ImPlasa Höchst - forward to future

ImPlasa Höchst - forward to future

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Implants
Doublegotic
Gotic
Nordic
Antic
Antic Ball
Antic Direct
Instruments
Drills
Keys and drivers
Measurers
Kits
Superstructures
Healing abutments
Impression coping transfers
Implant analogs
Abutments
Screws

News

0402.10
Structure
In the nearest future the opening of representations in Byelorussia, South Korea, Venezuela and Cuba is planned.
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0402.10
Partners
ImPlasa company is characterized by constant establishment of business connections.
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0402.10
History and plans
Unique technologies, developed by ImPlasa company extended the number of indications to implantation considerably and that fact is confirmed by the number of sells.
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Technological guideline

We are glad to demonstrate you the implantation guideline, prepared with the assistance of practicing specialists on the base of their experience and knowledge in professional sphere

This guideline is systematized and illustrated in the form of staged instruction. Visual "step-by-step" format of presenting the information and illustration of the surgery stages simplifies mastering the technology of the cure and allows to make the process  faster and start using the new knowledge in practice. All the instruments, used during the surgery must be properly cleaned and disinfected. For the cleaning of hard-to-reach zones for instruments it is recommended  to use a special device for ultrasonic cleaning. Dulled instruments should not be used and must be replaced otherwise, they may overheat bone stock, that may cause unsuccessful implant placement. Handpieces, ratchets and torque wrenches must regularly lubricated with  sterile oil.

 



step 1

Incision Opening

Subject to clinic case incision may pass through the alveolar crest with keeping the interdental gingival papillas. There may also be used semi-oval or heterotypic incision. Incision makes to the bone, its length depends on number of implants and must block the place of their placement for some millimeters. Such way, decreases the danger of denudation and infection of implant.




step 2

Opening the alveolar bone

Elevate the flap and open the alveolar bone.





step 3

Tapping the cortical bone shell

Perforate cortical bone shell in zone of axis of probable place of the implant by means of round burr or guide drill. The implant engine is used for drilling of bone, and the vacuum saliva suction is used for evacuation of blood, saliva and cooling liquid from the oral cavity.





step 4

Drilling and Implant Placement Procedure for Implasa Implant

Drill to the appropriate depth reference line with the 2 mm diameter drill. Check orientation of the osteotomy using direction indicator. When placing more than one  implant, place a direction indicator into the completed 2 mm pilot hole and proceed to the next implant site.  Align the 2 mm drill parallel to the direction indicator and drill the next osteotomy.

Forming of the implant site is implemented by back-and-forth motions of drill. By such motion of drill from the osteotomy getting out bone chips, and the bone overheating is prevented.





step 5

Drilling and Implant Placement Procedure

Drill to the desired depth of the appropriate length 2.5 mm twist drill to enlarge the implant site to its final diameter, observing anatomical landmarks.








step 6

Drilling and Implant Placement Procedure


Drill to the desired depth of the appropriate length 2,8 mm twist drill to enlarge the implant site, observing anatomical landmarks. The drill of the mentioned diameter is the last on placement of implant of 3,3 mm diameter.






step 7

Drilling and Implant Placement Procedure

Drill to the desired depth of the appropriate length 3,2 mm twist drill to enlarge the implant site, observing anatomical landmarks. The drill of the mentioned diameter is the last on placement of implant of 3,75 mm diameter.


step 8

Extraction of capsule with implant from the package

Open the package and extract the container with the implant. Take off the label from the sterile container and extract the capsule with implant (the color of the implant bearer defines the diameter of the implant).


step 9

Extraction of the bearer of implant from the capsule

Extract the implant bearer carrier from the capsule.


step 10

Extraction of the implant from the bearer

Take the bearer in left hand (for lefthander – in right), extract by the right hand the implant, pressing the implant adapter down with a little effort.


step 11

Implant insert

Insert the implant (hold the implant for implant adapter) into the implant site and manually tighten it clockwise up to the stop.




step 12

Extraction of the implant adapter

Extract the implant adapter by drawing it vertically up with a little effort.


step 13

Implant Placement

Insert 2,4 ratchet driver into the implant and place the implant by means of ratchet. When placing an Implasa implant, into the osteotomy turn the implant until it is fully seated into the prepared site. When placing the implant, align one of the sides on the implant driver parallel to the buccal/facial wall. This positions lobe or of the internal connection for ideal prosthetic abutment orientation.


step 14

Completion of implant placement

By the doctor’s choice, it is possible to complete the implant placement by means of torque wrench with effort of 30 N/cm.
If the torque wrench surgical, together with the surgical adapter, is required to complete placement of the implant, attach the implant driver select to the torque wrench surgical  and place the implant to its final depth. Do not exceed 45 Ncm   while placing Implasa     implant.


step 15

Cover screw placement

Make sure of absence of fragments of the bones and soft tissues on the prosthetic platform of implant and on its inner surface. For this you need to wash and dry the inner surface of the implant. Install the cover screw by means of manual hex driver of 1,27 diameter.


step 16

Management of the wound

On two-stage implant placement сlose the wound with interrupted sutures or connect the healing abutment (on one-stage implant placement), according to common surgical principles - without intention, first needle sticking-in shall be made on more movable flap border, first suture is put in on its middle.


step 17

The tissue flap closure

Practically always interrupted sutures are put in, sometimes some of the sutures may be П-like, which are considered as “discharging”. The distance between the sutures is about 0,5 cm. The most optimal is using of atraumatic suture material of 3/0-4/0 (vicryl).


step 18

Uncovering the Implant



The second stage of the treatment is conducted in 3-4 months on a lower jaw and in 5-6 months on an upper jaw. After control X-ray examination there will be conducted the conection of healing abutments - a procedure which is related to the surgical stage of implant placement and is considered to be a step to the stage of prosthesis.


step 19

Connection of healing abutment

This process takes 2 weeks and this time is necessary for forming the soft tissue surface of implant as a protective barrier.
Identify and expose the cover screw either with a separate incision or with a continuous crestal incision. If possible, make the incision in the attached mucosa above cover screws. Remove any overgrowth of bone above the cover screws. Remove the cover screws with the screwdriver when the previous steps have been performed.
Determine the height of the healing abutment by using a measuring gauge. The inner thread of the implant shall be washed over  and connected the healing abutment for 2-3 weeks.


step 20

Moving to the stage of prosthesis

The patient must carefully clean the teeth around the healing abutment. It is recommended to rinse the mouth cavity with a solution of chlorhexidine. After this the patient goes to the prosthetist, which in prosthetic stage of the cure begins working with direct fabrication of prosthetic restoration. For prosthetic restorations are used impression coping transfers, implant analogs and abutments (superstructures).


step 21

Prosthetic stage. Impression taking on the level of the implant

By means of manual hex 1,27 driver take off the healing abutment from the implant and make sure that the implant’s prosthetic platform is free of soft tissue and bone. Inner gum part of the transfer must correlate with the contour of the healing abutment and finally chosen abutment. On connection of several transfers it is necessary to do it by turns, remove one healing abutment at a time. It allows to avoid the ingress of soft tissues on prosthetic platforms of the implants.


step 22

Connection of the transfer on the implant

By means of manual hex 1,27 driver connect  the transfer on the implant. Carry out X-ray examination to make sure in correct fitting of the transfer.


step 23

Impression taking

Take impression, using one of the methods: - An impression by mono-phase material: injecting by the dispenser the mono-phase material (Impregum, Honigum) to impression tray and around the impression coping transfer in the mouth, put into the oral cavity and wait until it is set. Remove impression. - An impression by two-phase material: spread out the putty over the impression tray, put into the oral cavity and wait until it is set and extract it from the mouth and dry it. Apply with a syringe a corrective layer into the impression and around the impression coping transfer in the mouth, put into the oral cavity and wait for the corrective layer to harden. Remove impression.


step 24

Transferring the impression coping transfer with an analog into the impression

After the solidification of the material remove the impression tray, take off the transfer from the mouth and immediately conect the healing abutment, this will allow to avoid getting the soft tissues to the prosthetic platform of the implant. Connecting the impression coping transfer with analog first. Put the impression coping transfer with the analog to the proper hole into the impression. Make sure in correct position of analogs in the impression. Give the impression to the laboratory for making a master cast.


step 25

Master casting

Make the master cast.


step 26

Installation of impression coping transfer on the master cast.

Install to the master cast an optimally appropriate abutment, as it shown on the picture. Make sure that of abutment fits the inner hexahedral of the implant analog.


step 27

Milling of abutment

By means of hard-alloy dental drill carve the abutment, connecting it for the proper handle-analog. In laboratory conditions use milling machine. For correction of borders of the abutment usually diamond  drill is used.


step 28

Final abutment installation

Complete the abutment installation.


step 29

Fabrication of Wax up

Fabricate the wax up around the abutment.


step 30

Metal Framework casting

Cast the metal framework and after its processing make sure that the it fits the master cast.


step 31

Fitting metal framework in the mouth.

Fit on metal framework on the abutment in the patient’s mouth. After fitting, the metal framework and abutment should be given to the laboratory for completion of final prosthesis (metal ceramics, metal composition). Before the installation of the final prosthesis in the patient’s mouth, it is necessary to connect and fix the abutment with a torque wrench with a given effort (25-30 N/cm).


step32

Insertion of final prosthesis on the abutment and occlusal adjustment

Put some Fixing material to the inner surface of final prosthesis, install it on the abutment and adjust occlusal adjustment. Fixing material excesses must be taken off. It is recommended to conduct the control X-ray examination for estimation of fitting accuracy till cement gets finally fixed.