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Surgical Procedures

Surgical Procedures
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Surgical Procedures

Product catalog summary
Introduction
This manual is designed for clinicians with basic surgical and implant training, providing essential information on the Duravit system, focusing on implant planning and surgical procedures. B&B Dental emphasizes continuous education to keep practitioners updated on the latest implant trends and techniques.
Bone Classification
The document classifies bone density into four types (D1 to D4) based on Hounsfield units, each requiring specific surgical protocols:
  • D1: Mostly cortical bone, found in the anterior mandible, requires pre-cooled saline and gradual drill diameter increases.
  • D2: Thick cortical bone with coarse trabecular bone, found in the mandible, uses similar techniques as D1.
  • D3: Porous cortical bone with fine trabecular bone, found in the maxilla and posterior mandible, advises switching to a compacting manual technique.
  • D4: Primarily fine trabecular bone with minimal cortical bone, found in the posterior maxilla, requires manual compaction to assess bone resistance.
Duravit Evolution Implant
Features include:
  • Double Thread Body: For easy insertion and high primary stability.
  • Self-Tapping System: Facilitates self-drilling and tapping.
  • Apical Blade: Allows penetration in underprepared sites for optimal anchorage.
  • Back-Tapered Coronal Design: Supports soft tissue and maximizes alveolar bone volume.
Drilling Protocols
Specific drilling sequences for different implant diameters and bone types are outlined, emphasizing the use of specific drill sizes and sequences for dense (D1/D2) and soft (D3/D4) bone types.
Duravit 3P Implant
Features include:
  • Triple Thread Body: For enhanced stability.
  • Self-Tapping System: Similar to the Evolution Implant.
  • Micro-Grooving Collar: For optimal anatomical design.
Pre-Operative Procedures
Guidelines for pre-operative X-ray evaluation, bone measurement, and determining the appropriate implant size are included. Recommended implant sizes are based on specific clinical scenarios.
Surgical Kit and Instrument Care
Details the components of the surgical kit and provides instructions for cleaning and maintaining surgical instruments, including the torque ratchet, and sterilization procedures.
Specifications and References
Detailed specifications for various drilling tools and components used in dental implant procedures are provided, including references for different diameters and color codes for easy identification.
Implant Placement Procedures
Implant placement involves cutting and opening the flap for a clear view of the bone ridge, using a guide drill for cortical bone piercing, and employing standard metal stoppers for depth control. External irrigation and intermittent drilling are emphasized to prevent bone overheating.
Implant Insertion and Extraction
Implants are inserted using specific drivers until stability is achieved. Extraction involves using a ratchet mounter with a spring.
One and Two-Stage Procedures
Details on one-stage (transmucosal) and two-stage (submerged) procedures are provided, including the use of cover screws and suturing techniques.
Placement Levels
Implants should be placed 1 mm under crestal bone to facilitate healing and maintain soft tissue height. Placement at bone level is necessary under certain conditions, while placement over bone level is discouraged.
Pre-Operative Procedures
Comprehensive assessment of treatment feasibility involves patient questionnaires, oral examinations, biological tests, and radiological evaluations.
Pre-Implant X-Ray Evaluation
The use of dental panoramic radiographs for assessing bone height is outlined, though it notes the limitation in evaluating bone thickness.
Bone Measurement
Careful attention is required to avoid damaging critical anatomical structures. A minimum of 2.0 mm of bone should separate the implant apex from the mandibular canal.
Implant Size Selection
The selection of implant size depends on available bone and expected occlusal loads. The document recommends choosing the widest and longest implant possible.
Surgical Kit and Instruments
The surgical kit ensures optimal storage and sterilization of instruments, made from shock-proof thermoplastic suitable for autoclaving.
Cleaning and Maintenance
Proper cleaning and maintenance of the torque ratchet are crucial to prevent corrosion and ensure functionality.
Cleaning Phases
The cleaning process involves:
  • Cleansing: Place dirty instruments in a cleaning solution immediately after use.
  • Disinfection: Use an ultrasonic device with a disinfectant liquid to clean instruments.
Sterilization Phases
After cleaning, surgical instruments must be sterilized:
  • Ensure instruments are cleaned, disinfected, and dried before placing them in a surgical organizer.
  • Preferably use a steam autoclave at 121 °C for sterilization.
Important Notes:
  • Chemical sterilization is not recommended.
  • Avoid hot air sterilization.
  • Do not use spherical sterilizers.
  • Ensure the surgical cassette is correctly placed in the autoclave.
Company Information
B&B Dental, certified under UNI EN ISO 13485, is located in Italy. Contact details are provided for further information.
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Catalog excerpts

Surgical Procedures-1

implant company PROTOCOLLI CHIRURGICI SURGICAL PROCEDURES

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Surgical Procedures-2

INSERIMENTO IMPIANTO IMPLANT PLACEMENT

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Surgical Procedures-3

implant company Questo manuale è stato progettato per l'utilizzo da This manual is designed for being used by clinicians parte di medici che hanno partecipato ad almeno who have undergone at least basic surgical and in- un corso base teorico e pratico di chirurgia presso clinic implant training. All the information about uno dei nostri medici referenti. Le informazioni the Duravit system show to dentists and specialists contenute, relative al sistema Duravit, illustrano a essential steps regarding implant planning and dentisti e specialisti le fasi essenziali riguardanti la surgical procedures....

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Surgical Procedures-4

CLASSIFICAZIONE DELL’OSSO BONE CLASSIFICATION DENSITÀ OSSEA DESCRIZIONE BONE DENSITY DESCRIPTION TYPE I D1: da 1000 a 1600 HOUNSFIELD D1: l'osso è composto quasi completamente da massa ossea corticale. Si trova principalmente nella parte anteriore della mandibola. Questo tipo di osso permette la massima stabilità iniziale dell'impianto. D1: from 1000 to 1600 HOUNSFIELD D1: bone is composed of almost all cortical bone mass located primarily in the anterior mandible. This type of bone results in the greatest initial implant stability. D2: da 600 a 1000 HOUNSFIELD D2 è composto da uno spesso strato...

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Surgical Procedures-5

IMPIANTO DURAVIT EVOLUTION DURAVIT EVOLUTION IMPLANT CONO MORSE & ESAGONO INTERNO MORSE CONE & INTERNAL HEXAGON SPIRA A DOPPIO FILETTO - Doppia elica molto tagliente per profondità aumentata della spira - Permette facile inserimento e condensazione dell’osso - Stabilità primaria molto alta DOUBLE THREAD BODY - Thread of increased depth and highly sharp - Easy insertion - Bone's condensing body - High primary stability COLLARE CON CONICITÀ INVERSA E MICRO SCANALATURA ANULARE - Supporto ottimale dei tessuti molli - Massimo volume dell'osso alveolare - Minor riassorbimento crestale BACK-TAPERED...

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Surgical Procedures-6

TECNICHE DI FRESAGGIO - SL Ø3,4 DRILLING SEQUENCES - SL Ø3,4 PROCEDURA STANDARD DRILLING PROTOCOL - STANDARD PROCEDURA PER OSSO COMPATTO (D1) DRILLING PROTOCOL - DENSE BONE (D1) PROCEDURA PER OSSO SPUGNOSO (D4) DRILLING PROTOCOL - SOFT BONE (D4)

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Surgical Procedures-7

TECNICHE DI FRESAGGIO - EV Ø4 DRILLING SEQUENCES - EV Ø4 PROCEDURA STANDARD DRILLING PROTOCOL - STANDARD PROCEDURA PER OSSO COMPATTO (D1/D2) DRILLING PROTOCOL - DENSE BONE (D1/D2) PROCEDURA PER OSSO SPUGNOSO (D3/D4) DRILLING PROTOCOL - SOFT BONE (D3/D4) ref: 00074CUT Ø 2,2

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Surgical Procedures-8

TECNICHE DI FRESAGGIO - EV Ø4,5 DRILLING SEQUENCES - EV Ø4,5 PROCEDURA STANDARD DRILLING PROTOCOL - STANDARD PROCEDURA PER OSSO COMPATTO (D1/D2) DRILLING PROTOCOL - DENSE BONE (D1/D2) PROCEDURA PER OSSO SPUGNOSO (D3/D4) DRILLING PROTOCOL - SOFT BONE (D3/D4)

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Surgical Procedures-9

TECNICHE DI FRESAGGIO - EV Ø5 DRILLING SEQUENCES - EV Ø5 PROCEDURA STANDARD DRILLING PROTOCOL - STANDARD PROCEDURA PER OSSO COMPATTO (D1/D2) DRILLING PROTOCOL - DENSE BONE (D1/D2) PROCEDURA PER OSSO SPUGNOSO (D3/D4) DRILLING PROTOCOL - SOFT BONE (D3/D4) ref: 281-3P Ø3

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Surgical Procedures-10

IMPIANTO DURAVIT 3P DURAVIT 3P IMPLANT CONO MORSE & ESAGONO INTERNO MORSE CONE & INTERNAL HEXAGON MICROFILETTATURA DEL COLLARE MICRO-GROOVING COLLAR SPIRA A TRIPLO FILETTO TRIPLE THREAD BODY DESIGN ANATOMICO A STRUTTURA SIMIL RADICOLARE PERFECT ANATOMICAL DESIGN LIKE A RADICULAR STRUCTURE SISTEMA AUTOMASCHIANTE SELF-TAPPING SYSTEM APICE “BONE FRIENDLY” BONE FRIENDLY APEX

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Surgical Procedures-11

TECNICHE DI FRESAGGIO - 3P Ø3 DRILLING SEQUENCES - 3P Ø3 PROCEDURA STANDARD DRILLING PROTOCOL - STANDARD FRESA OPZIONALE OPTIONAL DRILL disponibile come procedura finale della sequenza Codice colore Color Code Diametro Reale Real diameter PROCEDURA PER OSSO COMPATTO (D1) DRILLING PROTOCOL - DENSE BONE (D1) PROCEDURA PER OSSO SPUGNOSO (D4) DRILLING PROTOCOL - SOFT BONE (D4) ref: 00074CUT Ø 2,2

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Surgical Procedures-12

TECNICHE DI FRESAGGIO - 3P Ø3,5 DRILLING SEQUENCES - 3P Ø3,5 PROCEDURA STANDARD DRILLING PROTOCOL - STANDARD FRESA OPZIONALE OPTIONAL DRILL disponibile come procedura finale della sequenza Codice colore Diametro Reale Color Code Real diameter PROCEDURA PER OSSO COMPATTO (D1) DRILLING PROTOCOL - DENSE BONE (D1) PROCEDURA PER OSSO SPUGNOSO (D4) DRILLING PROTOCOL - SOFT BONE (D4)

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Surgical Procedures-13

TECNICHE DI FRESAGGIO - 3P Ø4 DRILLING SEQUENCES - 3P Ø4 PROCEDURA STANDARD DRILLING PROTOCOL - STANDARD FRESA OPZIONALE OPTIONAL DRILL disponibile come procedura finale della sequenza Codice colore Color Code Diametro Reale Real diameter PROCEDURA PER OSSO COMPATTO (D1) DRILLING PROTOCOL - DENSE BONE (D1) PROCEDURA PER OSSO SPUGNOSO (D4) DRILLING PROTOCOL - SOFT BONE (D4) ref: 00074CUT Ø 2,2

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Surgical Procedures-14

TECNICHE DI FRESAGGIO - 3P Ø4,5 DRILLING SEQUENCES - 3P Ø4,5 PROCEDURA STANDARD DRILLING PROTOCOL - STANDARD FRESA OPZIONALE OPTIONAL DRILL disponibile come procedura finale della sequenza Codice colore Color Code Diametro Reale Real diameter PROCEDURA PER OSSO COMPATTO (D1) DRILLING PROTOCOL - DENSE BONE (D1) PROCEDURA PER OSSO SPUGNOSO (D4) DRILLING PROTOCOL - SOFT BONE (D4)

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Surgical Procedures-15

TECNICHE DI FRESAGGIO - 3P Ø5 DRILLING SEQUENCES - 3P Ø5 PROCEDURA STANDARD DRILLING PROTOCOL - STANDARD FRESA OPZIONALE OPTIONAL DRILL disponibile come procedura finale della sequenza Codice colore Color Code Diametro Reale Real diameter PROCEDURA PER OSSO COMPATTO (D1) DRILLING PROTOCOL - DENSE BONE (D1) PROCEDURA PER OSSO SPUGNOSO (D4) DRILLING PROTOCOL - SOFT BONE (D4) ref: 331-3P Ø 3,5

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Surgical Procedures-16

INSERIMENTO IMPIANTO IMPLANT PLACEMENT PROCEDURA PER OSSO COMPATTO DRILLING PROTOCOL – DENSE BONE Un'efficiente e atraumatica preparazione del sito implantare deve essere realizzata con una procedura progressiva utilizzando la tecnica di fresaggio graduale. Tutta la fase di perforazione del tessuto osseo deve essere effettuata sotto abbondante irrigazione esterna con soluzione fisiologica o acqua distillata sterile e con una tecnica di foratura intermittente per evitare il surriscaldamento dell’osso e per creare un effetto di drenaggio per l’efficace rimozione del tessuto osseo. An efficient...

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