Innovative Präzision Made in Germany - OT medical GmbH

Innovative PräzisionMade in GermanyPreparationAny implantation should in principle bepreceded by a thorough clinical examination.The vertical and horizontal bone quantity canbe determined with the aid of an osteometerwhich is placed through the gingiva. For anexact diagnosis, the use of a panoramic radiographand a template prepared in the laboratoryis mandatory. The X-ray indicator helps todetermine the optimal length and the diameterof the implant for the implant site prior tosurgery. The X-ray indicator which correspondswith the magnification factor of the X-ray unitused, is placed on the radiograph.An additional aid for diagnosis is the threedimensional CT or DVT scan method in order todecide for the exact implantation planning andsurgery.In many cases, model or computer supportedsurgery templates based on a virtual surgeryplanning at the computer, can be recommended.This guarantees a high safety both forthe doctor and the patient. An intra-operativedecision for the suitable implant size as describedabove, is usually not necessary with thismethod.A sufficient number of implants in differentlengths and diameters should be availableduring surgery as in many cases the definitivedecision as to which implant would have theoptimal dimensions for the revealed boneanatomy can be made only after exposure ofthe jaw bone.Surgical TrayThe surgical tray is compact and well-accessibleand contains all drills and accessories forinsertion of the OT-F 1 implants of 3.30 mm upto 4.90 mm diameter. Please note the SurgicalTray Guide.Immediately after insertion, the implantsshould be protected with the cover screw containedin the implant package.After healing and exposure, the implantsshould be provided with healing abutments instraight or flared shape.For impression taking, the doctor can choosebetween impression copings for the closed orthe open impression.The ideal planning prior to surgery shouldencompass the awareness about the availableprosthetic abutments and their indicationswhich the implant system offers.Preparation_OT-F 1 | 3

Innovative PräzisionMade in GermanyPreparationStep-by-Step Instructions for the Bone PreparationAll drills are cooled externally (an internal cooling would be difficult to clean). The drills are inserted into the jaw bonewith careful up and down movements. Any bone particles should carefully be preserved and used later for a possiblynecessary augmentation.Important: The drills must not be used more than 15 times as otherwise optimum cutting action cannot be guaranteed.Step 1: ExposureOT-F 1 implants are inserted after exposure of the jaw bone. Thedoctor decides if individual incisions are required in the presentsituation.Step 2: Preparation of the jaw boneIf the exposed alveolar crest shows protrusions which are unfavorablefor implant insertion, such as small or even sharp edgedridges, these can be removed by using a bone trephine in orderto prepare a plane level for insertion of the implant.Step 3: Perforation of the Cortical BoneThe pilot drill 1 (diameter 1.6 mm) perforates the cortical boneplate in an exact horizontal distance positioning and in verticalcorrespondence with the axis.The pilot drill is a very sharp three-edged drill which can performthe first drilling considerably easier than the conventional rosebur (recommended speed: 1,200 rpm).Step 4: Pilot DrillingThe first preparation is now continued to the complete depthwith pilot drill No. 2 (diameter 2.0 mm). This drill has a lasergraduation according to the implant lengths 8/10/12/14 and16 mm (recommended speed 1,100 rpm).1 2 3 46 | OT-F 1 _Preparation

Innovative PräzisionMade in GermanyInsertionStep by step instructions for the implant insertionPlease take care that the implant when removed from the sterile acrylic vial, does not come intocontact with for instance saliva, neighboring teeth, instruments or is contaminated by saline solution.The implant is mounted on a carrier which is connected with the round cover cap.Step 1: Primary fixationRemove the implant by pulling off the covercap from the acrylic vial and place directly intothe bone preparation which has ideally filledwith blood. Stabilize the implant in bone firstmanually by using two to maximum four turnsand then pull off the carrier from the hex of theimplant.Step 2: Complete insertionThe further insertion procedure is made with theinsertion key. Please note when selecting thecorresponding key that the OT-F 1 implants withthe smaller diameters of 3.30/3.80 (green/yellow)have a smaller internal hex connection (2.20),while the larger diameters 4.10/4.90 (red/blue)have a larger hex connection (2.50) accordingly.The insertion key for the diameters 3.30/3.80 mmis marked by two grooves at the shaft.A complete 360° turn – see marking on the fingerkey – will insert the implant by approx. 1.1 mmfurther into depth. Due to the self tapping expansionthreads of the OT-F 1 implant the friction willincrease the deeper the implant proceeds intothe bone preparation.If the resistance feels too strong, turn the implantback slightly counter-clockwise (120°-180°)and then proceed clockwise again. Repeat thisprocedure until the implant has reached thefinal depth and is ideally level with the alveolarcrest.Please consider for the final position of theimplant the most favorable prosthetic position ofthe internal hex in order to facilitate an optimalprosthetic restoration at this point.8 | OT-F 1 _Insertion

Innovative PräzisionMade in GermanyHealing time of the implantsHealing timeThe length of the healing time depends on several factors:• bone quality D1-D4 (mandible/maxilla)• implant surface (TPS or NANOPLAST®)• time of insertion (immediate/delayed/late)• age and state of health of the patient• required augmentation proceduresetc.Principal rule for healing time of OT-F 1 implants:• 3 months in the mandible• 5-6 months in the maxillaAt trans-gingival healing, the implants should be allowed toosseointegrate without loading. Please take care that the healingabutments should be selected – aside from the planned laterprosthetic restoration – with a height which will protrude fromthe gingiva, but on the other hand do not transfer any loadingforces on the implant.Special attention should be focused on the fact that there shouldbe absolutely no contact to the antagonists.A prolonged healing time due to the smaller implant surface ofimplants with a diameter of 3.30 mm should be accounted for.For control of the healing process a perio-test check is recommended.10 | OT-F 1 _Healing Time

Innovative PräzisionMade in GermanyExposure and ImpressionExposure of the implantsWhen the healing time has elapsed, the mucous membrane isreentered in order to expose the implants. 1The doctor decides which type of incision he will use, whichhealing abutment should be inserted and which suture techniquewould be favorable in each case.Exposure by laser technology is also indicated and is also up tothe surgeon’s decision. The use of a manual centering punch forexposure can also be indicated in certain cases. The implantsshould be covered with the healing abutments. 2At this point we recommend:• the check-up by a perio-test in order to control theosseointegration• the panoramic radiograph for documentation.ImpressionAfter complete healing of the gingiva, the impression can betaken.The implant system offers a selection between closed(reposition technique) 3 and open impression method(pick-up technique). 4Remove the healing abutments and place the impression copingsonto the implants and fix with the corresponding fixationscrews. The hex connection provides an exact transfer of theimplant position to the master model to be prepared.We recommend to use an individually prepared impression trayfor the impression taking.If an immediate temporary primary restoration with theabutments CREATIVELINE is planned with temporary crowns, werecommend to prepare these in anatomically smaller shape andto anchor these in stable connection to the neighboring teeth.1 234Exposure and Impression_OT-F 1 | 11

Innovative PräzisionMade in Germany09-713200000 • 11-2010/2OT medical GmbHKonsul-Smidt-Straße 8b, 28217 Bremen, GermanyTel. +49 421 557161-0, Fax +49 421 557161-95info@ot-medical.de, www.ot-medical.de