BioHorizons TeethXPress® Manual

TeethXpress® technique manual

Page Soft tissue flap preparation and ridge reduction Osteotomy preparation and implant placement Multi-unit abutment placement and denture modification Multi-unit abutment impression and titanium coping modification TeethXpress prosthetic pick up, final modification & delivery Prosthetic platforms Multi-unit abutments & components Prosthetic instrumentation Support materials Table of Contents: 2 3-5 5-6 7-8 9-10 11 12-16 17-18 19 TeethXpress® immediate-load solutions pre-operative photo post-operative photo Case Courtesy of: Andrew Ferrier, DDS, Prosthodontist, Lafayette, CA Arshiya Sharafi, DDS, Oral Surgeon, San Diego, CA

Your patients need full-arch treatment. Give them TeethXpress® Laser-Lok® zone creates a connective tissue attachment, retaining crestal bone Intelligent component design for restorative flexibility and ease of use Buttress threads engineered to provide primary stability essential for immediate load This surgical manual serves as a reference for using Tapered family implants and Multi-unit abutments in the TeethXpress protocol. 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. For more in-depth training, attend a full-arch, immediate-load course. Clinician judgment as related to any specific case must always supersede any recommendations made in this or any BioHorizons literature.

2 shop online at store.biohorizons.com SURGICAL PROTOCOL Extract remaining dentition. Following extractions, release the soft tissue with crestal incisions using a #15 blade. Fully expose the alveolar crest of the ridge using a periosteal elevator. Note the location of each mental foramen. Reduce the height of the ridge using an aggressive alveolar cutting bur to create at least 15mm of interarch occlusal space. If the required 15mm occlusal space is present due to atrophy, an alveoplasty may not be required. Note: The mandibular lingual flap can be temporarily sutured to keep the lingual tissue from obscuring the surgical area. Use a sterile #2 pencil to draw a line from buccal to lingual, across the crest of the ridge above the mental foramen. Draw a 30° guide mark on the facial of the ridge, anterior to the mental foramen. 30°

3 shop online at store.biohorizons.com SURGICAL PROTOCOL Widen the posterior osteotomy using the appropriate BioHorizons width increasing drills, maintaining the proper angle and A/P spread. Repeat steps on the opposing side. Note: To achieve adequate torque values in soft bone, undersizing the osteotomy may be necessary. Remove the BioHorizons Tapered Internal implants from the sterile vials using a handpiece or ratchet implant-level driver. Deliver the implants to the prepared osteotomies. If the insertion torque is too high, adjust the osteotomies as necessary. If the insertion torque is too low, consider changing to a larger implant size. Confirm proper osteotomy position using the surgical guide and two 30° angled parallel pins. The pins should emerge through the guide trough. Adjust the trajectory of the osteotomy as needed before widening. Initiate the two posterior osteotomies using a BioHorizons 1.5mm or 2.0mm diameter starter drill. In the center of the buccal-lingual drawn line, drill parallel with the 30° mark, anterior to the mental foramen, to achieve adequate A/P* spread and avoid damaging the mental nerve. *Anterior/Posterior spread

4 shop online at store.biohorizons.com SURGICAL PROTOCOL Initiate the anterior osteotomies using a BioHorizons Tapered Internal 2.0 diameter starter drill. Verify the correct implant trajectory using straight 2.0 parallel pins and the surgical guide. Note: In some instances, a 17°degree angled Multi-unit abutment may be necessary to create the proper angle through the guide trough. Following angled implant placement, screw in the BioHorizons profiler guide. Use a BioHorizons bone profiler to remove the crestal bone around the implant for a passive seating of the angled Multi-unit abutment. If the implant’s internal hex orientation is incorrect, use the BioHorizons implant-level ratchet driver to adjust the internal hex orientation to its ideal positioning for the angled Multi-unit abutment. Repeat the Multi-unit try-in abutment step to verify proper internal hex position. Use the BioHorizons 30° Multi-unit try-in abutment to verify proper implant hex orientation and to determine the necessary Multi-unit abutment height and angulation. Repeat steps on the opposing implant. Position the surgical guide to verify proper angulation and A/P spread. 5mm 4mm 3mm

5 shop online at store.biohorizons.com SURGICAL PROTOCOL Widen the osteotomy using the appropriate BioHorizons width increasing drills, maintaining the proper angle and A/P spread. Attach a Multi-unit carrier (MUCA) and .050” hex driver to the angled Multi-unit abutment and hold in one hand. Use the other hand to unscrew the plastic carrier from the abutment. Place the anterior implants. Adjust the internal hex orientation to its ideal position if an angled Multi-unit abutment is required. Verify angulation using the angled Multi-unit try-in abutments and determine necessary abutment height. Remove the straight Multi-unit abutments from the packaging and place in the anterior implants using the attached plastic carrier. Hand-tighten the abutments using a manual Multi-unit hex adaptor.

6 shop online at store.biohorizons.com SURGICAL PROTOCOL After the material sets, remove the denture and use a fissure bur to cut pilot holes in the indentations created in the bite registration material. Keep the bite registration material in place. Cover the intaglio surface of the immediate denture using bite registration material. Place the denture over the ridge and press down to register the cover caps. Hand-tighten the Multi-unit cover caps that came with the abutments using a .050” hex driver. Trim off any excess soft tissue and completely close the flap around the cover caps using an abundance of interrupted sutures from the midline to the posterior. Verify that bleeding is minimal as to not affect the subsequent impression steps. The surgical site is now ready for the TeethXpress immediate denture conversion. Seat the Multi-unit abutment hex in a posterior implant using the Multi-unit carrier and hand-tighten the abutment screw using the .050” hex driver. Remove the Multi-unit carrier and torque the abutment screw up to 30 Ncm*. Use an alveolar cutting bur to flatten divot areas around the angled implants and to smooth out sharp edges of the ridge. Use MinerOss cortical & cancellous bone chips to fill all voids created from the extractions. * May be necessary to hand tighten the Multi-unit abutment screw if the implant torque value was less than 30 Ncm.

7 shop online at store.biohorizons.com RESTORATIVE PROTOCOL Using a pear-shape carbide bur, continue to widen each of the holes and check fit until there is 2-3mm of clearance completely around each cover cap. Do not be concerned about the denture teeth. There should be lateral play between the denture and the Multi-unit cover caps. Remove the bite registration material when this step is complete. Attach Multi-unit abutment replicas to the impression copings and fabricate a working model in minimal expansion, high hardness die stone. A soft tissue material may be used to establish a soft tissue model. Verify proper replica seating and apply lubricant around the replicas where a soft tissue model will need to be created. Once set, prepare the working cast for the provisional prosthesis to be attached for additional modifications. Replace the cover caps with direct or indirect Multi-unit impression copings using an .050” hex driver. Take an impression. Remove the Multi-unit impression copings.

8 shop online at store.biohorizons.com RESTORATIVE PROTOCOL Reattach the titanium copings using a long .050” hex driver and hand-tighten. Place a square-shaped piece of rubber dam (with a small hole punched in the center) around each titanium coping to protect the wound and sutures from acrylic material. Remove each titanium coping from the mouth. Reduce the height of each titanium coping as necessary using a titanium cutting disc or bur. Titanium copings can be attached to a BioHorizons analog handle* for easier handling. Place a rolled PTFE membrane material* in each titanium coping using a perio probe and cover with a small piece of wax to prevent acrylic from infiltrating the abutment screw. *Often referenced clinically as “Teflon® tape”. Place each Multi-unit titanium coping. Seat the denture in the mouth and verify 2-3mm clearance around each titanium coping. Further widen the holes as necessary. Use a marker to indicate where titanium copings need to be reduced to be 1mm below the denture surface.* *Adequate bone reduction reduces this need and makes the denture less prone to fracture. *Attach a straight Multi-unit abutment directly to the Analog Handle, then attach the titanium coping.

9 shop online at store.biohorizons.com RESTORATIVE PROTOCOL Seat the denture back in the patient’s mouth. Use a small-tipped syringe to flow acrylic or pink composite material around each of the titanium copings to capture and pick them up in the denture. Immediately wipe away excess material from the occlusal surfaces and the top of the titanium copings. The patient is immediately guided into Centric Relation (CR) and held in the CR position until the acrylic material sets. Modify the provisional prosthesis by removing the flanges and distal cantilevers using a carbide bur. For maxillary cases, remove the palate as well. Fill in any voids, and smooth all rough edges. Secure the provisional prosthesis to the working cast and make any final modifications. Once adjustments are complete, final polishing is performed in preparation for delivery to the patient. Once the acrylic material has set, the wax, Teflon tape and coping screws are removed. The denture is removed from the patient’s mouth with the titanium copings picked up. The lab technician will fill any voids around the copings during the laboratory finishing. An extra-long 0.50” hex driver (19mm) may be necessary depending on the depth of the titanium copings and the thickness of the TeethXpress prosthesis.

10 shop online at store.biohorizons.com RESTORATIVE PROTOCOL Place rolled Teflon tape in each titanium coping, cover with wax and light-cured acrylic material. The TeethXpress procedure is complete. Send the patient home with the TeethXpress Soft Diet Suggestions and any other necessary postoperative instructions. Seat the provisional prosthesis in the patient’s mouth and hand-tighten the coping screws using a long or extra-long .050” hex driver. Check the patient’s occlusion and make any necessary adjustments. Additional adjustments can be made as needed during subsequent visits.

11 shop online at store.biohorizons.com IMPLANT & MULTI-UNIT ABUTMENT PLATFORM BioHorizons prosthetic components are color-coded to match BioHorizons implant prosthetic platform. The 3.5mm (Yellow) is the most common platform used for the TeethXpress procedure. There are multiple implant diameters that come with a 3.5mm platform*. Surgeons can use these options to match the appropriate diameter implant to the site conditions while minimizing the number of Multi-unit abutments in their inventory. 3.5mm Angled Multi-unit abutment 3.5mm Straight Multi-unit abutment 3.8mm diameter Tapered Internal 4.2mm diameter Tapered Pro 4.6mm diameter Tapered Plus 3.5mm diameter prosthetic platform 3.5mm diameter prosthetic platform 3.5mm diameter prosthetic platform 4.6mm diameter Tapered Pro 3.5mm diameter prosthetic platform * Available BioHorizons Multi-unit abutment sizes include 3.0 (Gray), 3.5 (Yellow), 4.5 (Green) and 5.7mm (Blue) to correspond with the available implant platform sizes. The corresponding implant and Multi-unit abutment sizes should be present at the time of the TeethXpress surgery.

12 shop online at store.biohorizons.com MULTI-UNIT ABUTMENTS Straight Multi-unit abutments may be used for multiple-unit restorations including: screw-retained restorations at the abutment level, cast alloy bars for overdentures and fixed/detachable (hybrid) restorations. Comes with a cover cap (PXMUCC). Final torque: 30 Ncm using a Multi-unit Hex Adapter. Titanium alloy. 17° Angled Multi-unit abutments may be used to angle-correct divergent implants. Use for multiple-unit restorations including: screwretained restorations at the abutment level, cast alloy bars for overdentures and fixed/detachable (hybrid) restorations. Comes with a cover cap (PXMUCC) and abutment screw (PXMUAS). Final torque: 30 Ncm. Titanium alloy. Conveniently deliver abutment one-handed using an .050 hex or Unigrip™ driver or two-handed using an angled Multi-unit carrier (MUCA). 2mm 17° 30° 30° Angled Multi-unit abutments may be used to angle-correct divergent implants. Use for multiple-unit restorations including: screwretained restorations at the abutment level, cast alloy bars for overdentures and fixed/detachable (hybrid) restorations. Comes with a cover cap (PXMUCC) and abutment screw (PXMUAS). Final torque: 30 Ncm. Titanium alloy. Conveniently deliver abutment one-handed using an .050 hex or Unigrip™ driver or two-handed using an angled Multi-unit carrier (MUCA). 2.2mm 2.25mm 4mm 1mm collar 2mm collar 3mm collar 4mm collar 5mm collar 3.0mm platform TP3MU1 TP3MU2 TP3MU3 - - 3.5mm platform PYMU1 PYMU2 PYMU3 PYMU4 PYMU5 4.5mm platform PGMU1 PGMU2 PGMU3 PGMU4 PGMU5 5.7mm platform PBMU1 PBMU2 PBMU3 - - 2.25mm collar 3mm collar 4mm collar 3.0mm platform TP3MU172 TP3MU173 - 3.5mm platform PYMU172 PYMU173 PYMU174 4.5mm platform PGMU172 PGMU173 PGMU174 5.7mm platform PBMU172 PBMU173 - 3mm collar 4mm collar 5mm collar 3.0mm platform TP3MU303 TP3MU304 - 3.5mm platform PYMU303 PYMU304 PYMU305 4.5mm platform PGMU303 PGMU304 PGMU305 5.7mm platform PBMU303 PBMU304 - 4.5mm 4.5mm 4.5mm 17° 3mm 4.5mm 30° 3mm 4.5mm 1mm 2.2mm 4.5mm L02015-028 Multi-unit abutment hybrid or fixed-detachable-screw-retained restoration module L02015-029 Multi-unit abutment bar overdenture - screw-retained restoration module L02015-031 Correcting a non-passive framework module

13 shop online at store.biohorizons.com Use for fabricating acrylic temporary and final prostheses. May be trimmed for height. Packaged with prosthetic screw (PXMUPSR). Titanium alloy. Use for fabricating metal-reinforced acrylic prostheses or bar overdentures. May be trimmed for height. Packaged with prosthetic screw (PXMUPSR). Acetal resin (Delrin® or Pomalux®) PXMUTC Use for fabricating metal-reinforced acrylic prostheses or bar overdentures, cemented using the passive-fit technique. May be trimmed for height. Packaged with regular and long prosthetic screws (PXMUPSR, PXMUPSL). Coping has a titanium alloy base with acetal resin (Delrin® or Pomalux®) sleeve. PXMUPC PXMUGC Use for fabricating metal-reinforced acrylic prostheses or bar overdentures. May be trimmed for height. Packaged with prosthetic screw (PXMUPSR). Coping has a gold alloy base with acetal resin (Delrin® or Pomalux®) sleeve. PXMUPFC 12mm 4.5mm to top of screw 12mm 4.5mm to top of screw 12mm 4.5mm to top of screw 12mm 4.5mm to top of screw Titanium Plastic Custom Castable Gold Custom Castable Passive Fit Laser-Lok Straight Multi-unit abutments may be used for multiple-unit restorations including: screw-retained restorations at the abutment level, cast alloy bars for overdentures and fixed/detachable (hybrid) restorations. When a Laser-Lok component is used and temporarily removed, keep the removed Laser-Lok component in sterile saline until reinserting into the site. Comes with a cover cap (PXMUCC). Final torque: 30 Ncm using a Multi-unit Hex Adapter. Titanium alloy. 3mm 2.2mm 2mm collar 3mm collar 3.0mm platform TP3MU2L TP3MU3L 3.5mm platform PYMU2L PYMU3L 4.5mm platform PGMU2L PGMU3L 4.5mm 2mm 2.2mm 4.5mm L02015-003 Handling of Laser-Lok abutments module MULTI-UNIT COMPONENTS

14 shop online at store.biohorizons.com MULTI-UNIT COMPONENTS Locator attachments for Multi-unit abutments have been designed as a free-standing option (LMUTC) for the angled Multi-unit posterior sites and for castable bar-splinted applications (LMUDC). The Locator Multi-unit Bar Processing Package includes Denture Cap with Yellow Bar Processing Male, Dual Retentive Replacement Males: Clear, Pink, Blue, and Block-Out Spacer. Offered in 2 packs and 10 packs. For complete instructions, visit the Zest Anchors website. Locator Multi-unit Abutment w/ Ti Collar (2 pack) Locator Multi-unit Abutment w/ Ti Collar (10 pack) Locator Multi-unit Abutment w/ Delrin® Collar (2 pack) Locator Multi-unit Abutment w/ Delrin® Collar (10 pack) Locator Multi-unit Bar Processing Package (2 pack) Locator Multi-unit Bar Processing Package (10 pack) LMUTC-2 LMUTC-10 LMUDC-2 LMUDC-10 LMUBPP-2 LMUBPP-10 Use Male Processing Package for these collars (LMPP-2 or LMPP-10). Use Locator Multi-unit Bar Processing Package listed below for these collars. 3mm 4.3mm Abutment w/ Ti Collar Abutment w/ Delrin ® Collar Use to make a direct pick-up impression (open-tray) at the abutment level. Packaged with a prosthetic screw, long. Titanium alloy. Hand tighten. Use to make an indirect transfer (closed-tray) impression at the abutment level. Titanium alloy. Hand tighten. Direct Pick-up Coping, Multi-unit Indirect Transfer Coping, Multi-unit PXMUDPC PXMUIC 16mm 9mm Direct Pick-up 8mm Indirect Transfer L02015-010 Multi-unit abutment impression technique - direct open tray module L02015-011 Multi-unit abutment impression technique - closed tray module L02015-030 Verification jig fabrication module

15 shop online at store.biohorizons.com Use at lab to represent the Multi-unit/Implant assembly in the working cast. Not for use with implant-level impressions. Titanium alloy. Use to protect abutment-coping interface when polishing the metal framework. Titanium alloy. Abutment Replica, Multi-unit Protection Analog, Multi-unit (pack of 5) PXMUAR PXMUPA Packaged with all Multi-unit abutments. Hand-tighten with .050” (1.25mm) Hex Driver or Unigrip™ screw driver. Titanium alloy. Cover Cap, Multi-unit PXMUCC MULTI-UNIT COMPONENTS 24mm For angled Multi-unit abutments only. Final torque: 30 Ncm with .050” (1.25mm) Hex Driver or Unigrip™ screw driver. Titanium alloy. Included with abutment but can also be ordered separately. Abutment Screw, Multi-unit Abutment Screw, Multi-unit (pack of 25) PXMUAS PXMUAS25 Use to deliver angled Multi-unit abutments to the surgical site. Titanium alloy. Angled Multi-unit Abutment Carrier (pack of 3) MUCA For attaching copings to the Multi-unit abutments. Hand-tighten or torque to 15 Ncm with .050” (1.25mm) Hex Driver or Unigrip™ screw driver, depending on application. Titanium alloy. Included with copings where indicated but can also be ordered separately. 15mm Prosthetic Screw, Multi-unit, Regular (pack of 5) Prosthetic Screw, Multi-unit, Regular (pack of 25) Prosthetic Screw, Multi-unit, Long (pack of 5) Prosthetic Screw, Multi-unit, Short (pack of 5) PXMUPSR PXMUPSR25 PXMUPSL PXMUPSS 2.5mm 1.5mm PXMUPSR PXMUPSL PXMUPSS

16 shop online at store.biohorizons.com MULTI-UNIT COMPONENTS Use parallel pins to assess implant angulation and estimate which angled abutment is appropriate for the restoration. 144-100 144-200 144-230 Straight Parallel Pins 20º Angled Parallel Pin 30º Angled Parallel Pin 5mm 4mm 3mm 2mm 1mm Straight abutment Laser marking 17°Angled Abutment Laser marking 30°Angled Abutment Laser marking 4mm 3mm 2.25mm 5mm 4mm 3mm Each Try-in is laser marked from 1mm to 5mm to correspond with the Straight Multi-unit Abutment collar heights and can also be used as a measuring tool for OD Secure, Locator, Locator R-Tx and Ball abutment systems. Try-in is carried to the site by the handle and snaps into the implant. Each Try-in is laser marked to correspond with the Angled Multi-unit Abutment collar heights. Try-in is carried to the site by the handle and snaps into the implant. 3.0mm Multi-unit Try-in Straight Abutment 3.5mm Multi-unit Try-in Straight Abutment 4.5mm Multi-unit Try-in Straight Abutment 5.7mm Multi-unit Try-in Straight Abutment 3.0mm Multi-unit Try-in 17° Angled Abutment 3.5mm Multi-unit Try-in 17° Angled Abutment 4.5mm Multi-unit Try-in 17° Angled Abutment 5.7mm Multi-unit Try-In 17° Angled Abutment 3.0mm Multi-unit Try-in 30° Angled Abutment 3.5mm Multi-unit Try-in 30° Angled Abutment 4.5mm Multi-unit Try-in 30° Angled Abutment 5.7mm Multi-unit Try-In 30° Angled Abutment TRYTP3MU TRYPYMU TRYPGMU TRYPBMU TRYTP3MU17 TRYPYMU17 TRYPGMU17 TRYPBMU17 TRYTP3MU30 TRYPYMU30 TRYPGMU30 TRYPBMU30 Multi-unit Try-in Abutments may be used to measure tissue thickness and verify proper prosthetic seating prior to final abutment seating. Manual Handpiece 4mm Square Manual Multi-unit Hex Adapter Use to hand tighten straight Multi-unit abutments. Use to torque straight Multi-unit abutments. Driven by latch-type handpiece. Do not exceed 30 Ncm. Use to torque straight Multi-unit abutments. Driven by 4mm square drive handwrench, ratchet, or torque wrench. Do not exceed 30 Ncm. PXMUHAM PXMUHAH Handpiece Multi-unit Hex Adapter 4mm Square Multi-unit Hex Adapter PXMUHAR

17 shop online at store.biohorizons.com PROSTHETIC INSTRUMENTATION 300-100* Provides improved vision and easy access to prosthetic components in posterior regions of the mouth. Hand Wrench and Drivers are sold separately. AS123 Hand Unit Use on drive end of AS123 Hand Unit. Also fits individual Hex Drivers/Adapters and Bone Taps. 300-400* Replaced 300-205 starting in June 2010. Includes PEEK C-ring for durable retention in Ratchet. Cannot be used with bone taps. 300-206* 4mm Square Drive Extender Hand Wrench Enhanced Prosthetic Instrumentation Kit Includes: • .050 (1.25mm) Manual Hex Driver • .050 (1.25mm) Manual Hex Driver, Long • .050 (1.25mm) Handpiece Hex Driver • .050 (1.25mm) Handpiece Hex Driver, Long • .050 (1.25mm) 4mm Square Hex Driver • .050 (1.25mm) 4mm Square Hex Driver, Long • Hand Wrench • 4mm Square Drive Extender • 4mm Square Multi-unit Hex Adapter • 12 Try-in Abutment Slots • 8 Optional Instrument Slots • Space for Torque Wrenches & AS123 Hand Unit PROS3000 PROS2500 Prosthetic Instrumentation Tray (not shown) Tray without instruments (included with PROS3000) EL-C12374 Elos Adjustable Torque Wrench Lightweight titanium design is easy to use as an adjustable torque wrench or a ratchet. Quickly disassembles for cleaning. No calibration required. ATW ITL Precise Adjustable Torque Wrench Place both implants and abutments with 9 distinct torque settings (15, 20, 25, 30, 35, 40, 45, 50 and 60 Ncm). A simple twist of the handle locks in precision-engineered torque values and guarantees accuracy and repeatability. AGYR-15500 Torque Control 15500 * Instrument o-rings & c-rings wear out over time. If an instrument is no longer held securely by its associated driver, order a replacement ring through Customer Care. EL-C8521 Elos Replacement Bit, 4mm Square Adapter EL-C8381 Elos Replacement Bit, Handpiece Multi-unit Try-in Abutments, 300-100 and ATW are sold separately. Ergonomic design is the ideal solution for access to screws placed in the posterior. The 7 predetermined torque values (10, 15, 20, 25, 30, 32 and 35 Ncm) make it a tool of extreme precision. Adjustable torque wrench designed to attach to all 4mm drivers from BioHorizons. Supplied with a dual direction mechanism that allows for insertion and removal functions. When the desired torque is reached (a choice of 10Ncm to 30Ncm) the torque wrench snaps to avoid over torquing. BIOTORQ BioHorizons Adjustable Torque Wrench

18 shop online at store.biohorizons.com TP3AH PYGAH PBAH 3.0mm platform Analog Handle 3.5/4.5mm platform Analog Handle 5.7mm platform Analog Handle Use to comfortably hold abutments for chairside or laboratory preparation. Abutments are secured to the handle with a standard abutment screw (PXAS). Comes in three sizes: 3.0, 3.5/4.5 and 5.7mm. PROSTHETIC INSTRUMENTATION * For installation and removal of cover caps, prosthetic and abutment screws. 135-251 135-351 135-451 134-350 134-450 300-350* 300-351* 300-354* Manual Hex Driver, Short Manual Hex Driver Manual Hex Driver, Long Handpiece Hex Driver Handpiece Hex Driver, Long 4mm Square Hex Driver 4mm Square Hex Driver, Long 4mm Square Hex Driver, Extra Long 11.5mm 6.5mm 13.5mm 8.5mm 6.25mm 12.5mm 4mm Square Manual Handpiece 19mm 6.5mm 9061381 9061383 9061382 Comfortview Lip and Cheek Retractor, Universal Comfortview Lip and Cheek Retractor, Small Comfortview Refill Cushions, Pink (10/pack) Achieve optimal buccal and gingival access. Anatomic design maximizes visibility and cushioned lip-supports provide greater patient comfort. Ideal for implant or full-arch procedures. Also suitable for use in diagnostic and preventive dental applications, digital impression scanning and intra-oral photography. TBD Retractor Vestibulum - Cheek Retractor Use for effect cheek retraction in maxillary and mandibular full-arch implant procedures.

19 shop online at store.biohorizons.com Custom Full-Arch Titanium Bars for BioHorizons Implant Systems • Authentic connection for precision fit • Titanium alloy (Ti6Al4V) milled framework for superior strength • Quick turn-around times • FDA clearance WWW . V U L C A ND E N T A L . C OM • 8 4 4 . 4 8 4 . 2 3 0 1 Vulcan Custom Dental is an advanced custom bar milling center offering the following benefits: TeethXpress Patient Education Model TeethXpress Patient Education Brochure TeethXpress Patient Education Magazine Solutions to Replace Missing Teeth - Patient Education Chart (pack of 25) EP-TXMOD ML0310 ML0315 ML0329 SUPPORT MATERIAL Millions of people are missing one or more teeth and have removable dentures or bridgework. Many people struggle with loose teeth. If you have this problem, you already know the embarrassment of eating and smiling in public. TeethXpress can restore the ability to eat your favorite foods and to smile again! restore your confidence eliminate loose dentures TeethXpress benefits Too many people who have conventional dentures don’t like to wear them because they don’t stay in place. TeethXpress offers a way to keep your teeth secure and allows you to go about your daily life with confidence. Teeth supported by implants have been successful for millions of people. The number of patients is growing rapidly due to their effectiveness, long-term durability and the high success rate of dental implants. TeethXpress® • Eat the foods you love while enjoying a better diet and improved overall health • No more embarrassment and difficulty speaking because of failing bridgework or slipping dentures • Increased comfort with reduced gum tissue irritation • No more costly and inconvenient denture adhesives • TeethXpress is minimally invasive and can generally be completed in one day 1. Please see Implant Clinical Overview (BioHorizons document ML0130) © BioHorizons. All Rights Reserved. ML0310 REV D JAN 2019 beautiful, secure teeth in as little as one day our office proudly uses Carly, age 39 actual TeethXpress® patient don’t settle for loose or partial dentures

20 shop online at store.biohorizons.com NOTES

21 shop online at store.biohorizons.com ORDERING & WARRANTY INFORMATION Territory Manager: cell phone: email and/or fax: BioHorizons Lifetime Warranty on Implants and Prosthetics: All BioHorizons implants and prosthetic components include a Lifetime Warranty. BioHorizons implant or prosthetic components will be replaced if removal of that product is due to failure (excluding normal wear to overdenture attachments). Additional Warranties: BioHorizons warranties surgical drills, taps and other surgical and restorative instruments. (1) Surgical Drills and Taps: Surgical drills and taps include a warranty period of ninety (90) days from the date of initial invoice. Surgical instruments should be replaced when they become worn, dull, corroded or in any way compromised. Surgical drills should be replaced after 12 to 20 osteotomies.1 (2) Instruments: The BioHorizons manufactured instrument warranty extends for a period of one (1) year from the date of initial invoice. Instruments include drivers, implant site dilators and BioHorizons tools used in the placement or restoration of BioHorizons implants. Return Policy: Product returns require a Return Authorization Form, which may be acquired by contacting Customer Care. The completed Return Authorization Form must be included with the returned product. For more information, please see the reverse side of the invoice that was shipped with the product. Disclaimer of Liability: BioHorizons products may only be used in conjunction with the associated original components and instruments according to the Instructions for Use (IFU). Use of any non-BioHorizons products in conjunction with BioHorizons products will void any warranty or any other obligation, expressed or implied. Treatment planning and clinical application of BioHorizons products are the responsibility of each individual clinician. BioHorizons strongly recommends completion of postgraduate dental implant education and adherence to the IFU that accompany each product. 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. Distributed Products: For information on the manufacturer’s warranty of distributed products, please refer to their product packaging. Distributed products are subject to price change without notice. Validity: Upon its release, this literature supersedes all previously published versions. Availability: Not all products shown or described in this literature are available in all countries. BioHorizons continually strives to improve its products and therefore reserves the right to improve, modify, change specifications or discontinue products at any time. Any images depicted in this literature are not to scale, nor are all products depicted. Product descriptions have been modified for presentation purposes. For complete product descriptions and additional information, visit store.biohorizons.com. 1) Heat production by 3 implant drill systems after repeated drilling and sterilization. Chacon GE, Bower DL, Larsen PE, McGlumphy EA, Beck FM. J Oral Maxillofac Surg.

*L01021* *REV G OCT 2019* L01021 REV G OCT 2019 s h o p o n l i n e a t s t o r e . b i o h o r i z o n s . c o m Direct Offices Distributors For contact information in our 90 countries, visit biohorizons.com BioHorizons Spain +34 91 713 10 84 BioHorizons Canada 866-468-8338 BioHorizons UK +44 (0)1344 752560 BioHorizons USA 888-246-8338 or 205-967-7880 BioHorizons Chile +56 (2) 23619519 BioHorizons Italy 800-063-040 BioHorizons®, Laser-Lok®, MinerOss®, AutoTac®, Mem-Lok® and TeethXpress® are registered trademarks of BioHorizons. Unigrip™ is a trademark of Nobel Biocare AB. Zimmer® Dental ScrewVent® and Tapered ScrewVent® are registered trademarks of Zimmer, Inc. AlloDermTM and AlloDerm GBRTM are trademarks of LifeCell Corporation, an Allergan affiliate. Grafton® DBM is a registered trademark of Medtronic, Inc. Cytoplast® is a registered trademark of Osteogenics Biomedical, Inc. Puros Dermis is a registered trademark of Zimmer Biomet. Mucograft is a registered trademark of Ed. Geistlich Sogne Ag Fur Chemische Industrie. Symbios PerioDerm is a registered trademark of Dentsply Sirona. Hu-Friedy® is a registered trademark of Hu-Friedy Mfg. Co., LLC. Spiralock® is a registered trademark of Spiralock Corporation. Pomalux® is a registered trademark of Westlake Plastics Co. Locator® is a registered trademark of Zest Anchors, Inc. Delrin® is a registered trademark of E.I. du Pont de Nemours and Company. Bio-Gide® is a registered trademark of Edward Geistlich Sohne AG Fur Chemische Industrie. BioMend® is a registered trademark of Zimmer Biomet Dental. IntraSpin®, L-PRF® and Xpression® are trademarks of Intra-Lock® International Inc. Not all products shown or described in this literature are available in all countries. As applicable, BioHorizons products are cleared for sale in the European Union under the EU Medical Device Directive 93/42/EEC and the tissues and cells Directive 2004/23/EC. We are proud to be registered to ISO 13485:2016, the international quality management system standard for medical devices, which supports and maintains our product licences with Health Canada and in other markets around the globe. Original language is English. ©BioHorizons. All Rights Reserved. BioHorizons Mexico 800-953-0498

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