1 Surgery CAMLOG Compendium

CAMLOG Compendium 

1 

Surgery


1 Surgery 

All materials and dental procedures 

mentioned in this Compendium must 

be used and applied by qualified 

dentists and physicians only. 

The CAMLOG Compendium consists of 

two parts: 

1 Surgery 

2 Prosthetics 

Single pages must not be distributed. 

Section Overview 

CAMLOG Compendium Part 1, 

Surgery: 

I. General system information 

II. CAMLOG concept 

Ill. Planning 

IV Surgery manual 

CAMLOG Compendium Part 2, 

Prosthetics: 

V. Prosthetics Manual 

CAMLOG Compendium | 1 Surgery

CAMLOG Compendium | 1 Surgery 

Bibliographic information 

of the German Library 

The German Library catalogs this publication in the German 

National Bibliography; detailed bibliographic information can 

be found on the Internet website: http://dnb.ddb.de. 

All rights, including reprinting, reproduction in any form and 

translation into other languages, are reserved by the copyright 

holder and publisher. The manual may not be reproduced in 

whole or in part by photomechanical means (photocopy, 

microfiche) or stored, exploited systematically or distributed 

with electronic or mechanical systems without written 

approval from CAMLOG Biotechnologies AG. 

Authors: 

Axel Kirsch, Karl-Ludwig Ackermann, 

Rainer Nagel, Gerhard Neuendorff, 

Alexander Focke, Dieter Mozer, 

Alex Schär, Bernd Wagner 

Manufacturer: 

ALTATEC GmbH 

Maybachstrasse 5 

71299 Wimsheim, Germany 

Copyright © 2007 CAMLOG Biotechnologies AG 

Art. No.: J8000.0027 web version 

Printed in Germany 

Cover design: CAMLOG Team, 

Thieme Verlagsgruppe 

Printing/binding: Grammlich, Pliezhausen 

ISBN: 978-3-13-134351-2 1 2 3 4 5 6 

Important note: Like every field of science, medicine is undergoing 

continuous change. Research and clinical experience are 

continuously extending our knowledge, particularly of treatment 

and medicinal therapy. Where this publication refers to a 

dosage or administration, the reader can be assured that the 

authors, editor and publisher have taken great care to ensure 

that this information conforms to the state of the art at the 

time of publication. 

However, the publisher cannot accept any liability for information 

on dosage instructions and forms of administration. Every 

user is urged to check carefully the information in the package 

inserts of the medications and if necessary consult a specialist 

to see if the recommended dosage and administration or the 

observance of contra-indications is different from the information 

given in this book. It is particularly important to check 

this in the case of rarely used medications or those that have 

just been introduced to the market. Every dosage or administration 

is the sole responsibility of the user. The authors and 

the publisher request all users to inform the publisher of any 

inaccuracies. 

Protected brand names (trademarks) are not specially indicated. 

The absence of such indication does not mean that it is 

not a trademarked name. 

The publication with all its parts is protected by copyright. 

Any exploitation beyond the narrow limits of the copyright Act 

is not permissible without the approval of CAMLOG 

Biotechnologies AG and is subject to legal sanctions.

Table of Contents 

I. General System Information 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . 1 

2. CAMLOG ® system - description . . . . . . . . . . 2 

3. Implant configuration . . . . . . . . . . . . . . . . 3 

Macroscopic shapes . . . . . . . . . . . . . . . . . . . . 3 

Internal and external configuration . . . . . . . . . . 4 

Bioseal Bevel / implant shoulder . . . . . . . . . . . 5 

Surfaces . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 

Tube-in-tube connection . . . . . . . . . . . . . . . . . 7 

Production precision . . . . . . . . . . . . . . . . . . . 8 

Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 

4. Mechanics and biomechanics . . . . . . . . . . . 9 

Mechanical studies . . . . . . . . . . . . . . . . . . . . . 9 

Lateral loading . . . . . . . . . . . . . . . . . . . . . . . . 9 

Failure loading . . . . . . . . . . . . . . . . . . . . . . . . 9 

Torsion loading . . . . . . . . . . . . . . . . . . . . . . . 10 

II. CAMLOG Concept 1. Team concept . . . . . . . . . . . . . . . . . . . . . . . 11 

The team . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 

Team input . . . . . . . . . . . . . . . . . . . . . . . . . . 12 

2. Treatment concepts . . . . . . . . . . . . . . . . . . 13 

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . 13 

Leverage relations at the implant . . . . . . . . . . . 13 

Esthetics . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 

Patient cooperation . . . . . . . . . . . . . . . . . . . . 14 

Patient information . . . . . . . . . . . . . . . . . . . . 14 

Fixed dentures . . . . . . . . . . . . . . . . . . . . . . . . 15 

Single crowns . . . . . . . . . . . . . . . . . . . . . . . . 15 

Splinted crowns . . . . . . . . . . . . . . . . . . . . . . 16 

Implant-supported bridges . . . . . . . . . . . . . . . . 17 

Removable dentures . . . . . . . . . . . . . . . . . . . 18 

Telescopic crowns . . . . . . . . . . . . . . . . . . . . . . 18 

Bar abutment . . . . . . . . . . . . . . . . . . . . . . . . . 19 

Ball abutment . . . . . . . . . . . . . . . . . . . . . . . . 19 

III. Planning 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . 20 

2. Anamnesis . . . . . . . . . . . . . . . . . . . . . . . . . 21 

General . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 

Special (dental) . . . . . . . . . . . . . . . . . . . . . . . 21 

3. Examinations . . . . . . . . . . . . . . . . . . . . . . . 21 

Clinical . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 

Radiographic . . . . . . . . . . . . . . . . . . . . . . . . . 22 

Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 


CAMLOG Compendium | 1 Surgery 

4. Preliminary prosthetic design . . . . . . . . . . . 24 

Wax-up / set-up . . . . . . . . . . . . . . . . . . . . . . . 24 

Planning template . . . . . . . . . . . . . . . . . . . . . 25 

Radiographic template . . . . . . . . . . . . . . . . . . 26 

5. Implant position verification . . . . . . . . . . . 27 

Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 

Clinical . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 

Orthopantomography . . . . . . . . . . . . . . . . . . . 27 

Dental film . . . . . . . . . . . . . . . . . . . . . . . . . . 27 

Computer tomography with/without 3-D analysis 28 

Drilling template . . . . . . . . . . . . . . . . . . . . . . 28 

Final prosthetic design . . . . . . . . . . . . . . . . . . 29 

Customizing the prosthetic design . . . . . . . . . . 29 

Planning treatment procedures . . . . . . . . . . . . 29 

6. Recommended indications for various 

configurations . . . . . . . . . . . . . . . . . . . . . . 30 

IV. Surgery Manual 1. Preparation of the patient . . . . . . . . . . . . . 33 

2. Drilling template . . . . . . . . . . . . . . . . . . . . 33 

3. CAMLOG ® surgical system . . . . . . . . . . . . . 33 

Surgical sets . . . . . . . . . . . . . . . . . . . . . . . . . 34 

Drilling system . . . . . . . . . . . . . . . . . . . . . . . 37 

4. Healing options . . . . . . . . . . . . . . . . . . . . . 38 

5. SCREW-LINE Implant . . . . . . . . . . . . . . . . . 39 

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . 39 

Preparation of implant bed for 

SCREW-LINE Implants . . . . . . . . . . . . . . . . . . 44 

Implant package . . . . . . . . . . . . . . . . . . . . . . 54 

Implant insertion . . . . . . . . . . . . . . . . . . . . . . 56 

6. ROOT-LINE Implant . . . . . . . . . . . . . . . . . . . 65 

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . 65 


ROOT-LINE Implants . . . . . . . . . . . . . . . . . . . . 70 

Implant package . . . . . . . . . . . . . . . . . . . . . . 80 

Implant insertion . . . . . . . . . . . . . . . . . . . . . . 82

7. SCREW-CYLINDER-LINE Implant . . . . . . . . . 91 

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . 91 

Preparation of implant bed for SCREW- 

CYLINDER-LINE Implants . . . . . . . . . . . . . . . . 96 

Implant package . . . . . . . . . . . . . . . . . . . . . .106 

Implant insertion . . . . . . . . . . . . . . . . . . . . . .108 

8. CYLINDER-LINE Implant . . . . . . . . . . . . . . .117 

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . .117 


CYLINDER-LINE Implants . . . . . . . . . . . . . . . . .122 

Implant package . . . . . . . . . . . . . . . . . . . . . . .130 

Implant insertion . . . . . . . . . . . . . . . . . . . . . .132 

9. Healing caps . . . . . . . . . . . . . . . . . . . . . . .137 

Introduction . . . . . . . . . . . . . . . . . . . . . . . . .137 

Healing caps - cylindrical and wide body . . . . . .138 

Healing caps - bottleneck . . . . . . . . . . . . . . . .138 

Tissue augmentation/support . . . . . . . . . . . . .139 

10. Transfer system . . . . . . . . . . . . . . . . . . . . .140 

Introduction . . . . . . . . . . . . . . . . . . . . . . . . .140 

Closed tray impression method . . . . . . . . . . . . .141 

Open tray impression method . . . . . . . . . . . . .144 

11. Bite registration . . . . . . . . . . . . . . . . . . . .147 

12. Provisional solution . . . . . . . . . . . . . . . . . .148 

13. Torque wrench . . . . . . . . . . . . . . . . . . . . . .151 

Introduction . . . . . . . . . . . . . . . . . . . . . . . . .151 

Cleaning, sterilization, care . . . . . . . . . . . . . . .154 

14. Information . . . . . . . . . . . . . . . . . . . . . . . . .155 

Cleaning, sterilization . . . . . . . . . . . . . . . . . .155 

Information protocol . . . . . . . . . . . . . . . . . . .157 

Materials . . . . . . . . . . . . . . . . . . . . . . . . . . .158 

Certificates . . . . . . . . . . . . . . . . . . . . . . . . . .159 


I. General System Information 

1. Introduction 

Modern implant prosthetics is now an 

established component of dentistry. The 

expectations and demands of patients 

are steadily increasing. Therefore, the 

ultimate goal of modern implant-supported 

treatment concepts is for full 

esthetic, functional, phonetic, and psychosocial 

rehabilitation. This applies 

equally to replacements of lost single 

incisors associated with trauma and the 

complex rehabilitation of periodontally 

compromised remaining teeth or the 

treatment of an edentulous heavily atrophied 

maxilla and mandible. 

This manual should help promote treatment 

success quickly, simply, and efficiently. 

The layout of this publication follows 

the logical sequence of planning 

and performance of a periodontal 

implant-supported prosthetic restoration. 

You get acquainted primarily with the 

configuration, mechanical, and biomechanical 

features of the implants, as well 

as with the innovative CAMLOG ® 

implant-to-abutment connection. 

Before presenting the prosthetic concepts, 

we give you an overview of the 

"backward planning" method and the 

team concept on which it is based, to 

ensure the best treatment result possible. 

The section Treatment Concepts provides 

an overview of the prosthetic 

options using the CAMLOG ® Implant 

System. 

The other sections follow the order of 

procedures suggested in the backward 

planning concept: 

• History, examination, diagnostics 

• Prosthetically oriented planning 

• Feasibility testing, adaptation, 

patient-oriented planning of the 

procedure sequence 

• Surgery 

• Prosthetics 

• Follow-up 

General System Information 

Introduction 

Warning 

The descriptions that follow are not adequate 

to permit use of the CAMLOG ® 

Implant System immediately. Instruction 

by an experienced operator in the management 

of the CAMLOG ® Implant 

System is strongly recommended. 

CAMLOG ® dental implants and abutments 

should be used only by dentists, 

physicians, surgeons and dental technicians 

trained in the system. Appropriate 

courses and training sessions are regularly 

offered by CAMLOG. 

Methodological errors in treatment can 

result in loss of the implant and significant 

loss of peri-implant bone substance. 

1


CAMLOG ® System Description 

2. CAMLOG ® 

System Description 

The CAMLOG ® Implant System 

The CAMLOG ® Implant System is based 

on many years' clinical and dental technological 

experience. It is a user-friendly, 

logically prosthetic-oriented implant 

system. All CAMLOG ® products are 

continuously manufactured according 

to state of the art. 

The CAMLOG ® Implant System was further 

developed progressively through inhouse 

research and development in collaboration 

with hospitals, universities, 

and dental technicians. Today, it represents 

the state of the art in implant 

dentistry. 

In the recent past, science has become 

more and more important at CAMLOG. 

Today, the CAMLOG ® Implant System is 

scientifically very well documented. The 

system has been confirmed by numerous 

studies investigating into different 

parameters, e.g., implant surfaces, time 

of implantation and/or implant loading, 

primary stability, design of implant-abutment 

connection or type of superstructure. 

Long-term results of up to seven 

years for the CAMLOG ® Implant System 

are convincing. 

2

3. Implant 

Configuration 

Macroscopic Shapes 

All CAMLOG ® implants are equipped 

with the CAMLOG ® tube-in-tube 

implant-to-abutment connection. The 

four different external implant configurations 

have the same diameter-matched, 

internal configuration. This makes the 

use of different implant configurations in 

an arch possible without curtailment of 

the prosthesis (see also the recommended 

indications for the different implant 

types). 

SCREW-LINE Implant, 

Promote ® 

ROOT-LINE Implant, 

Promote ® 


Implant Configuration 

SCREW-LINE Implant, 

Promote ® plus 

SCREW-CYLINDER-LINE 

Implant, Promote ® 

CYLINDER-LINE 

Implant, TPS 

3



External Configuration 

CAMLOG ® implants SCREW-LINE, ROOT- 

LINE and SCREW-CYLINDER-LINE with 

the Promote ® surface have a cylindrical 

machined portion 1.6 mm high in the 

coronal area (1). A rough machined 

chamfer - the Bioseal Bevel (height 0.4 

mm) - is attached to this apically (2). 

Below it is the self-tapping thread of the 

SCREW-LINE, ROOT-LINE or SCREW- 

CYLINDER-LINE implants (3) with the 

Promote ® surface. In the case of the 

CYLINDER-LINE implants, a TPS (titanium 

plasma-sprayed) surface is provided. 

Internal Configuration 

Starting from the coronal implant edge 

(4), all implants have three symmetrical 

grooves (width 0.5 or 0.7 mm, depth 1.2 

mm, 120° offset) in the upper cylindrical 

area (5). The abutment cams lock into 

these grooves. Beneath this area, an 

upper inner thread is found (6), on 

which the cover screw, healing caps, 

bar abutments, and male inserts of different 

prosthetic caps can be screwed. 

Apical to the thread is a short cylindrical 

part to which the abutment "tube" is 

attached (7). After another 60° offset, 

there follows apically a second inner 

thread (8) onto which the abutment 

screws M 1.6 or 2.0 are fastened. 

4 

1 

2 

3 

On the SCREW-LINE Implant with Promote ® plus 

surface, the machined part measures 0.4 mm. 

4 

5 

6 

7 

8

Bioseal Bevel/Implant Shoulder 

Following the protocol-conformal insertion 

of the implant, the implant shoulder 

lies approx. 0.4 mm above the bone level. 

Drilling irregularities between the 

implant drill hole and implant are totally 

excluded by the chamfer (Bioseal Bevel) 

beneath the implant shoulder which 

matches the profile of the drill hole. 

A biological width of approx. 2 mm 

remains (1 mm connective tissue adaptation 

and upon this an approx. 1-mm 

junction epithelial attachment) following 

protocol-conformal insertion of the 

implants with the Promote ® surface and 

TPS coating, and following exposure and 

a minor bone adaptation of approx. 

1 mm apically. 

SCREW-LINE Implants with Promote ® 

plus surface are likewise inserted so as 

to leave a 0.4 mm projection above the 

bone level. During the insertion and 

exposure, the periosteum should be 

removed only in the implant penetration 

area. 

Promote ® and TPS surface 

Promote ® plus surface 



5



Surfaces 

Promote ® and Promote ® plus 

Surface Structure 

Promote ® and Promote ® plus have an 

identical micro-macro surface structure, 

differing only in the vertical position 

of the rough/smooth boundary. The 

CAMLOG ® implants SCREW-LINE, ROOT- 

LINE and SCREW-CYLINDER-LINE are 

available with the Promote ® surface. 

Promote ® surface structure Laser scan of Promote ® surface Osteoblasts on a Promote ® surface 

Titanium Plasma-Sprayed 

Surface Structure 

The CAMLOG ® CYLINDER-LINE Implants 

have a titanium plasma-sprayed (TPS) 

surface in their endosseous portion, 

which has proven in long-term studies to 

be exceedingly reliable. 

Titanium plasma-sprayed surface structure 

6 

The CAMLOG ® SCREW-LINE implants are 

also available with the Promote ® plus 

surface, which has a machined part of 

only 0.4 mm in the coronal area. 

This sand-blasted, acid-etched surface 

has given excellent results in anchoring 

dental implants. 

Research results from cell cultures, bone 

histology, and extraction tests support 

this. The results suggest that the 

Promote ® surface promotes rapid 

osseointegration of the CAMLOG ® 

implants.

Tube-in-Tube Connection 

The long-term maintenance of periimplant 

soft and hard tissue health in 

implant-treated patients heavily depends 

on oral hygiene and pre-, intra-, and 

post-operative soft tissue management. 

The biomechanics of implant-supported 

restorations are controlled by the 

implant design and the components of 

the implant-abutment connection. 

Even if the number of implants is adequate 

and positioning is correct, a 

mechanically critical interface also exists 

between force application (through 

crown occlusion) and force absorption 

(by the ankylotic anchor in the bone) in 

the area of the implant-abutment connection. 

Numerous studies have shown that 

abutment screw loosening or fracture 

may occur here - even at submaximal 

load - depending on the implant-abutment 

connection used. Hence, the design 

of the implant-abutment connection is 

fundamentally important. Engineering 

science indicates the use of an connection 

with a diameter/insertion depth 

ratio greater than 1.4 for form-fit connection. 

The implant-abutment connection 

used in the CAMLOG ® System is a 

form-fit connection in which the diameter/insertion 

depth ratio is 1.5 to 2.4 

depending on the implant diameter. 

The design features of the patented 

CAMLOG connection result in improved 

results on statics strength and compression 

fatigue tests. To maintain these 

CAMLOG ® implant-abutment connection with abutment screw 



levels and ensure long-term stability, the 

connection must never be modified for 

any reason! 

7


Production Precision 

Production Precision 

The internal and external geometry of the 

implants and abutments are machined, 

with the exception of the milled cams 

and grooves. This means that production 

tolerances can be kept very tight, and a 

precision fit with rotational stability 

(0.5°-1.0°) is ensured for all system 

components. This is an essential requirement 

in the fabrication of prosthetic 

restorations, starting with the transfer of 

the implant position to the master cast 

and continuing up to the final oral insertion. 

Materials 

All CAMLOG ® implants are made of 

pure grade 4 titanium. The abutments, 

caps, and abutment screws are made of 

titanium alloy Ti6AI4V (ASTM F136) (see 

Information - "Materials"). 

8 

CAMLOG ® Implant 

Implant-abutment connection with 

abutment screw 

CAMLOG ® Abutment

4. Mechanics and 

Biomechanics 

Mechanical Tests 

Finite element models were prepared 

and the behaviors of different implantabutment 

connections were compared 

under vertical-lateral and torsional loading. 

The simulation was conducted using 

an FEM (finite element method) program 

(ASNSYS 3.3) at Offenbach Technical 

University. 

Lateral Loading 

The vector L of a load applied at 30° is 

divided into an axial force (Fa) and a 

lateral force (Fq). The axial component 

and lateral force must be compensated 

by the screw retention force as a function 

of the length of the lever from the 

fulcrum (D). 

Finite element studies show that when a 

vertical-lateral load is applied to the 

abutment, the forces are transmitted 

through the apical end of the tube to 

the implant body. Loading of the abutment 

screw hardly occurs. 

Failure Load 

Comparison of failure load (300 N at 

30°) in a 3.75 mm screw implant with 

an external hex connection clearly 

shows that the CAMLOG ® abutment 

screw is hardly stressed (blue = low 

strain, red = high strain). 

In the case of a force-based external hex 

connection, the Fa is ~5 Fq because of 

the lever ratio (the distance of the fulcrum 

from the middle of the axis is the 

implant radius). 

Force-based connection 


Mechanics and Biomechanics 

In the case of the form and force-based 

CAMLOG connection, the lateral component 

(Fq) is almost completely compensated 

by the supporting forces (F1 and 

F2) provided by the tube-in-tube connection. 

Because of the configuration of the 

tube-in-tube connection, the fulcrum 

location is practically on the midline of 

the implant. The lever length of the axial 

force component (Fa) is thereby reduced 

towards zero. 

Form and force-based connection 

External hex connection CAMLOG tube-in-tube connection 

9


Mechanics and Biomechanics 

Torsion Loading 

In the case of torque up to the moment 

the cams make contact in the implant, 

only the production clearance is considered, 

and therefore the repositioning 

accuracy of the abutment in the implant. 

The strain on the implant-abutment connection 

is very small (blue = low strain, 

red = high strain). The smaller the angular 

deflection, the more precise a position 

can be transfered. 

10 

Torsion [Nmm] 

Torsion behavior of the CAMLOG connection 

Angular deflection (°)

II. CAMLOG Concept 

1. Team Concept 

The Team 

Patient 

The patient must be fully informed about 

the options and limits of implant-supported 

rehabilitation in his or her particular 

case. The expectations and demands 

of the patient should be clearly formulated 

and documented. 

Dentist 

The restorative dentist providing prosthetic 

treatment is usually the team 

leader. His function is handling examinations, 

diagnostics, and treatment planning, 

and reaching a consensus for the 

treatment plan from the patient and 

possibly the surgeon and dental technician. 

He coordinates the prosthetic 

preparation while the surgeon plans and 

manages the treatment stages: surgical 

intervention, wound healing, and exposure. 

Surgeon 

The surgeon conducts a separate patient 

information session. He utilizes the diagnostic 

records, templates, medical/dental 

history, and radiographic information 

provided by the restorative dentist and 

dental technician. He performs the 

implantation procedures requested by 

the restorative dentist. 

Dental Technician 

The dental technician contributes his 

laboratory knowledge and experience to 

the preoperative planning of the 

implant-supported restoration. He prepares 

a setup/ wax-up, evaluates esthetic 

and functional issues, and makes suggestions 

for the design of the final 

restoration and implant positioning. His 

tasks include fabrication of the provisional 

and final restorations as well as 

provision of radiographic and drilling 

templates and he selects the implant 

abutments. 

Dental Hygienist/Nurse/Assistant 

An important prerequisite for the longterm 

success of a dental implant is 

excellent oral hygiene. The dental 

hygienist/nurse/assistant explains correct 

oral hygiene to the patient and takes the 

preparatory steps to create an inflammation-free 

oral situation. She is also 

responsible for ensuring regular followup 

appointments. 

CAMLOG Concept 

Team Concept 

CAMLOG 

CAMLOG supports all members of the 

implant treatment team by providing 

high product quality, information, 

service, continuing education, and 

continuous research and development 

of the CAMLOG ® Implant System. 

11


Team Concept 

Team Input 

Increasingly higher demands for quality 

and specialization require a multidisciplinary 

team approach to combine the 

members' acquired knowledge and experience. 

Modern implant-supported 

restorations need a high level of attention 

to detail and clinical experience. 

This is true equally for the restorative 

dentist, the surgeon, the dental technician, 

and the dental office support staff 

such as the nurse, hygienist, and chair 

assistant. The CAMLOG team concept 

takes all of these demands into consideration. 

The sequence of treatment procedures 

is structured, and specific procedures 

are clearly assigned to specific 

team members once the joint planning 

phase is complete. Pre-implantation surgical 

interventions and the implantation 

itself are carried out by the surgeon, or 

a surgically qualified restorative dentist. 

The surgical instrumentation should be 

simply and thoughtfully organized. If a 

transgingival implantation (one-step) is 

to be performed, this eliminates a second 

intervention (implant exposure). In 

contrast, if a covered implantation is 

selected (two-step), a healing cap must 

be attached for soft tissue conditioning 

for three weeks after the exposure and 

before taking the impression, depending 

on the indications. The dentist/surgeon 

takes the impression using the transfer 

system and an impression material of 

choice (silicone, polyether, etc.). In addition 

to the impression components, only 

a screwdriver is required. 

12 

The implant-abutment selection is made 

after the master cast has been fabricated 

in the laboratory. 

Because of the high precision of the 

implant components and the rotational 

stability of the implant-to-abutment connection, 

time-consuming intermediate 

try-ins can be skipped. Both dentist and 

dental technician can concentrate on 

esthetics and the hygienic adaptability 

of the restoration because the insertion 

of the abutment is so simple and quick. 

Single-crown restorations, small bridges, 

bar abutments with the CAMLOG passive-fit 

system, and telescopic crowns 

can be fabricated to offer a perfect fit. 

The CAMLOG ® Implant System is therefore 

user-friendly and time-saving. The 

scope and value of pre-implantation 

diagnostics have changed. Today, preimplantation 

diagnostics must be oriented 

exclusively to prosthetic needs (backward 

planning). 

Since implant-supported treatment success 

is judged almost entirely in terms of 

esthetics and function, no prior compromises 

in these areas should ever be considered. 

The objective is to obtain a 

patient-oriented total rehabilitation. 

Sequence of Treatment Procedures 

• Planning Team 

• Pre-treatment Dentist (surgeon, if needed) 

dental support staff, hygienist 

• Implantation Dentist (surgeon, if needed) 

• Impression taking Dentist (surgeon, if needed) 

• Cast fabrication Dental technician 

• Plan review, abutment selection Dentist, dental technician 

• Prosthesis fabrication Dental technician 

• First bake (esthetics) try-in Dentist, dental technician 

• Finishing Dental technician 

• Prosthesis insertion Dentist 

• Maintenance/recall Dentist, support staff

2. Treatment Concept 

Introduction 

It is known from general physiology that 

both non-loading and underloading of 

the bone induces degradation just as 

much as overloading (inactivity atrophy, 

pressure atrophy). The area between 

these two extremes is called normal 

loading. This consists in a balance 

between growth and degradation. 

Working with bridge restorations in conventional 

prosthetics has led to identification 

of consistently high rates of bone 

degradation in non-loaded or underloaded 

abutment teeth (Misch/Frost 

1990). 

W. Schulte recognized this in 1982 and 

proposed early (= immediate, if possible) 

implantation to offset atrophy of the 

periodontal structures, which commences 

immediately after tooth loss. The implant 

supports the alveolar bone and tooth-bytooth 

implant-supported rehabilitation 

prevents the bony areas from being 

either overloaded or subjected to inactivity 

atrophy (stress-shielding). 

References 

Frost HM. Bone "mass" and the 

"mechanostat": a proposal. Anat Rec 

1987; 219:1-9 

Misch CE. Contemporary implant dentistry. 

St Louis. Mosby Inc. 1999; 

Ch.22:317-318 

Schulte W. Das Tübinger Implantat. 

Schweiz Mschr Zahnmed 1985; 95:872- 

874 

Leverage Relations at the Implant 

Loading of the implant-bone interface is 

a result of the leverage relation generated 

by osseointegration-related resistance 

to the prosthesis load arm (equivalent to 

the supracrestal implant length plus the 

height of the crown above the implant 

shoulder). If this (IL) is less than 1 (CL), 

then the load must be reduced (e.g., 

through prosthetic splinting). 


Treatment Concept 

13



Esthetics 

The use of therapeutic methods from an 

esthetic perspective is very dependent 

upon the initial situation and the visibility 

of the esthetic impairment. In the 

"esthetic zone" (anterior maxillary 

area), the smile line (as described by 

Kois) determines the extent of work that 

may be necessary. If prominent transversal 

or vertical hard or soft tissue deficits 

are present that affect the extraoral soft 

tissue profile, then lip and cheek support 

will have to be provided through suitable 

augmentative methods such as 

implant positioning or prosthesis design. 

These can restore the patient's physiognomy 

to a large extent. 

14 

Low smile Line 

The patient exhibits: 

Fixed Restorations 

Single Crowns 

Single crown treatment in the form of 

tooth-by-tooth restorations is the desirable 

and ideal form of treatment for the 

purpose of a complete oral makeover. It 

contains all the beneficial elements of 

periodontal prosthetic rehabilitation: 

• Physiologically adequate, biomechanical 

loading prevents further atrophy of 

the hard and soft tissue. 

• Good preconditions for natural-looking 

esthetics are established. 

• Oral hygiene is simple. 

• Fabrication is technically straightforward. 

• Readily extendable/alterable. 

• Maintenance is easy. 

• Economical for the patient in the middle 

and long term. In the event of further 

tooth loss, no new construction is 

necessary, just extension. 

Esthetically difficult Areas 

To achieve an esthetically successful 

restoration, a number of important elements 

are required: a harmonious gingival 

line, optimal implant positioning on 

both vertical and horizontal planes, a 

natural-looking crown shape, and the 

presence of interdental papillae. The 

indications for the hard tissue configurations 

to be preserved and for soft tissue 

management must be observed during 

planning. Structure-preserving or structure-sparing 

procedures must be used 

during flap creation and implant placement. 

In addition, oral hygiene requirements 

must be kept in mind during planning. 

Vertical implant position 

Mesiodistal implant position at bone level Distance to bone level 

Objective 

Single crowns (tooth-by-tooth treatment) 

provide the ideal restoration in terms of 

biomechanical, esthetics, hygiene, 

tongue comfort, and muscular balance. 

They prevent inactivity atrophy of the 

bone surrounding the implant through 

physiological loading. 



15



Splinted Crowns 

In the event of unfavorable leverage 

relations around the implant, a choice 

must be made between a longer implant 

or, if this is anatomically impossible, 

splinting adjacent crowns. If splinting is 

required by reason of statics, then 

hygienic requirements must also be 

taken into account. 

Development of a uniform insertion 

direction for the crown block should be 

part of the abutment preparation. The 

implant-to-abutment connection should 

not be altered. 

16 

Single-crown restoration 

Crown splinting 

Single-crown restoration in the 

augmented maxillary posterior area 

Crown splinting in the augmented maxillary 

posterior area

Implant-Supported Bridges 

Implant-supported bridges can be inserted 

wherever an implantation is impossible. 

Implant distribution should be structured 

in such a way that spanned 

segments are kept small. 

Development of a uniform insertion 

direction for the crown block should be 

part of the abutment preparation. The 

implant-to-abutment connection should 

not be altered. 

Examples of bridge positioning 

Initial situation 

Abutments in a lab analog 

Prepared abutments Cemented bridge 



17



Removable Restorations 

Introduction 

A hybrid denture may be implantretained, 

mucosa-supported, or implantsupported. 

The tension-free seat of a 

secondary (telescopic crown) or primary 

(bar) splinted structure on implants is 

called as "passive fit". 

Telescopic Crowns 

The production precision of the CAMLOG 

connection is particularly necessary with 

a telescopic crown restoration since the 

abutments can be fastened always in the 

same, exactly defined position on the 

implant. A precision fit for the removable 

superstructure is made simple and consistent 

in every case. 

Indication: The telescopic crown technique 

is suitable for jaw relations in 

Angle Classes I and III. 

18 

In the case of telescopic crowns, this is 

obtained through intraoral bonding of 

the secondary crowns (preferably galvano 

crowns) onto the tertiary framework. 

In the case of bar structures, it 

involves the use of bar sleeves for a passive 

fit and intraoral bonding of the titanium 

bonding base. 

The idea is to create a fit that is free 

from stress or to minimize stress on the 

implants. In the planning of a removable 

denture the implants should be placed 

so that, if necessary, a tooth-by-tooth 

restoration or a fixed restoration is possible.

Bar supported Dentures 

Bars are suitable for jaw relations in 

Angle Class II and for large horizontal 

deficits. It may be possible to fabricate a 

bar structure with either prefabricated or 

individualized components. 

Ball Abutments 

The ball abutment is suitable for simple, 

implant-retained prosthetic restorations. 

It is simply a retainer, but positional stability 

can be created through addition of 

an extension prosthesis. 



19

Planning 

General Information 

III. Planning 

1. Introduction 

Modern implant prosthetics is planned 

by working back from the desired therapy 

goal; this is referred to as "backward 

planning." It applies particularly to preimplantation 

augmentation procedures 

to restore sufficient bony structure to 

allow placement of implants in the optimal 

prosthetic position. 

Overview 

A planning project may be divided into the following modules: 

• Actual situation / prosthetic 

initial situation 

Find out and document the actual situation 

by taking a general and special 

(dental) history and performing intraand 

extraoral clinical, functional and 

radiographic examinations. Together, 

these findings are the basis for a 

description of the initial situation of 

the oral-maxillofacial system. 

• Individual treatment goal 

A full analysis is conducted with the 

patient, including a cost/benefit, 

work/benefit, and risk/benefit analysis. 

The final result will be a treatment 

goal customized to the desires and 

options of the patient. 

20 

Function, phonetics, and hygienic potential 

require prosthetically oriented 

implant positioning and dimensioning, 

which the dental technician defines on 

the basis of the wax-up. The prosthetic 

design and the required implant position(s) 

and axial alignment(s) are 

planned by the dentist and dental technician 

working closely together. This 

requires both to be fully informed of the 

treatment options. 

• Ultimate treatment goal 

An ultimate treatment goal is defined 

by integrating the diagnosis, needs, 

patient's wishes for esthetics and 

function, and findings from the waxup/set-up. 

• Treatment sequence 

With the individualized treatment 

goal as guide, prosthetically oriented 

implant positioning is defined and 

verified clinically and radiographically. 

Then, a treatment sequence is set up. 

It includes the planning of ancillary 

procedures, augmentation, and any 

required pretreatment. 

If implant positions (implants approximating 

the former tooth positions) cannot 

be implemented for a fixed denture 

for whatever reason – functional 

(implant loading, crown length), esthetic 

(soft tissue support) or hygienic – a 

removable denture must be planned.

2. Anamnesis 

Introduction 

The medical history and diagnosis are 

not different from the evaluation procedures 

required for other dental surgery 

or restorative treatments. For this reason 

only the specific points for perio-implant 

prosthetic treatments are described 

below. 

The general, social and special (dental) 

medical history considers all general 

medical contraindications and diseases 

that could affect the microcirculation or 

the patient's suitability for the proposed 

implant-based restoration. Risk factors 

such as nicotine, alcohol and drug abuse 

are confidentially evaluated, discussed 

and documented. 

The patient's psycological and psychosocial 

situation gives an indication of the 

compliance that can be expected and 

will influence the planning of the treatment 

and the future prosthetic design. 

General 

The general medical history should 

include not only the disease history but 

also regular medication usage and the 

possibility of general medical problems 

that could adversely affect an implantbased 

prosthetic treatment. 

Special (dental) 

The special medical history must clarify 

the reasons for the current situation of 

the oral system. 

It may provide information on systemic 

diseases that may not have been detected 

yet. If implants or grafts were previously 

placed this may be important for 

assessment of the bone quality. 

3. Examinations 

Clinical 

In addition to all standard extraoral 

examinations, the soft tissue profile and 

support of the soft tissues (especially in 

the maxilla) are a critical factor in 

designing the prosthesis. If a large discrepancy 

exists between the required 

labial tooth position and the proposed 

implant position, the use of a removable 

denture (bar-structure, telescopic crown, 

ball abutment, Locator ® ) may be necessary 

for loading reasons. 

The results of the intraoral examinations 

determine which teeth can be saved. The 

standard of hygiene is evaluated and a 

check of the soft tissue for pathological 

conditions is performed for information 

on the patient's possible compliance 

during and after treatment. 

The static and dynamic occlusion, interalveolar 

distance, and centric relations 

are checked. Temporomandibular joint 

disorders are addressed before the start 

of treatment. 

All findings indicating elevated stress on 

the masticatory system (e.g., bruxism) 

must be investigated, documented, and 

considered in the prosthetic planning. 

The status of the soft tissue in edentulous 

arch segments (width and thickness 

of the attached gingiva) must be 

checked and the extension of the alveolar 

ridge must be evaluated for its suitability 

as a possible implant site. 

Planning 


21

Planning 


Radiographic Evaluation 

Dental x-rays 

Dental x-rays are sufficient for the initial 

assessment of bone supply with single 

tooth gaps or small interdental gaps. The 

periodontic situation of the remaining 

dentition must be closely examined, 

because the implant site may be colonized 

by pathogenic organisms from 

infected pockets. 

Orthopantomograph 

An OPG is a critical instrument for gathering 

basic information. Additional data 

required by the specific situation may be 

obtained through dental x-rays, remote 

x-ray side views, or computer-tomographic 

scans (CT). 

Remote x-ray side View 

Use for large sagittal differences and 

planned bone removal in the chin 

region. 

Computer-Tomographic Scan 

The CT is an instrument to be used for 

extensive radiological diagnostics. It 

enables a 3-D evaluation of the site 

from its anatomical structures and the 

planning of augmentations. Indications 

must be strictly adhered to because of 

the level of radiation exposure involved. 

22 

Laboratory 

Cast Analysis 

It is essential to mount a diagnostic cast 

in an adjustable articulator to assess jaw 

relations. Specifically, a check should be 

made whether a change of the 

occlusal position is worthwhile or 

required. If at all possible, it should be 

done before the actual implant-supported 

prosthetic treatment gets under way. 

In any case, a change in occlusal height 

must be preceded by treatment with a 

long-term provisional. 

Diagnostic Casts 

The diagnostic casts must clearly show 

not only the occlusal surfaces but also 

the vestibular fold and retromolar areas 

(see arrows). 

Diagnostic casts for implant planning are 

made of super-hard dental stone, just as 

in perioprosthetics, and mounted on an 

adjustable articulator with an arbitrary 

face bow and centrics registration. The 

centric registration must be freely 

adjustable to enable the casts to be 

mounted in correct axial alignment and 

position. 

The impression should reproduce the 

soft tissue situation and any hard or soft 

tissue deficits as far as the vestibular 

fold, since it is here we detect the first 

indications to incline the implant or the 

necessity for bone augmentation. Just as 

in perioprosthetics, the retromolar areas 

must be reproduced to allow specification 

of the dental arch and assessment 

of the vertical space available (see 

arrows). 

Planning and implementation of periodontal 

implant-supported rehabilitation 

will be considerably simplified if templates 

are used.

Articulator Set-Up 

The diagnostic casts are mounted in an 

adjustable articulator with the aid of an 

arbitrary face bow and centric registration 

as in perioprosthetics. 

Occlusal Height 

If an occlusal height requires correction, 

this must be done with a guard or longterm 

provisional before the implant-supported 

prosthetic restoration begins. 

Initial Prosthetic Situation 

The initial prosthetic situation describes 

the dental status, arch relations, the 

anatomical status of the oral hard tissue, 

the intraoral and extraoral soft tissue, 

the presence of functional, phonetic and 

esthetic restrictions on the patient, and 

the resulting influence on the patient's 

quality of life. 

Arch Relations (transversal) 

The arch relations control the load direction 

and therefore the axial alignment of 

the implants also. This is particularly 

important with cross-bite situations. 

Planning 


Arch Relations (sagittal) 

Crowns cannot be placed precisely over 

the implants in the presence of Angle 

Class II dentition because the soft tissues 

must be supported and the space 

for the tongue must not be reduced. A 

removable denture is indicated in this 

situation. 

23

Planning 


4. Preliminary 

Prosthetic Design 

Wax-Up/Set-Up 

The wax-up or set-up is prepared on the 

working cast in the dental laboratory. 

This permits planning of optimal tooth 

positioning from both functional and 

esthetic perspectives. It also enables early 

recognition of the need for augmentation 

procedures if a discrepancy is 

detected between the atrophied crestal 

bone and the required position for a 

prosthetic crown. 

The ideal articulation pattern to aim at 

is a situation-adapted anterior-to-cuspid 

line with early disclusion of the posteriors 

("freedom in centric" should be possible). 

24 

Initial Situation 

Wax-Up/Set-Up

Planning Template 

A planning template is fabricated to 

review the planned implant positions in 

the mouth. The template can be converted 

to a drilling template later. 

The dental technician initially fabricates 

a complete wax-up/set-up with all missing 

teeth in their ideal prosthetic position 

for preliminary planning of the prosthetic 

design. In accordance with the 

"backward planning" principle, any 

anatomical deficits are not considered at 

this stage. The treatment goal specifies 

the surgical and prosthetic procedure. 

A silicone index is fabricated from this 

set-up. After hardening, the index is 

divided orally along the central occlusion 

to form a labial and an oral section. An 

acrylic template can be fabricated with 

the aid of the silicone index. 

Alternatively, the work can be done with 

a rigid vacuum foil via a duplicate cast. 

Depending on the x-ray methods, radioopaque 

markers (e.g., titanium, steel, 

barium sulfate) are integrated. 

Silicone Index 

Cast with Planning Template 

Planning 


25

Planning 


X-Ray Template 

In the planning template or base produced 

from the wax-up/set-up, CT-planning 

tubes or other radio-opaque markers 

are integrated at the ideal 

implantation position and are used as 

reference positions in the x-ray image. 

The tubes consist of two parts: The titanium 

used leaves no scattering on CT 

scans. The lower part is polymerized in 

the template and the upper part inserts 

into this. The complete tube is used in 

radiologic diagnostics, and the upper 

part can be removed during surgery. 

Titanium tubes for CT-planning or other 

radio-opaque positioning components 

(steel, barium sulfate) are integrated, 

depending on the analysis software. If 

the tubes are placed directly on the 

mucous membrane, its thickness can be 

detected on the CT scan. For more information, 

see the documentation for these 

systems. 

26 

CT-tubes for CT-planning 

for drills Ø 2.0 mm: 

Inner Ø 2.1 mm 

Outer Ø 2.5 mm 

Planning template with tubes for CT planning 

X-ray template, outlined with tubes 

Drill for CT-tube 

placement 

Template without tube upper section for use as 

a drilling template 

X-ray template with radio-opaque teeth and 

installed tubes

5. Implant Position 

Verification 

Goal 

The goal is to specify the possible 

implant positions. Now, the final implant 

planning is performed depending on the 

selected concept. The x-ray images must 

show calibrated measurement points to 

enable measurement of the bone volume 

available for the implantation. 

Orthopantomogram 

Planning films are available in 1:1.25 

and 1:1.4 sizes for all implant types to 

check the dimensions on the OPG. The 

film magnifications match the magnification 

factors for most OPGs. However, 

they should be considered only as 

approximations in implant dimensioning. 

Dental Film 

To check the dimensions on x-ray film, 

the self-adhesive implant planning films 

(x-ray transfer pictures) for the specific 

implant type should be attached to the 

proposed implant positions on the film. 

Clinical 

The wax-up or set-up must be tried in on 

the patient. This allows esthetics to be 

included in the plan, such as the smile 

line, tooth shade, facial shape and general 

presentation of the patient. 

Planning 


27

Planning 


CT Scan with/without 3-D 

Evaluation 

A precise three-dimensional evaluation 

of the bone dimensions is possible only 

with a CT scan. Simulation programs can 

be used for computer-supported evaluation. 

Special conditions such as septation 

or infections in planned sinus-floor 

elevations and critical vertical relations 

in the mandible can be recognized. 

Depending on the program, the template 

must include radio-opaque position 

markers (titanium balls, titanium tubes, 

barium sulfate coating). 

28 

The medical information derived from 

the x-ray template can be used to determine 

the bone volume and quality with 

the aid of a CT scan and 3-D evaluation 

and this will define the subsequent therapy 

procedure (number of implants, 

implant position, implant diameter, and 

implant length). 

The final prosthetic design and the hard 

and soft tissue augmentation, if required, 

are discussed with the patient on the 

basis of this information and approved. 

Drilling Template 

Using this radiographic information, the 

planned implant positions are checked 

and adjusted if necessary. The x-ray template 

is thereby converted to a drilling 

template. The positions of the titanium 

tubes are modified or specified in the 

template. In consultation with the surgeon, 

the template is reduced to an 

outline after preparation of the flap to 

ensure it stays in position during surgery, 

i.e., stability requires a dental or gingival 

base outside the planned surgical 

field. 

View of the cast positioning X-ray templates in situ 3-D planning of implant positions 

View of the cast positioning X-ray templates in situ 3-D planning of implant positions

Final Prosthesis Design 

The surgical feasibility of the treatment 

sequence is checked with reference to 

the initial situation, the casts, and the 

x-ray findings. Depending on the clinical 

situation, periodontal or augmentation 

interventions are performed before 

implant surgery or at the time of the 

implant placement. 

Individualization of the Prosthetic 

Design 

The patient's wishes regarding the scope 

and cost of the implant-supported prosthetic 

restoration expressed in the 

patient interview are incorporated into 

the individual prosthesis design. The 

number of implants, the requirement for 

augmentation and possible soft-tissue 

corrections are determined exclusively by 

local conditions and the prosthetic 

design. This interview must be documented 

in detail and the patient must 

sign a statement of consent before 

implementing the treatment process. 

Planning the Treatment Sequence 

Now that the prosthetic goal has been 

defined, the required treatment steps are 

specified in a backward planning 

process. This process must include all 

details that are likely to be required, 

particularly in connection with augmentation. 

The planning template can now 

be converted into a drilling template. 

Documentation of Patient Interview and Explanation 

The results of the planning process are discussed with the patient. Casts, x-ray 

images, and the planning devices (wax-up and set-up) are helpful, here. 

The following criteria are considered: 

• Initial situation 

• Desires and expectations regarding esthetics, function and comfort 

• Effort/benefit ratio 

• Costs 

• Risk 

• Duration of treatment 

• Restrictions in comfort during treatment 

Planning 


29

Planning 

Recommended Indications 

6. Recommended 

Indications for the 

Different Implant 

Configurations 

CAMLOG ® implants are endosseous 

implants, available in different lengths 

and configurations. They are placed surgically 

in the maxillary and/or mandibular 

bone and serve as anchors for functional 

and esthetic oral rehabilitations in 

partial or fully edentulous patients. 

Prosthetic treatments include single 

crowns, bridges, partial or full dentures 

attached to CAMLOG ® implants through 

suitable connection elements. Generally 

there are no preferred sites for the use 

of the different implant geometrys. 

An independent selection of implants 

according to the surgical situation is 

possible because the diameter-specific 

prosthetic platform is identical for all 

implant configurations. Different implant 

types can be used in the same arche. 

30 

SCREW-LINE Implant 

Both Promote ® and Promote ® plus 

SCREW-LINE Implants are universally 

applicable. 

ROOT-LINE Implant 

The ROOT-LINE Implant (with Promote ® 

surface) is a root-shaped, screw-type 

implant and is specifically indicated in 

conditions of apically reduced bone supply 

(canine fossa, apically on the mylohyoid 

line). The root-shaped design is 

particularly advantageous in the presence 

of root convergence from adjacent 

teeth.

SCREW-CYLINDER-LINE Implant 

The SCREW-CYLINDER-LINE Implant 

(with Promote ® surface) is particularly 

suitable for restorations in structurally 

weak sites on the posterior maxilla. In 

conjunction with sinus floor elevation 

and augmentation, its segmentally 

threaded configuration permits use of 

the residual crestal bone height (>5 

mm) to stabilize the implant. The cylindrical 

apical segment preserves the sinus 

mucosa during insertion of the implant 

(no thread edges) and provides superior 

adaptation to the particular bone augmentation 

material used. 

CYLINDER-LINE Implant 

CYLINDER-LINE Implants (with TPS surface) 

are universally applicable. A particular 

advantage of this implant type is its 

simple, time-saving application procedure. 

In conjunction with sinus floor elevation 

and augmentation, the press-fit 

from the cylindrical configuration of the 

implant allows it to be placed in a structurally 

weak site with a residual bone 

height

IV. Surgery Manual 

1. Preparation of the Patient 

The patient is prepared according to the 

standard routine for a surgical intervention. 

Depending on the indication, 

antibiotics and anti-inflammatories may 

be administered before and/or after surgery. 

In addition, an oral or intravenous 

sedative may be indicated depending on 

the patient's history and general health 

status. 

2. Drilling Template 

Before using a drilling template, it is 

necessary to check its outline for the 

planned incision line and to disinfect the 

template. The drilling template must also 

be reproducible after the flap preparation 

by remaining stable in place, and 

must adhere to the soft tissue without 

pressure. 

3. CAMLOG ® Surgery System 

All the drills, drivers, and accessories 

required for the implantation of the particular 

implant configuration are systematically 

organized in the Surgery Set. The 

sequence of use of the drills and instruments 

in compliance with the CAMLOG 

surgical protocol is color-coded according 

to diameter. The following Surgery 

Sets with their matching drills are available: 

• SCREW-LINE 

• ROOT-LINE 

• SCREW-CYLINDER-LINE/CYLINDER- 

LINE 

Color Coding 

Ø 3.3 mm grey 

Ø 3.8 mm yellow 

Ø 4.3 mm red 

Ø 5.0 mm blue 

Ø 6.0 mm green 

Surgery Manual 

Introduction 

33


CAMLOG ® Surgery System 

SCREW-LINE Surgery Set 

34 

SCREW-LINE

ROOT-LINE Surgery Set 

ROOT-LINE 



35



SCREW-CYLINDER-LINE/CYLINDER-LINE Surgery Set 

SCREW-CYLINDER-LINE/CYLINDER-LINE 

36

Drilling System 

Drilling Speed 

The drilling speed is diameter-dependent. 

The recommended speed is 800-300 

rpm depending on the drill type. The 

recommended maximum drilling speed 

for thread tapping is 15 rpm. The tap 

adapter for ratchet also permits manual 

tapping. 

Article Speed (rpm) 

Round bur 800 

Pilot drill 2.0 mm / depth stop 800 

Pre-drill Ø 1.7 / 2.8 mm 600 

Form drill Ø 3.3 mm / depth stop 550 

Cortical bone drill Ø 3.3 mm** 550 

Tap Ø 3.3 mm* max. 15 













The lower edge of the depth mark is the reference for the implant length. The maximum apical 

extension length is 0.6 mm. 

** Use of a tap is recommended for SCREW-LINE , ROOT-LINE, and SCREW-CYLINDER-LINE Implants if 

the bone quality is D1 or D2. 

** The SCREW-LINE cortical bone drill reduces the torque for implant insertion into cortical bone (D1). 


Drilling System 

Cooling 

The CAMLOG ® drilling system for 

implant bed preparation consists mostly 

of internally irrigated drills for cooling. 

The cooling liquid is sterile saline solution 

(prechilled to 5°C/41°F). 

Optimum cooling consists of a combined 

internal/external cooling at the angled 

handpiece. 

Drill life 

Drill longevity depends on bone quality 

and drilling technique. The pilot drills, 

pre-drills, and form drills are good for 

10-20 drilling cycles. If excessive force 

has to be applied because of a dull drill, 

then change the drill immediately to prevent 

bone overheating. 

37


Implant Healing 

4. Healing Options 

Introduction 

Depending on the indication, healing of 

the CAMLOG ® implants may be managed 

through the transgingival or submerged 

techniques. Suitable components are 

available for the selected option. 

38 

One-step Healing 

(transgingival) 

Healing caps in different configurations 

and gingival heights are available for 

one-step, non-loaded healing (see the 

section "Healing caps"). 

Esthetic Immediate Restoration 

The PEEK Provisional Abutment can 

be used for an esthetic immediate 

restoration (see also the CAMLOG 

Compendium 2 Prosthetics section: 

"Temporary restoration"). 

Two-step Healing 

(submerged) 

The cover screw remains in the implant 

for the duration of the submerged healing 

period.

5. SCREW-LINE Implant 

Introduction 

The SCREW-LINE Implant is a universally 

indicated screw implant with the option 

of either Promote ® or Promote ® plus surface. 

It is suitable for both late implantation 

and immediate/delayed immediate 

implantation. The selected healing method 

may be either submerged or transgingival. 

The implant is easily insertable because 

the taper of the implant body (3°-9° 

depending on length and diameter) 

induces self-centering. The self-tapping 

thread provides a continuous grip on the 

bone and high primary stability. The 

macro-configuration of the implant in 

conjunction with the Promote ® plus surface 

leads to larger contact with the 

bone, compared with the Promote ® sur- 

Area of Use/Indication for the 

SCREW-LINE implants with 

Promote ® plus Surface 

A smaller coronal implant shoulder is 

especially beneficial in treating esthetically 

challenging areas. The machined 

segment of a SCREW-LINE Implant with 

Promote ® plus surface measures only 0.4 

mm. The implant is inserted into the 

bone as far as this segment. 

The following clinical prerequisites 

should be present: 

• Normal to thick biotype 

• Gingival height of at least 3.0 mm 

• Minimum width of 1.0 mm of the 

attached gingiva 

• Minimum distance of 2.0 mm between 

the attached gingiva and the mimetic 

musculature 

• Removal of the periosteum at the time 

of exposure to be performed at the 

implant insertion area only. 


SCREW-LINE Insertion 

Apart from these requirements, the 

range of indications and the implant bed 

preparation for SCREW-LINE Implants 

Promote ® and Promote ® plus are identical. 

face. SCREW-LINE Implant 

SCREW-LINE Implant 


Promote ® 

39



SCREW-LINE Implant with Promote ® 

plus Surface 

Overview of implant lengths and 

diameters. 

SCREW-LINE Implant with Promote ® 

Surface 

Overview of implant lengths and 

diameters. 

40 

The machined segment on the implant neck 

measures 0.4 mm. 

The machined segment on the implant neck 

measures 1.6 mm.

Incision line 

The example indication shows the insertion 

of a 4.3 / 13 mm SCREW-LINE 

Implant in the posterior mandible. The 

implantation technique is one-step 

transperiosteal. A split-flap preparation 

is selected for the incision line. 

Following a somewhat lingual, paracrestal 

mucosal incision, a predominantly 

epiperiosteal flap is created on the 

vestibular aspect. The muscle is divided 

and the preparation is continued for 

approx. 5 mm further. The mucosa is 

separated 2-3 mm lingually to facilitate 

later suturing. Following marking of the 

desired implant position (if necessary 

with the aid of a drilling template), the 

periosteum is removed circularly in the 

area of this site alone (with a gingival 

punch or scalpel). 

This is followed by shaping of the 

implant bed to match the selected 

implant diameter and length with the 

customized instruments for the SCREW- 

LINE Implant. 


Mucosal incision 

Epiperiosteal 

split-flap preparation 

Removal of the periosteum 

at the implant site 



41



Implant Bed Preparation 

Overview of the implant bed preparation. 

Note: implant bed preparation is identical 

for SCREW-LINE Implants with 

Promote ® and Promote ® plus surfaces. 

• Punch-mark the desired implant position 

with the internally irrigated Ø 

2.3 mm round bur. 

• Deep drill along the implant axial line 

with the internally irrigated Ø 2.0 mm 

pilot drill. 

• Check with Ø 1.7-2.8 / 2.0 mm paralleling 

pin with depth marks. 

• Pre-drill with the internally irrigated Ø 

1.7-2.8 mm pre-drill. 

• Check with the Ø 1.7-2.8 / 2.0 mm 

paralleling pin with depth marks. 

• Shape with internally irrigated form 

drill. 

• Probe the implant bed hole for its 

bony end. 

• Cortical bone drilling (for bone quality 

D1). 

• Thread cutting with SCREW-LINE tap 

(for bone quality D1 and D2) 

42 

Optional for all 

diameters 

1.0 mm 

0.4 mm 


Promote ® 

0.4 mm 

The indication range and implant bed 

preparation of the SCREW-LINE Implant 

are identical for Promote ® and Promote ® 

plus surfaces. 

Drilling Sequence 

Ø 3.3 mm 

Ø 3.8 mm 

Ø 4.3 mm 

Ø 5.0 mm 

Ø 6.0 mm 

Round bur 

Ø 2.3 mm 

Round bur 

Ø 2.3 mm 

Round bur 

Ø 2.3 mm 

Round bur 

Ø 2.3 mm 

Round bur 

Ø 2.3 mm 

Pilot drill 

Ø 2.0 mm 

16 mm 

13 mm 

11 mm 

9 mm 

16 mm 

13 mm 

11 mm 

9 mm 

16 mm 

13 mm 

11 mm 

9 mm 

16 mm 

13 mm 

11 mm 

9 mm 

16 mm 

13 mm 

11 mm 

9 mm 

Depth Stop 

Depth Stop 

Depth Stop 

Depth Stop 

Depth Stop 

* If the bone quality is D1 or D2, use of the tap (thread cutter) is recommended for SCREW-LINE 

Implants. 

Paralleling pin 





Pre-drill 

Ø 1.7 – 

2.8 mm 

rpm 800 800 600 

Pilot drill 

Ø 2.0 mm 

Pilot drill 

Ø 2.0 mm 

Pilot drill 

Ø 2.0 mm 

Pilot drill 

Ø 2.0 mm 

16 mm 

13 mm 

11 mm 

9 mm 

Pre-drill 

Ø 1.7 – 

2.8 mm 

rpm 800 800 600 

16 mm 

13 mm 

11 mm 

9 mm 

Pre-drill 

Ø 1.7 – 

2.8 mm 

rpm 800 800 600 

16 mm 

13 mm 

11 mm 

9 mm 

Pre-drill 

Ø 1.7 – 

2.8 mm 

rpm 800 800 600 

16 mm 

13 mm 

11 mm 

9 mm 

Pre-drill 

Ø 1.7 – 

2.8 mm 

rpm 800 800 600 

16 mm 

13 mm 

11 mm 

9 mm

13 mm 

11 mm 

9 mm 

13 mm 

11 mm 

9 mm 

13 mm 

11 mm 

9 mm 

13 mm 

11 mm 

9 mm 

13 mm 

11 mm 

9 mm 

Depth Stop 

Depth Stop 

Depth Stop 

Depth Stop 

Depth Stop 






Ø 3.3 

Form drill 

550 550 15 

Ø 3.3 

Form drill 

550 500 500 15 

Ø 3.3 

Ø 3.8 

Form drill 

550 500 400 400 15 

Ø 3.3 

Ø 3.8 

Form drill 

550 500 400 350 350 15 

Ø 3.3 

Ø 3.8 

Ø 4.3 

Ø 4.3 

Ø 4.3 

Ø 5.0 

Ø 5.0 

Ø 6.0 

Form drill 

550 500 400 350 300 300 15 

** The SCREW-LINE cortical bone drill reduces the torque for implant insertion into cortical bone (D1). 

Ø 3.8 

** 

Cortical bone drill 

** 


** 


** 


** 


* 

Tap 

Tap* 

* 

Tap 

* 

Tap 

* 

Tap 






Promote ® 

Promote ® 

Promote ® 

Promote ® 

Promote ® 

0.4 mm 

0.4 mm 

0.4 mm 

0.4 mm 

0.4 mm 

43



Implant Bed Preparation for SCREW-LINE Implants 

Shaping the implant bed includes Punchmarking 

the cortical bone, pilot drilling, 

pre-drilling, and form drilling. 

The pilot hole and pre-drill hole define 

the depth and axis of the implant bed 

and ensure conservative bone preparation 

by enlarging the diameter in small 

gradations. 

SCREW-LINE Depth Stop 

The SCREW-LINE pilot drill, reduced coil, 

and the SCREW-LINE pre-drill have a 

maximum working length of 16 mm. The 

drilling depths of 9, 11, and 13 mm are 

laser-marked. An insertable depth stop 

limits the drilling depth to the selected 

depth of 9, 11, or 13 mm. 

Caution! The pilot drill and predrill 

have a reduced diameter at 

the drill coil. The SCREW-LINE 

depth stops are matched to these 

drills. 

44 

Drill Extension 

A drill extension is available to prevent 

resting of the angled handpiece on the 

dental crown during preparation of the 

implant bed adjacent to elongated teeth. 

A longer irrigation tube is required for 

the internal irrigation system. 

Drill extension 

SCREW-LINE depth stop

SCREW-LINE paralleling Pin with 

Depth Marks 

On completion of pilot drilling and predrilling, 

the depth and axis orientation 

of the implant bed are checked with the 

paralleling pin with depth marks. 

The diameter combination 1.7-2.8/2.0 

mm permits consecutive use while 

matching the drill diameter. 

SCREW-LINE paralleling pin 

The depth marks and diameter gradations 

on the paralleling pins allow to 

check the drilling depth and axis at each 

stage of pilot drilling and pre-drilling. 

Short paralleling pins are available as 

accessories to check the implant/antagonist 

alignment. 

Paralleling pin, short 



45



Punch-Marking the Cortical Bone 

The Ø 2.3 mm internally irrigated round 

bur is used for Punch-marking the cortical 

bone, which secures the use of the 

drills to follow. The bur is inserted as far 

as the bur equator. Recommended 

drilling speed: 800 rpm. 

Round bur, Ø 2.3 mm 

46 

max. 800 rpm 

Punch-marking the cortical bone Pilot drilling 

Pilot Drilling 

The depth and axis orientation are prepared 

with the internally cooled pilot 

drill with reduced coil. The depth marks 

on the drill correspond to the implant 

lengths: 9 / 11 / 13 mm. The maximum 

drilling depth is 16 mm. For safety reasons, 

a depth stop matching the proposed 

implant length should be used. 

Recommended drilling speed: 800 rpm. 

max. 800 rpm 

Pilot drill with reduced coil, Ø 2.0 mm 

If a drilling template is used, the depth 

stops may be placed on the pilot drill 

after the positions have been marked. 

Once drilling is complete, the depth and 

axis of the implant bed are checked with 

the paralleling pin. If several implants 

are to be placed, a paralleling pin is 

inserted in the first hole to align the 

subsequent implant axes. 

The pilot drill is aligned parallel to the 

paralleling pin and visually checked on 

two planes (sagittal and transversal). 


Depth measurement after pilot drilling

Pre-Drilling 

A tapered SCREW-LINE pre-drill with a 

2.8 mm coronal and 1.7 mm apical 

diameter is available for the SCREW- 

LINE configuration. The recommended 

drilling speed is 600 rpm. 

The depth marks on the drill match the 

implant lengths (9, 11, and 13 mm). The 

maximum drilling depth is 16 mm. For 

safety reasons, a depth stop matching 

the proposed implant length should be 

used. Further drilling is performed with 

the form drills. 

SCREW-LINE pre-drill Ø 1.7–2.8 mm 

Pre-drilling 

max. 600 rpm 


Checking the axis orientation after 

pre-drilling Ø 1.7 – 2.8 mm 



Depth measurement after pre-drilling 

47



Form Drilling 

Diameter and Lengths 

Diameter- and length-calibrated form 

drills with reduced coil are available for 

each implant size. The internally irrigated 

form drills are color-coded and lasermarked. 

The form drills included in the surgery 

sets are supplied with a color-coded 

removable depth stop. This should be 

used with the SCREW-LINE form drill, 

only. Depending on the specified drilling 

depth (implant length), the hole diameter 

is expanded progressively with the 

series of form drills until the planned 

implant diameter is reached. 

Recommended drilling speeds: 

Ø 3.3 mm 550 rpm 

Ø 3.8 mm 500 rpm 

Ø 4.3 mm 400 rpm 

Ø 5.0 mm 350 rpm 

Ø 6.0 mm 300 rpm 

The protocol-specified insertion depth 

with depth stops in place for SCREW- 

LINE Implants is the implant length 

(9 / 11 / 13 / 16 mm) minus 0.4 mm 

with the circular stop at the bone level, 

so that the implant shoulder extends 

0.4 mm above the ridge. 

If a greater insertion depth is desirable, 

the depth stop can be removed and the 

preparation will then be guided by the 

depth marks (black). The distances 

between marks are 1.0 mm, while the 

mark width is 0.4 mm. 

48 

Ø 3.3 mm Ø 3.8 mm Ø 4.3 mm Ø 5.0 mm Ø 6.0 mm 

SCREW-LINE form drills 

Length 

9 mm 11 mm 13 mm 16 mm

Depth Stop 

During implant bed preparation, the 

depth stop rests on the highest point of 

the crest and thereby limits the insertion 

depth. Since the circular bony ridge may 

be irregular, the form drills are equipped 

with a removable depth stop. If a deeper 

insertion is required for esthetic or functional 

reasons, the depth stop can be 

removed and form drilling can be continued 

for a further 2 mm at most (watch 

for anatomic structures!). The reusable 

depth stop can be used on replacement 

form drills (delivered without depth 

stops). 

The depth stop must be removed before 

cleaning the drill. The cleaned depth 

stop must be placed back on the drill 

before sterilization (see "Preparation 

Instructions for the CAMLOG ® Implant 

System," Art. No. J8000.0032). Depth 

stops may be reordered individually. 

Promote ® Promote ® plus 

The bottom edge of the first depth mark corresponds to the implant length 

with the depth stop in position. 

Form drill with depth stop Form drill without depth stop 



Caution! 

Because of the cutting angle on the 

drill tip of the form drill, the 

length exceeds the implant by up 

to 0.6 mm. 

49



Adjusting the depth by 1 mm 

Form Drilling 

Once pre-drilling is complete, form drills 

in increasing diameters are used for finishing 

the final implant bed. Tissueconservative 

preparation of the bone is 

ensured by the small gradations in 

diameter size. 

Example: 

Ø 4.3 mm form drilling 

50 

Adjusting the depth by 2 mm 

Checking the Implant Bed 

Results of probing tests for the absence 

of soft tissue in the implant bed must be 

filed in the patient chart. If the probe 

detects soft tissue, this indicates a fenestration 

into the adjacent tissue by the 

drill. 

Checking the implant bed

Cortical Bone Drilling 

If the bone quality is D1, the cortical 

bone drill enables reduced-torque 

implant insertion through controlled circular 

expansion of the implant bed in 

the apical area. The flattened drill tip 

serves as a depth stop. A color-coded, 

laser-marked cortical bone drill is available 

for each implant diameter. 

The cortical bone drills are internally 

cooled. The maximum drilling speed 

should not exceed 300 rpm. 


max. 300 rpm 

SCREW-LINE Cortical Bone form drills 

Ø 4.3 mm cortical bone drill 

for implant length 13 mm 



51



SCREW-LINE Tap 

Introduction 

All SCREW-LINE Implants come with a 

self-tapping thread with sand-blasted, 

etched surface (Promote ® , Promote ® 

plus). Use of a tap is recommended for 

bone qualities D1 or D2. 

The taps are internally cooled. The maximum 

drilling speed should not exceed 

15 rpm during power-assisted tapping. 

We recommend manual tapping. 

SCREW-LINE tap with hexagon 


52 

max. 15 rpm

Manual tapping is performed with the 

tap adapter for SCREW-LINE taps and 

the locked torque wrench. Make sure 

that the implant bed axis orientation is 

maintained during insertion and removal 

of the tap. The limit for insertion of the 

tap is the upper edge of the cutting 

blade. See also the instructions for the 

torque wrench on page 151. 

Caution! 

The SCREW-LINE taps must not 

be used for ROOT-LINE or SCREW- 

CYLINDER-LINE Implants. 

Locked torque wrench 

Tap Adapter, short / long 



53



Implant Package 

All CAMLOG ® implants are double-sterile 

packaged. The primary package (blister) 

of SCREW-LINE implants contains the 

implant with pre-installed insertion post 

and mounted handle. 

Outer package with label Peel-back pouch (sterile) 

Primary package (sterile) 

with label (blister pack) 

Primary package with 

visible implant 

System information on the label 

54 

Opened primary package with 

implant and mounted handle 

Cover screw located in the handle

Implant Positioning 

Protocol-compliant implant positioning 

(form drilling with depth stop) is 

achieved when the cylindrical machined 

implant shoulder extends 0.4 mm above 

the crestal bone and one of the 3 

groove marks indicates the specified 


If it was decided to set preparation 

depths for the implants individually by 

removing the depth stop during form 

drilling, this should be kept in mind during 

implant insertion. It is possible to 

individually position implants with the 

1.6 mm implant shoulder and Promote ® 

surface, or the 0.4 mm implant shoulder 

and Promote ® plus surface, vertically to 

match the drilling depth. 

It should be made sure, however, to 

position the Bioseal Bevel circularly in 

the cortical bone. 

Mark 

Cam 

Groove 

Vestibular orientation of the groove 

Driver 

Insertion post 

Implant 



Groove Positioning 

Marks are inscribed on the drivers for 

the SCREW-LINE Implants that match 

the three grooves on the CAMLOG 

connection. These permit to check the 

groove positions during the insertion 

and their orientation as required for the 

prosthesis. If the dental technician has 

not indicated the groove position, a 

vestibular orientation is advantageous in 

most cases since the abutment angle 

originates at a groove. 

Note: Keep in mind during positioning of 

the grooves that turning to the next 

groove position (120°) will cause the 

screw implant to be inserted about 0.2 

mm deeper. 

55



Implant Insertion 

The implant is removed from the primary 

package (blister) by the sterile handle. 

Contamination from non-sterile parts 

must be avoided. 

Caution! 

The silicone plug and cover screw 

must be removed from the blue 

handle prior to implant insertion. 

Taking the implant by the handle, insert 

it into the implant bed. Make sure to 

follow the orientation of the implant bed 

axis. If the hole has been pre-threaded, 

the position of the thread dog point in 

the cortical bone must match with that 

on the implant. 

Tip: 

Screw the implant carefully to the 

left until the thread dog point can 

be felt. 

Then, using the handle, screw the 

implant to the right until it obtains 

sufficient grip to allow withdrawal 

of the handle. 

Inserting the implant 

56 

Optional Accessory 

CAMLOG ® PickUp Instrument 

If the intraoral space is insufficient to 

allow insertion of the implant with the 

handle, the implant can be removed 

from the handle with the PickUp instrument. 

Slide the PickUp instrument 

between the implant and the handle 

onto the insertion post and lift off the 

handle. For the insertion procedure, 

place the selected driver on the insertion 

post. The implant is then inserted into 

the bone and the PickUp instrument is 

removed.

Placing the PickUp on the insertion post 

Locked-on PickUp 



Removing the handle Inserting the implant Mounting the driver and removing 

the PickUp 

57



You have three options for the final 

insertion of the implant: 

- Power-assisted insertion (A) 

- Manual insertion with the torque 

wrench and driver (B) 

- Manual insertion with the cardanic 

driver (C) 

During insertion make sure to use the 

external mark for the groove position in 

the implant. 

58 

A 

A. Power-assisted insertion with the 

driver for screw implants, ISO shaft 

(max. 15 rpm). 

If the bone quality is D1 or D2 at the 

implant insertion site, the implant must 

be externally cooled (saline solution, 

5°C/41°F) during the insertion. 

B C 

B. Manual insertion with the locked 

torque wrench and driver (short/long) 

for screw implants. 

C. Manual insertion with the cardanic 

driver.

Next, unscrew the retention screw of the 

insertion post with the screwdriver and 

remove the insertion post (Caution! 

Danger of aspiration). If the implant site 

has a weak bone structure, a holding key 

for insertion post is available (as an 

accessory) to lock the insertion post and 

prevent implant movement when 

unscrewing the retention screw. 

Screwdriver, 

extra short / short / long 

Unscrewing the retention screw Removing the insertion post 



Holding key for insertion post 

59



Submerged Healing 

Once the silicone plug has been removed from the handle, the cover screw is lifted 

with the screwdriver and screwed into the implant manually (Caution! Danger of aspiration). 

The cover screw must be tightened by hand only, using the screwdriver. 

Inserting the cover screw 

Inserting the healing cap 

60 

Implant with cover screw 

Wound closure 

Open/Transgingival Healing 

In this example, a cylindrical healing cap is picked up with the screwdriver and screwed into the implant manually 

(Caution! Danger of aspiration). The healing cap should be tightened by hand only, using the screwdriver. 

Implant with healing cap Wound closure

Accessories 

Adapter for Screw Implants, long, 

for narrow Gaps 

A special reduced-diameter adapter for 

screw implants, long, is available for 

implant diameters 3.3 and 3.8 mm to 

assist manual insertion into small gaps. 

The setup must be performed under sterile 

conditions. After removal from the 

primary package (blister) the color-coded 

holding sleeve with correct diameter is 

inserted over the endosseous part of the 

implant to guide the adapter for screw 

implants, long, into the screw implant. 

The holding sleeve is squeezed together 

like a collet at the level of the implant 

shoulder and the handle is removed. 

Next, the insertion post is unscrewed 

with the screwdriver and removed. 

Adapter for screw implants, 

long, Ø 3.3 / 3.8 mm 

Setting up the holding sleeve Withdrawing the handle Unscrewing the retention 

screw 



Holding sleeve for implants to guide the 

adapter for screw implants, long, into the screw 

implant, Ø 3.3 mm and Ø 3.8 mm 

Removing the insertion 

post 

61



Accessories 

Following unscrewing and removal of 

the insertion post, slide the diametermatched 

adapter for screw implants, 

long, into the implant until the cams 

engage the notches. To fasten, manually 

tighten the retention screw on the insertion 

guide. 

After removal of the holding sleeve, the 

implant can be inserted. 

For the insertion, place the locked 

torque wrench over the hex of the 

adapter for screw implants, long, and 

screw the implant to its final position, 

making sure to line it up with the 

notched mark. 

Inserting implant 

62 

Placing adapter for 

screw implants, 

long 

Tightening retention 

screw 

Removing holding 

sleeve 

Implant attached to adapter 

for screw implants 

Placing torque wrench Turning implant into final position

Accessories 

Once the retention screw is unscrewed, 

detach the adapter for screw implants, 

long, from the implant. Remove the silicone 

plug from the prefastened handle 

of the implant, then pick up the cover 

screw with the screwdriver and insert it 

in the implant manually (Caution! 

Danger of aspiration). 

The cover screw must not be power 

tightened. A healing cap should be used 

for transgingival healing method (see 

page 137). 

Unscrewing the retention screw Removing the adapter for screw 

implants 


Implant with cover screw Wound closure 



63

6. ROOT-LINE Implant 

Introduction 

The ROOT-LINE Implant is a root-shaped 

screw implant. It is suitable for delayed 

implantation and especially for immediate 

or delayed immediate implantation. 

The healing method may be either submerged 

or transgingival. It can be used 

in a space-limited apical bony site 

because of its apical taper combined 

with a cylindrical body. Fenestrations can 

be avoided through appropriate selection 

of the prosthetic diameter and axial 

orientation. 

The self-tapping thread ensures high primary 

stability in the cylindrical area. The 

root-shaped macro-configuration in conjunction 

with the Promote ® surface produces 

greater contact with the bone surface. 

The CAMLOG connection enables 

the use of every type of prosthetic 

restoration. 

Available diameters are 3.8 mm, 4.3 

mm, 5.0 mm, and 6.0 mm, in lengths of 

9 mm, 11 mm, 13 mm, and 16 mm. 

ROOT-LINE Implant with 

Promote ® 


ROOT-LINE Insertion 

65



ROOT-LINE Implant with Promote ® 

Surface 

Overview of implant lengths and diameters. 

66 

The machined segment on the implant neck measures 1.6 mm

Incision Line 

The sample indication shows the insertion 

of a 4.3 mm-diameter, 13 mmlength 

ROOT-LINE Implant in the lateral 

mandible. The implantation technique is 

one-step transperiosteal. A split-flap 

preparation is selected for the incision 

line. 

Following a somewhat lingual paracrestal 






prepared 2-3 mm lingually to facilitate 

later suturing. Following marking of the 

desired implant position (if necessary 

with the aid of a drilling template), the 

periosteum is removed circularly in the 

area of this site alone (with gingival 

punch or scalpel). 

This is followed by preparing of the 

implant bed with the ROOT-LINE 

Implant-specific instruments until the 

desired implant diameter and length are 

obtained. 



Epiperiosteal 



at the implant position 



67





• Punch mark the desired implant position 

with the internally irrigated 

Ø 3.5 mm round bur. 



pilot drill. 

• Check with the Ø 2.0 / 3.3 mm paralleling 


• Pre-drill with the internally irrigated 

Ø 2.8 mm pre-drill. 

• Check with Ø 2.8 / 3.6 mm paralleling 



drill. 


bony end. 

• Use ROOT-LINE/SCREW-CYLINDER- 

LINE tap (for bone qualities D1 and 

D2). 

68 


Ø 3.8 mm 

Ø 4.3 mm 

Ø 5.0 mm 

Ø 6.0 mm 

Round bur Ø 3.5 mm 

16 mm 

13 mm 

11 mm 

9 mm 

Depth stop 


Ø 2.0/3.3 mm 

rpm 800 800 600 

Round bur Ø 3.5 mm Round bur Ø 3.5 mm 


16 mm 

13 mm 

11 mm 

9 mm 

Depth stop 

rpm 800 800 600 

16 mm 

13 mm 

11 mm 

9 mm 

Depth stop 

rpm 800 800 600 

16 mm 

13 mm 

11 mm 

9 mm 

Pilot drill Ø 2.0 mm 




Depth stop 


Ø 2.0/3.3 mm 


Ø 2.0/3.3 mm 


Ø 2.0/3.3 mm 

rpm 800 800 600 

The height of the depth stop for the form drill is 2 mm. 

* If the bone quality is D1 or D2, use of the tap (thread cutter) is recommended 

for ROOT-LINE Implants. 

Pre-drill Ø 2.8 mm 



Pre-drill Ø 2.8 mm

13 mm 

11 mm 

9 mm 

13 mm 

11 mm 

9 mm 

13 mm 

11 mm 

9 mm 

13 mm 

11 mm 

9 mm 

Depth stop * 

Depth stop 

Depth stop 

Depth stop 


Ø 2.8/3.6 mm 


Ø 2.8/3.6 mm 


Ø 2.8/3.6 mm 


Ø 2.8/3.6 mm 

Ø 3.8 

Ø 3.8 

Ø 3.8 

Ø 3.8 

Form drill 

Tap 

500 15 

Form drill 

Ø 4.3 

500 400 15 

Form drill 

Ø 4.3 

Ø 4.3 

* 

Tap 

Ø 5.0 

500 400 350 15 

Form drill 

Ø 5.0 

0.4 mm 

Ø 6.0 

0.4 mm 

500 400 350 300 15 

* 

Tap 

* 

Tap 

0.4 mm 



0.4 mm 

69



Implant Bed Preparation for ROOT-LINE Implants 

Preparation of the implant bed includes 

punch-marking the cortical bone, pilot 

drilling, pre-drilling, and profile drilling. 

The pilot drilling and pre-drilling define 


and ensure a tissue-conservative bone 

preparation by enlarging the diameter in 

small gradations. 

Pilot Drill and Pre-Drill Depth Stop 

The pilot drill and pre-drill have a maximum 

working length of 16 mm. The 





Caution! 

The depth stops, pilot drills, and 

pre-drills shown here should be 

used only for implant bed shaping 

of ROOT-LINE, SCREW-CYLINDER- 

LINE, and CYLINDER-LINE Implants. 

These instruments are closely 

matched to one another. 

70 









Depth stop for pilot drills and 

pre-drills

Paralleling Pin with Depth Marks 



are checked with the paralleling pin with 

depth marks. 

The diameter combinations 2.0 / 3.3 mm 

and 2.8 / 3.6 mm permit consecutive use 

matching the pre-drill diameter. 

Paralleling pins, long, with 

depth marks 







alignment. 

Paralleling pins, short 



71





bur is used for punch-marking the cortical 

bone, which secures the use of the 

drills to follow. The bur is inserted as 

far as the bur equator. Recommended 


Round bur, Ø 3.5 mm Pilot drill, Ø 2.0 mm 

72 

max. 800 rpm max. 800 rpm 



The depth and axis orientation of the 

implant bed are prepared with the internally 

irrigated pilot drill. The depth 

marks on the drill correspond to the 

implant lengths of 9 / 11 / 13 mm. The 

maximum drilling depth is 16 mm. For 

safety reasons, a depth stop matching 

the proposed implant length should be 

used. 



stops may be placed on the pilot drills 

after the positions are marked. Once 

drilling is complete, the depth and axis 


paralleling pin. 

If several implants are to be placed, a 

paralleling pin is inserted in the first 

hole to align the subsequent implant 

axes. 




Paralleling pin, long, 

with depth marks Ø 2.0 / 3.3 mm 

Depth / axis check after pilot 

drilling Ø 2.0 mm 


Ø 2.0 / 3.3 mm

Pre-Drilling 

An internally irrigated, pre-drill five 

bladed cutter, with a 2.8 mm diameter is 

available for the ROOT-LINE configuration. 


implant lengths. For safety reasons, a 

depth stop matching the proposed 

implant length should be used. Further 

drilling is performed with the form drills. 

The recommended drilling speed is 

600 rpm. 

max. 600 rpm 

Pre-drill, five bladed cutter, Ø 2.8 mm 

Paralleling pin, long, with 

depth marks Ø 2.8 / 3.6 mm 

Pre-drilling Checking the drilling depth after 

pre-drilling Ø 2.8 mm 


Ø 2.8 / 3.6 mm 



73



Form Drilling 



drills are available for each implant size. 

The internally irrigated form drills are 

color-coded and laser-marked. 



removable depth stop (height 2 mm). 

Depending on the defined drilling depth 

(implant length), the hole diameter is 

expanded progressively with the series 

of form drills until the planned implant 

diameter is reached. 


Ø 3.8 mm 500 rpm 

Ø 4.3 mm 400 rpm 

Ø 5.0 mm 350 rpm 

Ø 6.0 mm 300 rpm 

The protocol-compliant insertion depth 

for ROOT-LINE Implants with depth stop 

in place is the implant length (9 / 11 / 

13 mm) minus 0.4 mm with the circular 

stop at the crestal bone level so that the 


the bone level. 




depth mark. 

74 

Ø 3.8 mm Ø 4.3 mm Ø 5.0 mm Ø 6.0 mm 

ROOT-LINE form drills 

Length 

9 mm 11 mm 13 mm 16 mm

Depth Stop 

During form drilling the depth stop rests 

on the highest point of the crest and 

thereby limits the insertion depth. Since 

the circular bone level may be irregular, 

the form drills are equipped with a 

removable depth stop. If a greater insertion 

depth is required for esthetic or 

functional reasons, the depth stop can 

be removed and form drilling can be 

continued for a further 2 mm at most 

(watch for anatomic structures!). The 

reusable depth stop can be used on 

replacement drills (delivered without 

depth stops). 

Depth stops must be removed before 

cleaning the drills. The cleaned depth 

stops must be placed back on the drill 



System," Art. No. J8000.0032). 

The lower depth mark corresponds to the implant length with the depth stop in 

place according to the protocol. The two depth marks are situated 1 mm apart. 



Form drilling with depth stop Form drilling without depth stop 

75



Adjusting the depth by 1 mm Adjusting the depth by 2 mm 

76

Form Drilling 

Once pre-drilling is completed, form 

drills in increasing diameters are used 

for finishing the final implant bed. 

Tissue-conservative preparation of the 

bone is ensured by the small gradations 

in diameter size. 

Example: 

Ø 4.3 mm form drill 

Checking the implant bed 







detects soft tissue, this indicates a 

fenestration into the adjacent tissue by 

the drill. 

77



ROOT-LINE Tap 

Introduction 

All ROOT-LINE Implants come with a selftapping 

thread with sand-blasted, etched 

surface (Promote ® ). Use of a tap is recommended 

with bone qualities D1 or D2. 

The taps are internally irrigated. The maximum 

drilling speed should not exceed 15 

rpm during power-assisted tapping. We 

recommend manual tapping. 

ROOT-LINE, SCREW-CYLINDER-LINE tap 

Ø 3.8 mm Ø 4.3 mm 

78 

max. 15 rpm 

Ø 5.0 mm Ø 6.0 mm

Manual thread tapping is performed 

with the adapter with ISO shaft and the 

locked torque wrench. Make sure that 

the implant bed axis orientation is maintained 

during insertion and removal of 

the tap. The limit for insertion of the tap 

is the upper edge of the cutting blade. 

See also the instructions for the torque 

wrench on page 151. 

Caution! The ROOT-LINE taps must 

not be used with SCREW-LINE 

Implants. 


Adapter, ISO shaft 



79






of ROOT-LINE Implants contains the 

implant with pre-installed insertion post 

and mounted handle. 


Primary package (sterile) with 

label (blister pack) 




80 





The protocol-compliant implant position 



implant shoulder protrudes 0.4 mm 

above the crestal bone and one of the 3 



If it was decided to set the drilling depth 

for the implants individually by removing 

the depth stop during form drilling, this 

should be kept in mind during implant 

insertion. It is possible to individually 

position the 1.6 mm implant shoulder 

vertically. You should make sure, however, 

to position the Bioseal Bevel circularly 

in the cortical bone. 

Mark 

Cam 

Groove 


Driver 


Implant 





the ROOT-LINE Implants that match the 

three grooves on the CAMLOG connection. 

These permit you to check the 

groove positions during the insertion 

and their orientation as required for the 

prosthesis. If the dental technician has 

not indicated the groove position, a 

vestibular orientation is advantageous 

in most cases since the abutment angle 

originates at a groove. 

Note: Keep in mind during positioning 

of the grooves that turning to the next 


screw implant to be inserted about 

0.2 mm deeper. 

81








Caution! 






observe the orientation of the implant 

bed axis. If the hole has been prethreaded, 

the position of the thread dog point 

in the cortical bone must align with that 


Tip: 



be felt. 





Implant insertion 

82 





handle, the implant can be separated 







post. Then insert the implant into the 

bone and remove the PickUp instrument.

Placing the PickUp on the insertion post 

Removing the handle 




Inserting the implant Mounting the driver and removing 

the PickUp 

83









driver (C) 

During insertion, make sure to use the 


the implant. 

84 

A 







5°C/41°F) during the insertion. 

B C 





driver.

Next, extract the retention screw of the 






accessory) to lock the insertion post 

and prevent implant movement when 

loosening the retention screw. 

Screwdriver, 


Loosening the retention screw Removing the insertion post 




85




Once the silicone plug has been removed from the handle, the cover screw is lifted 

with the screwdriver and screwed into the implant manually (Caution! Danger of aspiration). 

The cover screw must be hand-tightened only with the screwdriver. 

Inserting the cover screw Implant with cover screw Wound closure 


In this example, a cylindrical healing cap is picked up with the screwdriver and screwed into the implant manually 

(Caution! Danger of aspiration). The healing cap should be hand-tightened only, using the screwdriver. 

Inserting the healing cap Implant with healing cap Wound closure 

86

Accessories 





implant diameter 3.8 mm to assist manual 

insertion into small gaps. The set-up 

must be performed under sterile conditions. 

After removal from the primary 

package (blister) the color-coded holding 

sleeve with correct diameter is inserted 

over the endosseous part of the implant 

to guide the adapter for screw implants, 

long, into the screw implant. The holding 

sleeve is squeezed together like a collet 

at the level of the implant shoulder and 

the handle is removed. Next, the insertion 

post is unscrewed with the screwdriver 

and removed. 

Setting up the holding 

sleeve 

Adapter for screw implants, 

long, Ø 3.8 mm 

Withdrawing 

the handle 

Unscrewing the 

retention screw 



Holding sleeve for implants to guide the 

adapter for screw implants, long, into the 

screw implant, Ø 3.8 mm 

Removing the 

insertion post 

87



Accessories 

Following unscrewing and removal of 


adapter for screw implants, 

long, into the implant until the cams 

engage the notches. To fasten, manually 

tighten the retention screw on the insertion 

guide. 

After removal of the holding sleeve, the 

implant can be inserted. 




screw the implant to its final position, 

making sure to align it with the notched 

mark. 

Inserting implant Placing torque wrench Turning implant into final position 

88 


screw implants, long 


screw 


sleeve 

Implant attached to 

adapter for screw 

implants

Accessories 

Once the retention screw is unscrewed, 






in the implant manually (Caution! 

Danger of aspiration). The cover screw 

must not be power tightened. A healing 

cap should be used for the transgingival 

healing method (see page 137). 

Unscrewing the retention screw 


Removing the adapter for screw 

implants 




89

7. SCREW-CYLINDER- 

LINE Implant 

Introduction 

The SCREW-CYLINDER-LINE Implant 

(with Promote ® surface) is particularly 

suitable for restorations in structurally 

weak sites in the posterior maxilla. In 

conjunction with sinus floor elevation 

and augmentation, its special configuration 

permits the use of the residual 

crestal bone height (>5 mm) for primary 

stabilization of the implant through its 

threaded segment. 

The cylindrical apical segment preserves 

the sinus mucosa during insertion of the 

implant (no thread edges) and provides 

superior adaptation to the particular 

bone augmentation material used. 

The CAMLOG connection enables the 

use of every type of prosthetic restoration. 


mm, 5.0 mm, and 6.0 mm, in lengths of 

9 mm, 11 mm, 13 mm, and 16 mm. 


SCREW-CYLINDER-LINE Insertion 


Implant with Promote ® 

91



SCREW-CYLINDER-LINE Implant 

with Promote ® Surface 


92 

The machined segment on the implant neck measures 1.6 mm.

Incision Line and Sinus 

Floor Elevation/ 

Augmentation 


of a 4.3 / 13 mm SCREW-CYLIN- 

DER-LINE Implant in the posterior maxilla 

with simultaneous sinus floor elevation 

and augmentation. The implantation 

technique is two-stage. A full flap preparation 

is selected for the incision line. A 

residual crestal bone height of at least 

5 mm is required for use of a SCREW- 

CYLINDER-LINE Implant. 

Following a somewhat palatal, paracrestal 

mucosal incision, a full flap is prepared 

on the vestibular aspect as far as 

the required height to outline the sinus 

window. A periosteal slit is performed at 

the superior margin of the flap to ensure 

tension-free wound closure later. The 

design of the window and sinus floor 

elevation are performed following standard 

surgical practice. Make sure to 

leave sufficient distance between the 

lower edge of the window and the alveolar 

ridge. Augmentation material is 

applied medially prior to preparation of 

the implant site, because this area is difficult 

to access after implantation. In 

addition, it helps to retain the elevated 

mucosa cranially. 

This is followed by preparing of the 


implant diameter with the customized 

instruments for the SCREW-CYLINDER- 

LINE Implant. 


Full flap preparation with 

periosteal slit 



Mucoperiosteal incision 

Sinus floor elevation with partial 

medial augmentation 

93





• Punch-mark the desired implant 

position with the internally irrigated 




pilot drill. 



• If desired, use of the planisher to level 

crestal bone irregularities. 














drill. 


bony end. 

• Thread cutting with ROOT-LINE/ 

SCREW-CYLINDER-LINE tap (for bone 

qualities D1 and D2). 

94 


Ø 3.8 mm 

Ø 4.3 mm 

Ø 5.0 mm 

Ø 6.0 mm 


16 mm 

13 mm 

11 mm 

9 mm 

rpm 800 800 


rpm 800 800 


16 mm 

13 mm 

11 mm 

9 mm 


rpm 800 800 


16 mm 

13 mm 

11 mm 

9 mm 

16 mm 

13 mm 

11 mm 

9 mm 




rpm 800 800 

Depth stop 

Depth stop 

Depth stop 

Depth stop 

The height of the depth stop for the form drill is 2 mm. 

* If the bone quality is D1 or D2, use of the tap (thread cutter) is recommended for 

SCREW-CYLINDER-LINE Implants. 


Ø 2.0/3.3 mm 


Ø 2.0/3.3 mm 


Ø 2.0/3.3 mm 


Ø 2.0/3.3 mm






600 550 500 15 


600 550 500 400 15 


13 mm 

11 mm 

9 mm 

Depth stop 

600 550 500 350 15 





13 mm 

11 mm 

9 mm 

13 mm 

11 mm 

9 mm 

13 mm 

11 mm 

9 mm 

Depth stop 

Depth stop 

Depth stop 

600 550 500 300 15 


Ø 2.0/3.3 mm 


Ø 2.8/3.6 mm 


Ø 2.8/3.6 mm 


Ø 2.8/3.6 mm 



Form drill Ø 3.8 mm 




* 

Tap 

* 

Tap 

* 

Tap 

* 

Tap 

0.4 mm 

0.4 mm 

0.4 mm 

0.4 mm 

95



Implant Bed Preparation for SCREW-CYLINDER-LINE Implants 



drilling, pre-drilling, and form drilling. 



and ensure tissue-conservative bone 










Caution! 

The depth stops for pilot drills, and 

pre-drills five bladed cutter, shown 

here should be used only for 

implant bed preparation of ROOT- 

LINE, SCREW-CYLINDER-LINE, and 

CYLINDER-LINE Implants. These 

instruments are closely matched to 

one another. 

96 










pre-drills





depth marks. 





depth marks 


on the paralleling pins allow you 

to check the drilling depth and axis at 

each stage of pilot drilling and predrilling. 




alignment. 



97






bone, which secures application of 

the drills to follow. The bur is inserted as 



98 

max. 800 rpm 

Round bur Ø 3.5 mm Pilot drill, Ø 2.0 mm 



The depth and axis of the implant bed 

are set with the internally irrigated pilot 

drill. The depth marks on the drill correspond 

to the implant lengths of 9 / 11 / 

13 mm. The maximum drilling depth is 

16 mm. For safety reasons, a depth stop 

matching the proposed implant length 

should be used. 

max. 800 rpm 

Depth/axis 

check after 

pilot drilling 

Ø 2.0 mm 


stops may be installed on the pilot drills 








axes. 





Paralleling pin, long, with 

depth marks Ø 2.0 / 3.3 mm 

Parallelism/axis 

check after pilot 

drilling Ø 2.0 mm 


Ø 2.0 / 3.3 mm

Pre-Drilling 

Internally irrigated pre-drills, five bladed 

cutter, are available for the SCREW- 

CYLINDER-LINE Implants; the available 

diameters are 2.8 mm / 3.3 mm / 

3.6 mm. The recommended drilling speed 

is 600 rpm. 





Pre-Drill, five bladed Cutter 

Sequence for SCREW-CYLINDER-LINE Implants 

Pre-drill 

Ø 2.8 mm 

For implant 

Ø 3.8 mm 

Pre-drill 

Ø 3.3 mm 

Form drill 

Ø 3.8 mm 

Ø 2.8 mm Ø 3.3 mm Ø 3.6 mm 

For implant 

Ø 4.3 mm 

Pre-drill 

Ø 3.6 mm 

Form drill 

Ø 4.3 mm 

Caution! 

The Ø 3.6 mm pre-drill must not be used for implant diameter 3.8 mm. 

Pre-drill, five bladed cutter, max 600 rpm 

The implant bed preparation is performed 

with pre-drills, five bladed cutter, 

in increasing size with reference to 

the selected implant diameter and 

insertion depth. Then, the implant bed 

is finished to the final size with a form 

drill of appropriate length. 

Ø 2.8 mm pre-drilling 



For implant 

Ø 5.0 mm 

Form drill 

Ø 5.0 mm 


with depth mark 

Ø 2.8 / 3.6 mm 

Drilling depth check after 


For implant 

Ø 6.0 mm 

Form drill 

Ø 6.0 mm 


Ø 2.8 / 3.6 mm 

Parallelism/axis 

check after pre-drilling 

Ø 2.8 mm 

99



Pre-drilling Ø 3.3 mm 

Pre-drilling Ø 3.6 mm 

100 

Drilling depth check 

after pre-drilling Ø 3.3 mm 

Drilling depth check 


Parallelism/axis check after 




Note 

If a simultaneous implantation into the 

augmented sinus is to be performed, 

pre-drilling continues only until penetration 

of the sinus cortical bone is felt. 

The use of a 9-mm depth stop is for 

demonstration purposes only since this 

configuration is also universally applicable. 

During final form drilling, the shortest 

possible form drill must be used to 

shape the Bioseal Bevel as far as the 

depth stop.

Form Drilling 



drills are available for the SCREW- 

CYLINDER-LINE Implants. The internally 

irrigated form drills are color-coded and 

laser-marked. 




The implant bed is shaped to its final 

size with the form drill matching the 

selected implant size. 

For bone qualities D1 or D2, the use of 

increasing diameter form drills is recommended. 


Ø 3.8 mm 500 rpm 

Ø 4.3 mm 400 rpm 

Ø 5.0 mm 350 rpm 

Ø 6.0 mm 300 rpm 


for SCREW-CYLINDER-LINE Implants 

with depth stop in place is the implant 

length (9 / 11 / 13 / 16 mm) minus 0.4 

mm with the circular stop at the crestal 

bone level, so that the implant shoulder 

extends 0.4 mm above the bone level. 




depth mark. 

SCREW-CYLINDER-LINE form drills 

Ø 3.8 mm 

9 mm 

Ø 4.3 mm Ø 5.0 mm Ø 6.0 mm 

Length 

11 mm 13 mm 16 mm 



101



Depth Stop 

During form drilling the depth stop rests 













depth stops). 






System," Art. No. J8000.0032). 

102 

The lower depth mark corresponds to the 

implant length with the depth stop in place 

according to the protocol. The two depth marks 

are situated 1 mm apart. 

Form drilling with depth stop Form drilling without depth stop





103




Tap 

Introduction 

All SCREW-CYLINDER-LINE Implants 

come with a self-tapping thread with 

sand-blasted, etched surface (Promote ® ). 

Use of a tap is recommended with bone 

qualities D1 or D2. 

The taps are internally irrigated. The 

maximum drilling speed should not 

exceed 15 rpm during power-assisted 

tapping. We recommend manual tapping. 

ROOT-LINE, SCREW-CYLINDER-LINE taps 

Ø 3.8 mm Ø 4.3 mm Ø 5.0 mm Ø 6.0 mm 

104 

max. 15 rpm

Manual tapping is performed with the 

adapter with ISO shaft and the locked 

torque wrench. Make sure that the 

implant bed axis orientation is maintained 

during insertion and removal of 

the tap. The limit for insertion of the tap 

is the upper edge of the cutting blade. 

See also the instructions for the torque 

wrench on page 151. 

Caution! The SCREW-CYLINDER-LINE 

taps must not be used with SCREW- 

LINE Implants. 

Note 

Since no tapping is required in the 

maxilla for bone qualities D3 or 

D4, we show a situation in the 

mandible for demonstration purposes. 


Adapter, ISO shaft 



105






of SCREW-CYLINDER-LINE Implants contains 

the implant with pre-installed 

insertion post and mounted handle. 







106 

Opened primary package with implant 

and mounted handle 







the crestal bone and one of the 3 









vertically to match the drill hole. You 

should make sure, however, to position 

the Bioseal Bevel circularly in the cortical 

bone. 

Mark 

Cam 

Groove 




Driver 


Implant 



the SCREW-CYLINDER-LINE Implants 

that match the three grooves on the 

CAMLOG connection. These permit you 

to check the groove positions during the 

insertion and their orientation as 

required for the prosthesis. If the dental 

technician has not indicated the groove 

position, a vestibular orientation is 

advantageous in most cases since the 

abutment angle originates at a groove. 

Note: keep in mind during positioning of 

the grooves that turning to the next 


screw implant to be inserted about 0.2 

mm deeper. 

107








Caution! 







axis. If the hole has been prethreaded, 

the position of the thread dog point in 

the cortical bone must mate with that 


Tip: 



be felt. 





Inserting the implant 

108 












post. The implant is then inserted into 

the bone and the PickUp instrument is 

withdrawn.

Install the PickUp on the insertion post 




Removing the handle Inserting the implant Mounting the driver and removing the PickUp 

109









driver (C) 

During insertion, make sure to use the 


the implant. 

110 

A 







5 °C/41°F) during the insertion. 

B C 





driver.

Next, loosen the retention screw of the 






accessory) to lock the insertion post and 

prevent implant movement when loosening 

the retention screw. 

Screwdriver, 


Loosening the retention screw Removing the insertion post 




111



Once the silicone plug has been removed 

from the handle, the cover screw is lifted 

with the screwdriver and screwed into 

the implant manually (Caution! Danger 

of aspiration). 

The cover screw must be tightened by 

hand only, using the screwdriver. 

A healing cap should be used for the 

transgingival healing method (see page 

137). 


112 

Implant with cover screw If the periosteum is not intact, we 

recommend use of a membrane 

Suture line Wound closure

Accessories 





implant diameter 3.8 mm to assist manual 

insertion into small gaps. The set-up 

must be performed under sterile conditions. 

After removal from the primary 

package (blister) the color-coded holding 

sleeve for implants with correct diameter 

is inserted over the endosseous part of 

the implant to guide the adapter for 

screw implants, long, onto the screw 

implant. The holding sleeve is squeezed 

together like a collet at the level of the 

implant shoulder and the handle is 

removed. 

Next, the insertion post is unscrewed 

with the screwdriver and removed. 

Setting up the holding 

sleeve 

Adapter for screw 

implants, long, 

Ø 3.8 mm 

Withdrawing the handle Unscrewing the retention 

screw 



Holding sleeve for implants to 

guide the adapter for screw 

implants, long, onto the screw 

implant, Ø 3.8 mm 

Removing the insertion 

post 

113



Accessories 

Following loosening and removal of 


adapter for screw implants 

onto the implant until the cams engage 

the notches. To fasten, hand-tighten the 

retention screw on the adapter for screw 

implants. 

Following removal of the holding sleeve, 

the implant can be inserted. 




screw the implant into its final position, 

making sure to align it with the notched 

mark. 

Inserting implant Placing torque wrench 

Turning implant into final position 

114 


screw implants, long 


screw 


sleeve 

Implant attached to 

adapter for screw 

implants

Accessories 

Once the retention screw is loosened, 






into the implant manually (Caution! 

Danger of aspiration). 

The cover screw must not be power 

tightened. A healing cap should be used 

for the transgingival healing method 

(see page 137). 

Loosening the retention screw 




Removing the adapter for screw implants Inserting the cover screw 

115

116

8. CYLINDER-LINE 

Implant 

Introduction 

CYLINDER-LINE Implants with TPS surface 

are universally applicable. The 

advantage of this implant type is its simple, 

time-saving application procedure. 

The CAMLOG connection enables the 

use of every type of prosthetic restoration. 


mm, 4.3 mm, 5.0 mm, and 6.0 mm, in 

lengths of 9 mm, 11 mm, 13 mm, and 

16 mm (for Ø 3.3 mm diameters, the 

lengths are 11 mm, 13 mm, and 16 

mm). 


CYLINDER-LINE Insertion 

CYLINDER-LINE Implant, TPS 

117



CYLINDER-LINE Implant with TPS 

Surface 


118 

The machined segment on the implant neck measures 1.6 mm (on the Ø 3.3 mm implant, the machined 

segment is 2.0 mm).

Incision line 


of a CYLINDER-LINE Implant with 

4.3 mm diameter and 13 mm length in 

the lateral mandible. The implantation 

technique is single-stage transperiosteal. 

A split-flap preparation is selected for 

the incision line. 

Following a somewhat lingual, paracrestal 






prepared 2-3 mm lingually to facilitate 

later suturing. 

Following marking of the desired implant 

position (if necessary with the aid of a 

drilling template), the periosteum is 

removed circularly in the area of this site 

alone (with a gingival punch or scalpel). 

This is followed by preparation of the 


implant diameter and length with the 

customized instruments for the 

CYLINDER-LINE Implant. 



Epiperiosteal 



at the implant site 



119





• Punch-mark the desired implant 

position with the internally irrigated 




pilot drill. 



• If desired, use of the planisher to level 

crestal bone irregularities. 














drill. 


bony end. 

120 


Ø 3.3 mm 

Ø 3.8 mm 

Ø 4.3 mm 

Ø 5.0 mm 

Ø 6.0 mm 

Round bur 

Ø 3.5 mm 

Round bur 

Ø 3.5 mm 

Round bur 

Ø 3.5 mm 

Round bur 

Ø 3.5 mm 

Round bur 

Ø 3.5 mm 

Pilot drill 

Ø 2.0 mm 

16 mm 

13 mm 

11 mm 

9 mm 

rpm 800 800 

Pilot drill 

Ø 2.0 mm 

16 mm 

13 mm 

11 mm 

9 mm 

rpm 800 800 

Pilot drill 

Ø 2.0 mm 

16 mm 

13 mm 

11 mm 

9 mm 

rpm 800 800 

Pilot drill 

Ø 2.0 mm 

16 mm 

13 mm 

11 mm 

9 mm 

rpm 800 800 

Pilot drill 

Ø 2.0 mm 

16 mm 

13 mm 

11 mm 

9 mm 

rpm 800 800 

Depth stop 

Depth stop 

Depth stop 

Depth stop 

Depth stop 


Ø 2.0/3.3 mm 


Ø 2.0/3.3 mm 


Ø 2.0/3.3 mm 


Ø 2.0/3.3 mm 


Ø 2.0/3.3 mm

Ø 2.8 mm 

Pre-drill, five bladed cutter 

Form drill 

600 550 

Ø 2.8 mm 

Ø 3.3 mm 


Form drill 

600 550 500 

Ø 2.8 mm 

Ø 3.3 mm 

Ø 3.6 mm 


Form drill 

600 550 500 400 

Ø 2.8 mm 

Ø 3.3 mm 

Ø 3.6 mm 


Form drill 

600 550 500 350 

Ø 2.8 mm 

Ø 3.3 mm 

Ø 3.6 mm 

13 mm 

11 mm 

9 mm 

13 mm 

11 mm 

9 mm 

13 mm 

11 mm 

9 mm 

13 mm 

11 mm 

9 mm 

13 mm 

11 mm 

9 mm 

Depth stop 

Depth stop 

Depth stop 

Depth stop 

Depth stop 


Form drill 

600 550 500 300 


Ø 2.8/3.6 mm 


Ø 2.0/3.3 mm 


Ø 2.8/3.6 mm 


Ø 2.8/3.6 mm 


Ø 2.8/3.6 mm 

Chirurgie-Manual 


Ø 3.3 mm 

Ø 3.8 mm 

Ø 4.3 mm 

Ø 5.0 mm 

Ø 6.0 mm 

TPS 

TPS 

TPS 

TPS 

TPS 

0.4 mm 

0.4 mm 

0.4 mm 

0.4 mm 

0.4 mm 

121



Implant Bed Preparation for CYLINDER-LINE Implants 



drilling, pre-drilling, and form drilling. 



and ensure tissue-conservative bone 










Caution! The depth stops for pilot 

drills, and pre-drills five bladed 

cutter, shown here should be used 

only for implant bed shaping of 

ROOT-LINE, SCREW-CYLINDER-LINE, 

and CYLINDER-LINE Implants. These 

instruments are closely matched to 

one another. 

122 










pre-drills





depth marks. 





depth marks 








alignment. 



123






bone, which secures application of 

the drills to follow. The bur is inserted as 



124 

max. 800 rpm 

Round bur, Ø 3.5 mm Pilot drill, Ø 2.0 mm 



The depth and axis of the implant bed 

are set with the internally irrigated pilot 

drill. The depth marks on the drill correspond 

to the implant lengths of 9 / 11 / 

13 mm. The maximum drilling depth is 

16 mm. For safety reasons, a depth stop 

matching the proposed implant length 

should be used. 

max. 800 rpm 

Depth/axis check after pilot drilling 

Ø 2.0 mm 


stops may be installed on the pilot drills 








axes. 






Ø 2.0 / 3.3 mm 


with depth marks Ø 2.0 / 3.3 mm 


pilot drilling

Pre-Drilling 

An internally irrigated pre-drill five bladed 

cutter is available for CYLINDER-LINE 

Implants; the available diameters are 2.8 

mm / 3.3 mm / 3.6 mm. 

The recommended drilling speed is 600 

rpm. 





Pre-Drill, five bladed Cutter 

Sequence für CYLINDER-LINE Implants 

for Implant 

Ø 3.3 mm 

Pre-drill 

Ø 2.8 mm 

Form drill 

Ø 3.3 mm 

max. 600 rpm 

Ø 2.8 mm Ø 3.3 mm 


for Implant 

Ø 3.8 mm 

Pre-drill 

Ø 3.3 mm 

Form drill 

Ø 3.8 mm 

Ø 3.6 mm 

The implant bed preparation is performed 

with pre-drills five bladed cutter 

in increasing size with reference to the 

selected implant diameter and insertion 

depth. Then the implant bed is finished 

to the final size with a form drill of 

appropriate length. 

Ø 2.8 mm pre-drill 

for Implant 

Ø 4.3 mm 

Pre-drill 

Ø 3.6 mm 

Form drill 

Ø 4.3 mm 

Caution! 



for Implant 

Ø 5.0 mm 

Form drill 

Ø 5.0 mm 

Drilling depth check after 




Paralleling pin, short, 

Ø 2.8 / 3.6 mm 


with depth marks, Ø 2.8 / 3.6 mm 

for Implant 

Ø 6.0 mm 

Form drill 

Ø 6.0 mm 



125



Pre-drilling Ø 3.3 mm Drilling depth check 


Pre-drilling Ø 3.6 mm Drilling depth check 


126 




pre-drilling Ø 3.6 mm

Form drilling 

Diameters and Lengths 


drills are available for the CYLINDER- 

LINE implants. The internally irrigated 

form drills are color-coded and lasermarked. 




The implant bed is shaped to its final 

size with the form drill matching the 

selected implant size. 

For bone qualities D1 or D2, the use of 

increasing diameter form drills is recommended. 


Ø 3.3 mm 550 rpm 

Ø 3.8 mm 500 rpm 

Ø 4.3 mm 400 rpm 

Ø 5.0 mm 350 rpm 

Ø 6.0 mm 300 rpm 


for CYLINDER-LINE Implants with depth 

stop in place is the implant length (9 / 

11 / 13 / 16 mm) minus 0.4 mm with 

the circular stop at the crestal bone level, 

so that the implant shoulder extends 

0.4 mm above the bone level. 




depth mark. 

Ø 3.3 mm 

9 mm 

Ø 3.8 mm Ø 4.3 mm Ø 5.0 mm Ø 6.0 mm 

CYLINDER-LINE form drills 

11 mm 

Length 

13 mm 16 mm 



127



Depth Stop 

During form drilling, the depth stop rests 













depth stops). 






System," Art. No. J8000.0032). 

128 

Implant length with the depth stop in place 

according to the protocol. The two depth marks 

are situated 1 mm apart. 

Form drilling with depth stop Form drilling without depth stop


Form Drilling 

With bone qualities D1 or D2, form drills 

in increasing diameters are used. Tissueconservative 

preparation of the bone is 

ensured by the small gradations in diameter 

size. 








detects soft tissue, this indicates a fenestration 

into the adjacent tissue by the 

drill. 

Checking the implant bed 

129






of CYLINDER-LINE Implants contains the 

implant with the cover screw already 

mounted and attached tilt-off placement 

head in the handle. 







130 



CYLINDER-LINE Implant with cover 

screw already mounted and attached tilt-off 

placement head






the crestal bone. 







vertically to match the drill hole. You 

should make sure, however, to position 

the Bioseal Bevel circularly in the cortical 

bone. 

Groove 

Mark 


Seating instrument 

Tilt-off placement head 

Cover screw 

Implant 




The CYLINDER-LINE Implants have three 

marks beneath the Bioseal Bevel on the 

implant body that match the groove 

position on the CAMLOG connection. 

Before insertion, align the implant with 

one of the groove marks at the specified 

position for the prosthesis. 

If the dental technician has not indicated 

the groove position, a vestibular orientation 

is advantageous in most cases. 

131








WARNING! 

Prior to insertion in the implant 

bed, the implant must be carefully 

aligned to the correct groove position 

with the aid of the external 

marks on the implant body. 

Changes cannot be made later! 

Pressing the handle into the 

implant bed 

132 

Lifting off the handle 




axis. Then press the implant in until it 

has sufficient grip to permit withdrawal 

of the handle. Take care that the tilt-off 

placement head is not bent too soon. 









onto the tilt-off placement head and lift 

off the handle. The implant is then 

inserted into the bone and the PickUp 

instrument is withdrawn.

Installing the PickUp on the tilt-off 

placement head 

Lifting off the handle Transferring the implant 

into the implant bed 




Installing the seating instrument 

and removing the PickUp instrument 

133



Following axial withdrawal of the handle 

(respectively after insertion of the 

implant into the bone with the PickUp 

instrument), the seating instrument is 

placed on the tilt-off placement head 

and the implant is tapped to its final 

position using the surgery mallet. The 

jaw requiring treatment should be 

appropriately supported by the dentist's 

assistant while this is being done. 

134 

The tilt-off placement head is removed 

by sideways bending of the seating 

instrument. The tilt-off placement head 

holds inside the seating instrument with 

in the aid of the silicone ring. 

Next, the fit of the cover screw must be 

checked with the screwdriver by hand. 

It must not be power-tightened. If a 

vertical correction of the seat depth is 

required, the tilt-off placement head 

lodged in the seating instrument can be 

re-inserted into the hex socket of the 

cover screw. 

Caution! Safety measures must be 

taken to prevent swallowing or 

aspiration of the components. 

Installing the seating instrument Tapping the implant to its final 

position 

Seating instrument Surgery mallet 

Removing the tilt-off placement 

head


The example shows submerged healing 

with the cover screw in place. 

Checking the cover screw Wound closure 


The cover screw must be removed with 

the screwdriver before installation of a 

healing cap. Next, as shown in the diagram, 

a healing cap cylindrical is picked 

up with the screwdriver and inserted in 

the implant manually (Caution! Danger 

of aspiration). 

Removing the cover screw 

The healing cap must be hand-tightened 

only with the screwdriver. 

Inserting the healing cap 

cylindrical 



Wound closure 

135

136

9. Healing Cap 

Introduction 

Use of a healing cap supports the development 

of peri-implant soft tissue. 

Healing caps are available in different 

geometrys: 

• cylindrical 

• wide body 

• bottleneck 

The healing caps are color-coded by 

implant diameter. 

Healing Caps cylindrical wide body bottleneck 


Healing Cap 

Diameter Gingiva height (GH) Gingiva height (GH) Gingiva height (GH) 

3.3 mm 2.0/4.0 mm 2.0/4.0 mm 4.0 mm 

3.8 mm 2.0/4.0/6.0 mm 2.0/4.0/6.0 mm 4.0/6.0 mm 

4.3 mm 2.0/4.0/6.0 mm 2.0/4.0/6.0 mm 4.0/6.0 mm 

5.0 mm 2.0/4.0/6.0 mm 2.0/4.0/6.0 mm 4.0/6.0 mm 

6.0 mm 2.0/4.0/6.0 mm 2.0/4.0/6.0 mm 4.0/6.0 mm 

137


Healing Cap 

Healing Caps - 

cylindrical and wide body 

For standard use, the most common 

healing caps are the cylindrical and wide 

body types. Once the cover screw has 

been removed, a diameter-matched healing 

cap is manually inserted with use of 

a screwdriver. When selecting the gingival 

height, make sure that the healing 

cap extends 1 - 1.5 mm above the gingiva. 

When the peri-implant soft tissue has 

stabilized, an impression is taken. 

Healing Cap - 

bottleneck 

In esthetically challenging areas, the 

treatment result will be enhanced 

through the use of a healing cap 

bottleneck. 

Healing phase 

138 

Healing cap, cylindrical 

The coronally rejuvenated cross-section 

promotes soft tissue growth during the 

healing period. 

Soft tissue growth 

Healing cap, wide body 

After 3-4 weeks (before final structuring 

of the elastic fibers) a healing cap cylindrical 

is inserted. No tissue should be 

excised during this procedure. The tissue 

is suppressed coronally and thereby 

forms a papilla-like structure. Once the 

periimplant soft tissue has stabilized, an 

impression can be taken. 

Coronal displacement of the 

soft tissue through replacement 

with a healing cap cylindrical

Tissue Growth/Tissue Support 

One-stage method 

(transgingival) 

Provisional 

restoration 

PEEK abutment 

bottleneck 

tissue growth - step 1 

OPTIONAL 

cylindrical 

tissue growth - step 2 

Two-stage method 

(covered) 

wide body 

tissue support 

Final restoration - 

abutment with 

supraconstruction 


Healing Cap 

139

Transfer System 

Introduction 

10. Transfer System 

Introduction 

The transfer system provides a highly 

precise, rotation-resistant impression 

system for both closed and open impression 

tray methods. The system components 

are color-coded by implant diameter. 

You should make sure to mix and match 

only implants and prosthetic components 

of the same diameter (by color-coding). 

No components of different diameters 

should be attached to one another. The 

system components must not be modified. 

Color-Coding 

140 

Ø 3.3 mm gray 

Ø 3.8 mm yellow 

Ø 4.3 mm red 

Ø 5.0 mm blue 

Ø 6.0 mm green 

Impression Methods 

The impression method may optionally 

be either for closed or open tray. 

If heavily divergent implant axes are 

present or combination with a functional 

impression is desired, the open impression 

method should be used. Special 

impression posts must be used along 

with ball abutments, Locator ® abutments, 

or bar abutments. 

Impression posts, closed tray 

Impression posts, open tray 

Impression Material 

Silicone or polyether materials can be 

used as impression materials in both 

closed and open methods.

Closed Impression 

Method 

System Components 

The system components for the closed 

impression method are consistently 

color-coded. A fixing screw for impression 

post, impression cap, and bite registration 

cap are supplied along with the 

impression post. A screwdriver - extra 

short, short, long - is required. The screw 

must be hand-tightened both in the 

implant and in the lab analog. 

All transfer system and bite registration 

components are single-use 

items! 

For precision reasons, they may not 

be reused. 

Screwdrivers, 

extra short, short, long 

The fixing screw extends 

about 2 mm above the 

inserted impression post. 

Overview of color-coded impression posts and impression caps 


Closed Impression Method 

Impression post, 

Lab analog, 

Fixing screw for 

impression post 

After fasten the screw, it 

sits flush with the upper 

edge (4-5 turns) 

Bite registration cap 

Impression cap 

141



Impression Post Insertion 

Following removal of the gingiva former 

or the temporary abutment, insert the 

impression post with its attached fixing 

screw into the implant. Rotate until 

engagement of the cams with the 

grooves is felt. 

Caution! 

The fixing screw will extend about 

2 mm from the post after it 

engages with the grooves. 

The post is rotationally symmetrical; 

no special orientation is 

required. 

142 

The fixing screw must be hand-tightened 

with the screwdriver. We recommend a 

radiographic check of the correct seating 

of the impression post prior to taking 

the impression.

Impression Taking 

The color-coded impression cap is now 

installed, using the guide grooves on the 

impression post, until a detectable pressure 

point is reached and the impression 

cap is definitely fastened. Three guide 

grooves on the impression post (placed 

at 120° intervals) facilitate contact-free 

placement relative to adjacent impression 

caps or teeth. The impression cap 

extensions must not be removed. 

Correct seating of the impression caps 

should be checked again before the 

impression is taken. 

The impression caps should remain in 

the impression after the impression tray 

is lifted. If this is not the case, repeat 

the impression. 

Tip: To shorten the procedure time, 

we recommend sending the matching 

lab analog also to the laboratory. 

To prevent loss of the fixing 

screw, the impression post must be 

shipped attached to the lab analog. 

Three possible positions for the impression cap 

I 

II 

III 



143


Open Impression Method 

Open Impression 

Method 

An individually fabricated impression 

tray is required for the open impression 

method. On the extension of the implant 

axis, the individual impression tray must 

be perforated to allow release of the fixing 

screw of the impression post. 


The system components for the open 

impression method are color-coded. The 

fixing screw is secured with an O-ring. 


only, both in the implant and in the lab 

analog. 

Before removing the impression, loosen 

the screw and pull it back until the stop 

(O-ring) is felt. Otherwise, removal of 

the impression will be impossible due to 

axial divergence of the implants, or the 

impression itself will be deformed 

through excessive compression. 

The fixing screw is equipped with a 

break-off point and it can be shortened 

by 3.0 mm by breaking it off with a 

screwdriver if space limitations are 

encountered. 

Caution! Shorten extra-orally only. 

144 

Screwdrivers, 

extra-short, short, long 

Overview of color-coded impression posts 

Impression post 

Lab analog 

O-ring O-ring

Impression Post Insertion 

Remove the gingiva former or temporary 

abutment. To ensure orientation in the 

direction of the implant axis, insert the 

screw fully in the apical direction before 

inserting the impression post. 

Place the impression post for the open 

impression on the implant and tighten 

the fixing screw slightly. 

The impression post is rotationally symmetrical; 

no special orientation is 

required. Rotate it onto the implant until 

the cams engage with the implant 

grooves. 

Caution! 

If the cams have not engaged, the 

height difference will be about 

0.4 mm. 


with the screwdriver. We recommend a 

radiographic check of the correct seating 

of the impression post prior to taking 

the impression 



145



Impression Taking 

Once a check of the perforations and the 

extension of the individual impression 

tray is complete, the impression can be 

taken with silicone or polyether material. 

To remove the impression, loosen the 

fixing screw, pull it back and then lift off 

the impression. 

Tip: To shorten the procedure time, 

we recommend sending the matching 

lab analog also to the laboratory. 

146

11. Bite Registration 


The impression posts for the closed 

impression method are used for the bite 

registration (see "Closed impression 

method", page 141). The diametermatched, 

color-coded bite registration 

caps are installed on the impression 

posts. Correct seating is indicated by a 

perceptible locking feel. Sharp edges in 

the register are prevented by the caps. 

Registration requires only standard 

materials. The caps should not be 

allowed to bond to the register and are 

delivered to the laboratory along with 

the impression posts. 

Alternatively, under limited space conditions 

and to prevent bite elevation, a 

6.0 mm healing cap cylindrical may be 

used. 

Caution! Record the diameter, position, 

and height of the healing cap 

on the information work sheet and 

deliver it with the corresponding 

healing cap to the dental laboratory. 

All transfer system and bite registration 

components are single-use 

items! 

For precision reasons, they may not 

be reused. 

Screwdrivers, 


Impression posts, closed tray 

Impression post 

Lab analog 


Bite Registration 

Fixing screw for 

impression post 

Bite registration 

cap 

147

Provisional Solution 

Introduction 

12. Provisional Solution 

Introduction 

The PEEK (polyether ether ketone) temporary 

abutment was designed for use in 

esthetic immediate restorations. It can 

also be used for long-term provisionals 

(max. 6 months). 

The benefits of immediate implantation 

with an esthetic, non-functional immediate 

restoration consist in preservation of 

the structures of the periodontal or periimplant 

tissue in esthetically critical 

zones. 

Once an adequate healing (osseointegration) 

period for the implant has elapsed 

and the peri-implant soft tissue has 

matured, a new impression for the final 

restoration can be taken. 

148 

Screwdrivers, 



The temporary abutment (PEEK) has a 

height of 12.0 mm and is available in 

diameters 3.8 mm – 6.0 mm. The abutment 

screw must be hand-tightened 

only, using the screwdriver. 

An abutment screw is supplied along 

with the abutment. 

Preparing the Temporary Abutment 

Insert the abutment into the implant and 

rotate until the cams engage with the 

grooves. Then insert the abutment screw 

and hand-tighten it. Mark the vestibular 

midpoint and the preparation margins 

on the abutment following the gingival 

line. 

Abutment screw 

Temporary abutment 

Lab analog

Perform any required grinding of the 

temporary abutment extra-orally to prevent 

contamination of the surrounding 

tissue. This procedure can best be managed 

by screwing the abutment into the 

universal holder for abutment grinding 

or into a lab analog. Depending on the 

marks, the preparation resembles conventional 

perioprosthetics. 

The best solution is obtained with a diamond 

bur at high drilling speed, without 

water irrigation and using little pressure. 

The chamfer or crown margins must lie 

paragingivally for esthetic immediate 

restorations, and approx. 1 mm – 1.5 

mm subgingivally for late restorations to 

achieve an anatomic emergence profile 

in the peri-implant tissue. A mark is 

placed on the vestibular aspect to facilitate 

detection of the insertion position 

of the abutment. 



149



Provisional Crown/Bridge 

A prefabricated crown or a previously 

prepared crown can be adapted to the 

situation by lining it with acrylic. 

The insertion direction of the crown, 

indicated by the adjacent teeth, rarely 

matches the orientation of the implant 

tube. Because of this, bridge structures 

should not be fabricated in one piece 

with the temporary abutment. Work on 

this must be performed extra-orally. All 

other procedures in the fabrication of 

temporary solutions are similar to those 

used in crown and bridge restoration. 

Inserting the Temporary Abutment 

Disinfect and sterilize the prosthetic 

components prior to insertion. Clean the 

inside of the implant with water spray, 

check for residues, and allow to dry. 

Insert the temporary abutment into the 

implant and rotate it until the cams 

engage with the implant grooves. Handtighten 

the abutment screw and seal the 

screw channel with easily removable 

material. Do not use composite since 

drilling it out would be required in order 

to remove the screw. Make sure that the 

screw channel is not overfilled; the surface 

should be concave. Remove all 

cement residues. 

Reference 

Sofortimplantation und Sofortbelastung. 

Das Einzelzahn-Sofortimplantat mit 

provisorischer Versorgung. 

Nagel, Rainer; Ackermann, Karl-Ludwig; 

Kirsch, Axel 

ZMK 17, 1-2/2000 

150

13. Torque Wrench 

Introduction 

The CAMLOG ® torque wrench is a stainless 

steel multi-component instrument to 

accomodate screwdrivers, drivers, 

adapters, and adapter for screw implants, 

long. The torque wrench is used for 

manual thread tapping, manual tightening 

of CAMLOG ® implants to their final 

position in the bone, and fastening of 

CAMLOG ® abutment screws and abutments 

at a torque specified in Ncm. 

Instrument Installation 

The instruments lock in when inserted 

into the wrench wheel. 

• For the insertion function: "IN" is visible 

on the wrench head. 

• For the removal function: "OUT" is 

visible on the wrench head. 

• To remove, press on the instrument 

button with the finger and remove 

downward. Do not use pliers! 

Insertion function "IN" 

The torque wrench is supplied with a 

dual direction wrench mechanism (for 

turning in and out). When the selected 

torque value is reached – a choice of 

10, 20, or 30 Ncm – the torque wrench 

bends down. This prevents use of an 

undefined torque value. 

The torque wrench is dismountable into 

five components for cleaning and care. 

Removal function "OUT" 


Torque Wrench 

Remove the instrument 

downward 

151


Torque Wrench 

Setting Torque Limits 

The release torque (10, 20 and 30 Ncm) is set by screwing in or screwing back the torque setscrew. 

10 Ncm 20 Ncm 30 Ncm 

The torque wrench bends down when the release torque is reached. After that, do not tighten further! 

For final installation in the implant, all 

abutment and prosthetic screws as well 

as abutments must be tightened to the 

preset torque with the torque wrench. 

Setting the tightening torque for the torque wrench 

Implant cover screw hand tighten only with screwdriver 

Healing caps hand tighten only with screwdriver 

Impression post hand tighten only with screwdriver 

Abutment-/prosthetic screw: 

- Temporary abutment hand tighten only with screwdriver 

- Ceramic abutment 20 Ncm 

- Esthomic ® abutment 20 Ncm 

- Telescope abutment 20 Ncm 

- Universal abutment 20 Ncm 

- Gold-plastic abutment 20 Ncm 

- Logfit TM abutment 20 Ncm 

- Prosthetic screw for bar abutment 15 Ncm 

Abutments: Ø 3.3 mm Ø 3.8–6.0 mm 

- Bar abutment 20 Ncm 30 Ncm 

- Ball abutment 20 Ncm 30 Ncm 

- Locator ® abutment 20 Ncm 30 Ncm 

NOTE: In the laboratory, abutments should not be tightened with the torque wrench! 

The named values are relevant only for the clinical setting. 

152 

Torque setscrew 

Caution! 

To reach maximum pre-tension on 

the screws, abutments should be 

retightened with the same torque 

after approx. 5 minutes. This will 

prevent loosening of the screws. 

Caution! To ensure optimal pre-tension, 

new abutment and prosthetic 

screws should be used for the final 

attachment of the abutment.

Manual Thread Tapping and Implant 

Insertion 

Lock the wrench during this function, 

following the instructions below: 

1.Loosen the torque wrench setscrew 

(anti-clockwise). 

2. Slide back the handle. 

3. Rotate handle 90°. 

4. Slide handle forward to the locking position in the wrench head. 

5. Fasten handle with the torque setscrew (clockwise). 

The torque function is now locked. 


Torque Wrench 

Torque function locked 

153


Torque Wrench 

Cleaning, Sterilization, Maintenance 

Disassembly 

The torque wrench should be disassembled after use into its five components: 

• To do this, completely unscrew the torque setscrew (anti-clockwise) and pull out the spring and handle. 

• Pull back the fastening pin with your thumb and forefinger and remove the wrench wheel from the wrench head. 

• Clean the individual parts with a small plastic brush under running water, and place them in a disinfectant-cleaning liquid (for the 

duration, see the manufacturer's instructions). 

• Dry all parts. 

• Wet the drop-marked places ( ) with angled handpiece oil or spray and reassemble the torque wrench. 

Assembly 

• First install the wrench wheel: with your thumb and forefinger, pull back the fastening 

pin on both sides and insert the wrench wheel narrow side in the wrench head 

("IN" must show). 

• Slide handle back on, insert spring in handle, insert and tighten torque setscrew 

(clockwise). 

• Sterilize the torque wrench in the autoclave prior to clinical use (see "Preparation 

Instructions for the CAMLOG ® Implant System," Art. No. J8000.0032). 

154 

Wrench head Push rod Handle 

Wrench wheel 

Fastening pin 

Fastening pin 

Spring Torque setscrew 

➦ 

➥ 

Wrench wheel, 

narrow side

Information 

Information on Preparation Instruction 

14. Information 

Cleaning and 

Sterilization 

1. Instruments 

The CAMLOG ® Implant System instruments 

are not supplied in sterile form 

unless specifically labeled as sterile. They 

must be cleaned, disinfected, and sterilized 

before first use and before every 

further use on the patient. 

2. Prosthetic Components 

The prosthetic components of the 

CAMLOG ® Implant System are not supplied 

in sterile form unless specifically 

labeled as sterile. They must be used 

only once. 

They must be cleaned, disinfected, and 

sterilized before use on the patient. 

Exceptions: The impression cap and 

bite registration cap must not be 

sterilized. 

Detailed information on the preparation 

of instruments and prosthetic components 

can be found in the "Preparation 


System," Art. No. J8000.0032. 

155

156

Dental Office/Laboratory Information Worksheet 

Patient 

Last Name: _________________________________________ First Name(s): _______________________________ Date of Birth: _______________________ 

Dental Office 

✼ 1 2 3 4 5 6 7 8 

▲ 18 17 16 15 14 13 12 11 

▲ 48 47 46 45 44 43 42 41 

✼ 32 31 30 29 28 27 26 25 

Name 

Date 

Alloy / Solder: ______________________________________________________ Technician: __________________________________________________________ 

Ceramic: ____________________________________________________________ Final check / date: _________________________________________________ 

Acrylic: ______________________________________________________________ Patient ID / Date: __________________________________________________ 

Tooth shade: _______________________________________________________ 

Date: 

Dental Laboratory 

9 10 11 12 13 14 15 16 

21 22 23 24 25 26 27 28 

31 32 33 34 35 36 37 38 

24 23 22 21 20 19 18 17 

Type of treatment 

Buccal marks 

Abutment 

Implant diameter 

Implant length 

Type of implant 

Type of implant 

Implant length 

Implant diameter 

Abutment 

Buccal marks 

Type of treatment 

Implant diameter: 3.3 / 3.8 / 4.3 / 5.0 / 6.0 mm 

Implant length: 9 / 11 / 13 / 16 mm, Type of treatment: SC / bridge / telescopic / bar / ball abutment / Locator ® 

Implant type: SL= SCREW-LINE / RL = ROOT-LINE / CL = CYLINDER-LINE / SCL = SCREW-CYLINDER-LINE 

✼ USA numbering 

▲ European numbering 

157

Informations 

Materials 

Titanium Grade 4 Properties: 

Titanium alloy Ti6AI4V 

PEEK 

(polyether ether keton) 

158 

Chemical analysis (in %): O 0.4 max. 

Fe 0.3 max. 

C 0.1 max. 

N 0.05 max. 

H 0.0125 max. 

Ti > 99.0 

Mechanical properties: Strength 680 MPa min. 

Elongation 10 % 

Properties: 

Chemical analysis (in %): AI 5.5 – 6.75 max. 

V 3.5 – 4.5 max. 

Fe 0.3 max. 

C 0.08 max. 

N 0.05 max. 

H 0.015 max. 

Ti ~ 90 

Mechanical properties: Strength 860 MPa min. 

Elongation 10 % 

Properties: 

Mechanical properties: Density 1,38 g/cm 3 

Elongation at break >25 % 

Bending strength 160 MPa 

Melting point 343 °C

Information 

Certificate 

Quality for Users and Patients 

ALTATEC GmbH is in all stages of its activities subject to the 

provisions set out by the Quality Protection System according to 

EN ISO 13485:2003. 

This European Standard defines in detail the criteria that have to 

be met by full quality protection of a company in all its processes 

in order for this company to be certified. Medical products have 

to adhere to standards that are parti-cularly demanding.They are 

defined in the European Standard ISO 13485,which we are also 

able to satisfy. 

We thereby ensure that the quality of our products and services 

meets the expectations of our customers,namely in a manner that 

is at all times monitored and retraceable.Our products fulfil the 

requirements for medical products in terms of product performance 

and patient safety,as they have been defined by the 

European Laws and Standards.Thus,all our legally controlled 

products carry the CE label. 

The products are in accordance with the strict requirements of 

the European Medical Device Directive 93/42/EEC for medical 

products and the Standards EN ISO 13485:2003. 

159

160

161

162

Headquarters: 

CAMLOG Biotechnologies AG 

Margarethenstrasse 38 

CH-4053 Basel 

Tel: +41 (0) 61/565 41 00 

Fax: +41 (0) 61/565 41 01 

info@camlog.com 

www.camlog.com

➤ 

➤ 

ISBN 978-3-13-134351-2 


1 

Surgery 

The CAMLOG ® Implant System is one of the most successful systems on the international 

implant market. 

The CAMLOG Compendium, consisting of manual 1 Surgery and manual 2 Prosthetics, 

describes (using more than 800 illustrations) the clinical and prosthetic procedures 

involved in the practice of implant dentistry. The CAMLOG Compendium is targeted 

at users in order to ensure the proper handling of the system. The prosthetically 

oriented CAMLOG ® Implant System stands for interdisciplinary teamwork – combining 

the skills of dentist and dental technician to develop implant solutions that 

benefit the patient. 

The CAMLOG Compendium 1 Surgery addresses the insertion of the different 

CAMLOG ® implant configurations. It consists of a description of the prosthetic 

CAMLOG concept, general information about the system, and prosthetic planning 

up to surgical intervention. 

The CAMLOG Compendium 2 Prosthetics presents the dentist and dental technician 

with an array of treatment options available in the CAMLOG ® Implant System. The 

patented CAMLOG ® implant-abutment connection allows natural-looking, implantsupported 

perioprosthetics for fixed and removable dentures. 

www.thieme.com

1 Surgery CAMLOG Compendium

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