CHAMPIONS – BASIC RULES 01.12.2009 - Champions-Implants

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CHAMPIONS – BASIC RULES 01.12.2009
1. Champions basis rule: Planning
For a fixed dental restoration, insert as many implants as possible. Pay attention to the jaw position. This means that when
one can choose between inserting the implants in the frontal area and inserting them in the distal area, then one should opt
for inserting the implants in the distal area. If possible, the canine and first premolar teeth should be supported. In
addition, pay attention to the distribution of the implants/teeth on the jaw: for a fixed denture, there should be 4-5
implants or fixed teeth in each quadrant. Dental implants can be connected with strong, natural teeth, (no intrusion) and
all long-term studies have even shown that this connection is not just possible but actually recommended.
2. Champions basic rule: Planning for the bone
Preferably, the implant should be inserted in the bone that has already healed (more than 6 months of regeneration)
instead of inserting it in the "freshly" extracted alveoli. If one has to implant in the alveolar area, then one should implant
in the palatinal or lingual area rather than the vestibular area: "the vestibular bone is sensitive." For immediate
implantations, one should try to insert implants in the bi- and trifurcation and septum areas and never in inflammatory
osseous areas (e.g. Granuloma). The so-called “party-breakers”, which consist of non resorbable material, are to be
avoided (alloplastic and bovine material) because otherwise, the “party”, that is the new natural bone formation, cannot
take place!
3. Champions basic rule: Planning and type of care
If the denture is removable, for the tulips make sure that both quadrants are well supported: four teeth or implants in the
lower jaw, six Champions in the upper jaw! Make sure that you connect (laser treated or glued) the MMTs (metal
matrices) with a MEG or a tight wire (secondary splinting)! What is also possible: milled, connected zirconium
frameworks! For this, square-shaped implants (at least six in the upper jaw and four in the lower jaw) are galvanized
through milled zirconium crowns, which are primarily connected together with bars, or milled secondary structures are
fitted on the implants (modified Ledermann school/"modifizierte Ledermann Schule). What a pleasure!
For enquiries or questions, you can also contact our two certified partnership companies 'Champions – Dental – Lab':
- Champions- LAB Nord in Bad Schwartau:
Master dental technician Mrs. Ramona Schmude: + 49- (0) 4518 - 83 62 01
- Champions- LAB Süd in Armsheim:
Master dental technician Mr. Harald Feldmann: + 49 - (0) 6734 - 96 08 43
4. Champions basic rule: DRILLING
If possible, start to drill both in the upper jaw and in the lower jaw 0,5 – 1 mm palatinally or lingually from the center of
the jaw ridge. In the upper jaw, drill intermittently and rather palatinally. In the lower jaw, drill rather in a straight,
axial direction or also vestibularly. Drill in the area where usually bone atrophy of both jaws occurs. Of course, you must
feel the area (with your fingers!), and a transgingival "drill check" is necessary! The mucosa thickness (after anaesthesia)
is measured either with the drill or with the cannula of the injection needle itself by placing an "endostop" over the
respective instrument, by introducing the instrument transgingivally to the required implant position until reaching the
bone, and then by placing the endostop onto the mucosa with a forcep. The results in mm are measured with a sterile
measure unit. For the measurement of the mucosa thickness, the drills will have the laser marks 2, 4, 6 (the 8 mm-mark
will still be missing, so the mark continues at 10 mm).
The drilling speed should be 200-250 rotations/minute. There should be enough "passage" on the contra-angle (green or
double green).
A cooling is not absolutely necessary, but it is recommended for the D1 bone.
The bone chips of the drills should be either collected (for re-implanting) or wiped off with a sterile swab. In this way,
through drilling, the cut and compression can be more effective.
5. Champions – basic rule: Drill – sequence…
in the D1 bone in the lower jaw for all Champions implants with a diameter of 3,5 mm:
Yellow-� black-� white
in the D1 bone in the lower jaw for all Champions implants with a diameter of 3,0 mm:
Yellow-� black-� Cylinder drill with a diameter of 2 mm
Proceed in the following way when you do not use the white drill or the cylinder drill of a diameter of 2 mm: while drilling
with the black drill, widen the bone cavity a little bit with this drill. When there are further difficulties while inserting the
implant (for example, when a torque of over 60 Ncm has been reached! Please also read the instructions of use of the new
torque wrench!!), then turn out the implant 4 times ¼ rotations (turn the torque wrench around from the metal insertion
aid so that you see “OUT”) and turn it in 6 times ¼ rotations – proceed in this manner until the implant is completely
inserted.

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6. Champions – basic rule: Torque wrench
The advantage of the new original Champions® wrench is that this wrench can be tightened with a torque ranging from
10, 20, 30, 40, 50, 60, 70, 80 until ∞. The advantage: immediate loading can usually be achieved if once the torque of 40
Ncm has been reached, the wrench bends. Then, readjust the torque wrench (with the small wheel at the bottom of the
torque wrench) to 40 Ncm if the moving unit indicates the torque value of 40 Ncm! If you adjust the torque wrench only to
20 Ncm, then the unit will never move to 70 Ncm. It is like the gearbox in a car: the reached torque should be reset so that
you can “shift into the higher gear”! --� See 2 nd page of the new torque wrench instructions of 01.12.2009! Make sure,
especially for the tulips, not to tighten the wrench to a torque of over 80 Ncm: when a torque reaches more than 80 Ncm,
the tulip head can break. When a square-shaped implant is tightened with a torque of over 100 Ncm, the square-shaped
implant can break over the groove as well!
7. Champions – basic rule: Implant diameter
Always start with a 3,5 mm-diameter-implant!!--> Never start with an implant of a diameter of 4,5 mm in the lower jaw
(also after using a yellow & black drill). In case the 3,5-diameter implant has not achieved its primary stability at 40 Ncm,
then one can take this implant out and use it as an osteotome. Instead of this implant, one can then insert a 4,5 mmdiameter
implant. After cleaning, the 3,5 diameter-implant can either be used again for this patient, or the implant can be
sent back to Champions-Implants GmbH or exchanged by the company without charge. Please send back the cleaned
implant with a “Nonconformity Report” (rinsed, autoclaved, without blood stains!) in the recipient with the corresponding
sticker! The form “Nonconformity Report” can be downloaded in www.champions-forum.de (under “Download”). Since
01.10.09, the access to the FORUM is for free for all customers.
8. Champions – basic rule: If possible, implant at least 1-2 mm subcrestally!
It is better to use a shorter implant and to insert it subcrestally than to use a longer implant and insert it equicrestally.
9. Champions – basic rule: Immediate loading is ALWAYS possible with the Champions, when at least 2-3 implants or
firm teeth can be connected to each other and if primary stability (40 - 70 Ncm) can be achieved!! The only exception
where immediate loading is not always possible (but where the immediate restoration in non-occlusion is possible, also
when there are protrusion movements!) single restoration for one-root, upper teeth (15-25)!!-� After the drainage,
directly glue the implant or the cemented Prep Caps with the approximal surfaces of the adjacent teeth (evtl. areas
underneath) by means of composite layers!
Information for the patients about immediate loading
The patient should be fully informed before surgery: especially for wearers of long-term temporaries for 8 weeks, the first
4-5 days after surgery are not as critical as the time period of the 2 – 8 weeks after surgery. These 2-8 weeks after surgery
are very critical!! The active participation of the patient is absolutely necessary! A loose temporary (for instance, with
“TempBond”), for example in the 3 rd week (stability is at its lowest point!), is considered as the main reason for implant
losses in general! If the temporaries get broken or loose, these must be fixed and repaired as quickly as possible.
Otherwise, there can be shear forces and extra-axial loadings that cannot be controlled! In addition, the patient should eat
soft food and must be informed of what foods, such as foods with sharp edges, should be avoided (e.g. carrots, rolls, crusts
etc.).
10. Champions – basic rule: Temporary restoration, temporary fit, and definitive fit
Fit the temporary on the implants with Harvard, Implant Link or similar solid cement! Do not fit a temporary with
TempBond for several weeks. By the way, you can separate the temporary bridge on one or two areas. Then, you can
palpate the fragments with a bar since neither axial nor extra-axial forces have a negative impact on the implants! Shape
the temporary very well in the basal areas of the implants (without any frictions): in this way, the temporary almost only
stays in place with Harvard! After having fitted the framework, cement again with Harvard and glue the fragments
together with the usual composite!
For instance, for restorations for free-end cases or single tooth restorations, the integrated insertion aid can be separated
over the groove with a separating disc. Then, place the insertion aid cement-free on the square-shaped implant and with
your hands connect it with Bonding and composites by means of a bar! The temporary should stay hollow for at least 1
mm and should not touch and irritate the gingiva! Make sure the definitive prosthodontic restoration is fit under hygienic
conditions! There should be no vestibular or lingual “overhangings”!
Many dentist colleagues also use an Impregum to fit the definitive prosthodontic restoration temporarily! In order to
definitely fit the prosthodontic restoration, you can use any cement that is also used for the definitive fitting of dental
crowns or bridges: Harvard, Ketac-Cem, Fuji Plus or Fuji IX… Pay attention to the passive fit of the superstructure on
the implants. In addition, be aware of the approved occlusion concepts of the professional organizations (canine or
balanced group guidance) with cusp and fissure reliefs that are not excessive!