Surgical Set for Short Implant

Surgical Set for Short Implant

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 for implants from 5 mm to 10 mm long:

- Marking bur (403419)
- 30 short cylindrical drills with an integrated stopper 5.0 mm, 6.0 mm, 7.0 mm, 8.0 mm, 10 mm and diameters of 2.0 mm, 2.8 mm, 3.2 mm, 3.65 mm, 4.2        mm, 5.2 mm with external cooling
- 3 Allen keys with 2.43 mm Allen key "standard platform" (431825 - long manual; 430525 - short manual; 430025 - machine),
- 3 Allen keys with 1.27 mm Allen key for screws (431412 - long manual; 431112-short manual; 430012-machine),
- Drill extension (431701),
- Universal torque wrench "ratchet" (446302),
- Key for removing the abutment from the implant (431912)

Intended use, indications for use

Designed for standard preparation of the bone bed and installation of two-stage dental implants 5.0 mm, 6.0 mm, 7.0 mm, 8.0 mm, 10 mm long. It is used for standard and short implants from 5 to 10 mm long and from 3.75 to 6.0 mm in diameter of the DMi system (UTI; PRTI; UMI; PMI).

The instruments for bone preparation and implant installation are comparable with other systems with an internal hexagon of 2.43 mm for dental implants 5.0 mm, 6.0 mm, 7.0 mm, 8.0 mm, 10 mm long. (Green, Zimmer, Direct, Mis, Alpha bio, Pal top, Bio Horizon, Cortex, AB, etc.).

Advantages

- Convenient use in the posterior sections of the lower and upper jaw.
- Facilitates work with difficulty opening the mouth.

Use allows to exclude

1. Use of a surgical stand.
2. Incorrect formation of the bone bed of the implant.
3. Injury to important anatomical structures (mandibular nerve, etc.).

Contradictions

The Surgical Set for Short Implant is not used to prepare the bone and install implants:

- length of 11.5 mm and more.
- narrow diameter of 3.0 mm and 3.3 mm.
- one piece of implant.
- zygomatic implant.

Procedure for use

1. Prepare a Surgical Set for Short Implant

- Check that all the instruments are in the kit.
- Check the sharpness of all the drills.

2. Clean using 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.

3. 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.

4. Bone preparation operation for implant insertion

The surgical kit for short implants is a set of instruments for bone tissue preparation and installation of two-stage dental implants 5.0 mm, 6.0 mm, 7.0 mm, 8.0 mm, 10 mm long with an internal connection of 2.43 mmd and an implant diameter of 3.75; 4.2; 5.0; 6.0; mm, which is comparable with other systems with a 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 jawbone, the method of dental implantation and the type of bone drills. The implant bed is prepared sequentially using drills of increasing diameter with integrated drilling depth stoppers. All bone preparation must 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 into it by 2-3 mm. 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 is obtained.

5. 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 with a diameter of 2 mm with a pre-planned drill stopper size. After preparation with a 2 mm drill to a depth of up to the stopper ledge, it is necessary to install a titanium depth gauge and perform an X-ray examination in the prepared hole - periapical (aiming) or panoramic image (Titanium 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 teeth, implants, etc. And only after this, further preparation of the implant bone bed is carried out with drills with stoppers with an increase in drill diameter. Each subsequent drill should enter the bone hole to the depth of the stopper ledge. 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. For accurate spacing and parallel placement, you can use Parallel Gate (450023). During 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. The working part has notches indicating the drilling depth into the bone bed of the implant. The first notch is 8 mm, then 10 mm, then 11.5 mm, then 13 mm, then 16 mm. At the end of the working part there is a hemisphere. On one side, its diameter is 1.9 mm, on the other - 3.0 mm. The use of this depth gauge simplifies the inspection of the walls and bottom of the prepared bone bed of the implant, determines the presence of perforation of the walls and bottom of the bone bed, and determines the integrity of the bone bed. Using this depth gauge, you can inspect 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. The last drill should be 0.5 mm smaller than the diameter of the implant. Drilling protocols with cylindrical drills are considered classic. This ensures a smoother and easier insertion of the implant into the bone, allowing for complete integration and immersion of the implant in the bone. This also prevents complications such as: - bone overheating, - bone fracture, - fracture of the implant hexagon, - jamming of the implant holder or implant driver key in the implant hexagon.

6. Implant installation

The implant is installed using a 2.43 mm Allen key (431825, etc.) for implants with an internal hexagon H2.43 (length from 5 mm to 10 mm and diameter from 3.3 mm to 6.0 mm) and with an internal cone + hexagon CH2.43 (length 8 mm and 10 mm with diameter from 4.2 mm and 6.0 mm) or a 2.1 mm Allen key (431821, etc.) for implants with an internal cone + hexagon CH2.1 (length 8 mm and 10 mm with diameter from 3.3 mm and 3.75 mm). The keys have hexagon edges along the entire working part of the key, which help to visually determine the position of the implant hexagon. It is recommended to place the flat part of the key edge on the vestibular side so that standard abutments can be used. In addition, there are two circular marks on the keys indicating the depth of the implant insertion relative to the bone: the gingival mark is at 3 mm, and the second is at 5 mm. After inserting 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 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 packaged medical device is not sterile. It is recommended to sterilize in an autoclave at 135 °C / 274 °F before use. The dentist / maxillofacial surgeon should be well acquainted with the technology of using the surgical kit with a stopper. The drills in the kit 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 the number of dead bone cells in the prepared bone bed of the implant and, as a result, implant rejection
- drill fracture
- a crack or chip in the jawbone, etc.

It is not recommended to immediately load the installed implant. Ball and locator abutments for removable prosthetics cannot be installed and used on short implants.

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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