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Dental Tribune Middle East & Africa Edition | March-April 2015 21implant tribune < Page 20 LOOKING FOR THE HIGHEST QUALITY HANDPIECE AT THE LOWEST PRICE? YOU FOUND IT! B.A. INTERNATIONAL ULTIMATE POWER+ RANGE For further information, contact your local dealer or B.A. International www.bainternational.com B.A. INTERNATIONAL Unit 9, Kingsthorpe Business Centre, Studland Road, Kingsthorpe, Northampton, NN2 6NE, England. info@bainternational.com 20w 17w Autoclavable 20w 17w Thermodisinfectable 20w 17w Ceramic Bearings 20w 17w Fibre Optic 20w 17w Titanium Body Available in 5 different fittings 1:1 1:5 6:1 3 models available DLC coated bearing Retractable ISO slider 20w 17w Autoclavable 20w 17w Thermodisinfectable 20w 17w Ceramic Bearings 20w 17w Fibre Optic 20w 17w Titanium Body Available in 2 head sizes Up to 20w torque 20w 17w 20w 20w 17w TURBINE CONTRA-ANGLE is thin or ill defined. The Max osteotome (Fig.15) also match all the available implant lengths and diameters in the range of the Max implant. It doubles up as a profile gauge which can be used in the osteotomy site to assess the preparation depth and position prior to commit- ting to placement (Fig.13). It is useful to confirm the prepara- tion position radiographically, once preparation finalization has been reached (Fig.14). This instrument has a central stalk with a concave profile. The con- cave dimples on the base of the instrument are used to steer the osteotome in different direc- tions, while the central dimple on the stalk serves as the main driving point. A rod shaped “chisel” is placed into these con- cave hollows, which in turn is driven by a surgical mallet. The central stalk is used to retrieve theinstrumentafteruse(Fig.16). The Max range of implants are designed specifically for imme- diate placement into molar ex- traction sockets. They are avail- able in 7, 9 and 11mm lengths and in 7, 8 and 9mm diameter. The tapered design makes them ideal for immediate placement in fresh molar extraction sites (Fig.17). They have a moder- ately rough surface which is cre- ated by sandblasting and chemi- cal conditioning with solvents of a grade 4 c.p. titanium. The restorative connection is avail- able in an external hex, tri-nex or internal octagon design. The wide diameter of these implants enables platform switching of at least 0.25mm in the horizontal plane and a further 0.35mm if the 45 degree bevel at the im- plant shoulder is included. Accurate and correct placement position and depth is vitally im- portant for the long term success of this treatment protocol. The golden rule is termed the 2x2 position (Fig.18). The implant should always be 2mm below the lowest point of the buccal wall crest and 2mm in (palatally or lingually) from this point. The implant should NEVER touch the buccal bone plate when it reaches its final placement po- sition. Primary stability in the case of a tapered wide diameter implant can be extremely posi- tive and can reach values that are much higher than those we are accustomed to, when using “conventional” diameter dental implants. The fixture mount on the dental implant has striped laser mark- ings at the implant platform height and at 3mm (Fig.19). These can be used to assist with depth determination during im- plant placement. Impressions for a temporary or permanent restoration can be completed during implant placement sur- gery and a wide diameter heal- ing abutment can be placed. Soft tissue adaptation around the healing abutment can be assisted with sutures (Fig.20). A final radiographic assessment ensures a comprehensive as- sessment of the implant position (Fig.21). Restoration of the implant can be completed as an immedi- ate protocol or once integration is considered to be complete (Fig.22). Related articles 1. Smith RB, Tarnow DP. Classi- fication of molar extraction sites for immediate dental implant placement: technical note. Int J Oral Maxillofac Implants. 2013 Jun;28(3):911–6. 2. Vandeweghe S. Factors affect- ing bone remodelling around surface modified Southern Im- plants [Internet] [dissertation]. Ghent University; 2010 [cited 2014 Apr 9]. Available from: http://hdl.handle.net/1854/LU- 1074594 3. Vandeweghe S, Ackermann A, Bronner J, Hattingh A, Tschaka- loff A, De Bruyn H. A retrospec- tive, multicenter study on a novo wide-body implant for posterior regions. Clin Implant Dent Relat Res. 2012 Apr;14(2):281–92. 4. Vandeweghe S, De Bruyn H. A within-implant comparison to evaluate the concept of platform switching: a randomised con- trolled trial. Eur J Oral Implan- tol. 2012;5(3):253–62. 5. Vandeweghe S, De Ferrerre R, Tschakaloff A, De Bruyn H. A wide-body implant as an alter- native for sinus lift or bone graft- ing. J Oral Maxillofac Surg. 2011 Jun;69(6):e67–74. 6. Vandeweghe S, Hattingh A, Wennerberg A, Bruyn HD. Sur- gical protocol and short-term clinical outcome of immedi- ate placement in molar extrac- tion sockets using a wide body implant. J Oral Maxillofac Res. 2011;2(3):e1. André Hattingh is a specialist periodontist in full time private practice in Sevenoaks, Kent, United Kingdom. He qualified as a dentist in 1991 and worked in general dental practice for 4 years. In 1996 he started a four-year full time postgraduate Masters degree in Periodontology and Oral Medicine which he received with distinction in 2000. He obtained both of his qualifications from the University of Pretoria in South Africa. He is chairman of the Tunbridge Wells Postgraduate Periodontal Group and has been placing dental implants for 16 years. He has presented lec- tures on periodontal and implant related topics in Australia, England, Belgium, Botswana, Greece, Holland, Iceland, Ireland, Scotland, South Africa and the USA. Email: achattingh@btconnect.com Dr. Costa qualified cum laude as a dentist in 1984 receiving numerous awards including the Gold Medal of the Dental Association of South Af- rica for the most outstanding graduate. In 1990 he completed his 4 year postgraduate Maxillo-Facial & Oral Surgery training. Since 1991 he is in full time specialist Oral & Maxillofacial Surgery private practice & has placed over 30,000 dental implants. In 2012 he established the SameDay Dental Implants Clinic in Dubai where he is also the co-director of the Branemark Osseointergration Center. SameDay Dental Implants FZ-LLC Unit 108, Building 39, Dubai Health Care City E-mail: info@samedayme.com About the Authors 1:11:56:1