Dental Tribune United Kingdom Edition

May 201414 United Kingdom Edition page 13DTß Implant Tribune Fig. 19 - 24: When inserting the implants using the flapless and periosteum preserving MIMI® method, we drill the bone cavity transgingivally at a rotation speed ranging from 50 – 250 rpm with the conical triangular drills, depending on the bone density. In most cases, this is done without water cooling. The cylindrical drills are additionally used to prepare the D1 and D2 bone. For preparing the soft D3/D4 bone, it is sufficient to use the conical tri- angular yellow drill and special bone condensers. After each step, the bone cavity must be checked with the thin BCC (Bone Cavity Check) probe. While avoiding bone overheating, a two-piece Cham- pions (R)Evolution®, which is equipped with an Insert/Shuttle, can be inserted at a torque ranging from 40-60 Ncm without deform- ing or breaking the inner thread and the thin titanium part (for instance, a 3.5 mm-diameter implant has an approx. 0.4 mm-thick outer part). Sufficient primary stability can be achieved. Fig. 25 - 29: The bacteria-proof plat- form-switched Shuttle (see Fig. 11 and „2“), which is set in the implant cone, is restored with a Gingiva-Clix. The Gingiva-Clix is made from white bio- compatible WIN!, and it is available in 6 combinations of heights and dimensions. During the bone remodeling phase within 8 weeks following surgery, the Gingiva- Clix stays on the Shuttle. After 8 weeks, the Gingiva-Clix is removed, and with this particular Clix type, the gingiva is shaped irritation-free. An impression post is transgingivally set in the Shuttle and manually screwed… Fig. 30 - 34: The Impression Coping is set. After making the impression and the supraconstruction, the Shuttle, which is connected to the implant, is removed with the Shuttle Extractor. The Shuttle is removed for the first time, while the screw remains uncontaminated. After remov- ing the Shuttle, the Abutment (ICA zircon abutment) is screwed seal-tight, preventing bacterial migration. Finally, the crown is cemented and fit. Fig. 35 - 36: After removing the small implant/Shuttle connecting screw, you can easily remove the Shuttle from the Champions-(R)Evolution® with the Shuttle-Extractor. This procedure is performed either about 8 weeks after implantation (transition between Primary Osseointegration Stability and Secondary Osseointegration Stability) in many cases or immediately after the insertion of the implants like in this case. Fig. 37: View of the implant in Tooth site 14: when the Shuttle was removed from the implant, the inner thread and the exterior wall of the Champions -(R)Evolution® remained intact and was not contaminated with bleeding, saliva and bacteria. Fig: 38: After removing the Shuttles, the Abutments for Ball-Head are screwed with the Insertion Aid that is also used for one-piece Champions®. Fig. 39 - 40: The Shuttles are removed from the implants (without local anesthesia because the treatment, including the impression, is performed supragingivally). Fig 19 Fig 20 Fig 21 Fig 22 Fig 23 Fig 24 Fig 25 Fig 26 Fig 27 Fig 28 Fig 29 Fig 30 Fig 31 Fig 32 Fig 33 Fig 34 Fig 35 Fig 36 Fig 37 Fig 38 Fig 39 Fig 40