Carmen Tran- 8/14/13

One Piece Implant Procedure

1.     Say hi to the patient and confirm the procedure

2.     Let patient rinse with Chlorhexidine (5 to 10 cc) before surgery

3.     Let patient sign consent form

4.     Use 2 small towels to cover trays. Also put a big towel over the patient’s chest after cleaning the mouth with Iodine

5.     Use the long forceps to pick up the needle in the jar

6.     Open the pouch of the irrigation cups and take them out

7.     Pick up the long forceps to grab the Iodine in the irrigation cup

8.     Use Iodine to clean the mouth and the face around the mouth

Sequence for One Piece Implant

1.     Use anesthesia to numb the patient’s teeth

2.     Make marks with explorer.  If the gingiva is not tough, directly use drill to penetrate it so that #15 may be not needed

3.     Load 1.5mm pilot drill in E16R slow-speed hand piece with irrigation to the depth of planned implant length

4.     Use x-ray device to check orientation of 1.5mm pilot drill(s).  To place 3.0 mm one piece implant, use 2.0 mm pilot drill half of the depth.  For mandible (hard bone), use 3.0 mm drill to open up the crest

5.     We should also check occlusion against the opposing arch while 1.5 mm or 2.0 mm pilot drill in place.  If the trajectory is off a little bit, CBA (angled abutment, 15°) will be used.  Look for the one piece implant box and take one bag out.  Take out the implant from the bag

6.     Use an appropriate CB driver (for example, 3.0 mm) first, second use the HT26 driver, and third use the adjustable torque wrench to turn the implant into the bone/gums (use regular ratchet wrench if we reach the maximum amount of torque of the adjustable wrench). In the end make sure the implant is tightly secured in the patient’s bone.  When the wrench touches the neighboring tooth/teeth, use HT20 (extension)

7.     We need the final x-ray to check if the implant is placed properly without touching the adjacent teeth

8.  Prepare abutments and check shade for temporary crowns or bridge

9.  Why do we need one piece implant?  Where are they used most often? 

Xin Wei, DDS, PhD, MS 1st edition 08/15/2013, last revision 08/18/2013