Perfect Titanium Implant Internal Hex H2.43

Bone preparation and installation of implants

Tools for bone preparation and installation of implants with a diameter of 4.2; 5.0; 6.0 mm, which is comparable to other systems with a 2.43 mm hexagon socket (Zimmer, Green, Direct, MIS, Alpha Bio, Pal top, Bio Horizon, etc.).

 Preparation of the implant bone bed depends on the type of jawbone, the method of dental implantation and the type of bone drills. The implant site is prepared in a sequential procedure using drills of increasing diameter with depth indicator lines that allow the desired drilling depth to be determined.

Drills should be replaced when their cutting efficiency decreases. 

All bone tissue preparation should be done under copious saline irrigation and using an intermittent drilling technique.

Surgical drills come in cylindrical or conical shapes, with internal and external cooling. When preparing bone, it is necessary to take into account the type, length and diameter of the implant planned for installation, the type and density of the bone, the implantation technique, and the type of planned restoration on implants. 

Drilling protocols with cylindrical drills are considered classic. It is recommended to prepare with cylindrical drills in bone types D1 and D2.

Protocol for dental implantation using cylindrical drills

The use of conical drills

The use of conical drills has advantages over the use of cylindrical drills:

• preparation of bone according to the shape of a conical implant;
• maximum preservation of the amount of bone in the prepared bone bed of the implant;
• obtaining maximum bone-implant contact and good primary fixation, since the prepared bone bed is identical in shape to the implant.

Protocol for dental implantation using conical drills

The use of conical drills has advantages in relation to the use of cylindrical drills in bone D3-D4:

• preparing the bone with counterclockwise rotation (reverse) allows you not to remove the bone, but to compact it.
• bone preparation to the shape of a conical implant;
• maximum preservation of the amount of bone in the prepared bone bed of the implant;
• obtaining maximum bone-implant contact and good primary fixation
  
  
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Implant is installed

The implant is installed using an implant drive key with a 2.1 hexagon. The keys have high edges that help visually determine the position of the implant hexagon. It is recommended to install the flat part of the facet on the vestibular side - this allows the use of standard abutments.

Also, the keys have two circular marks showing the depth of immersion of the upper part of the implant in relation to the bone and the gum-singing mark is 3mm, the second is 5mm. 

After installing the implant and removing the implant carrier, it is necessary to close the internal connection of the implant.

There are several approaches:

1. Two-stage implantation. Installation of the cover screw, which is in the sterile implant kit. Using a 1.25 hex key (431212, etc.), we take a screw from the sterile package and screw the plug into the PERFECT titanium implant and tighten it slightly. Next, we carry out hermetic suturing of the gums over the implant with the plug.

At the second surgical stage (6-8 months after implantation), it is necessary to make an incision in the gum above the implant, lift the gum, remove the closing screw, install the former and suture the wound.   

Prosthetics on implants can begin after 4-6 weeks.

2. Modified two-stage implantation. Installation of an open cover screw (720830, etc.). The screw is made of medical titanium alloy Ti6Al4V ASTM-136. The outer surface is smooth. 

Used for one-time closure of the internal connection of the implant in a modified two-stage implantation. The bottom of the screw has a 1-72 UNF thread that secures the screw to the implant. Sterilization in an autoclave at 135°C/274°F is required before use. There is a 1.25mm hex pin at the top of the screw. The top of the pin is sharp. The length of the pin is from 2mm to 6mm. Used with a 1.25 hollow hex key (431238.) Screw into the titanium implant and lightly tighten it. 

Next, we perform hermetic suturing of the gums over the implant and screw. At the second atraumatic surgical stage, there is no need to make an incision in the gum above the implant, lift the gum and suture the wound.

Using palpation, we find the screw pin and then, using a gum punch (471230) and a 1.25 hollow hex key (431238.), we remove the gum above the implant together with an open cover screw. Implant prosthetics can begin on the day the implant is opened.

3. One-stage implantation. The titanium healing abutment for implants with internal hexagon H2.1mmd is installed on the  implant immediately after the implant is inserted into the bone.

The titanium healing abutment is made of medical titanium alloy Ti6Al4V ASTM-136. Abutment diameter from 3.0 mm to 6.0 mm. The outer surface is smooth.  At the end of the healing abutment there is a hexagonal recess for a hex wrench with a diameter of 1.25 mm (431212, etc.).

At the lower end of the healing abutment there is a screw with a 1-72.UNF thread. Used to cover the internal connection of a titanium implant to form a gingival collar over the implant. The height of the abutment is selected based on the thickness of the gingival margin in each clinical case.

It is recommended: the height of the healing abutment should be higher than the edge of the gum, not less than 1 mm, and the healing abutment should.

4. Immediate loading. After implant placement, standard titanium abutments are installed and a cemented or screwed temporary or permanent restoration is performed.

After installing the abutment, the wound around the implant is sutured.

To carry out immediate loading, certain conditions must be met:

• occlusion balance;
• obtaining primary fixation of at least 45 nm2;
• installation of the implant using the basal implantation method or the bi-cortical implant fixation method;
• installation of an implant with a length of more than 10 mm and a diameter of 3.75 mm or more;
• and also many other factors that require special training at regular DMi courses.
  

For prosthetics on an osteo-integrated implant, removable and non-removable (screw and cemented) restorations are available. Large selection of prosthetic parts for any type of restoration.

Prosthetic details are comparable to other systems with 2.1 mm internal hex and 1-72 UNF internal thread implants.