
4.2
Twist
Drill
4.7
Twist
Drill
3.7
Guide
Drill
Twist
Drill
3.2
Twist
Drill
2.0
Twist
Drill
4.85
OsseoSpeed
™
5.0S
13mm
Twist
Drill
4.7
Twist
Drill
4.2
Cortical
Drill
5.0
Twist
Drill
3.7
OsseoSpeed
™
5.0 S
Drilling Sequences
DrI LLI nG SequenCeS
OsseoSpeed
™
5.0 S
13
Guide Drill
Markouttheplannedpositionoftheimplantsite(s).Thiswillalso
providevaluableinformationaboutthebonequality.
(useofanacrylicstentshownhere)
Twist Drill 2.0
Drillintheplanneddirectiontotheappropriatedepth.
Note:Depthshouldallowimplanttobelevelorslightlysubmerged
inrelationtoadjacentmarginalbone.
PlaceDirectionIndicator(s)inthesite(s)tofacilitatethedirectionof
thesubsequentdrilling.
3.5
mm
4.5
mm
4.0
mm
4.0
mm
Standard Protocol for Implant Installation
Step-by-stepproceduresforplacementofOsseoSpeed
™
4.0S
and4.5,13mm
regardlessofthepre-operativeplanningandchoiceofsurgicalprotocol,thetreatment
withdentalimplantsincludesasitepreparationandinstallationoftheimplant.The
followingisageneraloverviewofastandardimplantsitepreparationwithraised
mucosalfapsfortheinstallationofAstraTechOsseoSpeed
™
implants4.0Sand4.5.
Note:Alldrillingshouldbeperformedataspeedof1500rpmandunderprofuse
irrigation.
I MPLAnT SurGery
Standard protocol for a 4.0 S and 4.5 implant
Twist Drill 3.2
Drilltheimplantsite(s)toappropriatedepth.
14
Conical Drill 4.5
Finalizetheosteotomyforthe
OsseoSpeed
™
4.5implant.
Insoftbone:drilltothebeginning
ofthedepthindicationline.
Indenseandthickcorticalbone:drillto
thefulldepthofthedepthindicationline.
Makesurethereisenoughdepthprovidedfortheentireimplant.
Sometimesadditionaldrillingwithatwistdrillisneeded.Always
measurethedepthusingtheImplantDepthGauge.
Implant Depth Gauge
Itisimportanttoverifythedrillingdepthafterthedrillingwiththe
ConicalDrilliscompleted.PlacetheDepthGaugeagainstthe
walloftheosteotomytoverifythedrillingdepth.
Implant Installation – OsseoSpeed
™
4.5
Installtheimplantwithacontraangleatlowspeed(25rpm)
underprofuseirrigation.Setthemaximumtorqueto35ncm.
Lettheimplantworkitsownwayintotheosteotomyandavoid
applyingunnecessarypressure.
I MPLAnT SurGery
Standard protocol for a 4.0 S and 4.5 implant
Implant Installation continue
Theratchetwrench,incombinationwiththeDriverHandle,may
beusedforthefnalmanualseatingoftheimplant.
uselightfngerforcewhenlevelingtheimplant.excessiveforce
withtheratchetwrenchmustbeavoidedasthiswillcausetoo
muchcompressioninthebone.Atoohightorqueindicatesthat
theimplantneedstoberetrievedtofacilitateadditionaldrilling.
Softbone
Densebone
15
Positioning the Implant
Positiontheimplantatthemarginalbonelevelorslightlybelow.
Theobjectiveistogettheimplantincontactwithasmuchcortical
boneaspossible.
PositiononeofthefatsurfacesoftheImplantDriverbuccally
tofacilitateoptionalplacementofthechosenabutment.This
especiallyappliestopre-designedabutments,suchasTiDesign
™
.
releasetheImplantDriverfromtheimplantbyshiftingitslightly
fromsidetoside.
Twist Drill 3.7 – for OsseoSpeed
™
4.0 S
useaTwistDrill3.7tofnalizetheosteotomyforan
OsseoSpeed
™
4.0Simplant.
Implant Installation – OsseoSpeed
™
4.0 S
Installtheimplantwithacontraangleatlowspeed(25rpm)
underprofuseirrigation.Setthemaximumtorqueto35ncm.
Lettheimplantworkitsownwayintotheosteotomyandavoid
applyingunnecessarypressure.
I MPLAnT SurGery
Standard protocol for a 4.0 S and 4.5 implant
16
I MPLAnT SurGery
One- and two-stage procedures
Two-stage procedure
Installation of Cover Screw
InserttheCoverScrewintotheimplantandtightenwithonlylight
fngerforce(5–10ncm)orwithacontraanglepresetat25rpm.
repositionthemucoperiostealfapscarefullyandsuturetightly
together.
Two-stage procedure
Installation of abutment
exposetheCoverScrewandremovewithahexscrewdriver.
Installtheselectedabutmentintotheimplant.
For abutment selection and details, please refer to
Cement-, Screw- or Attachment-retained manuals.
One-stage procedure
Healing Abutment
usinglightfngerforce(5–10ncm),seattheHealingAbutments.
Itremainsinplaceduringthesofttissuehealingphaseandshould
thenbereplacedbyapermanentabutment.
Adaptandsuturebackthesofttissuefapsforatightsealaround
theabutments.
One-stage procedure
Temporary or permanent abutment
Optional:
Aone-stagesurgicalproceduremayincludeatemporary
prostheticrestorationattachedtoatemporaryorpermanent
abutments.
.
OvervI ew AnD COnSI DerATI OnS
Pre-operative procedures
Pre-operative Procedures
Pre-operative examination
The pre-operative examination should include a general evaluation of the patient's health
and a clinical and oral radiographic examination. Particular attention should be given
to mucous membranes, jaw morphology, dental and prosthetic history, and signs of
dysfunction.
A radiographic analysis should be used to evaluate bone quality and the topography
of the residual alveolar process. The initial radiographic evaluation, together with the
clinical examination, is the basis for determining whether or not a patient is a candidate
for implant treatment.
If the patient is found to be suitable, a more thorough clinical examination of the area for
treatment and the opposing jaw should be performed. Any local pathology in the jaws
should be treated before implant placement.
Pre-operative planning
Models from both jaws should be mounted on an articulator and the relationship between
the alveolar ridges and teeth studied. A diagnostic wax-up, replacing the missing teeth,
should be made on the model.
An analysis to evaluate the occlusal table, force distribution, and preferred
sites for the implants should then be performed. When an optimal
situation is achieved on the articulator, a duplicate model of the
wax-up should be fabricated and an acrylic stent produced from
this model. The stent should then be used during implant
installation to guide the placement of the implants in terms of
both position and inclination, taking into account the anatomical,
functional, esthetic, hygienic, and phonetic factors.
A transparent Radiographic Guide, presenting implants in different
magnifications, is helpful for planning optimal implant position and
direction.
A Computer Guided Implant Treatment software such as Facilitate
™
can
also be helpful in order to ensure accurate planning for optimized implant
position and placement. For more information see the Facilitate
™
Procedures
Manual.
Even though the final treatment approach is usually not determined until the time of
surgery the following should be considered based on the quality of supporting bone
and initial stability of the implants:
• Whether a one- or two-stage surgical procedure will be preformed
• If an immediate or early loading protocol will be used
• What is the expected healing time before loading
Before treatment begins, the patient should be informed about the results of the pre-
operative examination and given a clear explanation of what is entailed by the planned
treatment, including the expected outcome and risks involved.
o
OvervI ew AnD COnSI DerATI OnS
Pre-operative procedures
Implant-bone relationship
Factors influencing the implant-bone relationship are:
• Bone quantity
• Bone quality
• Diameter of the drilled implant site
• Depth of the drilled implant site
The implant site must be prepared in such a way that:
• The installed implant can achieve primary stability
• No harmful stress to the bone is induced during implant placement
Limited vertical dimension of bone for implant support may be compensated for by an increased
implant diameter, provided that sufficient bone support around the implant is present. Optimal
bone support can be additionally gained through the use of OsseoSpeed
™
implants. The surgical
methods, together with prosthetic flexibility for different implant positions, can often compensate
for reduced bone quantity.
When bone quality and quantity are compromised, the utilization of osteotome techniques can help
to improve the conditions for implant placement.
Loading guidelines
A three-month healing period in the mandible and a six-month healing period in the maxilla before
loading were originally advocated for implants. Extensive research and product development have
shown that reduced healing times can be applied which has been documented in numerous clinical
studies. However, when a shorter healing time before loading is being considered, the assessment
must always be based on the individual clinical situation.
Bone quality and quantity, design of superstructure, loading conditions, and primary stability
achieved, should be carefully examined and assessed.
Immediate loading protocol may be utilized when:
• Good primary stability can be achieved
• There is no risk of traumatic loading
• A one-stage protocol can be recommended
• There is no need for grafting procedures in close relation to implant surgery
Early loading protocol
When these prerequisites cannot be met, an early loading protocol (six weeks or more healing
period) may be considered. It is the responsibility of the clinician to determine which loading
protocol to use based on each invidividual case.
Surgical considerations
Supported by Computer Guided Surgery the implant installation is sometimes performed without
flaps being raised. This reduced surgical intervention is reported to give less postoperative swelling
and pain than the regular surgical protocol with incision and flap elevation, however it must be
stressed that there is no documentation available evaluating risks for surgical errors and other
complications using this method. It is up to the discretion and responsibility of each individual
clinician which surgical approach to choose.
'
Implant overview
The OsseoSpeed
™
implants have been developed and extensively documented for
both one- and two-stage surgical procedures.
Intended use
• In replacing missing teeth in single or multiple unit applications within the
mandible or maxilla
• Indicated for immediate placement in extraction sites, partially or completely
healed alveolar ridge situations
• Especially indicated for use in soft bone applications where implants with other
implant surface treatments may be less effective
• Suitable for immediate loading* in all indications, except in single tooth
situations in soft bone (type IV) where implant stability may be difficult to
obtain and immediate loading may not be appropriate
* Immediate loading of single-tooth restoration is not recommended for OsseoSpeed
™

Implant 4.0 S – 6 mm
It is important that the clinician takes local loading conditions into consideration
when determining the number and spacing of short implants. Considering the
reduced bone support provided by short implants, it is important for the purpose
of early diagnosis and treatment that the clinician closely monitor soft tissue and
supporting bone health status by means of probing and radiographic evaluation.
3.0 S 3.5 S 4.0 S 4.5 5.0 5.0 S
Forreplacmentof
maxillarylaterals
andmandibular
centralandlateral
incisorswhenthere
isnotenoughspace
forawiderimplant.
Inallpositionsin
thejaws.
Singletoothtofull
arch.
Inallpositionsin
thejaws.
Singletoothtofull
arch.
Inallpositionsin
thejaws.
Singletoothtofull
arch.
Inallpositionsin
thejaws.
Singletoothtofull
arch.
Inallpositionsin
thejaws.especially
indicatedfor
wideridgesand
largeedentulous
spacesandfor
increasedstability
inextraction
socketswhendoing
immediateimplant
installation
Singletoothtofull
arch.
Itisrecommended
thatwhenpossible,
awiderimplant
shouldbeused.
OsseoSpeed
4.0Simplant
–6mmshould
onlybeusedwhen
thereisnotenough
spaceforalonger
implant.Immediate
loadinginsingle
toothreplacementis
notrecommended.
3.0mm
2.7mm
3.5mm
3.5mm
4.0mm
4.0mm
4.5mm
3.5mm
5.0mm
4.0mm
5.0mm
5.0mm
OsseoSpeed
™

Implant
Indications
Note
OvervI ew AnD COnSI DerATI OnS
Implant overview
20
Drill Overview
Implant sites are prepared in a step-by-step procedure using drills of different
diameters to ensure an efficient and atraumatic widening of the implant site. All
drilling of the bone tissue should be carried out under profuse irrigation with
saline solution and with an intermittent drilling technique to prevent heating of
the bone and to create a pumping effect for efficient removal of bone tissue.All
Astra Tech drills have laseretched depth indication lines that allow for distinct
and clear depth reading.
Drills are available in two options:
Single Patient Drills
• Packaged sterile and opened as needed at time of surgery
• Optimized cutting properties and contamination-free ease of use
• Disposed of after each surgery
Note: Not available for OsseoSpeed
™
3.0 S.
Multiple-use Drills
• Optimal cutting properties
• Designed for multiple-use provided that they are carefully cleaned and
sterilized after each surgery
Must be replaced as needed to ensure optimal cutting properties for each
surgery. Not available for OsseoSpeed
™
4.0 S – 6 mm.
Drilling depth
The drilling depth is measured from the widest part of the drill tip up to the
indication line. For Single Patient Drills, the additional depth is 0.9 mm regardless
of drill diameter. For Multiple-use Drills, the additional depth or tip height
created by the point of the drill is 0.6 to 1.45 mm, depending on the diameter and
type of drill.
+0.9
Measurementsshowninmillimeters.
2.0 3.2 3.35 3.7 3.85 4.2 4.7 4.85
+0.6+0.9+0.95+1.05+1.1+1.25+1.4+1.45
8mm
11mm
13mm
15mm
17mm
19mm
9mm
8mm
9mm
6mm
11mm
13mm
11mm
13mm
8mm
9mm
OvervI ew AnD COnSI DerATI OnS
Drill Overview
TwistDrilllong,8–19mm
TwistDrillshort,8–13mm
TwistDrill,6–13mm
2
Drill types
There are five basic drill types:
Guide Drill
To mark out and create the insertion point.
Twist Drill
To prepare the installation site, reaching final width and depth.
Pilot Drill
Optional drill to guide succeeding with twist drills, e.g. suitable to facilitate
soft bone situation.
Cortical Drill
Optional drill for cervical preparation for OsseoSpeed
™
3.0 S, 3.5 S, 4.0 S and
5.0 S implants when the cortical bone is dense. Used to enlarge the opening of
an implant site to the exact implant diameter to reduce the pressure in the bone
around the implant neck.
Conical Drill
The apical boarder of the indication line indicates the minimum depth needed
to fit the implant. The recommendation is to drill to this depth in soft bone.
When the cortical bone is dense and thick the recommendation is to drill to the
marginal border of the depth indication line. Make sure there is enough depth
provided for the entire implant. Sometimes additional drilling with a twist
drill is needed. Always make a check-up with the Implant Depth Gauge.
Implant Depth Gauge
The depth indications on the Implant Depth Gauge
correspond to the laser markings on the Twist Drills
for the different implant lengths. A waist is available
on the depth gauge to facilitate the identification of the
13–15 mm indication band. The lower part of the gauge
has indications for 2–3, 4–5 mms and can be used for
measuring soft tissue height.
When measuring the final prepared implant site, rest the
depth gauge against the wall of the osteotomy.
Note: If the gauge is placed in the deeper central part of
the prepared implant site, the additional depth should be
taken into account.
OvervI ew AnD COnSI DerATI OnS
Drill Overview
22
Color-coding
Foreasyidentifcationoftheimplant-abutmentconnectionsizethe
productpackagingiscolor-coded:
yellow=X-small
Aqua=Small
Lilac=Large
Peel off
Peelofftheperforatedsectionofthelabelanduseitfor
documentationand/orcommunicationwithyourrestorative
partner.
Open
Slidethesterileinnercontainerontoasterilesurgicalarea.
Liftthecaptoexposetheimplant.
Pick up
AttachtheappropriateImplantDrivertotheContraAngle.
Tiltthecontainersothattheimplantrestsagainstthecontainer
wall.
Makesurethatthedriverisproperlyseated.Pickuptheimplant
fromtheinnercontainer.
PrePArATI On
Implant
23
Preparation of the Healing Abutment and Cover Screws
HealingAbutmentsaswellasCoverScrewsandothersterile
abutmentsarepackedinthesametypeofcontainerasimplants,
withcolor-codedlabelsthatindicatetheimplant-abutment
connectionsize.Theyaremountedinaconvenientplasticinsert
fordirectaccesswithaHexScrewdriver.
Open
Peelofftheperforatedsectionofthelabelanduseitfor
documentationand/orcommunicationwithyourrestorative
partner.Openthecontainerandslidethesterileinnerinsertonto
asterilesurgicalarea.
Lift out
SplittheinsertopenandliftouttheHealingAbutmentor
CoverScrew.
Connect
HoldtheinnerinsertsteadyandconnecttheHexScrewdriverto
theHealingAbutmentortheCoverScrewwithafrictionft.
PrePArATI On
Healing Abutment and Cover Screw
2^
BoneTrap
™
isthe
idealcollectorforharvesting
boneparticlesduringsurgery.The
uniquedesignoftheflterallowsforeffcient
collectionofboneparticleswithoutclogging.
TrAy AnD I nSTruMenTS
SinglePatientDrillsprovidetheidealsurgicalsituation
foreachindividualpatientandgiveyoutheconfdence
ofpredictablysharpdrillseverytime.
Surgical Tray and Instruments
The Astra Tech Surgical Tray is designed to conveniently and easily manage the required
drills, instruments, and implants for surgery. Whether a standard protocol or protocol for
sites with dense bone is planned, the layout of the tray easily accommodates both options
and navigates the surgeon through the drilling progression.
Acompletelineofinstruments
anddrillsneededforthesurgical
procduresareavailable.
2'
CLeAnI nG AnD STerLI ZATI On
wrenchHead
Shaft
Calibrator
Spring
Calibrator
Torquerod
Cleaning and Sterilization Guidelines
Drills
AstraTechprovidesMultiple-useandSinglePatientDrills.
• DisposeoftheSinglePatientDrillsintoasharpscontainer
immediatelyaftertheimplantprocedureiscompleted
•Do not sterilizetheSinglePatientDrills
•reusabledrillsaredesignedtobecleaned,disinfected,placed
backinthetrayandsterilizedaftereachuse
Instruments, Multiple-use Drills and trays
Choosebetweenthefollowingtwocleaningtechniques
Cleaning technique 1:
• CleanMultiple-useDrillsandinstrumentsandthenuseanultrasonic
cleanertoensureallthedebrisisremoved.rinsethoroughly
Cleaning technique 2:
• CleananddisinfectallMultiple-useDrills,instrumentsandtrayswithin
aspeciallydesigned instrumentprocedure
Sterilization
• ThoroughlydryMultiple-useDrills,instrumentsandtraysbefore
thesterilizationprocesstopreventpossiblecorrosionofthemetal
components
• SteamsterilizeMultiple-useDrills,instrumentsandtraysusing
anautoclavein134°C/273°Ffor3minutes(pleasereferto
manufacturer’sinstructions)
Note:ensurethatboththeratchetwrenchand/orcombination
Torquewrenchisdismantledbeforethecleaningandsterilization
process.
Contra Angle
Choosebetweenthefollowingtwocleaningtechniques
(pleaserefertomanufacturer’sinstructions).
Cleaning technique 1:
•Disassemblethecontraangle
•Cleanwithasoftbrushundercoldrunningwaterorinadishwasher
•Thoroughlydrythecontraangle
•Lubricatethecontraangleaccordingtothemanufacturer’sinstruction
Cleaning technique 2:
•Cleanandlubricateinanautomaticunitforcontraangles
Sterilization
•Steamsterilizethedisassembledcontraangle
2c
reFerenCeS
One- and two-stage surgery
Stanford,C.,etal.
Outcomesofafuoridemodifedimplantoneyear
afterloadingintheposterior-maxillawhenplaced
withtheosteotomesurgicaltechnique.
ApplOsseointegrationres2006;5:50-55
Cecchinato,D.,etal.
Submergedornon-submergedhealingofendosseous
implantstobeusedintherehabilitationofpartially
dentatepatients.
JClinPeriodontol2004;31:299-308
Cecchinato,D.etal.
Bonelevelalterationsatimplantsplacedinthe
posteriorsegmentsofthedentition:outcomeof
submerged/non-submergedhealing.A5-year
multicenter,randomized,controlledclinicaltrial.
ClinOralImplantsres2008;19(4):429-31
Abrahamsson,I.,etal.
Peri-implanttissuesatsubmergedandnonsubmerged
titaniumimplants.
JClinPeriodontol1999;26:600-607
Immediate placement/extraction sockets
DeKok,I.J.,etal.
Aretrospectiveanalysisofperi-implanttissue
responsesatlmmediateLoad/provisionalized
microthreadedimplants.
IntJOralMaxillofacImplants2006;21(3):405-12
Oxby,G.,etal.
earlyloadingofAstraTechOsseoSpeedimplants
placedinthinalveolarridgesandfreshextraction
sockets.ApplOsseointegrationres2006;5:68-72.
norton,M.andwilson,J.
Dentalimplantsplacedinextractionsitesimplanted
withbioactiveglass:humanhistologyandclinical
outcome.
IntJOralMaxillofacImplants2002;17(2):245-57
Immediate and early loading
Cooper,L.,etal.
Immediatemandibularrehabilitationwithendosseous
implants:simultaneousextraction,implantplacement,
andloading.
IntJOralMaxillofacImpl,2002;17(4):517-525
Cooper,L.,etal.
AMulticenter12-monthevaluationofsingle-tooth
implantsrestored3weeksafter1-stagesurgery.
IntJOralMaxillofacImplants2001;16(2):182-92.
Cooper,L.,etal.
Three-yearevaluationofsingletoothimplants
restored3weeksafter1-stagesurgery.
IntJOralMaxillofacImplants2007;22(5):791-800
Donati,M.,etal.
Immediatefunctionalloadingofimplantsinsingle
toothreplacement.Aprospectiveclinicalmulticenter
study.Acceptedforpublication2007inClinOral
Implantsres;inpressAugust2008.
norton,M.
Ashort-termclinicalevaluationofimmediately
restoredmaxillaryTiOblastsingle-toothimplants.
IntJOralMaxillofacImplants2004;19(2):274-81
Collaert,B.,andDeBruyn,H.
earlyloadingoffourorfveAstraTechfxtureswitha
fxedcross-archrestorationinthemandible.
ClinImplDentrelres2002;4(3):133-35.
Berglundh,T.,etal.
Bonehealingatimplantswithafuoride-modifed
surface:anexperimentalstudyindogs.
ClinOralImplres2007;18:147-52
References supporting the Astra Tech Implant System
™
AstraTechAB,P.O.Box14,Se-43121Mölndal,Sweden.Tel:+46317763000.Fax:+46317763010.www.astratechdental.com
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Asuccessfulimplantsystemcannotbedeterminedbyonesinglefeature
alone.Justasinnature,theremustbeseveralinterdependentfeatures
workingtogether.Thefollowingcombinationofkeyfeaturesis
uniquetoAstraTechImplantSystem
™
:
• OsseoSpeed
™
— morebonemorerapidly
• MicroThread
™
— biomechanicalbonestimulation
• Conical Seal Design
™
— astrongandstableft
• Connective Contour
™
— increasedsofttissuecontact
zoneandvolume
OsseoSpeed
™

MicroThread
™
Conical Seal Design
™
Connective Contour
™
Astra Tech BioManagement Complex
™

Australia
AstraTechPtyLtd.
Suite1,53GrandviewSt,PymblenSw2073
Tel:+61294883500.Fax:+61294400744
www.astratechdental.com.au
Austria
AstraTechGesmbH
SchloßhoferStraße4/4/19,AT-1210wien
Tel:+43-(0)1-2146150.Fax:+43-(0)1-2146167
www.astratechdental.at
Benelux
AstraTechBeneluxB.v.
Signaalrood55,nL-2718SGZoetermeer
Tel:+31793601955/+3232328150
Fax:+31793623748/+3232133066
www.astratechdental.nl
Canada
AstraTechInc.
2425MathesonBlvdeast,8thFloor
Mississauga,OnL4w5K4
Tel:+19053612844
www.astratechdental.com
Denmark
AstraTechA/S
HusbyAllé19,DK- 2630Taastrup
Tel:+4543713377.Fax:+4543717865
www.astratechdental.dk
Finland
AstraTechOy
PL96,FI - 02231espoo
Tel:+358986761626.Fax:+35898044128
www.astratechdental.fi
France
AstraTechFrance
7,rueeugèneetArmandPeugeot,TSA90002
Fr- 92563rueilMalmaisonCedex
Tel:+33141390240.Fax:+33141390244
www.astratech.fr
Germany
AstraTechGmbH
AnderkleinenSeite8.De-65604elz
Tel:+49643198690.Fax:+4964319869500
www.astratechdental.de
Italy
AstraTechS.p.A.
viaCristoni,86,IT- 40033Casalecchiodireno(BO)
Tel:+390512987511.Fax:+390512987580
www.astratechdental.it
Japan
AstraTechK.K.
1-7-16Sendagaya,Shibuya-ku,Tokyo151-0051
Tel:+81357750515.Fax:+81357750571
www.astratech.jp
Norway
AstraTechAS
Postboks160,nO-1471Lørenskog
Tel:+4767920550.Fax:+4767920560
www.astratechdental.no
Poland
AstraTechSp.zo.o.
ul.Orężna58,PL- 02-937warszawa
Tel:+48228536706.Fax:+48228536710
www.astratechdental.com
Spain
AstraTechS.A.
CalleCienciasnº73derecha.nave9,
PolígonoIndustrialPedrosa,
eS- 08908L´HospitaletdeLlobregat
Tel.Servicioalcliente:+34.902.101.558
Tel:+34.932.643.560.Fax:+34.933.363.231
www.astratechdental.es
Sweden
AstraTechAB
P.O.Box14,Se-43121Mölndal
Tel:+46317763000.Fax:+46317763017
www.astratechdental.se
Switzerland
AstraTechSA
AvenuedeSévelin18,P.O.Box54
CH-1000Lausanne20
Tel:+41216200230.Fax:+41216200231
www.astratech.ch
United Kingdom
AstraTechLtd.
Brunelway,Stonehouse,GlosGL103SX
Tel:+441453791763.Fax:+441453791001
www.astratechdental.co.uk
USA
AstraTechInc.
890winterStreet,waltham,MA02451
Tel:+1- 800- 531- 3481.Fax:+1- 781- 890- 6808
www.astratechdental.com
Other Markets
AstraTechAB,exportDepartment
P.O.Box14,Se- 43121Mölndal,Sweden
Tel:+46317763000.Fax:+46317763023
www.astratechdental.com P
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