12 shop online at store.biohorizons.com This surgical manual serves as a reference for using the Tapered PTG implants and surgical instruments. 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, nor does it replace clinical training or a clinician’s best judgment regarding the needs of each patient. BioHorizons strongly recommends appropriate training as a prerequisite for the placement of implants and associated treatment. The procedures illustrated and described within this manual reflect idealized patient presentations with adequate bone and soft tissue to accommodate implant placement. No attempt has been made to cover the wide range of actual patient conditions that may adversely affect surgical and prosthetic outcomes. Clinician judgment as related to any specific case must always supersede any recommendations made in this or any BioHorizons literature. Before beginning any implant surgical procedure with BioHorizons implants: • Read and understand the Instructions for Use that accompany the products. • Clean and sterilize the surgical tray and instruments per Instructions for Use. • Become thoroughly familiar with all instruments and their uses. • Study surgical kit layout and iconography. • Design a surgical treatment plan to satisfy the prosthetic requirements of the case. Small diameter implants are intended for the anterior region of the mouth and are not intended for the posterior region of the mouth due to possible failure of the implant. Indications Tapered PTG, Tapered Pro, Tapered Internal, Tapered Plus and Tapered Tissue Level Implants are intended for use in the mandible or maxilla as an artificial root structure for single tooth replacement or for fixed bridgework and dental retention. The implants may be restored immediately: 1) with a temporary prosthesis that is not in functional occlusion or 2) when splinted together for multiple tooth replacement or when stabilized with an overdenture supported by multiple implants. Because of their length and diameter, BioHorizons Tapered PTG implants are well-suited for implant placement through the maxillary tuberosity in the pterygoid plate, supporting full-arch treatment in extremely atrophic maxillae and providing an alternative to grafting, which may expedite treatment.13,14 Tapered Internal 3.0 and Tapered Tissue Level 3.0 Implants may be used as an artificial root structure for single tooth replacement of mandibular central and lateral incisors and maxillary lateral incisors. The implants may be restored immediately: (1) with a temporary prosthesis that is not in functional occlusion, (2) when splinted together as an artificial root structure for multiple tooth replacement of mandibular incisors, (3) for denture stabilization using multiple implants in the anterior mandible and maxilla. The implants may be placed in immediate function when good primary stability has been achieved and with appropriate occlusal loading. Important Considerations • Peri-operative oral rinses with a 0.12% Chlorhexidine Digluconate solution have been shown to significantly lower the incidence of post-implantation infectious complications.15 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. Surgical drills and taps should be replaced when they are worn, dull, corroded or in any way compromised. BioHorizons recommends replacing drills after 12 to 20 osteotomies.16 A Drill-usage Tracking Chart is available at biohorizons.com to record this important information. • There is a risk of injury to the mandibular nerve associated with surgical drilling in posterior mandibular regions. To minimize the risk of nerve injury, it is imperative that the clinician understands the drill depth markings as they relate to the implant length to produce the desired vertical placement of the implant. Surgical Manual Instructions for Use
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