Service Set Training Presentation English. André Breisinger BU Prosthetics

Transcription

1 Service Set Training Presentation English André Breisinger BU Prosthetics

2 Intended use The Service Set is intended for restoring a Straumann implantabutmentsystem, where the prosthetic component is damaged (without removing the implant)

3 The Service Set and its Supplements

4 The standard instruments Tweezers u c

5 The cutting instruments d used for drilling holes into fractured prosthetic components. Drills exist in different diameters depending on implant type compatible with: with a commercially available hand piece T T compatible with: guidance

6 Centering devices: Drill guides + guidances Drilling guides or guidance instruments are placed on the implant shoulder or in the implant cone and are used for the proper alignment of drills or taps. The guides can either be held between thumb and index finger or fixed on the drill guide holder. Use the provided Allen screw and driver for mounting the centering device to the drill guide holder. The Straumann Service Set contains two drill guide holders. We recommend to equip both with the appropriate guide and guidance prior to operating.

7 Micellaneous other instruments ln case a synocta abutment cannot be removed with the tweezers after a drilling procedure, the extractor sleeve is placed onto the implant. Afterwards an SCS screw is inserted and tightened with an SCS screwdriver in order to release the synocta abutment from the implant. Extractor bolts are used for removing damaged screws. For the procedure the Extractor bolt is inserted into the (previously drilled) hole, a ratchet is placed onto the Extractor bolt and fixed with the holding key. The Extractor bolt together with the damaged abutment is then turned out of the implant. The screw thread removal tool is specifically designed to unscrew a fractured screw thread inside a Bone Level implant.

8 What you should do prior to using the Straumann Service Set If patient is with practitioner, ask the prac titioner to try remov ing the f ractured screw f ragment with a probe. (counterclockwise action required) Please ensure y ou are up to date with y our knowledge on the serv ice set bef ore seeing the customer. F ailure to do so could lead to damage resulting f rom improper use. Receiving the Service Set/s & man uals: The set/s are sent to the customer directly or the Sales Specialist, or picked up by the Sales Specialist. If possible, it is adv isable to deliv er the s et/s ahead of time so the dentist can read the instructions ahead of the appointment. Sales Specialist is responsible f or detailing the Serv ice Set/s, usage, set up, operation, assembly, dismantling, operation, sterilisation and packaging f or transport. Instructions f or use are prov ided in the bound manual/s. Report and record any issues with any of the equipment immediately. If time permits, it may be possible to take correctiv e action ahead of ev ent.

9 What you should do during the use of the Straumann Service Set A repair can be a very time-consuming process and may take a few hours. Please inform your patient of that circumstance in advance. It is recommended that our technical advisor is present during the procedure and they can also act as an assistant at any time. All instruments must be secured against aspiration when used intraorally. (e.g. rubber dam) Assure that the implant is free from any residual Caution: Ensure that the implant shoulder does not get damaged or scratched, under no circumstances should a metal scaler be used. Apply gel or vaseline on the taps to avoid wedging. Sterile handling is essential.

10 What you should do after the use of the Service Set Dismantle the ratchet and unscrew the drill guides from drill guide holders Clean all instruments in an ultrasonic bath Pack instruments in a firmly closed pouch Sterilize all instruments in the autoclave at 134 C for 4-18 min Return the Straumann Service Set and instruments to your local Straumann representative. Missing or damaged parts must be identified so that HQ can be notified. Make a list of the parts in question and return this with the unit. Padded or boxed parcels will protect equipment. Ensure manuals are also returned.

11 Introduction Sheet how the presentation is built-up Current work step Indication Required instruments home button Required Service Set Implant affected

12 What situation are you currently facing? <click on the appropriate picture for instructions> screw/ abutment fractured in RN/ WN implant in a monotype implant in a NN implant abutment stuck in implant stuck old retentive anchor stuck healings or closure screws due to damaged SCS synocta 1.5 / 2.5 abutment stuck in implant screw / abutment fractured in BL implant stuck BL abutment due to damaged SCS

13 Fractured old retentive anchor Order a Service Set Basic Kit Article code:

14 Fractured old retentive anchor Initial condition Initial condition: Old retentive anchor fractured; a section stuck in implant Preparation, grinding Flatten the fractured retentive anchor with a diamond bur to provide a flat surface for drilling

15 Fractured old retentive anchor Caution Do not touch adjacent teeth with the centering device. Check the firm fit of the centering device in the implant. The operator/assistant must be able to hold the centering device comfortably in its correct axis. The centering device must not impede the operator s view of the operation side. Whenever the drill guides no. 1 and 2 cannot be placed due to thick mucosa, the drill guides no. 17 and 18 should be used instead.

16 Fractured old retentive anchor Equip the two drill guide holders with the required drill guides no. 5 and no. 20 before you start operating. Firmly place the drill guide no. 5 on the implant shoulder.

17 Fractured old retentive anchor Caution Drills have a left-hand thread The handpiece must rotate counterclockwise Do not exceed a max. speed of 600 rpm Ensure continuous cooling Continuously remove metal chips from implant Replace the drill as soon as the cutting performance is compromised

18 Fractured old retentive anchor Drilling procedure Insert the Ø 1.6mm drill into the drill guide and drill counterclockwise with max. 600 rpm until the shank of the drill reaches the drill stop. Remove the drill and the drill guide.

19 Fractured old retentive anchor Flush out drilled hole thoroughly

20 Fractured old retentive anchor Place the extractor bolt manually into the drilled hole and turn it slightly counterclockwise to see if it has enough grip (if the extractor bolt does not grip firmly, take it out and continue drilling and try again) Set the ratchet for counterclockwise action (pull direction indicator and turn it accordingly)

21 Fractured old retentive anchor Place the ratchet on the extractor bolt, stabilize it with the holding key and turn it counterclockwise. Work carefully so you do not harm either the patient or the osseointegrated implant

22 Fractured old retentive anchor Was the abutment removal successful? <Click on the appropriate photo for next steps> yes no

23 Fractured old retentive anchor Firmly place the drill guide no. 20 on the implant shoulder Insert the Ø 1.6mm drill into the drill guide and drill counterclockwise with max. 600 rpm until the shank of the drill reaches the drill stop. Remove the drill and the drill guide.

24 Fractured old retentive anchor The conical abutment section is now separated from the thread, which is still in the implant and cement traces are visible. Clean the implant thoroughly, making particularly certain that any cement on its conical section is completely removed. (use a prescribed implant scaler).

25 Fractured old retentive anchor Firmly place the drill guide no. 1 into the implant cone.

26 Fractured old retentive anchor Insert the Ø 1.6mm drill into the drill guide and drill counterclockwise with max. 600 rpm until the shank of the drill reaches the drill stop. Remove the drill and the drill guide.

27 Fractured old retentive anchor Firmly place the guidance no. 2 into the implant cone.

28 Fractured old retentive anchor Use the taps in the correct sequence to re-cut the implant thread properly; starting with the tap no. 1 with one groove Apply Vaseline to the tip of the tap to prevent tap from wedging After each ½ turn of tap, turn it back by ¼ turn for the release of stress & clearing the chips Flush out implant after the use of each tap

29 Fractured old retentive anchor Insert the tap with the number 1 with 1 groove into the guidance no. 1 Number of grooves Turn the tap clockwise for a ½ turn, turn it back by a ¼ turn and continue in this manner until the tap reaches the stop Remove the tap; flush the implant Continue with the next tap no. 1 with 2 grooves 3 grooves, no. 2 with 1 groove 2 with 2 grooves 2 with 3 grooves

30 Fractured old retentive anchor The implant has been restored A new abutment can be placed.

31 Removal of stuck closure screw or healing abutment with damaged SCS Order a Service Set Basic Kit Article code:

32 Removal of stuck closure screw or healing abutment with damaged SCS Drills have a left-hand-thread The hand piece must rotate counterclockwise Do not exceed a max. speed of 600 rpm Ensure continuous cooling Continuously remove metal chips from implant Replace the drill as soon as the cutting performance is compromised

33 Removal of stuck closure screw or healing abutment with damaged SCS Use the Ø 1.6mm drill and drill through the broken SCS configuration until you reach approximately 2 mm of depth. As the drill is left-hand cutting the screw might already loosen during drilling.

34 Removal of stuck closure screw or healing abutment with damaged SCS Place the extractor bolt manually into the abutment hole and turn it slightly counterclockwise to see if it has enough grip, if the grip is not sufficient; drill a bit deeper and try placing the extractor bolt again. Place the ratchet on the extractor bolt, stabilize it with the holding key and turn it counterclockwise. Work carefully so you do not harm either the patient or the osseointegrated implant.

35 Removal of stuck closure screw or healing abutment with damaged SCS The stuck component could be removed successfully

36 Removal of old conical abutments including angled abutments 6, 8, 15 Order a Service Set Basic Kit Article code:

37 Removal of old conical abutments including angled abutments 6, 8, 15 Initial condition Abutment in situ, cannot be removed In case there is composite in the abutment we recommend to removing it with a diamond bur. (max. 1.6 mm).

38 Removal of old conical abutments including angled abutments 6, 8, 15 Manually place the extractor bolt into the abutment hole and slightly turn it counterclockwise to see if it has enough grip. Place the ratchet on the extractor bolt, stabilize it with the holding key and turn it counterclockwise. Work carefully so you don t harm the patient and also not the osseointegrated implant.

39 Removal of old conical abutments including angled abutments 6, 8, 15 The implant has been restored A new abutment can be placed.

40 Removal of a stuck synocta 1.5 / 2.5 abutment Order a Service Set Basic Kit and a synocta Supplement Article code:

41 Removal of a stuck synocta 1.5 / 2.5 abutment Initial condition Damaged SCS screw in synocta 1.5/ 2.5 abutment in situ; abutment cannot be removed SCS no SCS (synocta ) (Octa) Please note: Octa and synocta abutments almost look the same. Always look inside the abutment to check if there is a SCS if yes, then it s a synocta abutment (otherwise an Octa)

42 Removal of a stuck synocta 1.5 / 2.5 abutment - Caution Do not touch adjacent teeth with the centering device. Check the firm fit of the centering device in the implant. The operator/assistant must be able to hold the centering device comfortably in its correct axis. The centering device must not impede the operator s view of the operation side. Whenever the drill guides no. 1 and 2 cannot be placed due to thick mucosa, the drill guides no. 17 and 18 should be used instead.

43 Removal of a stuck synocta 1.5 / 2.5 abutment

44 Removal of a stuck synocta 1.5 / 2.5 abutment - Caution Drills have a left-hand-thread The hand piece must rotate counterclockwise Do not exceed a max. speed of 600 rpm Ensure continuous cooling Continuously remove metal chips from implant Replace the drill as soon as the cutting performance is compromised

45 Removal of a stuck synocta 1.5 / 2.5 abutment - Drilling procedure Insert the Ø 1.6mm drill into the drill guide and drill counterclockwise with max. 600 rpm until the shank of the drill reaches the drill stop. Remove the drill and the drill guide.

46 Removal of a stuck synocta 1.5 / 2.5 abutment Flush abutment thoroughly Try to remove the synocta abutment with a pair of tweezers.

47 Removal of a stuck synocta 1.5 / 2.5 abutment If the abutment could already be extracted, proceed to the drilling procedure Place the appropriate extractor sleeve on the abutment and insert an occlusal screw ( )

48 Removal of a stuck synocta 1.5 / 2.5 abutment Tighten the occlusal screw with a SCS screw driver in order to lift the abutment from the implant

49 Removal of a stuck synocta 1.5 / 2.5 abutment In order to remove the remaining threaded part, firmly place the drill guide no. 1 into the implant cone. Guide no. 1 fits into RN and WN implants

50 Removal of a stuck synocta 1.5 / 2.5 abutment Insert the Ø 1.6mm drill into the drill guide and drill counterclockwise with max. 600 rpm until you reach the drill stop. Remove the drill and the drill guide.

51 Removal of a stuck synocta 1.5 / 2.5 abutment Firmly place the guidance no. 2 into the implant cone.

52 Removal of a stuck synocta 1.5 / 2.5 abutment Use the taps in the correct sequence to re-cut the implant thread properly; starting with the tap no. 1 with one groove Apply Vaseline to the tip of the tap to prevent tap from wedging After each ½ turn of tap, turn it back by ¼ turn for the release of stress & clearing the chips Flush out implant after the use of each tap

53 Removal of a stuck synocta 1.5 / 2.5 abutment Insert the tap with the number 1 with 1 groove into the guidance no. 1 Number of grooves Turn the tap clockwise for a ½ turn, turn it back by a ¼ turn and continue in this manner until the tap reaches the stop Continue with the next tap no. 1 with 2 grooves 3 grooves, no. 2 with 1 groove 2 with 2 grooves 2 with 3 grooves

54 Removal of a stuck synocta 1.5 / 2.5 abutment The implant thread has now been re-cut A new abutment can be placed

55 Removal of a broken thread in a TL implant a fractured screw thread still in situ Order a Service Set Basic Kit Article code:

56 Removal of a broken thread in a TL implant a fractured screw thread still in situ Do not touch adjacent teeth with the centering device. Check the firm fit of the centering device in the implant. The operator/assistant must be able to hold the centering device comfortably in its correct axis. The centering device must not impede the operator s view of the operation side. Whenever the drill guides no. 1 and 2 cannot be placed due to thick mucosa, the drill guides no. 17 and 18 should be used instead.

57 Removal of a broken thread in a TL implant a fractured screw thread still in situ Firmly place the drill guide no. 1 into the implant cone.

58 Removal of a broken thread in a TL implant a fractured screw thread still in situ Drills have a left-hand-thread The hand piece must rotate counterclockwise Do not exceed a max. speed of 600 rpm Ensure continuous cooling Continuously remove metal chips from implant Replace the drill as soon as the cutting performance is compromised

59 Removal of a broken thread in a TL implant a fractured screw thread still in situ Insert the Ø 1.6mm drill into the drill guide and drill counterclockwise with max. 600 rpm until the shank of the drill reaches the drill stop. Remove the drill and the drill guide.

60 Removal of a broken thread in a TL implant a fractured screw thread still in situ irmly place the guidance no. 2 into the implant cone.

61 Removal of a broken thread in a TL implant a fractured screw thread still in situ Use the taps in the correct sequence to re-cut the implant thread properly; starting with the tap no. 1 with one groove Apply Vaseline to the tip of the tap to prevent tap from wedging After each ½ turn of tap, turn it back by ¼ turn for the release of stress & clearing the chips Flush out implant after the use of each tap

62 Removal of a broken thread in a TL implant a fractured screw thread still in situ Insert the tap with the number 1 with 1 groove into the guidance no. 1 Number of grooves Turn the tap clockwise for a ½ turn, turn it back by a ¼ turn and continue in this manner until the tap reaches the stop Remove the tap; flush the implant Continue with the next tap no. 1 with 2 grooves 3 grooves, no. 2 with 1 groove 2 with 2 grooves 2 with 3 grooves

63 Removal of a broken thread in a TL implant a fractured screw thread still in situ The implant thread has now been re-cut. A new abutment can be placed.

64 Removal of a broken thread in a NN implant a fractured screw thread still in situ Order a Service Set Basic Kit and the NN Supplement Article code:

65 Removal of a broken thread in a NN implant a fractured screw thread still in situ Do not touch adjacent teeth with the centering device. Check the firm fit of the centering device in the implant. The operator/assistant must be able to hold the centering device comfortably in its correct axis. The centering device must not impede the operator s view of the operation side.

66 Removal of a broken thread in a NN implant a fractured screw thread still in situ Firmly place the drill guide no. 16 on the implant.

67 Removal of a broken thread in a NN implant a fractured screw thread still in situ Drills have a left-hand-thread The hand piece must rotate counterclockwise Do not exceed a max. speed of 600 rpm Ensure continuous cooling Continuously remove metal chips from implant Replace the drill as soon as the cutting performance is compromised

68 Removal of a broken thread in a NN implant a fractured screw thread still in situ Insert the Ø 1.45mm drill into the drill guide and drill counterclockwise with max. 600 rpm until you reach the drill stop. Remove the drill and the drill guide.

69 Removal of a broken thread in a NN implant a fractured screw thread still in situ Firmly place the guidance no. 19 on the implant shoulder

70 Removal of a broken thread in a NN implant a fractured screw thread still in situ Use the taps in the correct sequence to re-cut the implant thread properly; starting with the tap no. 1 with one groove Apply Vaseline to the tip of the tap to prevent tap from wedging After each ½ turn of tap, turn it back by ¼ turn for the release of stress & clearing the chips Flush out implant after the use of each tap

71 Removal of a broken thread in a NN implant a fractured screw thread still in situ Insert the tap with the number 1 with 1 groove into the guidance no. 1 Number of grooves Turn the tap clockwise for a ½ turn, turn it back by a ¼ turn and continue in this manner until the tap reaches the stop Remove the tap; flush the implant Continue with the next tap no. 1 with 2 grooves 3 grooves, no. 2 with 1 groove 2 with 2 grooves 2 with 3 grooves

72 Removal of a broken thread in a NN implant a fractured screw thread still in situ The implant thread has now been re-cut. A new abutment can be placed.

73 Removal of a fractured occlusal screw in a 1-part implant Order a Service Set Basic Kit Article code:

74 Removal of a fractured occlusal screw in a 1-part implant Do not touch adjacent teeth with the centering device. Check the firm fit of the centering device in the implant. The operator/assistant must be able to hold the centering device comfortably in its correct axis. The centering device must not impede the operator s view of the operation side.

75 Removal of a fractured occlusal screw in a 1-part implant Firmly place the drill guide no. 3 on the implant

76 Removal of a fractured occlusal screw in a 1-part implant Drills have a left-hand-thread The hand piece must rotate counterclockwise Do not exceed a max. speed of 600 rpm Ensure continuous cooling Continuously remove metal chips from implant Replace the drill as soon as the cutting performance is compromised

77 Removal of a fractured occlusal screw in a 1-part implant Insert the Ø 1.6mm drill into the drill guide and drill counterclockwise with max. 600 rpm until the shank of the drill reaches the drill stop. Remove the drill and the drill guide.

78 Removal of a fractured occlusal screw in a 1-part implant Firmly place the guidance no. 4 on the implant

79 Removal of a fractured occlusal screw in a 1-part implant Use the taps in the correct sequence to re-cut the implant thread properly; starting with the tap no. 1 with one groove Apply Vaseline to the tip of the tap to prevent tap from wedging After each ½ turn of tap, turn it back by ¼ turn for the release of stress & clearing the chips Flush out implant after the use of each tap

80 Removal of a fractured occlusal screw in a 1-part implant Insert the tap with the number 1 with 1 groove into the guidance no. 1 Number of grooves Turn the tap clockwise for a ½ turn, turn it back by a ¼ turn and continue in this manner until the tap reaches the stop Remove the tap; flush the implant Continue with the next tap no. 1 with 2 grooves 3 grooves, no. 2 with 1 groove

81 Removal of a fractured occlusal screw in a 1-part implant The implant thread has now been re-cut. A new abutment can be placed.

82 Remove abutment with damaged SCS Order a Service Set Basic Kit and the BL Supplement Article code:

83 Remove abutment with damaged SCS Drills have a left-hand-thread The hand piece must rotate counterclockwise Do not exceed a max. speed of 600 rpm Ensure continuous cooling Continuously remove metal chips from implant Replace the drill as soon as the cutting performance is compromised

84 Remove abutment with damaged SCS Damaged SCS Insert the Ø 1.6mm drill into the abutments screw channel and drill until the screw head is destroyed. Remove the abutment

85 Removal of a broken thread in a BL implant (broken basal screw, broken LOCATOR) Order a BL Supplement

86 Removal of a broken thread in a BL implant (broken basal screw, broken LOCATOR) Insert the screw thread removal tool into the implant (BL NC / BL RC) Apply slight vertical pressure on screw thread removal tool and turn it counterclockwise. (two to three 360 turns should be enough to loosen the thread) Remove the broken screw with a pair of tweezers

87 Removal of a broken thread in a BL implant (broken basal screw, broken LOCATOR) yes no

88 Removal of a broken thread in a BL implant (broken basal screw, broken LOCATOR) Do not touch adjacent teeth with the centering device. Check the firm fit of the centering device in the implant. The operator/assistant must be able to hold the centering device comfortably in its correct axis. The centering device must not impede the operator s view of the operation side.

89 Removal of a broken thread in a BL implant (broken basal screw, broken LOCATOR) Drills and milling cutters have a left-hand-thread The hand piece must rotate counterclockwise Do not exceed a max. speed of 600 rpm Ensure continuous cooling Continuously remove metal chips from implant Replace the drill as soon as the cutting performance is compromised

90 Removal of a broken thread in a BL implant (broken basal screw, broken LOCATOR) Firmly place the appropriate drill gauge (No. 50 for RC, No. 51 for NC). Insert the Ø 1.3 mm drill into the drill guide and drill counterclockwise with max. 600 rpm until the shank of the drill reaches the drill stop. Remove the drill and the drill guide.

91 Removal of a broken thread in a BL implant - Caution Use the taps in the correct sequence to re-cut the implant thread properly; starting with the tap BL 1 followed by 2, 3 Apply Vaseline to the tip of the tap to prevent tap from wedging After each ½ turn of tap, turn it back by ¼ turn for the release of stress & clearing the chips Flush out implant after the use of each tap

92 Removal of a broken thread in a BL implant (broken basal screw, broken LOCATOR) Rinse the interior of the implant Position the corresponding guidance (No. 52 for RC, No. 53 for NC). Use the specific BL taps in their correct order: Start with BL 1 Continue with BL 2 Finish with BL 3 Turn taps in clockwise direction; After each ½ turn of the tap, turn it back by ¼ turn to release stress and clear chips. Proceed until you reach the stop.

93 Removal of a broken thread in a BL implant (broken basal screw, broken LOCATOR) The implant thread has now been re-cut. A new abutment can be placed.

94 Removal of a stuck ceramic abutment fragment in a BL implant Order a Service Set Basic Kit Article code:

95 Removal of a stuck ceramic abutment fragment in a BL implant Attention Be very carefully in putting pressure on the fragment of the ceramic abutment so you don t harm the patient and also not the osseointegrated implant. Use the 7 extractor bolt to crack the stuck fragment of the ceramic abutment

96 Removal of a stuck ceramic abutment fragment in a BL implant Manually place the extractor bolt into the abutment hole and slightly turn it counterclockwise to see if it has enough grip. Place the ratchet on the extractor bolt, stabilize it with the holding key and turn it counterclockwise. Work carefully so you don t harm the patient and also not the osseointegrated implant.

97 Removal of a stuck ceramic abutment fragment in a BL implant Flush out implant or use a pair of tweezers to remove remaining ceramic fragments A new abutment can be placed.

98 To be continued Please do not hesitate to contact me and share your success stories, general inputs and also further explanations you are missing