Surgical Treatment Planning
– The number of implants is determined as part of a comprehensive treatment planning process, based on the planned restoration type.
– Bone dimensions, as well as the distances from adjacent teeth and other critical anatomical structures are determined based on up-to-date radiographs and CT scans.
– The use of a surgical guide is highly recommended to ensure correct position and angulation of each implant.
– Adin implant systems include a wide range of implant diameters and lengths, enabling clinicians to place and stabilize implants even in minimal bone volume.
Bone Quality and Quantity
– Dense, compact (Type I) bone provides better initial stability for implants, when compared to porous (Type IV) bone.
– Treatment planning and loading protocols should be decided upon based on individual bone conditions at each specific placement site.
– A minimum of 1.5mm of bone should surround each implant.
– A minimal distance of 2mm from critical anatomical structures (e.g., nerves) should be planned and maintained to avoid damage to these structures.
Shape and Design Considerations
Specific features of the unique design of Touareg-S™, Touareg- OS™, CloseFit™, One™ and Triple™ implants:
– The large range of diameters and lengths allows solutions even in sites with limited bone volume.
– The distinct narrowing of the Adin implants collar ensures favorable ridge adaptation, especially when crestal ridge width is limited.
– The active apex and sharp threads allow for angulation changes during placement, to enable correct final positioning of each implant.
Caution: Due to the active apex, implants may not stop at the bottom of the osteotomy. This requires full attention by the surgeon to prevent damage to surrounding structures.
– The unique thread design ensures excellent anchorage and stabilization in all bone types.
– The thread pitch allows insertion rates up to four times faster, compared to other implants. This means that less turns are required to fully insert an implant.
Implant Size and their Recommended Sites
– Implants with a diameter of 3.5mm or more can be placed to support any tooth in the mouth. Larger diameters should be considered when patient is heavy or when large biting and occlusal forces are anticipated because of habits, bruxism etc.
– Narrow platform (NP) and Ultra Narrow platform (UNP) implants should only be used for fixed partial denture restoration for the replacement of maxillary lateral incisors or mandibular incisors. In all other sites, NP and UNP implants should only be used when connected to other, larger diameter implant fixed partial denture restorations.
– All other implant platforms can be used for the restoration of fixed or removable partial dentures, in all sites of the mandible or maxilla.
– Clinicians should take into consideration occlusal forces as well as harmful habits when planning their cases, so that adequate implant diameter and length are used.
– Adin implants can be inserted manually or using a contra-angle at speeds not exciding 25-30rpm.
– The maximum insertion torque should not exceed 50Ncm.
The use of a Surgical Torque Ratchet or a drilling-unit can help avoid excess torqueing forces.
Caution: Excess torque may damage implant connection, and may compromise healing and osseointegration.
– Adin’s Implants may be placed in angulations up to 45°. Implants placed at angulations of 30° or more must be splinted.
Two-stage and One-stage Surgical Approaches
– Adin implants may be implanted with the two-stage or one-stage surgical approach or following the One-Stage surgical approach. The decision as to which approach to use lies completely in the hands of the surgeon.
– In the two-stage surgical approach, implants are covered by gingival tissues and are completely submerged bellow the gingiva during the healing phase. After placement, a cover screw which is supplied with each implant, is used to block the implant’s connection, and the soft tissues are sutured. A second surgery is performed once osseointegration is achieved (hence the term “two-stage”) to expose the connection of the implant and a healing cap or an abutment is used to fabricate an interim restoration and replace the cover screw, and the soft tissues are sutured.
– In the one-stage surgical approach, implants are not covered by gingival tissues after placement. Instead of a cover screw, a healing abutment is attached to the implant, and the soft tissues are sutured around the healing abutment. In the one-stage approach there is no need for a second surgery to expose the implant. However, attention must be given to the following important concerns:
– Implant should have high primary stability to use this approach.
– Healing abutment should extend about 2mm above gingival margins, to ensure that soft tissues do not cover the healing cap during the healing phase.
Adin implants may be placed utilizing the flapless technique.
However, since this technique prevents direct view of the bone, it requires meticulous planning and execution, and should only be considered for use with computerized-based guided surgery techniques.