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1. 2 0mm Depth Drill Using either the No Depth stop Option or Depth stop Option drill described on page 33 drill to the appropriate depth as indicated by the reference marks or depth stop ON Oveno O einen internal j e e e ooo e pa zm amp Cy 0 gt Tap 2 Sl a CE o e ID YY se Insert Note The surgical kit is supplied with four different lengths of the Depth stop Option Depth Drills 9mm 10 5mm 12mm and 15mm Each drill has a positive stop that is specific to the length of the implant being placed 1 888 246 8 33 8 OSTEOTOMY STARTER SEQUENCE Paralleling Pins Starter Sequence Place the paralleling pin in the osteotomy 2 0mm side to ascertain the angulation of the osteotomy A radiograph may be taken to help determine the osteotomy s proximity to anatomic landmarks Adjustments may be made at this point with a Lindemann bur or the Depth Drills 2 5mm Depth Drill Using either the No Depth stop Option or Depth stop Option drill described on page 33 drill to the appropriate depth as indicated by the reference marks
2. Note The surgical kit is supplied with four different lengths of the Depth stop Option Depth Drills 9mm 10 5mm 12mm and 15mm Each drill has a positive stop that is specific to the length of the implant being placed Optional Use an implant site dilator of appropriate size or substitute the drill as a site dilator by pressing the drill to final depth without rotating Paralleling Pins Starter Sequence 5 Place the paralleling pin in the osteotomy 42 5mm side to ascertain the angulation of the osteotomy A radiograph may be taken to help determine the osteotomy s proximity to anatomic landmarks Adjustments may be made at this point with a Lindemann bur or the Depth Drills BIOHORIZONS OSTEOTOMY WIDENING SEQUENCE Q Widening Sequence 3 0mm Width Increasing Drill 4 BIOHORIZONS The 3 0mm Width Increasing Drill is used to increase the diameter of the osteotomy The blunt tip on this drill will prevent it from increasing depth therefore the final osteotomy depth must be created with the Depth Drills The blunt tip may not stop in poor quality bone please exercise caution in D3 or D4 bone Depth marks are included on the drills as a reference Optional Use an implant site dila
3. PGWDC PBNDC PBRDC 3 5mm Narrow Hexed 3 5mm Regular Hexed 3 5mm Wide Hexed 4 5mm Narrow Hexed 4 5mm Regular Hexed 4 5mm Wide Hexed 5 7mm Narrow Hexed 5 7mm Regular Hexed Indirect Transfer Copings Closed Tray Hexed Hand Ea Tighten 050 Hex sa VI Direct Pick up Copings are packaged with the Direct Coping Screw PXDCS Hand STERILE B Tighten 050 Hex Used to take a closed tray implant level hexed timed impression Packaged with the Abutment Screw PXAS PYNIC PYRIC He do We do Go Yo do Ge PYWIC PGNIC PGRIC PGWIC PBNIC PBRIC 3 5mm Narrow 3 5mm Regular 3 5mm Wide 4 5mm Narrow 4 5mm Regular 4 5mm Wide 5 7 mm Narrow 5 7mm Regular Abutment Screw STERILE R Indirect Transfer Copings are packaged with the Abutment Screw PXAS 30 Ncm Low profile screw head Packaged with all two piece abutments 30 Ncm PXAS One size fits all platforms 050 Hex STERILE B Used to extend through tray with a Direct Pick up Coping May also be used in place of the Abutment Screw PXAS when extra length is needed Hand tighten or torque to 30Ncm depending on application Direct Coping Screw 050 Hex One size fits PXDCS all platforms BIOHORIZONS 17 CUSTOM CASTABLE HEXED Custom Castable Abutments Hexed 30oNem QQ 050 Hex Indicated for single and multiple unit screw retained or custom abutme
4. Always consider that a margin of safety should be factored into treatment planning when adjacent to a vital structure BIOHORIZONS SURGICAL INSTRUMENTS Om Owan BIOHORIZO S ls so oe En O A SD 16mm Diagram A 31 Diagram B Implant Spacer Depth Probe i esa Na THRE PEER po edad s Use of the Implant Spacer Depth Probe The Implant Spacer Depth Probe is a measurement instrument for osteotomy depth determination implant spacing and general length determination Diagram A indicates the relative positioning of the depth determination bands Note that each band is 1mm in height and ranges from 9mm to 16mm The rectangular end of the device provides measurement markings for implant spacing and ridge width Diagram B shows recommended implant to implant spacing for BioHorizons Internal implants using the Implant Spacer Recommended edge to edge implant spacing is approximately 3mm The measurement should be taken from the widest diameter of the implant which is the prosthetic platform for BioHorizons Internal implants Therefore the centerline to centerline distance for a 3 5mm 4mm 5mm and 6mm implant is approximately 6 5mm 7 5mm and 8 7mm respectively The V5mm and 6mm implants share the same prosthetic platform The measurement markings on the side of the rectangle can be
5. 2 4 E 10mm Narrow Abutments PYNEA PBNEA 23 5mm oun Fe 8mm Y 3inOne 1 5mm Abutments i PGREA Regular Emergence 95 3mm lt Abutment Screw PXAS O 3 8mm A 2 3mm lt 5 above implant 10m platform for all Wide abutments Emergence Abutments PGWEA gt 6 5mm lt 10mm Angled Abutments PYCAH PGCAH PBCAH PYCAN not shown PGCAN not shown PBCAN not shown 10mm il 3 6mm top of alloy coping Custom V Cast 0 75mm gt O4 2mm Abutments parts shown not to scale 1 888 246 8 33 8 ABUTMENT DIMENSIONS Abutment level I Abutment for Screw Screws y 2 5mm lt q 16mm I PXABS PXABSL 12mm E 24 7 mm 24 7 mm gt lt 24 2mm PXABIC PXABDC PXABGC PXABPC PYAFS1 am PGAFS1 PBAFS1 PYAFS3 PGAFS3 PBAFS3 PYAFS5 PGAFS5 Ball Abutments 2 5mm gt 5 0mm 5mm y 1 3 or 5mm i PYBA1 PBBA1 260 100 BCAS PYBA3 PBBA3 PYBAS E lt lt 3 5mm gt O4 5mm Q5 7mm S Diameters of Impression Copings are 25mm greater than the associated abutment The W4 5mm platform is shown here as an example Height measurements are equal for all prosthetic platforms The 3inOne abutment may be used with the Ball top Screw as an indirect transfer coping with regular emergence BIOHORIZONS parts show
6. a Following removal of the 3inOne Abutment the implant 2 should be thoroughly irrigated to remove blood and other i debris When a submerged healing technique two stage is desired the low profile surgical Cover Cap is used to seal the prosthetic platform of the implant This Cover Cap included with each implant is unscrewed from its holder and inserted into the implant body via the 050 Hex Driver fF x PRODIGY 6 mannana SURGICAL KIT Do not overtighten the Cover Cap The torque applied during the tightening process will be transferred to the surrounding bone and may cause movement of the implant in less dense bone An antibacterial paste may be placed on the end of the Cover Cap to help seal the Cover Cap with the implant body and decrease the risk of bacterial growth within the implant body during the healing phase Following placement of the Cover Cap the surgical site should be irrigated and the soft tissue adapted in a normal surgical fashion al at Caution Take precautions to prevent the Cover Cap from being aspirated by the patient 1 888 246 8 33 8 HEALING ABUTMENTS POST OP PROCEDURES Bone Profilers Bone Profiler Profiler Guide Ce Bone Profiling Burs are designed to remove and contour excess bone and soft tissue from the area
7. BioHorizons Ib rica Opciones de Envio Boc ngel 38 BioHorizons Ib rica dispone de una amplia variedad de 28028 Madrid Espa a m todos de env o Para m s informaci n contacte por favor con nuestro departamento de Atenci n al Cliente Atenci n al Cliente 34 91 713 10 84 Los productos BioHorizons se pueden solicitar por tel fono 34 91 713 10 84 por fax 34 91 355 83 75 a trav s de uno de nuestros Especialistas de Producto o por correo electr nico iberica Wbiohorizons com BioHorizons products are cleared for sale in the European Union under the EU Medical Device Directive 93 42 EEC BioHorizons is also proud to be registered to ISO 13485 2003 the international quality management system standard for medical devices All Rights Reserved Patent 6 083 004 5 628 630 5 927 979 5 954 504 5 823 777 6 045 361 6 068 480 6 402 759 8 Patents Pending 2005 BioHorizons Implant Systems Inc ML0115 JUL 2005 www biohorizons com
8. Implant Placement Level The implant is advanced into the prepared site until the bottom of the polished collar is flush with the crestal ridge If there is concern that premature loading Hard bone during the healing phase may occur Soft bone implant polished collar advance the implant into the site until the platform level with left above top of the prosthetic platform is flush with FJ osseous crest osseous crest the crestal bone refer to use of the CBD In dense bone it may be possible to leave the prosthetic platform slightly higher than the crest of the osseous ridge El KO aS The 050 Hex Driver is used for removal of the Abutment Screw In less dense bone or when the implant lacks initial stability a hemostat or abutment holder should be used to grasp the outside of the abutment to provide counter torque during the loosening of the Abutment Screw The 3inOne Abutment may be removed once the Abutment Screw has been completely loosened ae 0 S Il alle li wv iS i 6 i amp 3 k 5 z HE KA TA N i 4 Jaala e 9 A STe eE pe o o o y 41 The 3inOne Abutment and the Abutment Screw should be retained with the patient s chart It can later be used as an impression post when used with the Ball top Screw and as a temporary or final abutment for cement retention Cover Cap Placement
9. a New Dental Implant Design in Canine Models Bumgardner et al Implant Dentistry Vol 3 No 3 2000 4 Five Year Prospective Study of Immediate Early Loading of Fixed Prostheses in Completely Edentulous Jaws with a Bone Quality Based Implant System Misch CE and Degidi M Clinical Implant Dentistry and Related Research 17 27 Vol 5 No 1 2003 5 Immediate Functional and Non Functional Loading of Dental Implants a 2 to 60 Month Follow Up Study of 646 Titanium Implants Degidi M and Piattelli A J Periodontology February 2003 6 A Prospective Multicenter Clinical Investigation of a Bone Quality Based Implant System Kline R Hoar J Beck G Hazen R Resnik R and Crawford E Implant Dentistry 224 234 Vol 11 No 3 2002 7 Imbedded Particulate Contaminates in Textures Metal Implant Surfaces Ricci JL Lummer FJ Alexander H and Casar RS J Applied Bio Vol 3 1992 8 Histomorphometric Analysis of the Bone Implant Contact Obtained with 4 Different Implant Surface Treatments Placed Side by Side in the Dog Mandible Novaes A B Souza Sergio L S de Olive ria P T Souza Adriana M M S The International Journal of Oral and Maxillofacial Implants 17 337 383 2002 9 Survival of Hydroxyapatite Coated Implants A Meta Analysis Review Lee JJ Rouhfar L and Beirne OR Oral Maxillofacial Surgery 58 1372 1379 2000 10 Effects of Implant Thread Geometry on Percentage of Osseointegration and Resistance to Reverse Torque in the Tibia of Rabbits
10. at a rotational speed similar to the Bone Tap speed less than 30 rpm is recommended Paralleling Pins may be used in adjacent sites to guide the implant in at the correct angulation Do not overtighten the implant in the osteotomy as osseous microfracture may occur Too much pressure at the crest may also compromise final surgical results Note If the final restoration will use an Angled Abutment orient the implant with the abutment flat indexed to the facial buccal Doing so will properly align the Angled Abutment for the angulation correction Failure to do so may require the use of a Custom Castable Abutment to make the required correction 888 246 8338 IMPLANT PLACEMENT Placement with Ratchet Meee E Options 2 One of the four flat sides on the end of the Ratchet Adapter is aligned with the flat side OF pura ox MOORES of the 3inOne Abutment Seat the adapter ee in the 3inOne Abutment before the implant is removed from the inner vial Do not touch the implant Using firm apical pressure thread the implant into position Paralleling Pins may be used in adjacent sites to guide the implant in at the correct angulation Do not overtighten the implant in the osteotomy as osseous microfracture may occur Too much pressure at the crest may also compromise final surgical results AA TATTI Final implant seating via
11. no circumstances can BioHorizons accept product for return or exchange that has been used clinically Product returned 61 120 days after shipment from BioHorizons will be assessed a restocking charge of 15 Please contact your product support specialist for returns of product beyond 120 days from date of shipment BioHorizons strongly recommends completion of post graduate dental implant education and strict adherence to the instructions for use IFU that accompany our products Treatment planning and use of the products are solely your responsibility BioHorizons is not responsible for incidental or consequential damages or liability relating to use of our products alone or in combination with other products other than replacement or repair under our warranties BioHorizons continually strives to improve its products and therefore reserves the right to improve modify change specifications or discontinue products at any time 1 888 246 8 33 8 TABLE OF CONTENTS BIOHORIZONS Ordering and warranty information inside front cover BioHorizons Internal system overview 3 4 Product Catalog Implants 5 6 Healing Abutments and emergence profile 7 8 Surgical kit and components 9 10 Abutment selection flowchart 11 12 Abutment dimensions 13 14 Cement retained restorations 15 16 Custom castable restorations 17 18 Screw retained abutment level restorations 19 20 Ball Abutment restorations 21 22 Ancillary surgical and prosthetic instruments
12. of the thread form created in the osteotomy is more likely to occur at a higher rpm Starter Drill Starter Drill 145mm OF ppe pm NOHONEENS The Starter Drill has a unique pointed tip 14mm AIRES e 13mm Y making it an excellent drill for beginning 12mm ss S Ll an osteotomy The design prevents the 11mm eel e L 10mm r see 3 a E TW drill from walking during the creation 9mm AS of the osteotomy and facilitates precise placement of the 2mm Depth Drill Depth markings 6 Round Bur 6 Round Bur optional OF pep pams SOMONE These burs are designed to prevent lateral perforations 2 ss because they will roll away from the inner wall of the 22 i harder cortical plate and stay within the soft trabecular 55e o o 50 bone The use of the 6 bur is optional and is primarily oe Ae used for marking the implant recipient site and to taa determine spacing lt can also be used to stretch the initial osteotomy in any direction to improve final position prior to use of the surgical twist drills BIOHORIZONS CE 1 E0 33 SURGICAL INSTRUMENTS Depth Drills No depth stop 9mm stop
13. or damage to motors and handpieces that are not properly maintained or used contrary to the instructions for use Please contact your product support specialist or Customer Care at 888 246 8338 866 468 8338 in Canada if you need additional information W amp H ElcoMed Surgical Handpieces W amp H has designed a series of straight and contra angle handpieces for maxillofacial surgery implantology and microsurgery WS 75 W amp H 20 1 Contra Angle Handpiece WS 75 E KM Contra Angle Handpiece with speed reduction ratio of 20 1 2 500 rpm maximum Equipped with both internal cooling 4 external cooling Push button bar release Trapezoidal profile Safe grip particularly with gloves WS 92 W amp H 1 2 7 Contra Angle Speed Increasing Handpiece 1 2 7 speed increasing ratio 135 000 rom maximum Contra Angle Handpiece suitable for high speed preparation and tissue augmentation procedures External irrigation port Uses friction grip burs S 11 W amp H 1 1 Straight Surgical Handpiece 1 1 ratio 50 000 rom maximum Suitable for bone harvesting third molar extractions and osteoplasty Easily dismantled for cleaning Uses 45mm friction grip surgical burs 22 35mm S 12 W amp H 1 2 Contra Angle Surgical Handpiece 1 2 speed increasing ratio 80 000 rom maximum Suitable for surgical procedures such as bone smoothing third molar extractions and osteotomy site drilling High precision bearings ensure that the unit runs vibration free Us
14. patient BioHorizons recommends appropriate training as a prerequisite for the placement of implants and associated treatment Surgical Tray Legend This surgical manual contains easy to follow icons to demonstrate the location of the surgical component being discussed The location of the instrument is highlighted on the surgical tray icon so the location of that instrument can be found quickly and easily BIOHORIZONS 29 ICON LEGEND Color Code Legend In addition to the tray icons this manual contains color coded dots that indicate which implant diameter uses the instrument being described For example the Starter Drill is used when placing all diameter implants therefore yellow 3 5mm green 4mm blue 5mm and purple 6mm dots are used in conjunction with the tray icon The 5 2mm Width Increasing Drill is used only with 6 0mm implants therefore only a purple dot is shown Radiographic Template Designed to aid the clinician in the pre operative determination of options for implant length and diameter The clear overlay template shows all sizes of BioHorizons Internal system implants in 100 and 125 scale This template has several unique and important features e All implants are shown at 100 scale and 125 scale for panoramic radiography Be aware that panoram
15. the Ratchet Adapter may be desired to gain a tactile sense of implant stability If too much resistance is felt during insertion the implant may be rotated clockwise three revolutions then reversed one revolution counter clockwise until the implant is seated Placement with Hand Wrench into place The implant site may require tapping if too much resistance is felt Placement with Insertion Tool Po Placement Options E Options sun O BIOHORIZO S on pS wen preg Ot placement between teeth with long clinical crowns They allow for a narrower path of insertion as compared to placement via the 3inOne Abutment While the implant is still in the vial the 3inOne Abutment is removed from the implant The Insertion Tool is then mated with the internal hex of the implant and lightly screwed into place The implant can then be placed with the Hand Wrench and or Ratchet The Insertion Tools may also be used to adjust the implants rotational position after the removal of the 3inOne Abutment The tool s hex engages Simply mate the Insertion Tool with the the implant s internal hex of the implant and lightly screw internal hex into place The implant can then be rotated using the Hand Wrench and or Ratchet The screw secures the tool to the implant BIOHORIZONS ABUTMENT REMOVAL COVER CAP PLACEMENT
16. tongue habits depending on severity Warnings and Precautions Implant surgery is a complex dental procedure Appropriate training in proper technique is strongly recommended prior to implant use Improper techniques can result in implant failure and or loss of supportive bone Appropriate x ray films should be utilized to determine if adequate bone is available and to determine the location of important anatomical landmarks such as the mandibular canal maxillary sinuses and adjacent teeth Implants can break during function for a number of reasons including overloading due to improper occlusion metal fatigue and or overtightening of the implant during insertion An adequate number of implants should be used to provide support and to distribute the load to the abutments A certain percentage of implants may fail to achieve or maintain osseointegration as demonstrated by mobility and should be removed Potential causes of abutment fracture include but are not limited to casting beyond a 30 angle casting titanium above 2010 F inadequate implant support when attached to periodontically compromised teeth non passive fit of superstructure overloading due to improper occlusion incomplete seating of a cemented abutment too long a span of bridge and excessive cantilevering of pontics Peri operative oral rinses with a 0 12 Chlorhexidine Digluconate solution have been shown to significantly lower the incidence of post implantation infectious compl
17. tray with a medium or heavy bodied impression material and seat it in the mouth Wipe excess impression material off the coping screw before it sets y Remove coping screws Clinical 5 After the impression material has set first remove the coping screw and then remove the tray from the mouth Verify that the impression material is completely adapted around the pick up copings Replace the Healing Abutment immediately to prevent soft tissue collapse Send to Lab e Impression with coping inside e Coping screw e Implant Analog e Abutment and screw if chosen e Bite registration e Opposing model or impression e Shade BIOHORIZONS 53 o ETA Lab Assemble analog Assemble the appropriate diameter Implant Analog to the Direct Pick up Coping with the coping screw A soft tissue model material is recommended around the implant verify analogs are seated properly and apply lubricant around the analogs where soft tissue needs to be added 7 IET Fabricate stone model Fabricate a working cast Articulate according to normal laboratory procedures 1 888 246 8 33 8 NOTES amp REFERENCES Notes References 1 Data on file BioHorizons Implant Systems Inc 2 Case Report and Literature Review A Bioengineered Implant for a Predetermined Bone Cellular Response to Loading Forces Misch CE Bidez MW and Sharawy M J Periodontology September 2001 3 Preliminary Evaluation of
18. 0 over conventional v thread designs while also enhancing the bone response A recent randomized prospective animal study of various thread designs showed that square thread implants had more bone to implant contact and higher reverse torque values than v thread and reverse buttress thread implants at 12 weeks post surgery evaluation The study concluded that the square thread design may be more effective for endosseous implants than alternative designs In vivo human and animal histological research on implants with the BioHorizons thread design indicates lamellar bone formation apposing the implants to be similar to that found adjacent to natural teeth Healthy bone leads to healthy soft tissue and better esthetic results The modified square thread design is based on the principle that bone is strongest under compressive loading and weakest under shear loading It has shown a 99 4 success rate in a 5 year prospective multi clinic trial Square threads transmit 10 times more compressive load to the bone than conventional v threads while minimizing destructive shear loads This attribute has become increasingly important with the emergence of early and immediate load protocols The titanium alloy used throughout the system is the strongest in the industry It is 4 times stronger than commercially pure titanium and 1 6 times stronger than Grade 4 Titanium Nomarsky microscopy showing bone apposition to the implant Con
19. 0mm Lindemann Bone Cutter Side cutting drill used to correct eccentric osteotomy preparations 122 110 2 0mm Lindemann Bone Cutter Tissue Punches BioHorizons Tissue Punches are designed to be used in a latch type handpiece and are used to remove the soft tissue from the crest of the ridge prior to osteotomy preparation in a flapless surgical procedure Available in 3 platform diameters PYTP PGTP PBTP 3 5mm Tissue Punch 4 5mm Tissue Punch 5 7mm Tissue Punch Bone Profiling Burs Used at implant uncovery to contour crestal bone to accommodate abutments when the implant is subcrestal For use in latch type reduction handpieces The Profiler s internal geometry matches the geometry of the included Profiler Guide The Guide is screwed into the implant and then aligns the Profiler for precise removal of tissue surrounding the platform Comes in 3 sizes corresponding to the 3 Internal prosthetic platforms PYBP T PGBP PBBP 3 5mm Bone Profiling Bur and Guide 4 5mm Bone Profiling Bur and Guide 5 7mm Bone Profiling Bur and Guide Clean out Tap Tool Used to re thread implants where the internal threads have become damaged Requires a standard surgical Ratchet 130 000 or Hand Wrench 300 400 as a drive mechanism PXCT BioHorizons Internal Implant Clean out Tap Tool 1 888 246 8 33 8 PROSTHETIC INSTRUMENTS Implant Analog Handles Used to hold abutments for chairside or laboratory preparation these
20. 10 5mm stop 12mm stop 15mm stop Depth Drills The Depth Drills are designed to increase the depth of the osteotomy The drills are supplied in two diameters 52 0mm and 2 5mm with four depth gauging options The cutting geometry of the drills is an optimized tri fluted twist drill The drill tip geometry is configured such that the drill has end cutting capabilities The Depth Drill is used after the Starter Drill to set the osteotomy depth No Depth Stop Option This drill has standard depth grooves ranging from 7mm to 15mm The clinician must manually stop the drill at the desired depth based on the corresponding depth marks on the shaft of the drill This drill is used if the prosthetic platform is submerged below the crest at final implant placement Depth Stop Option These Depth Drills have a circular ring set at a pre determined distance along the length of the drill that acts as a stop that prevents the surgeon from drilling beyond a pre determined depth The depth stop is set to correspond with the length of the dental implant being placed 9mm 10 5mm 12mm and 15mm The use of this drill allows the implant prosthetic platform to be placed flush with the crestal bone Width Increasing Drills 15mm 12mm 10 5mm 9mm Width Increasing Drills A series of drills follows the Depth Drills in order to increas
21. 23 24 W amp H surgical motors and handpieces 20 26 Education and marketing materials 27 Surgical Manual Icon legend 28 29 Surgical template 29 30 Surgical instruments 31 34 Osteotomy sequence 35 38 Implant packaging 39 Implant placement 39 40 Abutment removal Cover Cap placement 41 Bone Profiler 42 Healing Abutment placement 42 Cleaning 43 Instructions for use 44 Post operative Instructions 45 Impression Techniques Impression technique overview 46 47 Closed Tray Indirect Transfer Impression implant level 48 50 Open Tray Direct Pick up Impression implant level 51 53 References 54 SYSTEM OVERVIEW BIOHORIZONS internal the implant system that blends the time proven biomechanical modified square thread design with the advantages and security of an internal hex connection A safe strong connection The 1 5mm deep internal hex connection is enhanced by the use of Spiralock screw technology the same design used by NASA and in orthopedics to guard against screw loosening in high load environments Utilizes industry standard tooling 050 hex and 30Ncm torque Biologic seal and lead in bevel at the implant The connection forms an intimate mating of the abutment interface abutment and implant for a tight biologic seal at this critical junction Precision machining BioHorizons Internal implants and prosthetic and 1 5mm hex components are color coded by the diameter of connection ensure the prost
22. 88 246 8 33 8 INSTRUCTIONS FOR USE Bur Testing Gauge Also called a Go No Go Gauge the Bur Testing Gauge is used to verify the dimensional accuracy of drill shanks of latch type burs Burs in proper condition WILL fit into the larger diameter hole but WILL NOT fit into the smaller hole marked red Burs that fail either of these criteria are unfit for use and may become stuck in the handpiece if used The gauge is included with all W amp H starter packages and may also be ordered from page 26 Instructions For Use Indications BioHorizons dental implants may be used in the mandible and maxilla for use as an artificial root structure for single tooth replacement or as abutments for bridgework and denture retention Contraindications BioHorizons dental implants should not be used in patients who have contraindicating systemic or uncontrolled local diseases such as blood dyscrasias diabetes hyperthyroidism oral infections or malignancies renal disease uncontrolled hypertension liver problems leukemia severe vascular heart disease hepatitis immunosuppressive disorder pregnancy and or collagen and bone diseases Dental implants are contraindicated in patients where ridge dimensions are insufficient to accommodate proper implant placement without ridge augmentation Relative contraindications may include habits such as tobacco use alcohol consumption poor oral hygiene bruxism nail biting pencil biting and or improper
23. NO ON QPACINS internal mE Product Catalog and Technique Manual Science Simplicity Value BIOHORIZONS ORDERING amp WARRANTY INFORMATION Product Support Specialist cell phone fax BioHorizons USA Customer Care Servicio al Cliente 888 246 8338 205 967 7880 BioHorizons Canada Customer Care Service a la Client le 866 468 8338 905 944 1700 BioHorizons Ib rica Atenci n al Cliente 34 91 713 10 84 BioHorizons No Exceptions Warranty Our warranty policies are a tangible expression of our belief in the excellence and simplicity of our products as well as our commitment to our customers We will repair or replace any of our products if they fail or cause problems within the warranty period for any reason without exception Lifetime Warranty on Implants and Prosthetics BioHorizons implants and prosthetic attachments carry a Lifetime Warranty We will provide a replacement for any BioHorizons implant or prosthetic attachment if removal of that product is required for any reason at any time Warranties on Instruments Surgical Drills Taps and Torque Wrenches BioHorizons warranties instruments surgical drills and taps and torque wrenches for the period specified for each in 1 4 2 below During the specified warranty period we will replace or repair any product with a defect in material or workmanship 1 Instruments The warranty on BioHorizons instruments extends for a period of one 1 year from the da
24. Steigenga J Al Shammari K Misch C Nociti F and Wang H L J Periodontology September 2004 11 The Influence of 0 12 Chlorhexidine Digluconate Rinses on the Incidence of Infectious Complications and Implant Success Lambert P Morris H and Shigeru O J Oral Maxillofac Surg 1997 55 25 30 Suppl 5 BIOHORIZONS BioHorizons USA Shipping Options Elecci n de Env os One Perimeter Park South UPS Next Day Early AM by 8 30 am Birmingham AL 35243 UPS Next Day Air by 10 30 am next day UPS Next Day Air Saver by 4 30 pm next day A SIA Day Air AM by 12 00 pm 2 day mer Care Servicio al Cliente Customer Care UPS 3 Day Select by 5 00 pm 3 day 888 246 8338 or 205 967 7880 UPS Ground BioHorizons products may also be ordered by fax 800 236 1271 or through your Product Support Specialist We process and ship all orders received by noon Central Time the same day For your convenience we accept Visa MasterCard American Express Money Orders Certified Checks or C O D Standard payment terms are net 30 days from invoice date Los productos de BioHorizons se pueden tambi n pedir por FAX 1 800 236 1271 o a trav s de su representante de la compa a Procesamos y enviamos todas las rdenes recibidas el mismo d a siempre y cuando las mismas lleguen antes de las 12 del mediod a zona Central Para su conveniencia aceptamos tarjetas de cr dito Visa MasterCard American Express giro postal cheques certificados o C O D Los t rmi
25. Transfer Copings by 3mm 1 888 246 8338 CUSTOM CASTABLE NON HEXED Custom Castable Abutments Non Hexed A 050 Hex Indicated for multiple unit screw retained restorations All two piece abutments are packaged with the Abutment Screw PXAS PYCAN 3 5mm Custom Cast Abutment Non Hexed PGCAN 4 5mm Custom Cast Abutment Non Hexed PBCAN 5 7mm Custom Cast Abutment Non Hexed Direct Pick up Copings Open Tray Non Hexed iong Tighten 050 Hex Used to take an open tray implant level non hexed impression Packaged with the extended Direct Coping Screw PXDCS PYNDCN 3 5mm Narrow Non Hexed i S i i a PGNDCN 4 5mm Narrow Non Hexed PBNDCN 5 7mm Narrow Non Hexed Implant Analogs Implant replicas for use in stone models PYIA 3 5mm Implant Analog PGIA 4 5mm Implant Analog E GS PBIA 5 7mm Implant Analog Abutment Screw CHIDEA 050 Hex Low profile screw head Packaged with all two piece abutments 30 Ncm 3 One size fits PXAS all platforms Direct Coping Screw uste E 050 Hex Used to extend through tray with a Direct Pick up Coping May also be used in place of the Abutment Screw PXAS when extra length is needed Hand tighten or torque to 30Ncm depending on application One size fits PXDCS all platforms BIOHORIZONS SCREW RETAINED ABUTMENT LEVEL Abutment for Screw CODINA Hex Adapter Indicated for multiple unit restorations including scre
26. ackage BCDR Directional Rings Used for obtaining parallelism BCS 0 7 and 14 rings Set of 3 Set of 3 tools Insert Seating Tool Reamer and Paralleling Tool O Ring Attachment System Standard O ring attachment 000 c EJ 260 210 Clinical O Ring Used for clinical applications A Silicone 12 per package O Ring Attachment Set 260 220 Processing O Ring 260 100 pe a 7 SO O nc tia Used for lab processing 2 E Omings applications Buna 12 per package 2 Clinical O rings Si 260 300 O Ring Encapsulator Female receptacle processed into denture Titanium 2 per package BIOHORIZONS 23 ANCILLARY SURGICAL INSTRUMENTS Extended Shank Drills Extended Shank Drills are 3mm longer than our standard drills They have the same depth marks and cutting geometry as our standard drills They allow you to work next to long clinical crowns without having to use the drill extension They are an optional purchase and are not included in the BioHorizons Internal Surgical Kit PSKC 122 420 122 425 122 430 122 432 122 437 122 442 122 447 122 452 2 0mm Depth Drill Extended Shank 2 5mm Depth Drill Extended Shank 3 0mm Width Increasing Drill Extended Shank 3 2mm Width Increasing Drill Extended Shank 3 7mm Width Increasing Drill Extended Shank 4 2mm Width Increasing Drill Extended Shank 4 7mm Width Increasing Drill Extended Shank 5 2mm Width Increasing Drill Extended Shank 2
27. ade from impressions form the foundation for the restoration and care must be taken ensure as accurate a transfer as possible Doing so will prevent the loss of time and the expensive of re works There are three types of impression techniques utilized in implant dentistry Prepared Abutment Impression Impression types types O An intra oral impression is made of prepared abutment s similar to a standard crown amp bridge impression An intra oral impression is made transferring the emergence of the implant The implant s location and angle are recorded with or without the orientation of the internal hex An intra oral impression is made recording the position of Abutments for Screw that have been placed onto the implants Abutments for Screw location and angle are recorded for fabrication of a screw retained prosthesis See the BioHorizons Internal Prosthetic Manual for details regarding Abutment Level impressions BIOHORIZONS 47 IMPRESSION METHODS There are two methods for making Implant Level and Abutment for Screw Level Impressions 1 Closed Tray Indirect Transfer Technique or 2 Open Tray Direct Pick up Technique Note Prepared Abutment impressions are always made using the Closed Tray technique The method chosen is dependent on the treatment plan and the degree of accuracy needed to fabricate the final restoration The Open Tray Technique is more accurate than the Closed Tray Techniq
28. be easier to accomplish using the suture groove on the Healing Abutment see diagram below BIOHORIZONS CLEANING Surgical Kit Cleaning All BioHorizons surgical instruments are provided non sterile and must be cleaned and sterilized prior to use Always remove instruments from the packaging prior to sterilization and remove and discard packaging materials used to stabilize and secure kits during shipment Double check your surgical instruments to ensure their functionality prior to surgery Verify the dimensional accuracy of drill shanks using a Bur Testing Gauge see facing page It is recommended to have back up sterile drills available prior to any surgical procedures Cleaning procedure for Surgical Tray and Instrumentation 1 Disassemble the surgical kit and wash the tray using a broad spectrum cleaning or disinfecting agent such as Hu Friedy Enzymax amp 800 483 7433 or equivalent Rinse the tray with water and dry thoroughly Place the instruments in a beaker of detergent solution and sonicate for 10 minutes Rinse thoroughly Remove any visible debris or bone fragments with a soft bristle brush Rinse thoroughly Rinse instruments with alcohol to remove any soap residue and minerals important to help prevent corrosion Blot instruments with a towel and allow them to air dry completely Check latch type burs with the bur testing gauge to verify fitness for future use see facing page Discard and replace unfit burs Return instrum
29. centric lamellae of the forming osteons and interstitial lamellae are apparent Photomicrograph of the implant bone interface of an immediately loaded maxillary posterior implant removed one year after function demonstrating more than 80 bone contact Photograph courtesy of Dr Marco Degidi and Dr Adriano Piattelli Two surface treatment options to address various conditions Unlike other systems that blast their implants with aluminum oxide BioHorizons uses RBT technology to create the optimal surface texture 75u Ra average without the chance of leaving imbedded particles on the implant The biocompatible calcium phosphate used in the blast process is dissolved during the passivation phase of manufacturing leaving an ideal roughness profile on a pure titanium oxide surface BioHorizons pioneered the use of RBT in 1997 and it has been proven to improve bone cell contact as compared to a machined titanium surface HA coating and improved thread form create an unbeatable combination for rapid integration initial stability and long term success These factors are increasingly important when working in soft bone and or areas high load Multiple clinical studies document the improved success rates of HA coated implants in compromised bone BIOHORIZONS Hydroxylapatite HA IMPLANT COLOR CODE LEGEND BioHorizons Internal components have a prosthetic platform specific color code for easy identificati
30. dpiece testing gauge spray cap irrigation spike and service oil E WH200 W amp H ElcoMed SA 200 Professional Kit Re order items WH ST 10 PK Green Single Use Spray Tubes 10 pack WH CLP 10 PK Set of Spray Tube Clamps 10 pack WH 200PTWC Pump Tube 190mm with Connectors WH 200RPT 3 PK Replacement Pump Tubes 190mm 3 pack E gt WH 200INI INI Cards 3 pack p rd WH 200D0C DOC Cards 3 pack a WH 200MC Motor Cable 1 8 meter ElcoMed 100 Legacy Re order Items WH ST 10 PK Green Single Use Spray Tubes 10 pack WH CLP 10 PK Set of Spray Tube Clamps 10 pack WH 100PTWC Pump Tube with Connectors 65mm WH 100RPT 5 PK Replacement Pump Tubes 65mm 5 pack WH 100MC Motor Cable 1 8 meter Universal W amp H Re order Items WH ST 10 PK Green Single Use Spray Tubes 10 pack WH ISA Irrigation Spike Assembly autoclavable WH ITWOS Irrigation Tubing w o Spike autoclavable WH MD400 MD 400 Service Oil F1 WH OSC Oil Spray Cap WH SP Sterilization Plug for Motor Cable 1 888 246 8 33 8 HANDPIECES IMPORTANT NOTE W amp H motors and handpieces are distinguished by their precision craftsmanship and reliability and are covered by a 1 year manufacturer s warranty Instructions for required cleaning and maintenance are outlined in each product s user manual and adherence to these procedures is essential for proper function and longevity of the products BioHorizons assumes no liability for the failure of
31. e the width of the osteotomy to correspond to the diameter of the dental implant being placed These drills are the Width Increasing WI drills The WI drills have a tri fluted twist side cutting geometry The tip of the drill lacks the end cutting geometry of the Depth Drill thereby creating a built in stop This feature prevents the surgeon from increasing the osteotomy depth when subsequent drills are used in the drill series and reduces the need for the doctor to rely on the depth markings of each drill to reach the desired depth The drill diameters of the WI drills increase in small increments until the final desired osteotomy diameter is reached By using this sequence of drills the surgeon has better control over the angulation of the osteotomy Furthermore an incremental step in the drill sequence reduces excess heat and helps prevent thermal necrosis of the surrounding tissue 1 888 246 8338 SURGICAL INSTRUMENTS Crestal Bone Drills Level 3 Level 2 Crestal Bone Drill The Crestal Bone Drill CBD is used to prepare the crestal bone for receipt of the implant crest module The crest module is the area beneath the prosthetic platform and above the implant threaded area This drill is optional in less dense bone which also lacks a crestal bone ridge There are three significant levels on the CBD L
32. ent Analog PBBAA 5 7mm Ball Abutment Analog 1 888 246 8338 BALL ABUTMENT RESTORATIONS Ball Attachment System The Ball Attachment system offers several advantages over traditional O ring attachments It requires less mesial distal buccal lingual space and offers four 4 different levels of retention The retention inserts can be easily changed chairside Includes 1 Titanium Housing 3 Female Nylon Inserts white more retention pink less retention black lab processing and 1 Protective Disk tissue protector for impression taking and chair side denture pick up t Du BCAS Ball Attachment Set BCAHT Attachment Housings Titanium BCCBP Castable Ball Pattern Burn out component used by the lab for fabrication of a custom bar with ball attachments 2 balls per pattern w w BCIB Black Nylon Insert J gt For Resin pickup or Soldering 2 per package Lab Processing and Chair side Denture Pick up 2 per package BCIST Insert Seating Tool Used to seat nylon inserts BCIG Green Nylon Insert in attachment housings Clinical Elastic 2 per package BCIY Yellow Nylon Insert BCR Reamer Clinical Extra Soft 2 per package Used to adjust retention of nylon inserts E BCIP Pink Nylon Insert Clinical Soft 2 per package C BCPT Paralleling Tool A laboratory tool used on a surveyor to position and wax castable balls on a bar Ga BCIW White Nylon Insert Clinical Standard 2 per p
33. ents to the appropriate location in the surgical tray Wrap the kit in a double layer of autoclave approved paper Use one of three qualified steam sterilization cycles a Pre vacuum Steam 132 C 270 F for five minutes minimum b Gravity Steam 132 C 270 F for thirty minutes minimum c Gravity Steam 121 C 250 F for fifty minutes minimum 2 0 eo A Sf Dry for 20 to 50 minutes as needed Do not remove the surgical kit from the autoclave until the dry cycle is complete Caution The use of hydrogen peroxide or other oxidizing agents will cause damage to the surface of the instruments Towel or air dry all instrumentation before sterilizing Drills and taps should be replaced when wear is noticed such as a decrease in cutting efficiency or when signs of discoloration appear BioHorizons recommends replacing the drills after approximately 12 to 20 osteotomy cycles depending on the bone density It is also recommended that proper testing cleaning and calibration of sterilization equipment occur frequently to assure that the units are in proper working order Equipment operating conditions vary and it is the responsibility of each dental office to ensure that proper sterilization technique for instrumentation is followed Lay out all the surgical instruments into the sterile field in the order of use prior to surgery This assures a natural progression through the surgical sequence The surgical kit is set up in this fashion 1 8
34. er Narrow Regular or Wide Custom Cast abutment emergence will be determined by laboratory prescription Helpful Hint When placing impression copings on multiple implants remove one Healing Abutment at a time replacing it immediately with the selected impression coping This prevents the possibility of soft tissue collapsing onto the implant Work from the posterior to the anterior 2 Clinical Place impression coping Place the appropriate diameter Direct Pick up Coping either hexed or non hexed on the implant body and retain with the included Direct Pick up Coping Screw hand tighten These screws feature a knurled top to aid in manual insertion as well as a 050 hex access hole for insertion with the Hex Driver Take a radiograph along the long axis of the implant to ensure the coping is fully seated 1 888 246 8 33 8 OPEN TRAY DIRECT TRANSFER Y Try in impression tray MT Try in the impression tray to verify that the coping screw protrudes through the tray The custom tray is fabricated using a tray material of choice A window is cut out of the tray over the area of the implant to allow clearance for the coping screw Alternatively a stock impression tray may be modified to accommodate the coping screw which will protrude through the top of the tray Y Make an impression MIT 4 Syringe a light or medium bodied impression material around the coping assembly Load the impression
35. es friction grip surgical burs at least 65mm long 2 35mm Hex Driver for Latch Type Reduction Handpieces Used with right angle latch connection handpieces for installation and removal of Cover Caps Healing Abutments Abutments and Abutment Screws 134 350 050 Handpiece Hex Driver Bur Testing Gauge Used to verify the condition of latch type burs Burs in proper condition will fit into larger diameter hole but will not fit into the smaller hole marked red Burs that fail either of these criteria are unfit for use and may cause damage to the handpiece if used O WH BTG Bur Testing Gauge BIOHORIZONS 21 EDUCATION amp MARKETING ML0118 ML0203 P4XIM ERAT 5 BIOHORIZONS ss ma F TEE ma EC og MA L0114 SE sone a a G i E g g 410 las ML0103 BioHorizons Internal Prosthetic Manual This guide walks the clinician and staff through impression making techniques and prosthetic lab procedures with the BioHorizons Internal System Step by step written instructions are coupled with detailed graphics to illustrate procedures and help identify the accompanying prosthetic and lab components Regeneration Specialty Catalog This catalog contains information on AlloDerm Grafton DBM MinerOss CCC the Bone Fixation Screw Kit and AutoTac Titanium Tack System Also shown are a wide range of bone and soft tissue grafting inst
36. evel 1 is where the cutting geometry begins Engaging the CBD in the bone to Level 2 opens up the osteotomy to accept the slightly wider crest module on the implants and allows the polished collar to be placed above the crest of the bone Preparing the bone to Level 3 allows the implant to be placed with the prosthetic platform level with the crestal ridge As shown in the recommended drilling sequence the Crestal Bone Drills should be used at the following stages of osteotomy preparation 2Z3 5mm Crestal Bone Drill Following the 3 0mm Depth Drill 4 0mm Crestal Bone Drill Following the 3 2mm Depth Drill 25 0mm Crestal Bone Drill Following the 4 2mm Depth Drill 6 0mm Crestal Bone Drill Following the 5 2mm Depth Drill Bone Taps Ratchet amp Hand Wrench amp Ratchet Extender Ratchet Extender Bone Tap Thread Former The osteotomy should be tapped in dense bone Dense bone typically requires that the full length of the osteotomy be prepared with the tap The use of a Bone Tap is suggested in less dense bone when one or two sides of the osteotomy are in contact with a lateral cortical plate of bone Hand Wrench Place the tip of the Bone Tap into the osteotomy apply firm pressure and begin rotating slowly 30 rpm or less is recommended When the threads engage allow the thread former to feed without excessive
37. ew with the 050 Hex Driver Insert the coping assembly into the corresponding location in the impression ensuring that the flat of the coping aligns with the corresponding indice in the impression Create soft tissue model A soft tissue model material is recommended around the implant verify analogs are seated properly and apply lubricant around the analogs where soft tissue needs to be added Fabricate stone model Lab 7 Fabricate a working cast Articulate according to normal laboratory procedures BIOHORIZONS 51 OPEN TRAY DIRECT TRANSFER Implant Level Impression Hexed and Non hexed Open Tray Direct Pick up Technique IMPORTANT Open Tray Direct Pick up Impression Technique The Direct Pick up impression technique requires the use of a custom tray or modified stock tray with screw access holes over the area of the implants The holes allow the long screws to protrude through the top of the tray See the BioHorizons Internal Prosthetic Manual for custom tray fabrication It is available through Customer Care 888 246 8338 or viewed in pdf format at www biohorizons com 1 Clinical Remove Healing Abutment Remove the Healing Abutment with the 050 Hex Driver Make sure that the implant prosthetic platform is free of bone and soft tissue The emergence of the impression coping selected should match the emergence of the Healing Abutment and the intended final abutment eith
38. handles mimic the implant analog hex geometry Abutments are secured to the handle with the standard Abutment Screw PXAS Comes in two platform sizes 3 5 4 5mm and 5 7mm PYGAH 3 5 4 5mm Platform Analog Handle PBAH 5 7mm Platform Analog Handle Abutment Clamp Used to apply counter torque during torque delivery shielding the bone implant interface from potentially damaging stresses HF IMPAH Abutment Clamp Prosthetic Instrumentation System 320 000 Complete Prosthetic Instrumentation System ate Includes AS123 Hand Unit Hand Wrench 30 Ncm EXTENDER WREN Torque Wrench 050 Hex Driver 050 Hex Driver Long Hex Adapters for Abutment for Screw Square Drive Extension and Sterilization Tray 300 070 Prosthetic Sterilization Tray WRENCH Autoclavable tray for prosthetic instrumentation included with the 320 000 300 100 AS123 Hand Unit Provides improved vision and easy access to prosthetic components in posterior regions of the mouth Hand Wrench and Drivers must be purchased separately May also be purchased as part of the 320 000 Complete Prosthetic Instrumentation System see above 300 430 30 Ncm Torque Wrench Used to deliver final torque to all prosthetic components 300 350 regular 050 Hex Driver Regular and Long amp Used to drive all surgical and prosthetic components 050 H with the exception of the Abutment for Screw ds 300 351 long PXHA Hex Adapter Abutment for Screw O Requ
39. he abutment level Used only with the Abutment for Screw SOS rao Analog Abutment for Screw Used to represent the Abutment for Screw Implant assembly in the lab model Not for use with implant level impressions SOS men Screw regular Abutment for Screw 050 Hex Used to retain bars and abutments fabricated with the Abutment for Screw Copings Used only with the Abutment for Screw i O D PXABS 5 pack Screw long Abutment for Screw Hand Tighten 050 Hex Used in the lab when a longer screw is desired Used only with the Abutment for Screw O D PXABSL 5 pack BIOHORIZONS 21 BALL ABUTMENT RESTORATIONS Ball Abutments CADRELE o 050 Hex Ball Abutments are indicated for retention of tissue supported overdentures They are recommended for relatively parallel implants See facing page for attachment options Ball Abutments may be used as indirect transfer copings for production of a lab model PYBA1 3 5mm Ball Abutment 1mm Collar PYBA3 3 5mm Ball Abutment 3mm Collar D PYBA5 3 5mm Ball Abutment 5mm Collar PGBA1 4 5mm Ball Abutment 1mm Collar PGBA3 4 5mm Ball Abutment 3mm Collar S PGBAS 4 5mm Ball Abutment 5mm Collar PBBA1 5 7mm Ball Abutment 1mm Collar PBBA3 5 7mm Ball Abutment 3mm Collar Ball Abutment Analogs Used to represent the Ball Abutment Implant assembly in the lab model Only used in conjunction with Ball Abutments PYGBAA 3 5 4 5mm Ball Abutm
40. hetic platform to ensure confusion free correct abutment seating every time restorations g ry Abutments and Abutment Screws utilize the Spiralock thread standard 050 Hex Driver and are torqued to seal aber ole i virtually 30Ncm which eliminates the need for multiple eliminates screw drivers and wrenches loosening _ mk Free esthetic abutment with every implant Are you tired of paying a la carte for your abutments With the patented 3inOne Abutment you don t have to Included free with each implant it serves as a prepable titanium abutment as well as a surgical mount and impression coping when used with a ball top screw It features an esthetic margin profile and a gold hued titanium nitride coating for tissue esthetics The natural taper allows for easy restoration with minimal modification Use of the 3inOne abutment maximizes simplicity and value while minimizing inventory requirements and cost Providing the restoring dentist with the final abutment is a strong marketing tool for specialists looking to expand their practice 1 888 246 8 33 8 SYSTEM OVERVIEW Surface treatment amp Surface area Quality amp Quantity Surface treatment and bone to implant contact are important in promoting rapid osseointegration Why then do most companies choose to put their surfaces on implants that by design limit the amount of surface area BioHorizons thread design increases surface area up to 15
41. ic radiography varies in magnification from 15 to 35 e 5mm circular representations are shown at 100 and 125 for the radiographic ball technique This technique uses radiographic marking balls embedded in a plastic template prior to radiographic examination of the patient These marking balls will be visible on the radiographic image e Measurements can be taken to determine the precise magnification factor of the radiograph and help the practitioner accurately determine the amount of available bone for implant placement The following example shows the calculation of a distortion factor and the subsequent determination of available bone The radiographic marking ball has a known diameter of 5mm Assume the marking ball appears on the radiograph to have a diameter of 6mm The distortion factor is calculated as 5 6 0 833 Assume that the distance between the crest of the ridge and the superior aspect of the mandibular nerve canal appears on the radiograph to have a length of 15mm The actual distance between the crest of the ridge and the mandibular canal would be calculated as 15mm x 0 833 12 5mm 1 888 246 8338 SURGICAL TEMPLATE L0114 BIOHORIZONS nm BioHorizons Implant Systems Inc In t e rn a One Perimeter Park South Suite 230 South 1 888 BIO TEETH Birmingham AL 35243 Radiographic Implant Template 1 888 246 8338 tem son Radiographic Ball 5 0 mm Radiographic Ball 5 0 mm
42. ications The Influence of 0 12 Chlorhexidine Digluconate Rinses on the Incidence of Infectious Complications and Implant Success Lambert Paul M et al J Oral Maxillofacial Surgery 55 25 30 1997 Suppl 5 A pre operative 30 second rinse is recommended followed by twice daily rinses for two weeks following surgery Complications and Adverse Effects The risks and complications with BioHorizons dental implants are similar to those of other dental implants and include but are not limited to 1 infection requiring revision of the dental implant 2 nerve damage that could cause permanent weakness numbness and or pain 3 allergic reaction s to the implant material 4 histologic responses possibly involving macrophages and or fibroblasts 5 formation of fat emboli 6 perforation of the maxillary sinus 7 perforation of the labial and lingual plates 8 breakage of the implant or abutment 9 loosening of the implant requiring revision surgery 10 loosening of the Abutment Screw and or retaining screw 11 bone loss possibly resulting in revision or removal Handling and Sterilization The implants are supplied sterile and should be considered sterile unless the package has been opened or damaged Using accepted sterile technique remove from the package only after the correct size has been determined and the operative site has been prepared for final implantation Always handle the products with powder free gloves and avoid contact w
43. ired for placement of Abutment for Screw May be driven ek tele by either Hand Wrench Torque Wrench or AS123 Hand Unit i 300 400 Hand Wrench Used on drive end of AS123 Hand Unit Also fits individual Hex Drivers Adapters and Bone Taps products shown not to scale BIOHORIZONS MOTORS W amp H ImplantMed 110 Starter Kit The ImplantMed 110 is designed for use in dental implantology and provides the surgeon with a high quality power unit that is easy and safe to operate Maximum motor speed is 40 000 rpm The motor comes with the WS 75 20 1 handpiece testing gauge spray cap irrigation spike and service oil AN WH 110 W amp H ImplantMed 110 Starter Kit Re order items WH ST 10 PK Green Single Use Spray Tubes 10 pack WH 110CLP 5 PK Set of Spray Tube Clamps 5 pack WH 110PTWC Pump Tube 85mm with Connectors WH 110RPT 3 PK Replacement Pump Tubes 85mm 3 pack WH 110ISAWRC Irrigation Spike Assembly with Roller Clamp g WH 110RC Flow Regulating Roller Clamp WH 110MC Motor Cable 1 8 meter W8H ElcoMed SA 200 Professional Kit The ElcoMed SA 200 combines power performance and intelligence to support the surgeon in maxillofacial surgery implantology microsurgery and small bone surgery Maximum motor speed is 50 000 rpm The SA 200 also permits the storage of torque characteristics of a treatment stage which can then be saved on a DOC card for archiving purposes The kit also includes the WS 75 20 1 han
44. ith hard objects that may damage the surface of the implant Surgical components and metal laboratory components can be cleaned and then re sterilized using an appropriate autoclave cycle Implants are single use only and re use should not be attempted BioHorizons assumes no responsibility for attempted re use or re sterilization of dental implants BIOHORIZONS 45 POST OPERATIVE INSTRUCTIONS Post Operative Instructions A period of unloaded healing time is often recommended This is dependent on individual patient healing rates and bone quality of the implant site Each case must be independently evaluated This unloaded healing period allows for integration between the bone and implant surface The patient must be instructed to follow a post surgical regimen including cold packs for 24 hours post implantation The patient s diet should consist of soft foods and possibly dietary supplements Pharmacological therapy should be considered as the patient s condition dictates If a removable prosthesis is used during the initial healing phase it is recommended that a soft re line be used to prevent pressure on the surgical site This soft re line should be relieved over the implant sites The patient should be checked periodically to monitor healing of the soft tissues and bone using radiographic evaluations Notes 1 888 246 8338 IMPRESSION TECHNIQUE TYPES Impression Techniques BioHorizons Internal Stone models m
45. llowing this protocol will make the seating of prosthetic components much easier by contouring the soft tissue away from the prosthetic platform Custom Cast Abutments do not specify an emergence since the emergence will be determined by the contour of the final restoration Narrow Regular Wide 1 888 246 8 33 8 HEALING ABUTMENTS Healing Abutments EE Available in three heights to accommodate various tissue thickness 1mm 3mm and 5mm Emergence Narrow Regular or Wide should be chosen based upon the desired emergence of the final restoration Utilizes a 050 Hex Driver 050 Hex lt Q 0 0 E PYNHA1 PYNHA3 PYNHAS PYRHA3 PYRHAS PYWHA3 PYWHAS PGNHA1 PGNHA3 PGNHAS PGRHA3 PGRHAS PGWHA3 PGWHAS PBNHA1 PBNHA3 PBNHAS PBRHA3 PBRHAS BIOHORIZONS 3 5mm Narrow Healing Abutment 1mm Height 3 5mm Narrow Healing Abutment 3mm Height 3 5mm Narrow Healing Abutment 5mm Height 3 5mm Regular Healing Abutment 3mm Height 3 5mm Regular Healing Abutment 5mm Height 3 5mm Wide Healing Abutment 3mm Height 3 5mm Wide Healing Abutment 5mm Height 4 5mm Narrow Healing Abutment 1mm Height 4 5mm Narrow Healing Abutment 3mm Height 4 5mm Narrow Healing Abutment 5mm Height 4 5mm Regular Healing Abutment 3mm Height 4 5mm Regular Healing Abutment 5mm Height 4 5mm Wide Healing Abutment 3mm Height 4 5mm Wide Healing Abutment 5mm Height 5 7mm Narrow Healing Abutme
46. low chatter instruments made of surgical grade stainless steel The drill series consists of a Starter Drill Depth Drills 2 0mm and 2 5mm diameter and Width Increasing Drills 83 0mm through 5 2mm diameter The patent pending system incorporates a series of dental burs that allows the doctor to drill into the bone to a pre determined depth and width to create an osteotomy for receipt of the dental implant BioHorizons surgical twist drills are externally irrigated This design allows for proper channeling of the irrigant to the base of the osteotomy while eliminating the possibility of irrigant restriction from blockage in an internal drill lumen Externally irrigated drills are much easier to clean and provide a decreased risk of cross contamination between patients Every drill Starter Drill through 5 2mm diameter drill is labeled with highly visible dark contrast marks and grooves These grooves are easier to see in surgery than flush surface marks when blood and tissue are present Also the glare of light used during surgery does not affect the visualization of these grooves when compared to other typical surface markings Each drill reference mark of the Depth Drills prepares the bone to receive an implant of corresponding length The stated length of a BioHorizons Internal implant is measured from the apex of the implant up to the level of the prosthetic platform therefore drill to the 9mm depth mark to place a 9mm implant Internal implan
47. ment emergence and prosthetic platform label BioHorizons Internal implants are packaged in sterile blister trays and vials When the lid of the tray is removed the implant vial is exposed The vial is then placed in the sterile field The vial cap is removed by rotating it counter clockwise At this point the implant and the patented 3inOne Abutment are exposed This 3inOne Abutment is used to place the implant eliminating the need to purchase a separate implant mount that has no additional value Two different types of surgical placement adapters handpiece or ratchet are provided that interface with the 3inOne Abutment to facilitate surgical placement Remove the inner vial from the outer packaging The peel and stick label on the outer blister tray packaging should be placed in the patient s chart as a record of the device s used Be certain to hold the inner vial upright when the cap is removed so the implant will not fall out of the vial Q Placement Options A BIOHORIZO I Implant Placement with Handpiece One of the four flat sides on the end of the surgical Handpiece Adapter is aligned with the flat side of the 3inOne Abutment Seat the adapter in the 3inOne Abutment before the implant is removed from the inner vial Do not touch the implant Using firm apical pressure thread the implant into position
48. mm 4 0mm x 12mm 4 0mm x 15mm 5 0mm x 9mm 5 0mm x 10 5mm 5 0mm x 12mm 5 0mm x 15mm 6 0mm x 9mm 6 0mm x 10 5mm 6 0mm x 12mm 6 0mm x 15mm Low Profile for use during submerged surgical healing Packaged FREE with each implant system Utilizes a 050 Hex Driver y Y PYCC 3 5mm Cover Cap PGCC 4 5mm Cover Cap BIOHORIZONS T PBCC 5 7mm Cover Cap 050 Hex HEALING ABUTMENT LEGEND Healing Abutments and Emergence Profile Healing Abutments are used for tissue healing at second stage uncovery or as the transmucosal element for a single stage procedure The Suture Groove allows the surgeon to apically position the soft tissue flap and retain it in this position for improved esthetic results Three factors should be considered when ordering Healing Abutments diameter height and emergence profile The diameter of the Healing Abutment must be the same as the prosthetic platform width of the corresponding implant either 03 5mm 4 5mm or 25 7 mm The height of the Healing Abutment is typically chosen based upon the soft tissue thickness Available heights are 1mm 3mm and 5mm The emergence profiles offered are narrow regular and wide They should be chosen based upon the desired emergence of the final restoration For example if the final restoration calls for a Wide Emergence Profile Abutment the Healing Abutment and Impression Coping used should also be Wide Emergence Fo
49. n not to scale CEMENT RETAINED RESTORATIONS Abutments for Cement Retained Restorations Hexed 30onem 050 Hex Indicated for single and multiple unit cement retained restorations All two piece abutments are packaged with the Abutment Screw PXAS le lo Ue lo Ve Bo Vo Ve ls dede PYNEA PGNEA PBNEA PYREA PGREA PBREA PYWEA PGWEA PYRAA PGRAA PBRAA Ball top Screw ESD inen 3 5mm Narrow Emergence Abutment 4 5mm Narrow Emergence Abutment 5 7mm Narrow Emergence Abutment 3 5mm 3inOne Abutment Regular Emergence 4 5mm 3inOne Abutment Regular Emergence 5 7mm 3inOne Abutment Regular Emergence 3 5mm Wide Emergence Profile Abutment 4 5mm Wide Emergence Profile Abutment 3 5mm Angled Abutment Regular Emergence 4 5mm Angled Abutment Regular Emergence 5 7mm Angled Abutment Regular Emergence Hand 050 Hex Used with the 3inOne Abutment for closed tray hexed timed transfers Hand tighten PXBT One size fits May also be used all pl atforms to extend length of Indirect Transfer Copings by 3mm L Implant Analogs PYIA PGIA PBIA 3 5mm Implant Analog 4 5mm Implant Analog 5 7mm Implant Analog 1 888 246 8338 CEMENT RETAINED RESTORATIONS Direct Pick up Copings Open Tray Hexed Used to take an open tray implant level hexed timed impression Packaged with the extended Direct Coping Screw PXDCS PYNDC PYRDC PYWDC PGNDC PGRDC
50. nos de pago normal son 30 d as netos de la fecha de la factura BioHorizons Canada Shipping Options Options de Livraison 24 Amber Street Unit amp 7 UPS Next Day Early AM by avant 8 30am next day le lendemain matin i UPS Next Day Air by avant 10 30am next day le lendemain matin Markham Ontario L3R 423 UPS Next Day Air Saver by avant 4 30pm next day le lendemain i i UPS 2 Day Air AM by avant 12 00pm 2 day le 2e jour Customer Care Service a la Clientele UPS 3 Day Select by avant 5 00pm 3 day le 3e jour 866 468 8338 or ou 905 944 1700 UPS Ground BioHorizons products may also be ordered by fax 905 944 1894 or through your Product Support Specialist We process and ship all orders received by noon Central Time the same day For your convenience we accept Visa MasterCard American Express Money Orders Certified Checks or C O D Standard payment terms are net 30 days from invoice date Vous pouvez commander les produits BioHorizons par t l copieur en composant le 905 944 1894 ou en consultant votre repr sentant sp cialis Nous livrons le jour m me toutes les commandes recues au plus tard a midi heure centrale De plus les paiments peuvent tre r gl s par cartes de cr dit Visa MasterCard et American Express ou par mandat poste ch que certifi ou payable sur livraison Le paiement doit tre effectu dans les trente 30 jours suivant la date de commande retrouv e sur la facture
51. nt 1mm Height 5 7mm Narrow Healing Abutment 3mm Height 5 7mm Narrow Healing Abutment 5mm Height 5 7mm Regular Healing Abutment 3mm Height 5 7mm Regular Healing Abutment 5mm Height SURGICAL KIT amp COMPONENTS Starter Drill 122 103 2 0 x 9mm Depth Drill 122 12009 Drill Extender 122 100 2 0 x 10 5mm Depth Drill 122 120105 2 0 x 12mm Depth Drill 122 12012 2 0 x 15mm Depth Drill 122 12015 2 0mm Depth Drill 122 220 4x Straight 144 100 1 050 Hex Driver 135 351 2x Angled 144 200 Hand Wrench 300 400 2 5 x 9mm Depth Drill 122 12509 2 5 x 10 5mm Depth Drill 122 125105 2 5x 12mm Depth Drill 122 12512 2 5 x 15mm Depth Drill 122 12515 2 5mm Depth Drill 122 225 3 0mm W Drill 122 230 3 5mm Crestal Bone Drill PCBD35 3 5mm Bone Tap PT35 6 Round Bur 122 106 Ratchet Hand Wrench Extender 300 205 3 2mm W I Drill 122 232 3 3 mm W Drill 122 237 4mm Crestal Bone Drill PCBD40 4mm Bone Tap PT40 1 888 246 8 33 8 SURGICAL KIT amp COMPONENTS 4 2mm 4 7mm 5 2mm W Drill W Drill W Drill 122 242 122 247 122 252 5mm Crestal 6mm Bone Drill Crestal PCBD50 Bone Drill PCBD60 5mm 6mm Implant Bone Ta Bone Ta Spacer PT50 p PT60 p Ratchet Depth Probe 130 000 144 300 Handpiece 3 5 4 0mm Adapter Inse
52. nt cement retained restorations All two piece abutments are packaged with the Abutment Screw PXAS PYCAH 3 5mm Custom Cast Abutment Hexed PGCAH 4 5mm Custom Cast Abutment Hexed PBCAH 5 7mm Custom Cast Abutment Hexed Direct Pick up Copings Open Tray Hexed Gf ane Tighten 050 Hex Used to take an open tray implant level hexed timed impression Packaged with the extended Direct Coping Screw PXDCS PYNDC 3 5mm Narrow Hexed i i i PYRDC 3 5mm Regular Hexed PYWDC 3 5mm Wide Hexed 5 MIA U d PGNDC 4 5mm Narrow Hexed i PGRDC 4 5mm Regular Hexed E E PGWDC 4 5mm Wide Hexed PBNDC 5 7mm Narrow Hexed Direct Pick up Copings are packaged with the Direct D PBRDC 5 7mm Regular Hexed Coping Screw PXDCS Indirect Transfer Copings Closed Tray Hexed JF and Tighten 050 Hex Used to take a closed tray implant level hexed timed impression Packaged with the Abutment Screw PXAS PYNIC 3 5mm Narrow L aI PYRIC 3 5mm Regular PYWIC 3 5mm Wide PGNIC 4 5mm Narrow p L 5 PGRIC 4 5mm Regular PGWIC 4 5mm Wide H j a PBNIC 5 7mm Narrow Indirect Transfer Copings are packaged with the T S PBRIC 5 7mm Regular Abutment Screw PXAS Ball top Screw Ea jee Tighten 050 Hex Used with the 3inOne Abutment for closed tray hexed timed transfers Hand tighten One size fits May also be used PXBT all platforms to extend length of Indirect
53. ock tray with a screw access hole in the area above the implant is required The Direct Coping Screw that holds the Direct Pick up Coping in place while the impression is made is removed through the access hole after the material sets The impression is removed with the Direct Pick up Coping embedded within the impression The Implant Analog is connected to the embedded coping and a working model is poured in dental stone providing a replica of the implant s location in the patients mouth 1 888 246 8 33 8 CLOSED TRAY INDIRECT TRANSFER Implant Level Impression Hexed Closed Tray Indirect Transfer Technique Remove Healing Abutment Clinical 1 Remove the Healing Abutment with the 050 Hex Driver Make sure that the implant prosthetic platform is free of bone and soft tissue The emergence of the impression coping selected should match the emergence of the Healing Abutment and the intended final abutment either Narrow Regular or Wide Custom Cast emergence will be determined by the lab prescription amp Helpful Hint When placing impression copings on multiple implants remove one Healing Abutment at a time replacing it immediately with the impression coping This prevents the possibility of soft tissue collapsing onto the implant Work from the posterior to the anterior Option A Seat the 3inOne Abutment and secure it with a Ball top Screw hand tighten Option B Seat the Indirect Transfer C
54. of the prosthetic platform prior to the seating of a healing or prosthetic abutment There are three sizes of bone profiling burs one for each of the three prosthetic platforms O3 5mm 4 5mm and 5 7mm Their use requires the removal of the surgical Cover Cap from the implant and placement of the profiler guide both use the 050 Hex Driver which will help align the Bone Profiler and protect the implant from damage The Profiler bur is used in a latch type reduction handpiece under copious amounts of sterile irrigation Bone Profilers and guides are not included in the surgical kit Ordering information can be found on page 23 Healing Abutment Placement Healing Abutments are often used after initial bone healing in a two stage surgical approach They may also be used in lieu of a Cover Cap for a non submerged healing single stage approach BioHorizons Internal Healing Abutments are specific to each of the three prosthetic platform diameters O3 5mm 4 5mm and 5 7mm They come in three heights 1mm 3mm and 5mm and a choice of narrow regular and wide emergence profiles A Healing Abutment should be selected so that it extends through the tissue approximately 1mm The tissues may be approximated in the usual fashion A gingivectomy or apically positioned flap technique may be used to reduce the soft tissue thickness and to decrease sulcular depth around the implant An apically positioned flap technique can
55. on Parts that are cross compatible between platforms are not color coded M3 5mm Prosthetic Platform yr up 4 5mm Prosthetic Platform TON 25 7 mm Prosthetic Platform THE All Internal Implants have a 0 5mm polished collar between the implant abutment interface and the top of the RBT or HA surface treatment Each implant is packaged with the 3inOne Abutment Cover Cap and Abutment Screw Please note that 5 0mm and 6 0mm diameter implants share the 5 7mm prosthetic platform therefore blue color coded prosthetic components are cross compatible between these two implant diameters However the surgical instruments specific to 5 0mm implants are color coded blue whereas instruments for 6 0mm implants are color coded purple 5 7mm 5 7mm Each implant is packaged with the 3inOne Abutment Cover Cap and Abutment Screw Choice of RBT or HA surface treatment IMPLANTS BioHorizons Internal Implants RBT Surface PYR3509 PYR35105 PYR3512 PYR3515 PGR4009 PGR40105 PGR4012 PGR4015 PBR5009 PBR50105 PBR5012 PBR5015 PBR6009 PBR60105 PBR6012 PBR6015 Surgical Cover Cap HA Surface PYH3509 PYH35105 PYH3512 PYH3515 PGH4009 PGH40105 PGH4012 PGH4015 PBH5009 PBH50105 PBH5012 PBH5015 PBH6009 PBH60105 PBH6012 PBH6015 Diameter and Length D3 5mm x 9mm 3 5mm x 10 5mm 3 5mm x 12mm D3 5mm x 15mm 4 0mm x 9mm 4 0mm x 10 5
56. oping and secure it with the included screw hand tighten If practical orient the flat side of the abutment coping to the facial for easier indexing Option B Take a radiograph along the long axis of the implant to ensure the coping is fully seated BIOHORIZONS CLOSED TRAY INDIRECT TRANSFER 3 Clinical Block out screw access hole Option A Block out the hex hole on top of the Ball top Screw Option A or the screw access hole of the Indirect Transfer Coping Option B gt with a material of choice Option B Q Clinica Clinical Apply impression material Syringe a light or medium bodied impression material around the coping assembly and record a full arch impression with a medium or heavy bodied material Remove the coping assembly after the tray has been removed Replace the Healing Abutment immediately to prevent soft tissue collapse Send to Lab e Impression e Impression coping either e 3inOne Ball top Screw Combo or e Indirect Transfer Coping e Abutment Screw comes with 3inOne e Implant Analog e Bite registration e Opposing model or impression e Shade 1 888 246 8 33 8 CLOSED TRAY INDIRECT TRANSFER Assemble analog Lab 5 Option A Assemble the 3inOne Abutment with the appropriate diameter Implant Analog using the Ball top Screw neon a Option B Assemble the Indirect Transfer Coping with the i appropriate diameter Implant Analog using the included scr
57. pressure To remove switch the handpiece to the reverse mode and back out Do not pull on the Bone Tap The implant site may also be threaded by hand by attaching the Ratchet Extender and Hand Wrench or Ratchet to the tap The Hand Wrench or Ratchet may also engage the thread former without the Ratchet Extender BIOHORIZONS 35 OSTEOTOMY STARTER SEQUENCE IMPORTANT Peri operative oral rinses with a 0 12 Chlorhexidine Digluconate solution have been shown to significantly lower the incidence of post implantation infectious complications A pre operative 30 second rinse is recommended followed by twice daily rinses for two weeks following surgery Drilling must be done under a constant stream of sterile irrigation A pumping motion should be employed to prevent over heating the bone Drills that cannot advance 2mm per second in the osteotomy have become dull and should be replaced There is a risk of injury to the mandibular nerve associated with surgical drilling in lower posterior regions To minimize the risk of nerve injury it is imperative that the clinician understand the drill depth markings in order to correlate implant length with the actual drilling depth to produce the desired vertical placement of the implant a Starter Sequence Starter Drill Center the Starter Drill in the desired area of the osteotomy and drill to the appropriate depth reference mark
58. rtion Tool PHA PYGIT Ratchet 8 Hand 5 0 6 0mm Wrench Adapter Insertion Tool PRA PBIT BIOHORIZONS ABUTMENT SELECTION FLOWCHART Single Tooth Screw Retained Custom Cast Abutments Hexed page 17 11 Narrow Emergence Abutments page 15 3inOne Abutments Multiple Units Screw Retained Custom Cast Abutments Non Hexed page 18 j Cement Retained 00 Wide Emergence Angled Abutments Regular Emergence Profile Abutments Regular Emergence page 15 page 15 1 888 246 8 33 8 ABUTMENT SELECTION FLOWCHART Overdentures ULL 606 Abutment Retained Implant Level Bar Retained Abutment Level Bar Retained Overdenture Overdenture Overdenture page 21 page 18 page 19 The Abutment Selection Flow Chart is provided to aid in the proper selection of the abutment s needed based on the final prosthetic option desired Simply determine if the case is for a single tooth multiple unit or overdenture restora tion Next select the desired abutment s based on cement retained or screw retained fixation For an overdenture prosthesis select the desired abutment based on either a bar retained or abutment retained denture BIOHORIZONS 13 ABUTMENT DIMENSIONS O3mm 3 5mm 4 7mm
59. ruments including Implant Site Dilators SA 2 Osteotomes and other sinus grating instruments BioHorizons Internal 4x Scale Model This 4 times scale model includes the implant Abutment Screw Healing Abutment Cover Cap implant driver and Hex Driver Excellent for demonstrating implant components to the patient Radiographic Implant Template overlay Designed to aid the clinician in the pre operative determination of options for implant length and diameter The clear overlay template shows all sizes of BioHorizons Internal system implants in 100 and 125 scale Please refer to page 29 30 for detailed instructions for use Patient Education Dental Implants The Path Back to Your Smile This four fold brochure helps the implant candidate understand the rationale and the advantages of implant therapy compared to traditional treatment methods The message focuses on the positives of implants rather than attacking other treatment options 1 888 246 8 33 8 SURGICAL MANUAL Surgical Manual BioHorizons Internal This Surgical Manual serves as a reference for use of the BioHorizons Internal system implants and surgical instrumentation It is intended solely to provide instructions on the use of BioHorizons products It is not intended to describe the methods or procedures for diagnosis treatment planning or placement of implants and it does not replace clinical training or a clinician s best judgment about the needs of each
60. s Se ae e om Sam Ann Optional Use an implant site dilator of appropriate size or substitute the drill as a site dilator by pressing the drill to final depth without rotating 1 888 246 8338 OSTEOTOMY WIDENING SEQUENCE 4 2mm Width Increasing Drill Widening Sequence 4 The 4 2mm Width Increasing Drill is used to increase the diameter of the osteotomy The blunt tip on this drill will prevent it from increasing depth therefore the final osteotomy depth must be created with the Depth Drills The blunt tip may not stop in poor quality bone please exercise caution in D3 or D4 bone Depth marks are included on the drills as a reference Optional Use an implant site dilator of appropriate size or substitute the drill as a site dilator by pressing the drill to final depth L Use Crestal Bone Drill for 5 0mm implant after wingu rotating the 4 2mm drill Follow with 5mm Bone Tap if desired 4 7mm Width Increasing Drill The 4 7mm Width Increasing Drill is used to increase the diameter of the osteotomy The blunt tip on this drill will prevent it from increasing depth therefore the final osteotomy depth must be created with the Depth Drills The blun
61. t tip may not stop in poor quality bone please exercise caution in D3 or D4 bone Depth marks are included on the drills as a reference Optional Use an implant site dilator of appropriate size or substitute the drill as a site dilator by pressing the drill to final depth without rotating 5 2mm Width Increasing Drill The 5 2mm Width Increasing Drill is used to increase the diameter of the osteotomy The blunt tip on this drill will prevent it from increasing depth therefore the final osteotomy depth must be created with the Depth Drills The blunt tip may not stop in poor quality bone please exercise caution in D3 or D4 bone Depth marks are included on the drills as a reference Optional Use an implant site dilator of appropriate size or substitute the drill as a site dilator by pressing the drill to final depth Use Crestal Bone Drill l i j e for 6 0mm implant after without rotating the 5 2mm drill Follow with 6mm Bone Tap if desired BIOHORIZONS 39 IMPLANT PACKAGING Implant Packaging Implant surface treatment and dimensions label BioHorizons Internal implant packages have color coded labels for easy identification of contents Inner vial caps are also color coded for easy reference Abut
62. te of initial invoice The instruments covered by this warranty include drivers sinus lift components implant site dilators and other BioHorizons tools used in the placement or restoration of our implants with the exception of surgical drills and taps which are specified below 2 Torque wrenches require recalibration every 12 months Our Customer Care Department can provide information on where to send your wrenches for recalibration and service 2 Surgical Drills and Taps The warranty on surgical drills and taps extends for a period of 90 days from the date of initial invoice Surgical drills and taps should be replaced when they are worn dull corroded or in any way compromised Smaller diameter drills used more often than larger diameter drills should be replaced with greater frequency BioHorizons recommends the replacement of drills after 12 to 20 osteotomies Return Policy All returns of product require a Return Authorization Form which can be acquired by calling Customer Care at 888 246 8338 Please include a copy of the Return Authorization Form with the product Special regulations for tissue products AlloDerm and AlloDerm GBR may not be exchanged or returned for credit Grafton must be exchanged or returned within ten 10 days of receipt Product may be returned for full credit up to 60 days after the date of shipment provided 1 it is returned to BioHorizons freight prepaid and 2 it is in its original un opened package Under
63. tor of Use Crestal Bone Drill appropriate size or substitute the drill as a for 3 5mm implant l site dilator by pressing the drill to final depth after the 3 0mm drill without rotating Follow with 3 5mm Bone Tap if desired 3 2mm Width Increasing Drill The 3 2mm Width Increasing Drill is used to increase the diameter of the osteotomy The blunt tip on this drill will prevent it from increasing depth therefore the final osteotomy depth must be created with the Depth Drills The blunt tip may not stop in poor quality bone please exercise caution in D3 or D4 bone Depth marks are included on the drills as a reference Optional Use an implant site dilator of Use Cresta Bone Dail appropriate size or substitute the drill as a for 4 0mm implant site dilator by pressing the drill to final depth after the 3 2mm drill without rotating Follow with 4mm Bone Tap if desired 3 7mm Width Increasing Drill The 3 7mm Width Increasing Drill is used to increase the diameter of the osteotomy The blunt tip on this drill will prevent it from increasing depth therefore the final osteotomy depth must be created with the Depth Drills The blunt tip may not stop in poor quality bone please exercise caution in D3 or D4 bone Depth marks are included on the drills as a reference 3 BIOHORIZONS QB Oveno O wasthnaessng ons internal
64. ts have 0 5mm polished collars Placing an implant subcrestal countersinking requires that the surgeon drill to the next incremental 1mm marking Drilling Technique It is recommended that copious amounts of refrigerated sterile irrigant be used in any osseous drilling procedure With BioHorizons surgical drills this irrigant must be applied externally and adjacent to the drill shaft Many commercially available handpieces are equipped with an external irrigation port Drilling Speed The speed of the drill may be adjusted in relation to the quality of the bone being prepared Harder bone usually requires up to 2500 rpm to proceed without exerting excessive pressure Intermittent pressure of 1 second on the bone and 1 to 2 seconds off the bone is recommended Enough pressure should be used to proceed at least 2mm per second If this is not achieved new drills are indicated for each preparation Note Heat generation in bone is a function of both drill soeed and pressure The correct combination of speed and pressure will reduce the possibility of thermal necrosis of surrounding tissues Thread Forming Thread forming tapping may be indicated in dense bone Tap the bone at a maximum speed of 30 rpm Note that the tap must engage the osteotomy and proceed at an axial rate of speed relative to the rotational speed rpm of the tap Example The tap will proceed slower into the osteotomy at a tap speed of 10 rpm versus 30 rpm Please note that stripping
65. ue and is recommended in multiple unit restorations 1 Impression Methods Closed Tray Indirect Transfer This indirect impression technique records the soft tissue profile as well as the implant s location The implant s internal hex orientation is transferred when using the 3inOne Abutment with a Ball top Screw or any of the Indirect Hexed Closed Tray Copings f the hex location is not needed for the prosthesis fabrication the Direct Pick up Non hexed Open Tray Coping may be used In this technique the Indirect Transfer Coping remains in the mouth after the impression is removed from the mouth The coping is then removed from the mouth and connected with the appropriate Implant Analog The coping analog assembly is then indexed transferred into its corresponding position in the impression A working model is poured in dental stone providing a replica of the implant s location in the patients mouth Open Tray Direct Pick up This impression technique records the soft tissue profile as well as the implant s location The implant s internal hex orientation is transferred when using the Direct Pick up Hexed Open Tray Copings If the hex location is not needed for the prosthesis fabrication the Direct Pick up Non Hexed Open Tray Copings are used In the open tray transfer technique the Direct Pick up Coping remains in the impression when it is removed from the mouth For this technique a custom tray or modified st
66. used to measure available ridge width The recommended spacing between an implant and a natural tooth is 1 5mm to 2mm measured from the contact of the tooth to the edge of the implant Be careful of situations where the tooth root is beyond the contact region of the crown as in angled or tipped teeth Paralleling Pins Paralleling Pins Force Direction Indicators Following the 2 0mm Depth Drill the Paralleling Pins may be used to evaluate any minor changes needed to improve implant angulation and position The Paralleling Pins are provided straight or with a 20 angle that corresponds to the angulation of the 20 angled abutments The large end of the paralleling pin may be used again after the osteotomy is enlarged to 2 5mm Clinicians may wish to initiate all osteotomies with the 2 0 x 9mm Depth Drill as this is the length of each side of the pin After visual and radiographic verification of positioning is made the osteotomy can be taken to depth with the appropriate 2 0mm Depth Drill Note The mid section of each paralleling pin has a small pass through hole To avoid accidental dislodging and swallowing it is recommended that silk suture be placed through the hole prior to use 1 888 246 8 33 8 SURGICAL INSTRUMENTS Design of BioHorizons surgical drills BioHorizons surgical drills are high efficiency
67. w retained restorations at the abutment level cast alloy bars for overdentures and fixed detachable hybrid restorations Comes packaged with the Cover Cap PXABCC PYAFS1 3 5mm Abutment for Screw 1mm Collar PYAFS3 3 5mm Abutment for Screw 3mm Collar D PYAFS5 3 5mm Abutment for Screw 5mm Collar PGAFS1 4 5mm Abutment for Screw 1mm Collar PGAFS3 4 5mm Abutment for Screw 3mm Collar PGAFS5 4 5mm Abutment for Screw 5mm Collar PBAFS1 5 7mm Abutment for Screw 1mm Collar PBAFS3 5 7 mm Abutment for Screw 3mm Collar Hex Adapter Gold Coping Abutment for Screw 30 Ncm 050 Hex Machined gold alloy base with Delrin waxing sleeve May be trimmed for height Packaged with the Screw regular Abutment for Screw PXABS Plastic Coping Abutment for Screw 30 Ncm 050 Hex Delrin waxing sleeve May be trimmed for height Packaged with the Screw regular Abutment for Screw PXABS Cover Cap Abutment for Screw Hand Tighten amp 050 Hex Packaged with all Abutments for Screw Uses 050 hex Hand tighten ci SOS PXABCC 1 888 246 8 33 8 SCREW RETAINED ABUTMENT LEVEL Impression Copings Abutment for Screw Hand Tighten Y 050 Hex Used to make a direct pick up impression open tray at the abutment level Packaged with the Screw long Abutment for Screw PXABSL Used only with the Abutment for Screw PXABDC Used to make an indirect transfer closed tray impression at t

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