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Das CAMLOG Implantatsystem: Chirurgisches Handbuch

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  • 1. Table of Contents 1. The CAMLOG® implant system 2. Rehabilitation with CAMLOG® implants 3. Patient evaluation 4. Contraindications 5. Pre-implant prosthetic surgical measures 6. Pre-operative planning 7. Post-operative measures 8. 9. The CAMLOG® surgical system 9. Placing CAMLOG® implants (1)10. Placing CAMLOG® implants (2)11. Placing 3,3mm implants12. Placing 3,8mm implants13. Placing 4,3mm implants14. Placing 5,0mm implants15. Placing 6,0mm implants16. Maintenance of surgical instruments
  • 2. The CAMLOG® transfer systemNote: All of the information and procedures contained in thismanual are solely for the use of qualified personnel. Thismanual is a synthesis of concepts and should be consideredin this entirety and not as individual treatmentrecommendations.
  • 3. Table of Contents next The CAMLOG® Implant system 1ImplantsPrecisionThe Bioseal® BevelThe SurfacesThe CAMLOG® ConnectionImplantsExternal GeometryThe uppermost portion of all three implant geometrieshave a 1.5mm polished collar (- 1 -).Below the collar is a 0,5mm textured, machined 45°chamfer, the Bioseal® Bevel (-2-).Below this are either the blasted, etched self-tappingthreads of the Screwcylinder and Root Lines(-3-)or the titanium plasma spray coating of the CylinderLine (-4-).Internal GeometryIn the uppermost cylindrical portion (-5-) of all three
  • 4. implant geometries are three symmetrical notches(0.5mm or 0.7mm in diameter, 1.2mm deep, 120°apart) (-6-).These notches engage corresponding cams on theabutments. Below ore internal threads (-7-),which accept the Gingivaformers, the PDL Lineabutments, and other prosthetic components. Furtherdown inside the implant, within the I.D. of the upperthread, extends an odditional cylindrical part (-8-),engaging the apical tube extension of the abutments.After a 45° chamfer, a second internal thread (-9-)extends apically, accepting the abutment fixing screw.
  • 5. PrecisionAll internal and external geometries of the implants,abutments, and other components are machined onlathes. This allows the tolerances to be kept very close.The result is a precise fit of all system components andguarantees absolute (0°) rotational stability. Such closetolerances are absolutely essential to the constructionof ,inovable prostheses with double crowns, Dalboattachments, etc.Der Bioseal® BevelPreparation related discrepancies between receptorsite and implant are mechanically sealed by themachined 45°chamfer below the polished collar.Connective tissue downgrowth is thereby inhibited. lfthe implant is placed according to protocol (approx.0.4mm above bone crest), after exposure and aphysiological bone adoptation of up to 1 mm, there isavailable a biologic length of 2mm that remains stableover time (1 mm connective tissue and 1 mm junctionalepithelium).The Surfaces
  • 6. TPS cooting of the Cylinder Line implantsPromote® surface of the screwcylinder Line and RootLine implants(Ra= 3,0 µm, Rmax= 20,5 µm)The CAMLOG® Connection
  • 7. The Iong term maintenance of soft and hard tissuehealth in the patient freoted with implants dependsupon the patients oral hygiene, the pre-, intro-, andpostoperative soft tissue management, thebiomechanics of the reconstruction, and the design ofthe implant hardware and components. As forces aretransmitted and distributed during function andparafunction, the implant/abutment connection plays acentral role.The tube-in-tube design of the CAMLOG connection ismechanically very stable and absolutely (0°) rotationfree. The CAMLOG connection is a form-and force-based connection.The design features of the CAMLOG connection, whencompared with FDA minimum requirements (admodem Brånemark), demonstrate nearly 100% highervalues in static compression tests (required: 54.5 lbs,achieved: 103.6 lbs) and over 60% higher values incompression fatigue tests (required: 20.0 lbs,achieved: 32.5 Ibs).Table of Contents next
  • 8. back Table of Contents next Rehabilitation with CAMLOG® Implants 2 Team members The CAMLOG Team Concept Team members Patient The long term health, expectations, ond wishes of the patient should be ascertained and clearly ocumented. The case specific possibilities and limitations of an implant- prosthetic rehabilitation must be clearly spelled out for the patient. The importance of a comfortable patient cannot be underestimated, especially if further measures are to be recommended.
  • 9. DentistThe restorative dentist is generally the team leader.Responsibilities include diagnosis treatment planning,communication of findings to the patient and reachingconsensus os to the course of action with the patient,surgeon, and technician. The team leader coordinates thetreatment throughout the various phases:surgery, healing, and rehabilitation. The restorative dentistshould work closely with the technician cind surgeon forexample, in the construction of the surgical template tooptimize function and aesthetics. Supervision ofcommunication, logistics and patient trust are the teamleaders responsibilities.SurgeonThe surgeon carries out the pre-implantation andimplantation procedures as prescribed by the restorativedentist using the diagnostic and surgical templates created inadvance by the technician and restorative dentist. Thesurgeon should explain the procedures to be performed tothe patient and may request further radiologic and medicalinformation.Dental technicianThe technicion adds his laboratory skills and experience tothe preoperative planning phase. He creates a set-up andwax-up designed to optimize function and aesthetics, andmake suggestions as to the design, of the definitiverestoration. He constructs the provisional and finalprostheses, the x-ray and surgical templates, and choosesthe implant abutments.
  • 10. HygienistThe patients oral hygiene is basic to the long term successof dental implant therapy. The hygienist plays a vital role ininstructing and motivating the patient. The hygienist isinvolved throughout all phases of the treatment includingheoling and, of course, the follow-up phase with continuousreinstruction and re-motivation to maintain a high level of oralhygiene.AltatecALTATEC has made its business directly supporting allmembers of the implant rehabilitation team through productdevelopment, production, and sharing of information.Production takes place under strictest protocols in order toachieve the highest possible quality control standards.ALTATEC can assist the restorative dentist in the selectionand correct application of prosthetic components to achieveoptimal function and aesthetic results. ALTATEC standsready to assist both technician and dentist with case specificadvice in planning and selection of components.The CAMLOG Team Concept
  • 11. The modern implant prosthetic reconstruction requires a highlevel of attention to detail and clinical experience from allinvolved, the dentist, the oral surgeon, the technician, as wellas the dental assistants and auxiliaries. Emphasis an quality,quality assurance and specialization, dictates a multi-disciplinary opproach for a knowledgeable, experiencedteam. The CAMLOG team concept requires that thetreatment plan is clearly structured, the separate phases ofthe treatment are the result of collaborative planning, and allteam members are clearly informed of the logical course ofthe treatment.Pre-implantation and implantation procedures are corried outby the surgeon or surgically qualified restorative dentist. TheCAMLOG surgical armamentarium is simple and thoughtfullyassembled. lf the implantation is one-stage, a secondsurgery is not required. lf the implantation is two-stage(covered), a Gingiformer is used for soft tissue conditioningfor approximately three weeks between exposure andimpression taking. Using the transfer system, the dentisttakes an impression with a material of choice (hydrocolloid,silicon, polyether, etc.) Apart from the transfer components,only a screwdriver is required. After the master model isproduced, selection of abutments is accomplished in the labfrom a trial abutment set. The required components are thenordered and delivered. There is no need for dentists or labsto maintain extensive and costly inventories. Due to the highprecision of the components and the absolute rotationalstability of the implant/abutment connection, time consumingintermediate try-in oppointments can generally be skipped.Since placing the abutments is quick and easy, dentist andtechnician can fully utilize the try-in appointment toconcentrate on the aesthetic andhygienic aspects of therestoration. Single crowns, small bridges, bars constructedwith the CAMLOG Passive Fit system, and telescopingoverlay prostheses constructed with galvono-formed copings
  • 12. fit with predictable accuracy. The CAMLOG implant system is extremely user-friendly and time saving. Course of Treatment Planning Team Pre-treatment Dentist (Surgeon), Technicion, Hygienist Implantation Dentist (Surgeon) Exposure and Impressions Dentist (Surgeon) Model work, Approval of the Plan Technicion, Dentist and Abutment Selection Prosthetic Crection Technicion Bisque Bake- Dentist, Technician Dentist, Technicion Esthetic Try-in Finalization Technicion Insertionof the Prosthesis Dentist Maintenance Dentist, Hygienistback Table of Contents next
  • 13. back Table of Contents next Patient evaluation 3 General Documentation Guidelines Anamnesis Recording findings General Documentation Guidelines A basic and thorough pre-operative plan is essential for the long- term success of the implant prosthetic restoration. The plan should be developed with input from the entire team influencing the treatment concept reducing problems and complications. All information from the anamnesis, findings, diagnostics and observations must be documented. A greater understanding comes from this thorough documentation and results in a better treatment plan and informed consent form. Anamnesis
  • 14. In the general, social and special anamneses, all aspects ofmedical contra-indications, such as disecises which inhibitmicrocirculation or surgical unsuitabilities relating to the plannedimplant prosthetic restoration must be examined. Risk factors likesmoking, alcohol and drug abuse must be discussed anddocumented in a trust building fashion. The psychic and psycho-social situation of the patient indicates the level of expectedcompliance and influences treatment plan and prosthesis design.GeneralIn the general anamnesis, thorough medical history, especially theregular intake of medicines and pre-existing conditions that maynegatively influence the success of an implant prostheticrehabilitation should be evaluated. Of further importance areconditions which affect the patients ability to cope with thetreatment and later to maintain the restoration hygienically.SpecialIn the special anomnesis the current state of the stomotognaticsystem is examined. Evidence of yet undiscovered systemic illnessmay be discovered. Evaluation of the bone quality will influencewhether preimplant augmentation will be required.Patient expectationIn planning the entire scope of the treatment, especially pre -implantation augmentative procedures, it is imperative to assess thepatients willingness to accept the possible functional and aestheticlimitations. An optimal result requires optimal preparation. Thismust be made absolutely clear to the patient. The motivation for thetreatment corresponds directly with the patients actual decrease inquality of life and experience with previous attempts to solve dentalproblems.
  • 15. It is important to ascertain the patients willingness to comply withthe level of maintenance required by the planned implant prostheticrestoration . The aesthetic and functional expectations of thepatient frequently do not correspond with economic and practicalfeasibilities. The job of the team, from the very first appointment, isto explain a n d document these boundaries.Recording findingsThe extra- and intra orol findings should, when possible, bediscussed with the technician. The current condition should beroutinely documented in words and photographs. Upper andlower impressions and bite registration should be taken forsubsequent evaluction of possible prosthetic schemes. Radiologicfindings with intra-oral and panoramic x- rays generally round outthe diagnostic spectrum. More indepth imaging techniques meybe required in some cases (see Preoperative planning: furtherradiologic diagnostic techniques).
  • 16. extraoralIn addition to findings acquired in a routine extraoral exam (nerves,muscles, sensitivity), the patients profile and the need to enhancethe support of facial structures is critical to the design of theprosthesis, especially in the maxilla. If a great discrepancy existsbetween the desired labial position and the expected location of theimplants, then, from a loading standpoint, a removable appliance isindicated (bar or double crown type).intraoralNext, the existing intra-oral condition of all structures is assessedand the prognosis for each tooth determined. Along with checkingfor soft tissue pathologies, the level of hygiene is evaluated. This isa primary indication of the patients later motivation to cooperate.For implant prosthetic rehabilitation, occlusion, articulation, inter-alveolor space, and also eventual TMJ problems are importantfactors. TMJ problems should be corrected prior to implant therapy.All findings that would result in an increased loading of themasticatory system must be closely examined, documented andweighed in the prosthetic planning. The existing prosthesis shouldbe evoluated for aesthetics, phonetics, and functionality. Theexisting prosthesis can be used to inquire about the patientssubjective problems ond perceptions.In edentulous areas, examine the condition of the soft tissue,especially the width of the attached gingiva. Resorbed or undercutareas are noteworthy in evaluating a possible implant site asaugmentative procedures may be required.radiologicIn addition to examining for pathologies, a panoramic x-roy givesfirst insight into the structure of the hard tissues (especially inedentulous areas), and the possible apical expansion of the implantsite. In some cases, radiologic findings must be augmented with
  • 17. special images.back Table of Contents next
  • 18. back Table of Contents next Contraindications 4 Medical contraindications Anatomic contraindications Medical contraindications Contraindications must be actively looked for and corefully evoluoted. Commonly, they may be overcome through separate medical therapy. Without successful remedies or adequate patient cooperation, implant prosthetic treatment is ruled out. Relative Relative contraindications are patient health conditions that, with special care, can still receive implant prosthetic treatment. Patients with a history of heart attock, arterial sclerosis, und stroke should only be treated after consultation with their physician, und where oppropriate, proper medication. All conditions which influence bone regeneration, microcirculation, und the blood increase risk. These patients may only receive implant prosthetic treatment if their conditions are able to be controlled with medication. Implantation should not be done during pregnancy. Absolute
  • 19. The general medical contraindications are uncontrollable conditions, for example, with hypertension, diabetes, etc. Implant prosthetic therapy should also be withheld in cases of immunosuppression und diseases of the rheumatic family, collagenosis, leukemia, hepatitis, and the condition after radiation treatment. Psychological and physical conditions that preclude the patients cooperation or understanding during the therapy und maintenance phases are contraindications. Patients who cannot be motivated to good oral hygiene are not condidates for implont therapy. Unless nicotine abuse, alcohol abuse, or parafunction like bruxism, pencil chewing, etc. con be dealt with in the pre-treatment phase, implant treatment should be withheld. Anatomic contraindications Todays augmentative possibilities, und ongoing advances in membrane techniques, reduce the absolute anatomic contraindications to only those situations where it is just not possible to create an adequate implant bed.back Table of Contents next
  • 20. back Table of Contents next Pre-implant -prosthetic surgical measures 5 Time of operation Overview of procedure Healing phases Time of operation The choice of when to operate is greatly dependent upon the particular situation and the experience level of the surgeon. From two-stage procedures with adequate healing time, to onestage (simultaneous) procedures, to minimally invasive soft tissue manipulation at implant exposure, encomposses o broad spectrum of level of difficulty. If primary stability of the implant in conjunction with hard tissue augmentation is not achievable, then a two-stage procedure is required. Often a secondary soft-tissue manipulotion is avoidable if the hord-tissue correction is well done in the first place. Overview of procedure
  • 21. Hard-tissueWhere inadequate bone exists in the mandible, granular materialshould be used for lateral augmentation and bone blocks forvertical and/or lateral augmentations.In the maxilla, in most cases, an adequate zone of bone can becreated through lateral augmentation with granular material, lateraland/or vertical augmentation with bone blocks, or sinus floorelevation and augmentation with granular material and/or boneblocks.Soft-tissueIn correcting soft-tissue deficiencies, the guiding principal must be:"softtissue follows hard" meaning without adequate underlying hard-tissue structures, soft-tissue manipulations generally have a highrisk of recidivism. Procedures like vestibuloplasty, lateral andcoronal flap transposition, as well as mucosol/connective tissuetransplant are possible options. Always ensure there is a zone ofattached mucosa around the implant.Healing phasesAfter hard-tissue augmentation procedures, a healing phase of fourto six months should be expected. This period can be longerdepending upon the particular case. Healing time for soft-tissues isnot relevant to implantation.
  • 22. back Table of Contents next
  • 23. back Table of Contents next Pre-operative planning 6 General guidelines Consent Form Evaluation of radiographs Further radiologic diagnostic techniques Model analysis Set-up, Wax-up Prosthetic design Indications for the various implant geometries Construction of a planning and drilling template General guidelines
  • 24. The best evidence that the patient understands thepossible risks of a dental procedure, is a signedinformed consent form, created by the dentist and anattorney, limiting liability. In order to gain the consent ofthe patient, the dentist must first explain the reasonsfor the treatment and the type of therapy indicated. Theprocedures to be performed should be explained indepth as well as the underlying reasons for each.Second, possible alternative treatments should beoffered along with the dentists reasons for having apreferred course of action. Third, the risks associatedwith the prescribed treatment must be explained, Riskswhich are commonly understood, or that the patient isfamiliar with from o previous treatment, need not bereiterated. The risks that the patient is unaware of, andnecessary for the patients informed decision must bemade clear. The dentist presumably need not detailevery associated risk, the exact language is a matter ofjudgment. All risks that occur with known probabilitiesmust be explained.The informed consent form should also be signed bywitnesses. The form then becomes a part of thepatients medical record. A copy of the agreement isgiven to the patient. Guidelines recommended by theInternational Congress of Oral Implantologists are anthe following page. The form is intended os areference. ALTATEC refrains from offering an opinionan the adequacy of this form. It is highly recommendedthat such an informed consent form be used. This formshould advise the patient of the expected results andthe risks associated with the surgical procedures. Thepatient should be informed that there is no guaranteeof success, and a successful implantation may not lastforever. The content ond manner of use of the consent
  • 25. form varies from state to state and country to country.Consult an attorney in constructing your own form .The informed consent agreement provides thepatient with an explanationof the expectations for a dental procedure in easilyunderstood language.To be included:1. why the treatment is necessory2. which alternative treatments exist;3. which risks are associated with the treatment:4. what would happen if the treatment were notcompleted.*The available information comes from the U.S. department OFHealth andhuman services, Public Health service PublicationNo. 81-1531, fromDecember 1980 with the title Dental Implants:Benefits and Risk: AtNIH Harvord consensus developmentConference.Consent FormClick here, around Consent Form to display.
  • 26. Evaluation of radiographsRidge form, size of the maxillary sinus, and the pathof the mandibular canal influence the positioning ofimplants.In most cases, these anatomic constraints can bedocumented with radiographic film. For forensicreasons pre-and post-implantation x-rays should betaken.Conventional x-raysIn cases of single implantation in an area of adequatebone and adequate distance from critical structures, aconventional x-ray (right-angle technique) may suffice.lf a measuring ball is included in the x-ray, thedimensions of the zone of available bone may becalculated. Length (actual) = Length(image) x Ball Diameter (actual) / Ball Diameter (image)AidsInclude objects of known dimension in radiographs forevaluation. Use, for exemple metal balls cured in anacrylic base in the planned implant positions. Trulyaccurate metric analysis requires a CT scan (seefurther radiologic diagnosis). Use of small titaniumtubes in a CT scan template produces no artifacts, andallows planning of implant axis as well.
  • 27. Panoramic x-rays A panoramic x-roy makes immediately clear whether a patient is a good condidate for implant therapy. Enlargement scales vary (25-40%). Use metal pins or balls in an acrylic base to verify enlargement. The enlargement factor may be calculated by comparing the actual length of the mecisuring pin with the x-ray. Ball bearings in an acrylic base are very suitable measurement aids. Panoramic x-rays should be used in conjunction with other radiologic techniques in assessing the height,Segment of a panoramic x-ray width, and quality of bone, and position of vital structures like the inferior alveolor nerve, the mental foramen, maxillary sinus and floor of the nose. The image in a panoramic x-ray is locally distorted. The CAMLOG implant template allows for an average distortion factor of from 1:1.25 to 1:1.4. In cases of minimal clearance from critical structures, further radiologic diagnostic techniques should be employed. Further radiologic diagnostic techniques
  • 28. For difficult anatomical situations , i. e. a severelyatrophied region of a posterior mandible or maxilla, theDental-CT scan is a helpful, if not indispensable aid.From a prosthetic standpoint, implant position and axismay be simultaneously planned, dictating theconstruction of a planning and drilling template anmounted casts. For the transfer of the planned implantpositions, titanium tubes are embedded in the CT scantemplate (titanium generates no artifacts). Evaluationof the scans is either by direct measurement or withthe use of specialized computer programs.Model analysisMounted casts and a diagnostic wax-up are animportant aid in planning and verifying implant positionin edentulous or particilly edentulous ijws. The castsare to be mounted with a face-bow and in centricrelation.
  • 29. Set-up, Wax-upThe diagnostic wox-up is an important aid for thesurgeon and restorative dentist in verification of theindividual implant positions. The diagnostic wax-up isproctical for cemented or screw-retained bridges andvital in tooth-for-tooth restorations and can be used toconstruct the planning/drilling template.Prosthetic designFor decades, Antes rule has been the basis inplanning conventional perio-prosthetic rehabilitation.Analogously, a tooth-for-tooth perio-implant-prostheticconcept is based an the principal that each tooth bereplaced with an implant whose surface area is at leastas great as the root surface area of that tooth. Therelationship between crown length and osseointegratedimplant length, and the angle between crown axis andimplant axis directly influence the lever relationship andtherefore the magnitude, the direction and thelocalization of the static and dynamic forces at theinterface. Peak loads at the interface of implant and
  • 30. bone, and the surrounding bone structure must beavoided. The forces should be directed over the largestsurface area possible. The relationship between crownlength and root length should correspond with: crownlength (CL) to osseointegrated implant length (IL). lf therelationship between crown length (CL) and implantlength (IL) > 0.8, then single crowns should be splintedfor bio-mechanical reasons. A cuspid guidanceocclusal scheme and the resulting posterior disclusionprevents the occurrence of para-functional forces.Indications for the various implant geometriesThe choice of implant geometry is not location specific.The self-tapping threads of the Screwcylinder Line andthe Root Line may be used when the surgeon feels theneed for greater primary stability. Preparing an implantreceptor site in bone qualities D1 and D2 where thecortical bone is very dense may require pre-tapping.
  • 31. Construction of a planning and drilling template
  • 32. Since optimal implant placement improves lang term prognoses, the routine use of a drilling template is recommended. The technician can construct this from the diagnostic set-up/wax-up. lf necessory, three dimensional positioning may be accomplished with CT scan data and the oppropriate computer software (see also "further radiologic diagnostic techniques"). Teeth are waxed up in the desired implant positions for the construction of the planning ond drilling template. In certain circumstances, this wax-up may be used to fabricate a long term provisional appliance. In this situation, a silicon matrix is used to transfer the exact position of the eventual implant crowns to the template. An acrylic template is fabricated with the aid of the silicon matrix. In centric position, titanium tubes are then placed through the planned implant crowns in their proper axes. The oppropriateness of the planned implant placement axes in two dimensions can be checked with the panoramic x-ray. Three dimensional imaging requires a CT scan. the planning/drilling template may be used for this too.back Table of Contents next
  • 33. back Table of Contents next Post-operative measures 7 General Instructions Patient preparation Provisional prostheses After surgery General prosthetic instructions Complications General Instructions Routine postoperative procedures apply to procedures as well. The surgerized area must be kept free of all mechanical influences. Cold is used to reduce swelling. Antibiotics may e prescribed as the case dictates. Always take a postoperative x- ray and advise the patient to contact the practice if anything that seems abnormal occurs. Patient preparation
  • 34. The patient is prepared as he would be for any other surgicalprocedure. As the case dictates, an antibiotic may be givenbefore or after the procedure. Medical history and thepatients general health dictates the use of oral orintrcivenous sedation.Provisional prosthesesThe patient may only be treated with a provisional applianceto the extent that there is no force being applied to theimplant or the sutures. This possibility should be made clearto the patient in the planning phase. In the extreme case,going without a prosthesis must be tolerated. Generally, aIong term provisional supported by the remaining dentition isfabricated a head of time ond seated after the surgicalprocedure. Typical provisionals include Maryland bridges,metal reinforced acrylic temporaries, and free-end bridgeswith short distal extensions. In some cases the existingprosthesis can be modified. In all situations, no pressure is tobe exerted on the implant or the stitches. Temporary bridgepontics and denture borders can prolong the healing phase.After surgery
  • 35. The patient should be examined the day after surgery andmonitored for ci week. Pay close attention to the tightness ofthe sutures and indications of onset of infection. The suturescan typically be removed in seven to ten days.General prosthetic instructionsDue to the high stability of the CAMLOG connection, theprecision of the components and the transfer systern, toothfor tooth restorations are now possible. Contilevered ponticsare not to be used on free standing implants. The occlusalscheme of choice is simultaneous cinterior/cuspid guidancewith subsequent posterior disclusion. Upper lip support incases of severely atrophied anterior maxillas should beaccomplished with removable prostheses (baroverdenture ordouble crown) to avoid excess inclination of implant crowns.Complications
  • 36. Care must be exercised in the following situations to avoidcomplications. In general, the hand piece must not beallowed to rotate with the wrist and not kept parallel. Thisresults in an eccentric implant receptor site and the implant isinclined toword the distal. In certain circumstances the root ofan adjacent tooth con be damaged.In the mandible:The mandible narrows below the linea mylohyoid. lf the drill isplaced too for lingually, a perforation can occur even if the re-operative x-ray indicated adequate bone mass. lf the apicalaspect of the mandible is made level, the available boneheight is reduced and the implant length must be carefullychecked. Otherwise the possibility of damaging importantstructures (nerve) exists.
  • 37. In the maxilla: The transversal contour of the maxillary sinus can only be ascertained with 3D imaging techniques. Should the pilot drill perforate the sinus, the implantation must be aborted or augmentation procedures must be employed.back Table of Contents next
  • 38. back Table of Contents next The CAMLOG® surgical system 8 Surgical instrumentation Screwcylinder/Cylinder Line surgical set Root Line surgical set Implants Surgical instrumentation Surgical sets The content of the CAMLOG surgical set is organized to guid you step by step through the procedure. The set is identical for the Screwcylinder and Cylinder Lines. There is a separate set for the Root Line. Both sets are aoilable with either connon-shaped or five-bladed pre-drills. The sets are organized in autoclavable trays.
  • 39. Color codingWhite 3,3 mm All diameter specific components of the CAMLOG implant system are color coded. This color coding of the individual elements simplifies theYellow 3,8 mm selection of instruments, implants, and related accessories and Red 4,3 mm greatly reduces the chance of mix-up. Drills for a certain implantBlue 5,0 mm diameter are the same color as the implant and its packaging.Green 6,0 mm Screwcylinder / Cylinder Line surgical set
  • 40. Best.-Nr. J5300.0001 with cannon drillsBest.-Nr. J5300.0003 with 5-bladed drillsRoot Line surgical setBest.-Nr. J5300.0002 with cannon drillsBest.-Nr. J5300.0004 with 5-bladed drills
  • 41. ImplantsAll Screwylinder Line implants have a Promote® surface. Orderl-No. Diameter Length J1022.3809 3,8 mm 09 mm J1022.3811 3,8 mm 11 mm J1022.3813 3,8 mm 13 mm J1022.3816 3,8 mm 16 mm J1022.4309 4,3 mm 09 mm J1022.4311 4,3 mm 11 mm J1022.4313 4,3 mm 13 mm J1022.4316 4,3 mm 16 mm J1022.5009 5,0 mm 09 mm J1022.5011 5,0 mm 11 mm J1022.5013 5,0 mm 13 mm J1022.5016 5,0 mm 16 mm J1022.6009 6,0 mm 09 mm J1022.6011 6,0 mm 11 mm J1022.6013 6,0 mm 13 mm J1022.6016 6,0 mm 16 mmAll Cylinder Line implants have a titanium plasma spray coating(TPS).
  • 42. Order-No. Diameter Length J1011.3311 3,3 mm 11 mm J1011.3313 3,3 mm 13 mm J1011.3316 3,3 mm 16 mm J1011.3809 3,8 mm 09 mm J1011.3811 3,8 mm 11 mm J1011.3813 3,8 mm 13 mm J1011.3816 3,8 mm 16 mm J1011.4309 4,3 mm 09 mm J1011.4311 4,3 mm 11 mm J1011.4313 4,3 mm 13 mm J1011.4316 4,3 mm 16 mm J1011.5009 5,0 mm 09 mm J1011.5011 5,0 mm 11 mm J1011.5013 5,0 mm 13 mm J1011.5016 5,0 mm 16 mm J1011.6009 6,0 mm 09 mm J1011.6011 6,0 mm 11 mm J1011.6013 6,0 mm 13 mm J1011.6016 6,0 mm 16 mmAll Root Line implants have a Promote® surface.
  • 43. Order-No. Diameter Length J1032.3809 3,8 mm 09 mm J1032.3811 3,8 mm 11 mm J1032.3813 3,8 mm 13 mm J1032.3816 3,8 mm 16 mm J1032.4309 4,3 mm 09 mm J1032.4311 4,3 mm 11 mm J1032.4313 4,3 mm 13 mm J1032.4316 4,3 mm 16 mm J1032.5009 5,0 mm 09 mm J1032.5011 5,0 mm 11 mm J1032.5013 5,0 mm 13 mm J1032.5016 5,0 mm 16 mm J1032.6009 6,0 mm 09 mm J1032.6011 6,0 mm 11 mm J1032.6013 6,0 mm 13 mm J1032.6016 6,0 mm 16 mmback Table of Contents next
  • 44. back Table of Contents next Placing CAMLOG® implants (1) 9 Incision Implantation modalities Gingiformers Implantation modalities Temporary abutments Suture closure Drilling system Aids Incision Choice of incision placement is based on the planned course of treatment. The crestal incision is the easiest, but due to the possibility of post-operative complications such as suture dehiscence, not recommended. In order to achieve a tension free suture closure with adequate flap length to be leak free, the vestibular incision is recommended in all cases. Additionally, the sutures should not rest atop the implant.
  • 45. Vestibular incision Crestal incision Implantation modalities
  • 46. The placement of the different implants can,according to the indication, be a one-phasetransgingival, or a two-phase covered procedure.Immediate loading is possible whether placernent isat time of extraction or delayed. Prerequisites forimmediate loading are optimal primary stability andsimultaneous overload protection. The systemcontains specific components for virtually everyimplantation modality. Whether the implant isimmediately loaded, or already integrated,impression taking procedure remains the same.Covered healing is the standard method for theCAMLOG system in all indications.
  • 47. In special circumstances in which maintenance of softtissue structure is desired as in cases of simultaneousextraction with implant placement, open healing cantake place around a Gingiformer.GingiformersThe use of the Gingiformer promotes and supports thecreation of a papilla around the implant, optimizing theaesthetic result. When the bottleneck shapedGingiformer in inserted, a correspondingly shapedtissue form is created which, when compressed by therestorative crown, is papilla-like in appearance. Thebottleneck Gingiformer is available in both titanium andplastic (PEEK) in all diameters and in 4 mm and 6 mmprotrusion lengths.
  • 48. ProtrusionOrder Number Diameter Length J2012.3340 3,3 mm 4 mm J2012.3360 3,3 mm 6 mm J2012.3840 3,8 mm 4 mm J2012.3860 3,8 mm 6 mm J2012.4340 4,3 mm 4 mm J2012.4360 4,3 mm 6 mm J2012.5040 5,0 mm 4 mm J2012.5060 5,0 mm 6 mm J2012.6040 6,0 mm 4 mm J2012.6060 6,0 mm 6 mm ProtrusionOrder Number Diameter Length J2010.3340 3,3 mm 4 mm J2010.3360 3,3 mm 6 mm J2010.3840 3,8 mm 4 mm J2010.3860 3,8 mm 6 mm J2010.4340 4,3 mm 4 mm J2010.4360 4,3 mm 6 mm J2010.5040 5,0 mm 4 mm J2010.5060 5,0 mm 6 mm J2010.6040 6,0 mm 4 mm J2010.6060 6,0 mm 6 mm
  • 49. Implantation modalitiesIn cases of absolute primary stability in a recessionfree receptor site, where the relation of implant lengthto crown length is greater than 1 : 1 , a temporary maybe placed on a plastic (PFEK) provisional abutment.The crown must be adjusted out of occlusion.Temporary abutmentsThe temporary abutments of the CAMLOG system aremade of plastic (PEEK) and can, where operatingparameters permit, be used to support a lang termprovisional restoration. After implantation, theprovisional abutment is fixed in the implant and theform of the surrounding gingiva is marked on theabutment. The abutment is then modified accordinglyand polished in the Iaboratory (Not in the mouth!). Afterre-insertion in the mouth, the screw is covered withwax and a prefabricated temporary crown is relined tofit, or a chairside temporary is made. The crown is
  • 50. placed with temporary cement. Order Number Diameter J2240.3800 3,8 mm J2240.4300 4,3 mm J2240.5000 5,0 mm J2240.6000 6,0 mmSuture closureVestibular incisionThe vestibular incision makes possible in all cases atension-free flap adaptation. This method has distinctadvantages, especially in cases of small simultaneousaugmentations like recessions and perforations. lf amembrane is used, closure must be absolutely leak-free.
  • 51. with membrane Crestal incision Closure is made with single button stitches. lf there is a blood clot directly below the incision, the risk of dehiscence increases. A deep mattress stitch may be used to reduce the tension. The crestal incision is not recommended.
  • 52. Drilling systemSpeedThe recommended top speed for drills is 2,000 RPM.The top speed for thread cutting is 50 RPM. Pleasemake sure your surgical drill is properly limited.CoolingWith the exception of the round burs and threadcutters, the drills of the CAMLOG system are internallycooled. Sterile saline solution should be used forcooling. The internally cooled drills require specialattention be paid to ensure the irrigation ports are notclogged with bone chips. When using the pilot drills,pre-drills and form-drills, a pumping motion should beemployed. In this way the bone is drilled for two tothree seconds and then the drill is retracted withoutstopping the handpiece motor. This allows theirrigation system to clear the bone debris. Proceed inthis fashion until the desired depth is reached. Shouldthe irrigation port become clogged, take the drill out ofthe handpiece and clear the blockage with the cleaningneedle. Do not drill if no irrigation solution is flowing!Service life of the drillsHow long the drills remain sharp is greatly dependenton drilling technique and bone quality. The pilot-, pre-,and form drills normally last through 10 to 20 uses.This number can vary greatly. lf a great amount offorce is required, replace the drill immediately to avoidoverheating the bone. Remember that each
  • 53. sterilization cycle compromises the cutting efficiency ofthe drill.AidsDepth stopAll CAMLOG pilot- and pre-drills can be fitted withdepth stops to avoid creating too deep a receptor site.Without depth stop the drill is for 16 mm long implants.With the appropriate stop installed the bore is limited to9, 11, or 13 mm respectively. The stops are intendedfor the spiral drills the connon drills, and the five-bladed drills. Order Number Length J5016.0009 09 mm J5016.0011 11 mm J5016.0013 13 mm
  • 54. Depth and axis controlAfter pilot boring, depth and axis may be checked byinserting the parallel pin/depth gauge. The pins aresupplied in all pre-drill diameters. Order Number Diameter J5300.2033 2,0/3,3 mm J5300.2836 2,8/3,6 mm
  • 55. RoundburThe round bur has a diameter of 3.1 mm and is used tomake an indentation in the compact bone, to facilitatethe subsequent insertion of the cannon drill or five-bladed cutter. It is used with external irrigation as thisis a minimally invasive step. In certain indications, theround bur is used prior to the spiral drill as well. Theround bur is used to make a slight depression in thealveolor ridge (half the depth of the bur), in which thetip of the next drill seats. The round bur may also beused to remove sharp edges and other irregularities onthe crest of the ridge. This should be done with ampleexternal irrigation. Order Number J5005.3100Pilot drillWith the 2 mm pilot drill, the depth and orientation ofthe bore is finalized. The marks cut in the toolrepresent the implant lengths 9, 11 , and 13 mm. Theoverall tool length is for 16 mm implants. We generallyrecommend the use of the depth stops correspondingto the planned implant lengths. lf a drilling template isused, the stops can be put on after the holes havebeen marked. After drilling, the depth and orientation ofthe receptor sites are checked with the 2 mmparalleling pins. lf more than one implant is to beplaced, it is advisable to place a paralleling pin in thefirst hole as a visual guide for the subsequent bores.This technique is, of course, not applicable when adrilling template has been prepared that indicates thedesired axes.
  • 56. Order Number J5005.2000 Planisher In select instances, it can make sense to planish the alveolar crexxx in order to create a regular bone surface around the implant. The choice of diameter of planisher corresponds to the planned implant diameter (see illustration). The planisher is used following the pilot drill. The tip of the planisher is placed in the pilot hole. Pay special attention to the speed of the motor, and proceed slowly and carefully so the planisher doesnt chatter. After planishing, the depth of available bone must be rechecked, paying special attention to critical anatomical structures! (alternatively a shorter implant must be selected). Order Number Diameter J5006.5200 5,2 mm J5006.6200 6,2 mm J5006.7200 7,2 mmback Table of Contents next
  • 57. back Table of Contents next Placing CAMLOG® implants (2) 9 Pre-drills Form drills Receptor site preparation sequence Placement instruments Removing the implants from the packaging Orientation of the implant Screwcylinder Line/ Root Line Cylinder Line Pre-drills Screwcylinder/Cylinder Line Pre-drills for the Screwcylinder and Cylinder Lines are 2.8 mm, 3.3 mm, and 3.6 mm in either cannon or five- bladed geometries. Marks on the tools correspond to the various implant lengths analogous to the pilot drills. Use of depth stops is recommended for safety. Use the xxxll chart in selecting the proper diameter drills for the various implant sizes. Order Number Diameter
  • 58. J5018.2800 2,8 mm J5018.3300 3,3 mm J5018.3600 3,6 mmRoot LineFor the root line, only the 2.8 mm pre-drill in cannon orfive-bladed form is used. Use of depth stops isrecommended. For the further enlargement of thereceptor site, form-drills in increasing diameters areused sequentially. Refer to the drill chart for theappropriate implant diameter. Order Number Diameter J5020.2800 2,8 mm J5020.3300 3,3 mm J5020.3600 3,6 mmForm drills
  • 59. Screwcylinder/Cylinder LineThe form-drills of the Screwcylinder and Cylinder Lineshave depth stops. The depth stops are designed toleave the implant 0.4 mm supro crestal. Thesecolorcoded metal rings sleeve over the drill andengage in a groove. In situations where the alveolarridge is uneven, it can be difficult to achieve thedesired depth. First, prepare the receptor site with thedrill stop in place, then, when the drill stop is removed,on additional 2 mm of drill is available (Exercisecaution near critical structures!) to achieve therequired depth.Root LineThe form-drills of the Root Line have depth stops.These color-coded metal rings sleeve over the drill andengage in a groove. In situations where the alveolarridge is uneven, it can be difficult to achieve thedesired depth. First, prepare the receptor site with thedrill stop in place, then, when the drill stop is removed,an additional 2 mm of drill is available (Exercisecaution near critical structures!) to achieve therequired depth.
  • 60. Thread cuttersAll CAMLOG implants in the Screwcylinder and RootLines have self tapping threads. lf required by specialindications, thread cutters are available for each of theimplant diameters. Do not operate the thread cuttersabove 50 RPM to avoid overheating. The axis of thereceptor must be carefully observed. The threadcutters are only inserted as for as the cutting part ofthe tool extends. Order Number Diameter J5030.3855 3,8 mm J5030.4355 4,3 mm J5030.5055 5,0 mm J5030.6055 6,0 mmReceptor site preparation sequence
  • 61. Overview of receptor site preparation- Roughening of the alveolor ridge in the desiredimplant placement area (optional)- Marking of the implant position with the 2mm twistdrill- Depth drilling and axis determination- Verification with depth gauge/paralleling pin- Planishing of the alveolar ridge (optional)- Re-verification (optional)- Pre-drilling according to the drill chart- Form drilling- Thread cutting (optional)Placement instrumentsScrewcylinder/Root LineAll the required instruments are included in the set.The torque ratchet can adjusted 90° by turning thehandle. The wrench will not work past the selectedtorque. The torque can be varied between 10 and 30Ncm by turning the adjustment screw in the end of thehandle in or out to the appropriate mark. Description Order Number A Drive Mandrell J5300.0007 B Cardanic Driver J5300.0010
  • 62. C Torque Wrench J5300.1030 D Ratchet Adapter J5002.0010Cylinder Line Description Order Number Seating instrument J5300.0005
  • 63. Removing the implant from the packagingContents of the Smart Pac®The Smart Pacs for the Screwcylinder and Root Linescontain the implant and the mounted placement headin a hand grip. The implant sealing screw in under afoil closure in the hand grip. The Smart Pacs for theCylinder Line contain the implant with sealing screw inplace and a mounted, breck-away placement head in ahand grip.Orientation of the implantAll CAMLOG implants are conceived so that whenthe drill system is properly used, the coronal aspectof the implant lies approximately 0.4 mm above thebone. In excepted cases, removal of the depth stopon the form drill facilitates another 2 mm of depth.
  • 64. Corresponding to the cams of the CAMLOGconnection are clearly visible (1 mm diameter) marksmachined into the outer surface of the implants of theCylinder Line. One of these marks is oriented towardthe vestibule at implantation. The corresponding camis therefore also oriented toward the vestibule.Corresponding to the cams of the CAMLOGconnection are marks machined into the placementinstruments for the Screwcylinder and Root Lineimplants. These marks must be orienied toward thevestibule at implantation.Warning: Dont confuse these marks with dimplesholding instrument tips on!Screwcylinder Line/Root Line
  • 65. The implant is sterile when removed from the innerpackaging and therefore should only be grasped bythe hand grip. The implant is placed by hand in thereceptor site, and finger tightened. The hand grip isthen removed.For the tightening of the implant, three options areavailable.-mechanical tightening with the mandrel-manual tightening with the ratchet-manual tightening with the cordanicdriverThe final positioning is always done manually to avoidovertightening the external threads of the implant inthe bone. The correct implant position is reached whenthe upper edge of the implant is cipproximotely 0.4 mmabove the bone and one of the cam marks is orientedtoward the buccal.Once the desired position is reached, the fixing screwis unscrewed and the insertion head is removed. Aftercleaning the threads, the accompanying sealing screwis installed. The sealing screw is in a foil coveredcompartment in the hand grip.Warning: Take precautions to avoid swallowing oraspiration of the parts.Cylinder Line
  • 66. The implant is sterile when removed from the inner packaging and therefore should only be grasped by the hand grip. The implant, with one of the marks oriented buccally, is pressed into place as far as it will go by hand, making sure not to remove the breakaway placement head. Slide, rather than snap, the hand grip off the placement head! Next, place the seating instrument an the placement head and tap into place with the surgical hammer. The final position is recognized by a "satisfying" hollow sound. At this point the placement head is broken away from the implant. The placement head stays in the seating instrument because of its silicon o-ring. The tightness of the sealing screw is checked with a hand screwdriver. Warning: Take precautions to avoid swallowing or aspiration of the parts.back Table of Contents next
  • 67. back Table of Contents next Placing 3,3mm implants 10 Placing Cylinder Line implants Placing Cylinder Line implants Drilling sequence
  • 68. Order Number Description UsageJ5005.2000 Pilot drill 2,0 mmJ5016.00xx Depth stop According to planned implant length xx=LengthJ5300.2033 Parallel/Depth pinJ5006.5200 Planisher 5,2 mm OptionalJ5020.2800 Pre-drill 2,8 mm Or J5018.2800 Cannon drillJ5021.33xx Form drill 3,3 mm According to planned implant length xx=Length
  • 69. back Table of Contents next
  • 70. back Table of Contents next Placing 3,8mm implants 11 Placing Screwcylinder/Cylinder Line implants Placing Root Line implants Placing Screwcylinder/Cylinder Line implants Drilling sequence
  • 71. Order Number Description UsageJ5005.2000 Pilot drill 2,0 mmJ5016.00xx Depth stop According to planned implant length xx=LengthJ5300.2033 Parallel/Depth pinJ5006.5200 Planisher 5,2 mm OptionalJ5020.2800 Pre-drill 2,8 mm Or J5018.2800 Cannon drillJ5020.3300 Pre-drill 3,3 mm Or J5018.3300 Cannon drill
  • 72. J5021.33xx Form drill 3,3 mm According to planned implant length xx=LengthJ5030.3855 Thread cutter Optional Placing Root Line implants Drilling sequence
  • 73. Order Number Description UsageJ5005.2000 Pilot drill 2,0 mmJ5016.00xx Depth stop According to planned implant length xx=LengthJ5300.2033 Parallel/Depth pinJ5006.5200 Planisher 5,2 mm OptionalJ5020.2800 Pre-drill 2,8 mm Or J5018.2800 Cannon drillJ5022.38xx Form drill 3,8mm According to planned implant length xx=Length
  • 74. J5030.3855 Thread cutter Optionalback Table of Contents next
  • 75. back Table of Contents next Placing 4,3mm implants 12 Placing Screwcylinder/Cylinder Line implants Placing Root Line implants Placing Screwcylinder/Cylinder Line implants Drilling sequence
  • 76. Order Number Description UsageJ5005.2000 Pilot drill 2,0 mmJ5016.00xx Depth stop According to planned implant length xx=LengthJ5300.2033 Parallel/Depth pinJ5006.6200 Planisher 6,2 mm OptionalJ5020.2800 Pre-drill 2,8 mm Or J5018.2800 Cannon drillJ5020.3300 Pre-drill 3,3 mm Or J5018.3300 Cannon drill
  • 77. J5020.3600 Form drill 3,6 mm Or J5018.3600 Cannon drillJ5021.43xx Thread cutter 4,3 According to mm planned implant length xx=LengthJ5030.4355 Gewindeschneider Optional Placing Root Line implants Drill sequence
  • 78. Order Number Description UsageJ5005.2000 Pilot drill2,0 mmJ5016.00xx Depth stop According to planned implant length xx=LengthJ5300.2033 Parallel/Depth pinJ5006.6200 Planisher 6,2 mm OptionalJ5020.2800 Pre-drill 2,8 mm Or J5018.2800 Cannon drillJ5022.38xx Form drill 3,8 mm According to planned implant length
  • 79. xx=Length J5022.43xx Form drill 4,3 mm According to planned implant length xx=Length J5030.4355 Thread cutter Optionalback Table of Contents next
  • 80. back Table of Contents next Placing 5,0mm implants 13 Placing Screwcylinder/Cylinder Line implants Placing Root Line implants Placing Screwcylinder/Cylinder Line implants Drill sequence
  • 81. Order Number Description UsageJ5005.2000 Pilot drill 2,0 mmJ5016.00xx Depth stop According to planned implant length xx=LengthJ5300.2033 Parallel/Depth pinJ5006.6200 Planisher 6,2 mm OptionalJ5020.2800 Pre-drill 2,8 mm Or J5018.2800 Cannon drillJ5020.3300 Pre-drill 3,3 mm Or J5018.3300 Cannon drill
  • 82. J5020.3600 Pre-drill 3,6 mm Or J5018.3600 Cannon drillJ5021.50xx Form drill 5,0 mm According to planned implant length xx=LengthJ5030.5055 Thread cutter Optional Placing Root Line implants Drill sequence
  • 83. Order Number Description UsageJ5005.2000 Pilot drill 2,0 mmJ5016.00xx Depth stop According to planned implant length xx=LengthJ5300.2033 Parallel/Depth pinJ5006.6200 Planisher 6,2 mm OptionalJ5020.2800 Pre-drill 2,8 mm Or J5018.2800 Cannon drill
  • 84. J5022.38xx Form drillr 3,8 mm According to planned implant length xx=Length J5022.43xx Form drill 4,3 mm According to planned implant length xx=Length J5022.50xx Form drill 5,0 mm According to planned implant length xx=Length J5030.5055 Thread cutter Optionalback Table of Contents next
  • 85. back Table of Contents next Placing 6,0mm implants 14 Placing Screwcylinder/Cylinder Line implants Placing Root Line implants Placing Screwcylinder/Cylinder Line implants Drill sequence
  • 86. Order Number Description UsageJ5005.2000 Pilot drill 2,0 mmJ5016.00xx Depth stop According to planned implant length xx=LengthJ5300.2033 Parallel/Depth pinJ5006.7200 Planisher 7,2 mm OptionalJ5020.2800 Pre-drill 2,8 mm Or J5018.2800 Cannon drillJ5020.3300 Pre-drill 3,3 mm Or J5018.3300 Cannon drill
  • 87. J5020.3600 Pre-drill 3,6 mm Or J5018.3600 Cannon drillJ5021.60xx Form drill 6,0 mm According to planned implant length xx=LengthJ5030.6055 Thread cutter Optional Placing Root Line implants Drill sequence
  • 88. Order Number Description UsageJ5005.2000 Pilot drill 2,0 mmJ5016.00xx Depth stop According to planned implant length xx=LengthJ5300.2033 Parallel/Depth pinJ5006.7200 Planisher 7,2 mm OptionalJ5020.2800 Pre-drill 2,8 mm Or J5018.2800 Cannon drillJ5022.38xx Form drill 3,8 mm According to planned implant length
  • 89. xx=Length J5022.43xx Form drill 4,3 mm According to planned implant length xx=Length J5022.50xx Form drill 5,0 mm According to planned implant length xx=Length J5022.60xx Form drill 6,0 mm According to planned implant length xx=Length J5030.5055 Thread cutter Optionalback Table of Contents next
  • 90. back Table of Contents next Maintenance of surgical instruments 15 Instrumentation Instrumentation 1. After every surgical procedure, all the surgical drills, hand instruments, and accessories should be cleaned with a soft brush and an appropriate surgical instrument cleaning solution. 2. Clean the inside of the drills with the help of a dull needle and syringe. 3. Clean all components in an ultrasonic in an appropriate surgical instrument cleaning solution. After ultrasonic cleaning, scrub the drills thoroughly. 4. Clean in ultrasonic with distilled water. 5. Use a dull needle and syringe to rinse internal parts with distilled water. 6. Dry all components and reassemble the set. Place the cleaned drills in the holder with the tips up. Return the hand instruments to
  • 91. the holder and close the lid. 7. The complete surgical set is now ready for sterilization. Sterilize in a steam autoclave for one hour at 121° C. Do not exceed 160° C. Do not place the set directly an the metal of the autoclave, use a towel or tray holder. Use only appropriate disinfection and cleaning products.back Table of Contents next
  • 92. back Table of Contents The CAMLOG transfer system 16 Closed tray impression taking Open tray impression taking Registration The transfer of the oral situation to the moster working model is accomplished with great precision with the CAMLOG Transfer System. The absolute rotational stability of the impression posts is the basis for the trouble-free, adjustment-free, and time saving insertion of the prosthesis. The impression may be taken with a closed or open tray as desired. There are impression posts optimized for both modalities. Impression caps are used on the impression posts for closed impression taking. All components are color coded. Closed tray impression taking
  • 93. After cleaning the implant threads, the impression postis placed in the implant. With light rotation, the camspositively engage in the notches in the implant. It doesnot matter which cam engages which notch. The fixingscrew is then placed in the impression post andtightened. Next, the impression cap is snapped atopthe impression post. Make sure the cap is seated inthe notches of the impression post. Any accurateimpression material may be used. The impressioncaps remain in the impression. The impression postsare removed and given to the Iaboratory with theimpression. Do not modify the impression posts! Order Number Diameter J2110.3300 3,3 mm J2110.3800 3,8 mm J2110.4300 4,3 mm J2110.5000 5,0 mm J2110.6000 6,0 mmOpen tray impression taking
  • 94. After cleaning the implant threads, the impression postis placed in the implant. With light rotation, the camspositively engage in the notches in the implant. lt doesnot matter which cam engages which notch. The fixingscrew, captive in the impression post, is tightened. Anyaccurote impression material may be used. When theimpression material has set, the fixing screws areloosened and the impression removed. Theimpression posts remain in the impression. Do notmodify the impression posts! Order Number Diameter J2120.3300 3,3 mm J2120.3800 3,8 mm J2120.4300 4,3 mm J2120.5000 5,0 mm J2120.6000 6,0 mmRegistration
  • 95. For the bite registration, use the closed tray typeimpression posts. The registration caps are colorcoded according to implant diameter. Do not modifythe modify the registration caps! The registrationcaps make for repositioningcaps make forarticulation easy. Due to the rounded geometry ofthe registration caps, the master model withimpression posts in place can be fitted to the bitewithout modificcition.After cleaning the implant threads, the impression postis placed in the implant. With light rotation, the camspositively engage in the notches in the implant. lt doesnot matter which cam engages which notch. The fixingscrew is then placed in the impression post andtightened. Next, the registration cap is seated atop theimpression post. Any accurate registration materialmay be used. The registration caps should not stay inthe registration. They may be easily repositioned in thelaboratory. Do not modify the registration caps!
  • 96. Order Number Diameter J2110.3300 3,3 mm J2110.3800 3,8 mm J2110.4300 4,3 mm J2110.5000 5,0 mm J2110.6000 6,0 mmback Table of Contents
  • 97. back to the manual Table of ContentsINFORMATION AND CONSENT FORM FOR THE IMPLANT PATIENT1. I have been informed and I understand the purpose and the nature of the implant surgery procedure. Iunderstand what is necessory to accomplish the placement of the implant under the gum or in the bone.2. My doctor has corefully examined my mouth. Alternatives to this treatment hove been explained. I have tried orconsidered these methods, but I desire an implant to help secure the replaced missing teeth.3. I have further informed of the possible risks involved with surgery, drugs, and anesthesia. Such complicationsinclude pain, swelling, infection and discoloration. Numbness of the lip, tongue chin, cheek, or teeth may occur. Theexact duration may not be determinable and may be irreversible. Also possible cre inflammation of a vein, injury tothe teeth present, bone fractures, sinus penetration, delayed healing, allergic reactions to drugs or medicationsused etc.4. I understand that if nothing is done, any of the following could occur: bone disease, loss of bone, gum tissueinflammation, infection, sensitivity, looseness of teeth, followed by the necessity of extraction. Also possible aretemporomandibular joint (jaw) problems, headaches, referred pains to the back of the neck and facial muscles, andtired muscles when chewing.5. My doctor has explained that there is no method to accurately predict the gum and the bone healing capabilitiesin each patient following the placement of the implant.6. It has been expleined that in some instances implants fail and must be removed. I have been informed andunderstand that the practice of dentistry is not an exact science; no guarantees or assurance os to the outcome ofresults of treatment or surgery can be made.7. I understand that excessive smoking, alcohol, or sugar may affect gum healing and may limit the success of theimplant. I agree to follow my doctors home care instructions. I agree to report to my doctor for regular examinations
  • 98. as instructed.8. I agree to the type of anesthesia, depending on the choice of the doctor. I agree not to operate a motor vehicleor hazordous device for at least 24 hours or more until fully recovered from the effects of the anesthesia or drugsgiven for my care.9.To my knowledge I have given an accurate report of my physical and mental health history. I have also reportedanyprior allegic or unusual reactions to drugs, food, insect bites, anesthetic, pollens, dust, blood or body disease, gumor skin reactions, abnormal bleeding or ony other conditions related to my health.10. I consent to photogrAphy, filming, recording, and x-rays of the procedure to be performed for the advoncementof implant dentistry, provided my identity is not revealed.11. I request and authorize medical/dental services for me, including implants and other surgery. I fully understandthat during and following the contemplated procedure, surgery, or treatment, conditions may become apparentwhich warrant, in the judgment of the doctor, additional or alternative treatment pertinent to the success ofcomprehensive treetment. I also approve any modification in design, material, or core, if it is felt this is for my bestinterest._____________________ _____________________Signature of the Dentist Signature of the Patientlf the patient is unable to sign er is a minor, then signiture of parent er legal guardion_____________________Witness___________ _____________________Date Relationship to Patient
  • 99. That internationally Congress OF orally Implantologists is responsiblea non-profit international educationalorganization and not for theinterpretation, presentation or final results of the procedures whichare above. back to the manual Table of Contents

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