Surgical Set Conical Drills with Stopper

Surgical Set Conical Drills with Stopper

Before using DMi Instrument, the dentist/oral maxillofacial surgeon must carefully study the indications, contraindications, recommendations, warnings and instructions, as well as all other product-specific information (product description, description surgical and reconstructive equipment, catalog, etc.) and fully included communicate with them. DMi also recommends visiting our corresponding refresher courses managed on site and remotely by authorized DMi specialists. Above mentioned documents and training details courses can be obtained from the relevant representatives in different countries and on the company website: www.dmimplant.online

Product Description

It has the necessary instruments for the surgical stage of implantation:

- Pilot Drill with a diameter of 1.5 mm (401715)
- Marking Bur (403419)
- 6 Conical Drills (2.0 / 2.4 mm; 2.4 / 2.8 mm; 2.8 / 3.2 mm; 3.2 / 3.65 mm; 3.6 / 4.0 mm; 4.0 / 5.3 mm) with external cooling and a locking device
- Allen Key with 2.43 mm "standard platform" (431825 - long manual)
- Allen Key with  H2.1 mm "narrow platform" (431821 - long manual)
- Allen key with  1.27 mm for screws (431412 - long manual)
- Drill Extension (431701)
- 6 Stoppers for Drills 5 mm, 6 mm, 7 mm, 8 mm, 10 mm, 11.5 mm long
- Universal Torque Wrench "Ratchet" (446302)

Intended use, indications for use

The Surgical Set conical drills with stopper is designed to prepare the bone bed and install two-stage conical dental implants. It is used for implants of standard and narrow diameters from 8 to 16 mm long and from 3.0 to 6.0 mm in diameter of the DMi system (UTI; PFTI; UMI; PMI). The instruments for bone preparation and implant installation are comparable with other systems with an internal hexagon of 2.1 mm and 2.43 mm (Green, Zimmer, Direct, Mis, Alpha bio, Pal top, Bio Horizon, Cortex, AB, etc.).

Advantages

The use of drills with stoppers allows you to exclude:

- Incorrect shaping of the bone bed of the implant
- Injury to important anatomical structures (mandibular nerve, etc.)

Contradictions

Surgical kit with stoppers is not used for installation of implants:

- one-piece implant,
- zygoma implant

Procedure for use

1. Prepare a surgical kit with stoppers.
2. Check that all the instruments are in the kit.
3. Check the sharpness of all the drills.
4. Clean according to the generally accepted method:
    - Soak in a solution of 3-6% hydrogen peroxide for 20 minutes.
    - Rinse in running distilled water for 3-5 minutes.
    - Ultrasonic cleaning in distilled water at a temperature of 60-70 degrees Celsius for 20-30 minutes.
    - Soak in a special disinfectant solution for medical institutions for 30 minutes.
    - Rinse in running distilled water for 3-5 minutes and drying.
5. Autoclave sterilization:
    - Surgical kits with instruments are sterilized by steam.
    - The sterilizing agent is saturated water vapor under excess pressure of 0.05 MPa (0.5 kgf/cm2) - 0.21 MPa (2.1 kgf/cm2) (1.1-2.0 bar) with a temperature of 135 °C / 274 °F.
    - A full cycle from 15 to 180 minutes.

Bone preparation operation for implant insertion

Surgical set with stoppers is a set of instruments for bone preparation and installation of implants with internal connection of 2.1mmd and 2.43mmd and implant diameter of 3.0; 3.3; 3.75; 4.2; 5.0; 6.0; mm, which is comparable with other systems with hexagonal socket H2.1 mm and H2.43 mm (Zimmer, Green, Direct, MIS, Alpha Bio, Pal top, Bio Horizon, etc.).

Preparation of the bed for the bone implant depends on the type and volume of the jaw bone, the method of dental implantation and the type of bone drills. The implant bed is prepared sequentially using drills of increasing diameter with indicator lines to determine the required drilling depth or using drill stops. All bone tissue preparation should be done with copious cooling of the drill and jawbone with sterile and cold saline and using the intermittent drilling technique. Intermittent drilling technique: the drill enters the bone and goes 2-3 mm into the bone. Then you make the opposite movement - the drill comes out of the bone. The cut bone comes out of the bone hole together with the drill, it must be removed with suction. Then the process is repeated until the planned drilling depth and diameter are obtained.

Drilling sequence

Mark the bone with a spherical bur (173419) to a depth of 2–3 mm. Then prepare the bone with a pilot drill (401715) or a 2 mm drill (401724, etc.). After preparation with a 2/2.4 mm drill (401524) to a depth of 8 mm, it is necessary to install a titanium depth gauge and, in parallel with it, perform an X-ray examination in the prepared hole - a periapical (target) or panoramic image. (Titanium depth gauge (451630) and shortened titanium depth gauge (451030) for determining the depth and parallelism of implant bone preparation during surgery. Considering that the thread pitch on the gauge is 1 mm, it is possible to determine with high accuracy how far we are from the nerve trunk, tooth, etc., and also to determine how parallel the drilling is compared to the teeth, implants, etc. And only after this is further preparation of the implant bone bed carried out. If you need to install several implants. It is recommended to maintain a minimum distance of 3.5 mm from each implant to the next. At the drilling stage, it is necessary to constantly inspect and examine the bone hole or socket of the extracted tooth. For this, use the implant bone depth gauge (450001), which is a pen with a double-sided working part. It is made of stainless steel. There are notches on the working part indicating the depth of drilling into the implant bone bed. The first notch is 8 mm, then 10 mm, then 11.5 mm, then 13 mm, then 16 mm. There is a hemisphere at the end of the working part. On one side, its diameter is 1.9 mm, on the other - 3.0 mm. Using this depth gauge allows you to simplify the inspection of the walls and bottom of the prepared bone bed of the implant, determine the presence of perforation of the walls and bottom of the bone bed, and determine the integrity of the bone bed. Using this depth gauge, you can examine the mucous membrane of the maxillary sinus, measure the height of the alveolar process to the bottom of the maxillary and nasal sinuses on the upper jaw and the mental foramen on the lower jaw, take the necessary measurements during the operation and choose the tactics of further actions. After accurately determining the drilling depth, use the drill limiters from the set. The limiter is suitable for all drill diameters. Continue drilling with an increase in the drill diameter. The last drill should be 0.5 mm smaller than the implant diameter. Conical drill protocols for conical shaped implants allow for maximum bone retention, good bone-implant contact and high primary implant fixation in the bone.

Implant installation

The implant is installed using a 2.43 mm Allen key (431825, etc.) for implants with an internal hexagon H2.43 and with an internal cone + hexagon CH2.43 or a 2.1 mm Allen key (431821, etc.) for implants with an internal hexagon H2.1 and with an internal cone + hexagon CH2.1. The keys have high edges that help to visually determine the position of the implant hexagon. It is recommended to place the flat part of the veneer on the vestibular side so that standard abutments can be used. In addition, the keys have two round marks indicating the depth of implant immersion relative to the bone: the gingival on mark is at 3 mm, and the second is at 5 mm. After the implant is placed and the implant carrier is removed, the internal connection of the implant must be closed. There are several approaches:

1. Two-stage implantation

  - installation of a screw-cover, which is in the sterile implant kit. Using a 1.27 Allen key (431412, etc.), take a screw from the sterile package and screw the        cover into the titanium implant.

2. One-stage implantation.

The titanium healing abutment for implants is installed on the implant immediately after the implant is installed in the bone. Using a 1.27 mm Allen key (431412, etc.), screw the healing abutment into the titanium implant. The height of the abutment is selected based on the thickness of the gingival margin in each clinical case. Recommended: the height of the healing abutment should be at least 1 mm higher than the gingival margin, and the healing abutment should not come into contact with antagonists and adjacent teeth. 

Warnings

The medical product in the package is not sterile. Autoclave sterilization at 135 °C / 274 °F is recommended before use. The dentist/maxillofacial surgeon should be properly familiar with the technology of using the Surgical Set with stopper. The drills in the set should be replaced when their cutting efficiency decreases. It is recommended to change the drills after 30-50 drillings.

When the cutting efficiency of the bone drill decreases, undesirable complications occur:

- Large collateral edema of soft tissues
- Severe postoperative pain
- An increase in dead bone cells in the prepared bone bed of the implant and, as a result, rejection of the implant;
- A fracture of the drill
- A crack or chip in the jawbone, etc.

Disclaimer

DMi, the importer and supplier of DMi products shall not be held responsible for complications, other negative consequences or damages that may arise due to reasons such as incorrect indications or surgical technique, incorrect choice of implant or handling, improper use or handling of instruments, etc. The dentist/oral and maxillofacial surgeon is responsible for any such complications or other consequences. The dentist/oral and maxillofacial surgeon must properly instruct and inform the patient about the operation, handling and necessary care of the device, as well as any known risks associated with the device.

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