Drills Intended Use
  Adin’s drills are bone cutting instruments intended for the preparation of dental implant sites in the maxilla or the mandible, prior to the insertion of dental implants.

Drills Description and Characteristics
Adin’s drills are made of surgical stainless steel and are used with external irrigation.
Drills are available in two lengths: Short 6-13mm and Long 8-18mm.

Depth Measurement System
Each Adin drill is marked with a unique line sequencing pattern to ensure correct measurement of the desired drilling depth.
Dental practitioners must review and become thoroughly familiar with Adin’s measurement system to avoid damage to adjacent anatomical structures.
The marks indicate actual millimeter lengths and correspond to the top of the implant.
Caution: The drills are marked so that preparation is up to 1mm longer than the actual length of the corresponding implants.
Caution: Failure to properly analyze desired drill depth for each implant, and/or failure to drill to the planned depth can result in permanent damage and injury to nerves and other anatomical structures.

Adaptation of Drilling Protocols to Different Bone Conditions
Drilling protocols proposed by Adin cannot replace the professional knowledge and clinical judgement of the performing surgeon.
Standard drilling protocols that are published in Adin’s catalog are for full bone conditions, i.e.: for cases in which placed implants are completely covered with bone.
Following these protocols in type 1-3 bone will result in implants stable enough for immediate loading, when this treatment modality is indicated. Note: The success of immediate loading procedures does not only rely on the stability of dental implants, but also on prosthetic procedures that are the complete responsibility of the performing dentist.
In soft bone conditions, it is recommended to consider a reduction of one drill size (relative to standard drilling protocols), to ensure adequate implant initial stability. The self-tapping features and the conical shape of the implants allow for smooth insertion coupled with bone condensation during placement into undersized osteotomies. In such cases, it is also recommended to drill 1–2mm less than the total length of the desired implant. The active apex will enable further bone cutting into the final depth.
Caution: This procedure requires surgeons to pay special attention in order to prevent damage to surrounding structures.
In dense bone conditions, it is recommended to prepare an osteotomy that is 1mm longer than the length of the planned implant. In such conditions, the implant’s self-drilling properties should not be utilized.
NEVER exceed 50Ncm of torque when placing Adin dental implants.
All drilling and pre-tapping procedures should be performed using sharp instruments, under constant and profuse irrigation.

Step-by-Step Drilling Procedure
Stable In-and-out vertical movement of the drill is critical to allow irrigation and flushing away of debris while penetrating the bone.
Drill to bone contact should not exceed a few seconds, while pushing the drill further into the bone up to the pre-determined length. Replace drills and proceed drilling as indicated for the desired implant diameter, paying attention to adjustments that may be required due to bone quality at the specific site.
Drilling should be performed at low speeds (800rpm -2000rpm).
Pre-tapping (threading of the bone) and implant placement procedures should be accomplished at very low speed (25-30rpm) or manually.
The use of drill stoppers is highly recommended to enable easier control of drill penetration to the correct depth.
Drilling sequence: The recommended drilling sequence for specific implant diameters is illustrated in the following table:

  Bone Type D-IV Bone Type D-II-III Bone Type D-I
2.75mmD 1. 2.5 For all bone types 1. 2.5 For all bone types 1. 2.5 For all bone types
3.0mmD 1. 2.0 1. 2.0
2. (2.8)
1. 2.0
2. 2.8
3.3mmD

Swell™ implants:
1. 2.0
2. (2.8)

One™ implants:
1. 2.0

Swell™ implants:
1. 2.0
2. (2.8)
3. (3.2)

One™ implants:
1. 2.0
2. (2.8)

Swell™ implants:
1. Three Step*

One™ implants:
1. 2.0
2. (2.8)

3.5 / 3.6mmD 1. Three-Step* 1. Three-Step*
2. (3.2)
1. Three-Step*
2. (3.2)
3.75mmD 1. Three-Step* 1. Three Step*
2. (3.2)
1. Three-Step*
2. 3.2
4.2 / 4.3mmD CloseFit™, Touareg™-S/OS, Triple™ and One™
1. Three-Step*
2. (3.6)
Swell™ implants:
1. Three Step*
2. 3.2
1. Three-Step*
2. (3.6)
1. Three-Step*
2. 3.6
5.0mmD 1. Three-Step*
2. 3.6
3. (4.2)
1. Three-Step*
2. 3.6
3. 4.2
4. (4.6)
1. Three-Step*
2. 3.6
3. 4.2
4. 4.6
6.0mmD CloseFit™, Touareg™-S/OS, Triple™
1. Three-Step*
2. 3.6
3. 4.2
4. (5.2)

Swell™ implants:
1. Three-Step*
2. 3.6
3. 4.2
4. 4.6
5. (5.2)

CloseFit™, Touareg™-S/OS, Triple™
1. Three-Step*
2. 3.6
3. 4.2
4. 5.2
5. (5.6)
Swell™ implants:
1. Three-Step*
2. 3.6
3. 4.2
4. 4.6
5. 5.2
6. (5.6)
CloseFit™, Touareg™-S/OS, Triple™
1. Three-Step*
2. 3.6
3. 4.2
4. 5.2
5. 5.6
Swell™ implants:
1. Three-Step*
2. 3.6
3. 4.2
4. 4.6
5. 5.2
6. (5.6)

* A series of 2, 2.8 and 3.2 drills may be used as an alternative to Three-Step drills.

Important: All measurements are in mm.
Caution: The drills are marked so that preparation is up to 1mm longer than the actual length of the corresponding implants.
Drill diameter in parenthesis (x.x) indicates a recommendation to drill to the depth of the cortical bone only.

Drilling Accessories
Drill Extension Shaft
A drill extension shaft is used to enable elongation of the regular drill shaft to enable access of Twist Drills between or near teeth/restorations. The elongated shaft requires adjustment of the irrigation mechanism to ensure that a constant flow of saline reaches the drill.
Caution: Extension shafts are not intended for use with any tool other than drills.

Parallel Implant Positioning
Implants placed in each edentulous area should be placed parallel or with a mild angulation between each other.
Parallel Pins are supplied in all surgical kits, and are used during the surgical phase to indicate implant position and angulation.
A parallel pin should be placed into the first osteotomy, and based on its angulation, the next osteotomies should be prepared. Placement of parallel pins into each osteotomy will ensure parallelism among a series of implants.
Attention: Bone anatomy and adjacent anatomical structures should be taken into account, and either deviation from parallelism or the use of shorter implants should be considered to prevent damage to vital structures.
Radiographic evaluation of the implant sites is highly recommended, using the parallel pins to ensure correct implant placement.


Drill Cautions and Warnings
Adin drills should only be used by a licensed dentist who has the knowledge, skills and training related to the surgical placement and restoration of dental implants.
Dental practitioners must review and become thoroughly familiar with Adin’s measurement system to avoid damage to adjacent anatomical structures.
Adin drills are supplied non-sterile. The drills must be cleaned and sterilized prior to first use and before each reuse. Cleaning and sterilization instructions are described in the relevant instructions for use.
Prior to use, drills should be inspected for any wear and/or damage. Defective drills must not be used.
Do not exceed the maximum speeds published by Adin.
Excessive drilling speed and/or drilling duration may cause overheating and may compromise healing and osseointegration.
Note: Dental professionals must review and become thoroughly familiar with Adin’s systems and instructions prior to use to avoid damage to patients.

Cleaning and Sterilization
Cleaning
Note: The following cleaning procedure should be performed prior to first clinical use and immediately after each surgery, and are applicable to all of Adin’s drills and instruments:
Manual cleaning using ultrasonic cleaner
Disassemble the entire kit, including all drills and components that were not used.
Remove residual blood, soft or hard tissue debris using running tap water immediately after use. Brush each instrument thoroughly with a soft bristled brush, away from your body, for a minimum of two minutes.
Clean the interior lumen using a thin brush (where applicable).
Note: Do not use hot or boiling water.
Clean each instrument-holding silicone tube separately to ensure removal of all blood or debris.
Use an ultrasonic cleaner for 10 minutes using a neutral or mild pH enzymatic detergent
(e.g. deconex® POWER ZYME) diluted with purified water as 1ml/liter or as per the manufacturer’s instructions.
Clean kit’s plastic components thoroughly using a mild detergent, and then rinse in running tap water.
Inspect each tool or component for any remaining visible debris and repeat the cleaning process if needed.
Automated cleaning using automated washer, applicable for all reusable drills and instruments
Disassemble the entire kit, including all drills and components that were not used.
Remove residual blood, soft or hard tissue debris using running tap water.
Place the instruments in an automatic washer with neutral or mild pH enzymatic detergent
(e.g. deconex® POWER ZYME) diluted per the manufacturer’s instructions
Perform a washing cycle, using the following cycle parameters:
1. 4 minutes cold prewash at 30 ± 5°C
2. 10 minutes cleaning wash at 55 ± 5°C
3. 1 minute rinse at 30 ± 5°C
4. 10 minutes rinse at 30 ± 5°C with distilled water
Inspect each tool or component for any remaining visible debris and repeat the cleaning process if needed.
Sterilization
Prior to reassembly and sterilization, all components should be rinsed in running tap water to remove any residual detergent or cleaning solution.
All components MUST be completely dry prior to steam-sterilization, to prevent corrosion. Use single-use, lint-free wipes or clean compressed air to dry all components prior to steam-sterilization.
Place assembled kits or individual tools and instruments in sterilization bags or wrap them in sterilization level single-use wrapping material. Kit’s type and date of sterilization should be marked on the outside using a permanent marker.
Adin recommends the use of steam sterilization with a gravity displacement cycle for 4 minutes at 132°C/270°F and drying for 20 minutes.
Storage
Sterile kits should be stored in a clean cabinet/drawer at room temperature.
Note: Kits remain sterile for a limited period of time, based on the specifications provided by sterile bag/ wrap manufacturer.

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