1
PROSTHETIC GUIDE
Your time to win
Updated on March 2013
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P R O S T H E T I C
G U I D E
O S S F I T
Thanks
We would like to thank you for your confidence in choosing to work with the Ossfit® implant solution.
For your safety and comfort of use, our products have been created using the benefits of proven scientific knowledge and clinical
experience.
Thanks to many years of collaboration with a committee of foremost dental implantologists and our own R&D team, the Ossfit ®
implant range is both simple to use and high-performance from an aesthetical and biomechanical point of view.
This instruction manual contains most of the information necessary to place implants. Some key points to a global therapeutic
dental implant approach are here presented as a reminder. But the most important part of this manual deals with the presentation of
the Ossfit® system and its associated surgical protocol.
We invite you to carefully read this document before placing any implants.
Your success will be ours.
Our network of business partners and our experts remain at your disposal to provide you with any further information needed.
The Anthogyr team
ANTHOGYR
2 237 Avenue André Lasquin - 74 700 Sallanches - FRANCE
Tel. : +33 (0)4 50 58 02 37
Fax : +33 (0)4 50 93 78 60
e-mail : sales@anthogyr.com
www.anthogyr.com
INTERNATIONAL NETWORK :
please contact our exclusive representatives for further informations.
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Contents
1. Generalities
A/ PACKAGInG AnD PICTOGRAMS
Packaging of prosthetic components
Pictograms and traceability labels
Storage
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7
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B/ ANCILLARY PARTS
Torq Control® dynamometrical wrench ref. 15500
Prosthetic dynamometrical wrench ref. IN CCD
Prosthesis kit
8
9
11
C/ THE OSSFIT® RAnGE
The Ossfit ® system offers 2 prosthetic connections
Internal Octagon (OI) connection
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14
D/ MAInTEnAnCE OF THE PROSTHESIS
Maintenance by the patient
Professional maintenance
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15
E/ PROSTHETIC KIT
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2. Prosthesis cemented on full abutments
A/ USAGE PROTOCOL FOR A NON-MODIFIED FULL ABUTMENT
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B/ USAGE PROTOCOL FOR MODIFIED FULL ABUTMENT
21
3. The prosthesis sealed onto the screw-retained abutments
A/ USE OF THE STRAIGHT SCREW-RETAINED ABUTMENT
24
B/ USE OF THE ANGULATED SCREW-RETAINED ABUTMENT
27
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P R O S T H E T I C
G U I D E
4. The screwed prosthesis
O S S F I T
31
5. Stabilisation of complete prosthesis
A/ MOVABLE BAR PROSTHESIS
35
B/ MOVABLE PROSTHESIS ON BALL ATTACHMENTS
39
Complications
Instructions for further treatment of Anthogyr dental implant solutions
Recommended reading
Training
42
Symbols used in this manual
Indications to thoroughly respect
E
Indications to facilitate your surgery
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Introduction to the prosthetic guide
This document provides all the necessary instructions for use an Ossfit® prosthetic solution.
Our components are conceived in order to allow the production of screw-retained or cemented fixed prosthetics, whether
for unitary or plural edentulism, as well as to stabilise total overdentures.
In order to obtain the full benefit of the components’ quality and features, they have to be used following precise guidelines from the overall treatment plan, clearly assessed by the clinician prior to the start of the project.
This present document should not be considered as a dental implant prosthetic training manual.
Clinicians are understood to be properly trained in managing such prosthetic projects.
This manual also assumes that the user manages all the laboratory techniques necessary to deal with conventional
prosthetic constructions.
Foreword
The choice of the kind of prosthetic construction to be conducted is the clinician’s own responsibility.
This choice will be made according to clinical and aesthetical considerations.
For any further information about contra-indications to dental implantology, please refer to the surgical guide.
For correct use of the Ossfit® system, all prosthetic reconstruction steps should be conducted using Anthogyr components and
instruments as described in the current manual.
In order to ensure total traceability, prosthetic component batch numbers should be kept in the patient medical file.
In order to avoid any risk of inhalation or swallowing of components by the patient, one should:
- Secure the manual instruments using suture wire or place a pad within the patient’s mouth, maintained in position by
tweezers during manipulation.
- Verify the correct positioning of the instruments in the hand-piece, wrench or any other instrument used for transport.
For a direct use in mouth, healing screws are supplied sterile.
Sterility of the component can only be guaranteed if the expiration date has not been reached.
Prosthetic components and instruments are supplied non sterile, thus they should be sterilised prior to use, following
appropriate procedures.
Handling and use of the product are to be conducted by a practitioner who maintains an aptitude for successful use of the product.
Under no conditions can Anthogyr be held responsible for any damage resulting from inappropriate handling or use of the product.
We take particular care when making our products. However, we reserve the right to bring evolutions or improvements to them
without prior notice. In case of visible faults when unpacking the products, users are kindly requested to inform Anthogyr or its
representative of the nature of the fault, the references and batch numbers of the incriminated parts. We guarantee thorough
manufacturing control for all the products we sell.
If the blister pack/ bag is damaged, do not use the product. Do not re-sterilize it. Please report to the distributor or to Anthogyr
the nature of the defect along with the parts and batch numbers of the pieces concerned.
The product has to be used before the use-by date mentioned on the tracking sticker.
Reproduction or further diffusion of the following instructions for use require prior written agreement from Anthogyr.
This manual cancels and replaces all previous versions. However, we reserve the right to bring evolutions or improvements to
them without prior notice. In the event of visible defects when unpacking the product, do not use it and report Anthogyr or to
the distributor the nature of the defect, the references and batch numbers of the defective parts.
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P R O S T H E T I C
G U I D E
O S S F I T
1. Generalities
A/ PACKAGING AND PICTOGRAMS
Packaging of prosthetic components
The prosthetic parts are delivered non-sterile in individual bags.
The cover screws and healing screws are delivered sterile. Refer to the Ossfit® surgical manual.
The components and other devices delivered sterile must be unpacked observing the different sterility areas (outside of the blister /
bag = non sterile, inside of the blister / bag = sterile, plastic stopper tube = sterile, implant = sterile).
Pictograms and traceability labels
Symbols used on the labels :
REF
Part number
LOT
Manufacturing batch
STERILE
R
Gamma ray sterilization
Sterilisation control sticker
(not appearing on the picture)
Non sterile
2
Do not re-use
Manufacturing date
Expiration date
CE number
See instruction for use
Can be sterilised in an autoclave at 135°C
Do not autoclave sterilise
The sterilisation control disc turns red during the Anthogyr sterilisation process.
It does not suffice to guarantee product sterility and must not be confused with the colour coding for the diameter of the implant.
Each component has a batch number. If the device has any obvious defect when the tube is opened, do not use it and report the nature
of the defect to the distributor or Anthogyr along with the part numbers and batch numbers of the pieces concerned.
Storage
The components of the Ossfit® system must be stored at a temperature between 15 and 35° C in a place with relative humidity of between
30 and 70%. Avoid any exposure to light. Protect packages against dust.
Do not store solvents and/or paints containing solvents or chemical substances in the same place.
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B/ ANCILLARY EQUIPMENT
Calibrated tightening of the prosthetic components can be achieved using either the prosthetic dynamometrical wrench ref. IN CCD or the
Torq Control® ref. 15500.
Secure screw tightening
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Torq Control manual dynamometrical wrench ref. 15500
Torque adjustment
10 to 35 N.cm
(10, 15, 20, 25, 30, 32 & 35 N.cm)
1
2
Screwing
Select the torque
3
The screw automatically stop when
the selected torque is reached
• Precise tightening thanks to the torque control and automatic declutching
(7 torque levels).
• Prevents screws from breaking or prosthetic parts from unscrewing.
• Easy access in mouth and easy to use thanks to the micro-head and its lightness.
• Hygiene and maintenance (see leaflet provided with the product).
Prosthetic purpose only (do not use it for implant tightening).
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P R O S T H E T I C
G U I D E
O S S F I T
Prosthetic dynamometrical wrench ref. IN CCD
SCOPE OF USE
The prosthetic dynamometrical wrench ref. IN CCD is used for dental requirements in the area of dental prostheses.
Any other form of use is forbidden and can cause danger. This instrument is fitted with a torque system that enables very precise tight
locking of prosthetic parts: 15 - 25 - 35 N.cm.
USING THE KEY
The key is supplied non-sterile. Before first using it, the key must be decontaminated and sterilized.
Before use, check that the key is not damaged or that no part is missing.
Connecting / Disconnecting the rotary instrument
It is preferable to wear protective gloves for all tool handing.
Check the condition of the rotary instruments used and handle them cautiously and carrefully.
Inserting and locking the rotary instrument
- Insert the rotary instrument and turn it slightly until hearing a clicking sound and until the ratchet enters the groove.
- Check that the rotary instrument is correctly held with a slight axial movement each time the tool is changed.
Removing the rotary instrument
- Remove the instrument by pulling it out.
Using the torque system
Once the rotary instrument is connected to the prosthetic part, operate the flexible rod so as to reach
the desired tightening torque.
If the flexible rod does not indicate «0» when you do not use the prosthetic dynanometrical wrench,
this means that it may be damaged. In this case, please return it to the Anthogyr After-Sales Dept.
HIGIENE AND MAINTENANCE
Re-sterilisation of re-used medical appliances has to be done by someone who has been trained and is protected, and the regulations in force have to be
adhered to. The re-sterilization protocol must be adapted to the infectious risk. The appliance has to be cleaned and sterilized after each use. For each
used product: please refer to the manufacturer’s instructions at the end of the manual. Respect in particular the concentrations, the exposure durations,
the solutions’ replacement and the product’s lifetime. Never mix the products. Please dispose of products as per their solutions.
Where appropriate, wear protective clothing.
Protective gloves must be worn to prevent any risk of infection and injury.
Cleaning
Use only detergent or disinfectant solutions with a neutral or slightly alkaline pH.
It is extremely unadvisable to use products which may fix proteins to the unit (alcohol, aldehydes ...).
Do not use sodium hypochlorite (bleach): there is a high risk of corrosion.
External cleaning
The prosthetic dynamometrical wrench can be cleaned by using a brush under tap water.
External disinfection using a spray or a wipe soaked with disinfectant products microbiologically controlled (pH between 2.5 and 9).
In any case, it is important to follow the reaction time of the disinfectant product used.
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Do not use disinfectant products containing alkaline and chlorine.
Sterilization
Before being sterilized the prosthetic dynamometrical wrench has to be
disassembled as mentioned below:
- Remove the head from the main body by exercising slight traction.
- Remove the parts «ratchet + spring» from the head.
Now that the wrench is disassembled, it can be sterilized.
We strongly advise to use class B autoclaves.
Any other sterilization method must not be used.
Read the autoclave manufacturer’s instructions. Respect the space between each bag
and do not overload the autoclave.
- Before being sterilized, the instruments must be pre-disinfected, cleaned, lubricated and tested.
- Remove the rotary instrument beofre sterilizing the wrench.
- Make sure that the device does not have any areas of corrosion or cracks, and check that
it is operating properly.
Make sure that the product is dry; if necessary, dry any residual water with medical quality pressurised air.
- Sterilization pouches must be adapted to the wrench and to the autoclave. Only one single wrench must be put in a pouch.
- In order to avoid any retention of water, place the pouch in the steriliser in such a way that any concave parts are face down.
- If the steriliser has several types of cycles, choose a cycle designed for medical devices
(a minimum of 135°C at 2.13 bars (275°F at 30.88 psi) for 18 minutes).
- After each sterilization cycle, check that there is no water remaining inside and outside of the packaging.
Make sure that the flow indicator has changed to the correct colour.
- Keep the devices in the sterillization pouches away from light, moisture and any kind of contamination.
Follow the manufacturer’s recommendations as seen on the packaging.
- The duration for which the device is kept after sterilization should not exceed 1 month.
Label the devices, specifying the expiration date.
After the expiration date, repeat the cleaning and sterilization procedure.
Reassembly of the prosthetic dynamometrical wrench after sterilization.
- Fit together the parts «ratchet + spring» aligning the laser markings.
The point of the ratchet must be visible through the hole where the tool is passing through.
If the ratchet is not fitted completely and properly, it will not be possible to
assemble the body (avoiding any malfunction of the key).
Properly position the lugs and insert the
head on the body. A clicking sound will
confirm that it is well inserted. If not,
check whether the ratchet is well inserted
in the head.
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P R O S T H E T I C
E
G U I D E
O S S F I T
Screw loosening is usually caused by an incorrect tightening torque and by occlusion problems.
Respect the recommended torque so that the fixing screw respects occlusal strengths.
Prosthetic kit
1- Cleaning the kit
The kit must be cleaned immediately after the surgery. If necessary, the kit can be entirely disassembled.
Each component can be cleaned by brushing meticulously under tap water, by using a spray or a wipe soaked with microbiologically
controlled detergents / disinfectants (pH between 2.5 and 9).
In any case, it is important to follow the reaction time of the disinfectant product used.
Do not use disinfectant products containing alkaline and chlorine.
Rinse the components in demineralised water. Dry carefully with sterile fluffless wipes combined possibly with medical quality
pressurised air. Make sure that cleaning has removed all visible soiling: if not, repeat the cleaning procedure. Before continuing to
prepare the kit, confirm that its components are entirely dry. Re-assemble the kit following the instructions below.
2- Heat disinfection of the kit
Do not disassemble the kit. Place it flat in the heat-disinfector with the cover shutters open.
The heat-disinfection cycle used is 10 minutes at 95°C (203°F).
Follow the heat-disinfector manufacturer’s instructions and particulary recommendations about the substances to use or not to use
with the instrument.
Observe the drying cycle (do not exceed 140°C (284°F) during the drying cycle).
Dry carefully with sterile fluffless wipes combined possibly with medical quality pressurised air.
Make sure that cleaning has removed all visible soiling: if not, repeat the cleaning procedure.
Before continuing to prepare the kit, confirm that its components are entirely dry.
3- Sterilization of the kit
Before the first and each subsequent use, the kits must be cleaned, disinfected/decontaminated and sterilised . The device can be
sterilised at 135°C at 2.13 bars (278°F at 30.88 psi), only by steam autoclave for a minimum of 20 minutes (sterilization time).
We strongly recommend the use of class B autoclaves. Any other sterilization method must not be used.
Read the autoclave manufacturer’s instructions. Respect the space between each bag and do not overload the autoclave.
- Before being sterilized, the instruments must be pre-disinfected, cleaned and tested.
- Make sure that the device does not have any areas of corrosion (stainless plates) or cracks, and check that it is operating properly.
Make sure that the product is dry; if necessary, dry any residual water with medical quality pressurised air.
- Sterilization pouches must be adapted to the key and to the autoclave.
- In order to avoid any retention of water, place the pouch in the steriliser in such a way that any concave parts are face down.
- If the steriliser has several types of cycle, choose a cycle designed for medical devices (minimum 135°C at 2.13 bars - 275°F at
30.88 psi - for 20 minutes).
- After each sterilization cycle, check that there is no water remaining inside and outside the packaging.
Make sure that the flow indicator has changed to the correct colour.
- Keep the devices in the sterilization pouches away from light, moisture and any kind of contamination.
Follow the manufacturer’s recommendations as seen on the packaging.
- The duration for which the device is kept after sterilization should not exceed 1 month.
Label the devices, specifying the expiration date. After the expiration date, repeat the cleaning and sterilization procedure.
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Disassembling / Assembling the kit
1
4- Opening the kit
3
2
* If difficulty is experienced opening the transparent
covers, ensure that the inserts are correctly
positioned and clipped.
5- Placing in «desk stand» position
Position the lug of the transparent rear cover in the hole of the main plate.
«Clik !!!»
Hole
for
pegs
6- Disassembling inserts
1) Unclip the 2 base pegs of the insert to be removed.
2) Remove the insert from the main plate.
3) Repeat the same for each insert.
1 2
1
2
3
4
1
1
4
1
3
4
3
2
2
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P R O S T H E T I C
G U I D E
7- Disassembling the transparent covers
1) Carefully take off the side of the main plate.
2) Remove the base peg of the transparent cover.
3) Repeat the same for the other side.
1
2
8- Disassembling the side covers
1) Disengage the cover from the main plate.
2) Repeat the same for the other side.
1
9- Disassembling the stainless steel side plates
1) Remove the stainless steel plate from the cover.
2) Repeat the same for the other side.
1
E
To assembly the kli, repeat stages 4 to 9 in reverse order.
O S S F I T
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C/ THE OSSFIT® RANGE
The Ossfit ® system offers 2 prosthetic connections :
Internal Octagon (OI) Dia. 4.8 mm and Internal Octagon (OI) Dia. 6.5 mm.
These two connections are offered independently of the type of Ossfit® implant: Standard or Esthétique implant.
OI
OI
Ø 6.5 mm
Ø 4.8 mm
Internal Octagon (OI) connection
The choice of prosthetic components must be linked to the prosthetic implant base.
Each diameter of prosthetic base is stated on all the prosthetic components in order to facilitate communication between the laboratory and the
practitioner during the restoration phases.
Ø 4.8 mm
Ø 3.5 mm
Ø 6.5 mm
Ø 4.2 mm
Ø 5.0 mm
*The 3.5 mm diameter is not recommended in the posterior sites.
Clinical evaluation of the patient and the choice of treatment solution are the sole responsability of the practitioner.
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P R O S T H E T I C
G U I D E
O S S F I T
D/ MAInTEnAnCE OF THE PROSTHESIS
The maintenance of an implant-supported prosthesis is the responsibility of both the patient and the practitioner.
Maintenance by the patient
Daily removal of dental plaque :
1/ The prosthetic area must be maintained using normal hygiene instruments (toothbrush, dental floss, interdental brushes).
2/ Use a low-abrasion toothpaste which does not contain acid fluorides.
3/ The additional use of an antiseptic for short periods may be recommended for difficult-to-reach areas and / or if there is
any sign of inflammation.
4/ Water sprayers used in conjunction with anti-plaque agents are recommended for patients with reduced manual dexterity.
Professional maintenance
For the first year, a visit is advisable every three months. After the first year, visits should occur every three to six months if there is periodontal disease or peri-implantation lesions. This period may vary depending on the patient’s state of health. Each visit will consist of :
1/ An assessment of the mucous tissues (inflammation, consistency, volume, contour).
2/ Plaque index and amount of tartar.
3/ Bleeding when probed.
4/ Prosthetic adaptation, detection of prosthetic mobility in a fixed prosthesis.
5/ Checking the occlusion.
6/ Radiographic examination (checking the peri-implantation bone level).
Ultrasound scalers and steel or titanium curettes are prohibited for the removal of tartar.
Use plastic curettes instead.
E/ PROSTHETIC KIT
Some, but not all of the instruments required for the tightening of Anthofit® prosthetic components are the same as those used for the Ossfit®
range.All the instruments required for prosthetic restoration are available as a unit or in prosthetic kit.
Prothèse - IN MOD PRH
Short prosthetic wrench
Long prosthetic
wrench
Dynamometrical
manual wrench
Prosthetic
mandrels
Conical abutments
mandrels
Conical abutment
wrench
Ball attachment
mandrels
Ball attachment
wrench
Dalbo wrench
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2. Prosthesis cemented on full abutments
Implant
+
Full abutment
«Coping» impression
Full titanium
taking
abutments
Instruction for use
> Full abutments are intended for the insertion of single or plural fixed prosthesis.
Full abutments may be used in either the maxillary or mandibular posterior or anterior sector.
> The usage protocol varies according to whether or not the abutment has undergone a modification.
> IMPORTANT: Monoblock abutment cannot be modified in the laboratory; they can be modified in the mouth using a
diamond bur at high speed and with copious irrigation.
> In the context of a multiple tooth restoration, the angular differences tolerated with full abutments are in the region of 12°
axis for a 2 implant bridge. In the event of significant angular divergence, it is possible to use the Ossfit® range of angulated
abutments, or to handle the multi-tooth restoration using a single unit prosthesis.
The use of a surgical guide during surgery is highly recommended in order to comply with these maximum divergences.
A/ USAGE PROTOCOL FOR A NON-MODIFIED FULL ABUTMENT
Manual tightening
Necessary material :
Short tightening wrench Long tightening wrench Short mandrel
Long mandrel
(ref. IN CHECV)
(ref. IN CHELV)
(ref. IN MHECV) (ref. IN MHELV)
Laboratory
analog
Impression
coping
Trial
abutment
Full
abutment
Peek
based caps
Castable
coping
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P R O S T H E T I C
G U I D E
O S S F I T
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Select the appropriate abutment for the implant base diameter: refer to the table below :
Ossfit® IMPLANT
Implant Ø 3.5 mm
Platform
Implant Ø 5.0 mm
Implant Ø 4.2 mm
Ø 4.8 mm
Ø 6.5 mm
OSPC001
OSPC005
Cover screw
Healing screw
OSPC002
OSPC003
OSPC004
OSPC006
OSPC007
OSPC008
Transfers
OSTR019
OSTR020
OSTR021
OSTR022
OSTR023
OSAN006
OSAN007
OSAN008
OSAN009
OSAN010
OSTI014
OSTI015
OSTI016
OSTI017
OSTI018
OSTI019
OSTI020
OSTI021
OSTI022
OSTI023
OSTI034
OSTI035
OSTI036
OSTI037
OSTI038
OSTI029
OSTI030
OSTI031
OSTI032
OSTI033
OSTI024
OSTI025
OSTI026
OSTI027
OSTI028
Analogs
Trial abutments
Titanium abutments
Temporary Peek
based caps
Anti- rotational
castable coping
Rotational castable
coping
Comment: impression transfers onto the full abutments must not be sterilised by autoclaving.
They must be decontaminated before use (follow the cleaning and disinfection instructions in the paragraph describing the instructions for
treating products belonging to the Anthogyr range at the end of this manual). Reuse in the mouth is strictly prohibited.
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For the practitioner :
Remove the healing screw with the screwdriver ref. IN CHECV or IN CHELV.
Then select the appropriate full abutment using the trial abutments. (Note*)
Position the full abutment selected in the mouth and pre-screw using the screwdriver ref. IN CHECV or IN CHELV.
Tighten the abutment permanently at 35 N.cm using the mandrel ref. IN MHECV or IN MHELV and the
Torq Control® ref. 15500.
Insert the impression transfer that matches the full abutment. (Note**)
Clik !
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P R O S T H E T I C
G U I D E
O S S F I T
Then take the impression using a closed-top impression tray in an elastomer material.
Once the material has hardened, remove the impression tray.
Protect the hexagonal driving connection of the abutment with wax, then, inside the patient’s
mouth, secure the appropriate protection cap ot the full abutment using temporary seating
cement, or alternatively insert the temporary prosthesis.
Select the analog abutment that matches the full abutment (note*) and reposition the analog in the
inner surface of the impression by apllying pressure.
Notes
(*) The impression caps, analogs, (protection caps and castable cylinders) corresponding
to each full abutment format are identifiable by a number code 1, 2, 3, 4 and 5 distributed
as follows: cf. enclosed diagram.
The code is visible on the part itself.
Make sure that components used together have the same code.
Clik !
Note specific ot the impresison cap: the impression cap code is not visible when the instrument is
inside the impression material: the practitioner needs to make a note of the respective codes of
the impression caps before taking the impression.
These codes should be passed on to the prosthetist to enable him to choose the corresponding
analog.
1
OSTI019
2
OSTI020
3
OSTI021
4
OSTI022
5
OSTI023
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In the laboratory :
Cast the master model. (Note***)
Select an anti-rotational cylinder for a single restoration and
a rotaional cylinder for a multiple restoration.
Add die-spacer on the coronal part of the analog so that
the cap may be inserted completely, without ability for
micromovements.
Rotational
cylinder with
plane
Anti-rotational
cylinder without
plane
Prepare the cylinder by adding modelling wax directly to the castable.
Cast the cylinder and make the crown according to current procedures.
For the practitioner:
Prosthesis trial and in-mouth cementing. (Note****)
Notes
(**) The impression caps are not radio-opaque: a visual check is necessary to ensure that caps are properly secured to the implant flange,
and, for the impression, to ensure that the impression materials are not covering the flange of the cap.
(***) It is advisable to use artificial gum for making the plaster model.
It is also important to prevent plaster from flowing into the undercuts of the plastic impression caps of the monoblock abutments.
(****) In the case of a sealed prosthesis, the insertion depth of the implant should allow access for the removal of excess cement.
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P R O S T H E T I C
G U I D E
B/ USAGE PROTOCOL FOR MODIFIED FULL ABUTMENT
O S S F I T
®
Manual tightening
Necessary material :
Short tightening
wrench
(ref. IN CHECV)
Long tightening
wrench
(ref. IN CHELV)
Short mandrel
(ref. IN MHECV)
Long mandrel
(ref. IN MHELV)
Trial
abutment
Full
abutment
Castable
coping
Select the appropriate abutment for the implant base diameter: refer to the table below :
Ossfit® IMPLANT
Implant Ø 3.5 mm
Platform
Implant Ø 4.2 mm
Implant Ø 5.0 mm
Ø 4.8 mm
Ø 6.5 mm
OSPC001
OSPC005
Cover screw
Healing screw
OSPC002
OSPC003
OSPC004
OSPC006
OSPC007
OSPC008
Trial abutments
OSTI015
OSTI016
OSTI017
OSTI018
OSTI019
OSTI020
OSTI021
OSTI022
OSTI023
OSTI029
OSTI030
OSTI031
OSTI032
OSTI024
OSTI025
OSTI014
Titanium abutments
Temporary Peek
based caps
Anti-rotational
castable coping
OSTI024
OSTI025
OSTI026
OSTI023
OSTI027
OSIT027
OSTI033
OSTI028
OSTI028
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Stages of restoration
For the practitioner :
Remove the healing screw with the screwrider ref. IN CHECV or IN CHELV.
Then select the appropriate full abutment using the trial abutments.
Position the full abutment selected in the mouth and pre-screw using the screwdriver ref. IN CHECV or
ref. IN CHELV.
Tighten the abutment permanently at 35 N.cm using the wrench ref. IN CHELV or IN CHECV and the
prosthetic dynamometrical wrench ref. IN CCD ; or using the mandrel ref. IN MHECV or IN MHELV and
the Torq Control® ref. 15500.
Carry out modifications to the abutment using a diamond bur at high speed and under copious irrigation.
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P R O S T H E T I C
G U I D E
O S S F I T
To allow the full abutments to be loosened if necessary, be careful
to avoid reworking the abutments at the hexagonal tightening
impression.
Then take a conventional impression (as with a natural tooth).
In the laboratory :
Cast the master model fully in plaster. Add spacer to the part of the abutment no covered with the
castable cap.
Select and insert the castable cap that matches the full abutment.
Adjust the castable cylinder according to the modifications performed on the abutment.
Prepare the cylinder by adding modelling wax directly to the castable.
Make the prosthesis in accordance with current procedures.
For the practitioner :
Trial of the prosthesis, then in-mouth cementing. (Note*)
Note
(*) In the case of a cemented prosthesis, take care to remove the excess cement.
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24
3. The prosthesis sealed onto the screw-retained abutments
Taking of impression
directly on implant
Implant
Screw-retained
titanium abutments
Instructions for use
> The screw-retained abutments are intended for unitary or plural sealed prostheses.
The screw-retained abutments can be used both in the posterior or anterior sector in both maxilla and mandible.
> The screw-retained abutments are fixed onto the implant using a Black Tite® screw. They may be modified alternatively in
the laboratory or directly in the mouth using a diamond bur at high speed with generous irrigation.
A/ USE OF THE STRAIGHT SCREW-RETAINED ABUTMENT
Manual tightening
Necessary material :
Short tightening
wrench
(ref. IN CHECV)
Long tightening
wrench
(ref. IN CHELV)
Short mandrel
(ref. IN MHECV)
Long mandrel
(ref. IN MHELV)
Analog
Transfer
Pop-in
Transfer
Pick-up
Straight abutment
25
P R O S T H E T I C
G U I D E
O S S F I T
Select the appropriate abutment for the implant base diameter: refer to the table below :
Ossfit® IMPLANT
Implant Ø 3.5 mm
Platform
Implant Ø 5.0 mm
Implant Ø 4.2 mm
Ø 4.8 mm
Ø 6.5 mm
OSPC001
OSPC005
Cover screw
Healing screw
OSPC002
OSPC003
OSPC004
OSPC006
OSPC007
OSPC008
Transfers
OSTR001
OSTR003
OSTR002
OSTR004
Analogs
OSAN001
OSAN002
OSTI041
OSTI042
Straight titanium
abutments
Restoration stages
In the practitioner’s room :
Remove the healing screw with screwdriver ref. IN CHECV or ref. IN CHELV.
®
26
Take an impression directly on the implant using Pick up technique (a) using
an open impression tray or Pop in technique (b) using a common impression
tray.
Transfers are screwed using screwdriver ref. IN CHECV.
Check correct fitting of the transfers onto the implant by radiography.
Replace the healing screw on the implant once impression is completed.
(Note*)
(a)
(b)
(a)
(b)
Reposition the implant analog in the impression intrados.
Clic !
In the laboratory :
Cast the model master and screw the abutment selected above using screwdriver ref. IN CHELV.
(Note**)
Comment 1: Use the fixing screw provided with the analog in the laboratory.
Keep the Black Tite® screw provided with the abutment for final screwing.
Comment 2: The abutment may also be chosen in the laboratory.
Carry out minor finishing (using the drill bit with generous irrigation).
Protect the screw access hole and create the prosthesis following the current protocol.
27
P R O S T H E T I C
G U I D E
O S S F I T
In the practitioner’s room:
Place the abutment in the mouth using the Black Tite® coated screw (provided with the
abutment) and screw at 35 N.cm using mandrel ref. IN MHELV and prosthetic dynamometrical
wrench ref. IN CCD or using Torq Control® ref. 15500.
(Note ***)
Seal the prosthesis after closing the screw access holes. (Note ****)
Notes
(*) To prevent assembly problems or pain from interposition of gum at the shoulder implant, it is
recommended that the healing screw is replaced rapidly after taking the impression.
(**) It is recommended that the model gum be used to fashion the plaster model.
It is essential also to avoid pouring the plaster on the counter-surfaces of the plastic cuffs of the
impression taking for the monoblock abutments.
(***) The angulated abutments are provided with their specific coated Black Tite® screw.
This screw is available as a unit, ref OSTI001.
The implant analogs are delivered with the non-coated Black Tite® screw.
(****) For a sealed prosthesis, the implant insertion depth must enable access to remove excess
cement.
B/ USE OF THE ANGULATED SCREW-RETAINED PROSTHESIS
Manual
tightening
The angulated abutment exist in A and B versions.
Two types of abutments, indexed
A and B available for each
angulation in order to propose 16
possibilities of indexation.
The angulation B is indexed on the
flat of the octagon. The angulation
A is indexed on the peak of the
octagon.
Use the trial abutments in mouth
or on cast models in order to
select the most appropriate one.
A
B
Indexation on the peak
Indexation on the flat
®
28
Trial abutments are available to select the appropriate angulation and indexation (cf. table on page 21 and page 28).
The angulated abutments make it possible to correct angles of 15° and 20°. In order to make full use of these abutments, you are strongly advised
to use a surgical guide including the most appropriate angulation for the prosthesis restoration.
Necessary material :
Short tightening
wrench
(ref. IN CHECV)
Long tightening
wrench
(ref. IN CHELV)
Short mandrel
(ref. IN MHECV)
Analog
Long mandrel
(ref. IN MHELV)
Transfer
Pop-in
Transfer
Pick-up
Trial
abutment
Angulated
abutment
Select the appropriate abutment for the implant base diameter: refer to the table below:
Ossfit® IMPLANT
Implant Ø 3.5 mm
Platform
Implant Ø 4.2 mm
Implant Ø 5.0 mm
Ø 4.8 mm
Ø 6.5 mm
OSPC001
OSPC005
Cover screw
Healing screw
OSPC002
OSPC003
OSPC006
OSPC004
OSPC007
OSPC008
Transfers
OSTR001
Trial abutments
A
OSTI002
Angulated titanium
abutments
A
OSTI008
OSTR003
B
OSTI003
B
OSTI009
A
OSTI004
A
OSTI010
OSTR002
B
OSTI005
B
OSTI011
A
OSTI002
A
OSTI012
OSTR004
B
OSTI003
B
OSTI013
29
P R O S T H E T I C
G U I D E
O S S F I T
Stages of restoration
For the practitioner:
Remove the healing screw with the screwdriver IN CHECV or IN CHELV.
Then select the appropriate full abutment using the trial abutments.
(a)
(b)
Take an impression directly on the implant using the Pick-up
technique (a) and using an open impression tray or the Pop-in
technique (b) using a common impression tray. The transfers
are tightened with a screwdriver ref. IN CHECV.
Take an X-ray to check that the transfers are properly secured.
Replace the healing screw on the implant once the impression
is made.
(Note *)
®
30
(a)
Reposition the implant analog in the inner surface of the impression.
(b)
Clic !
In the laboratory :
Cast the master model and screw the abutment selected above using a screwdriver ref. IN CHELV.
(Note **)
Comment 1 : In the laboratory, use the fixing screw delivered with the analog.
Keep the Black Tite® screw supplied with the angulated abutment for the final tightening.
Comment 2 : The choice of angulated abutment can also be made in the laboratory using trial abutments.
Then carry out any miror reworking required (using the bur, with copious irrigation).
Protect the screw access hole and make the prosthesis in accordance with current procedures.
For the practitioner :
Place the abutment in the mouth using the Black Tite® screw (delivered with the abutment) and tighten
to 35 N.cm using the mandrel ref. IN MHELV and prosthetic dynanometrical wrench ref. IN CCD or Torq
Control® ref. 15500.
(Note ***)
31
P R O S T H E T I C
G U I D E
O S S F I T
Reposition the implant analog in the inner surface of the impression.
(Note ****)
Notes
(*) To avoid problems with assembly or with pain linked to friction of the gum against the implant flange, it is advisable to replace the
healing screws quickly after taking the impression.
(**) It is advisable to use artificial gum for making the plaster model. It is also important to prevent plaster from flowing onto the
undercuts of th eplastic impression caps of the monoblock abutments.
(***) The angulated abutments are delivered with their specific coated Black Tite® screw.
This screw is available as a unit under ref. OSTI001. The implant analog are delivered with this non-coated Black Tite® screw.
(****) For a cemented prosthesis, the insertion depth of the implant should allow access for the removal of excess cement.
4. The screwed prosthesis
Implant
Direct impression taking on the implant or
on conical abutment
Conical abutment
Instruction for use
> The conical abutment is for use with a plural tightening prosthesis. This type of prosthesis can be easily dismantled if necessary.
Occlusal and aesthetic contraints must however be anticipated with regard to the location of the screw access hole.
Screwed prosthesis on conical abutment
Caution : The conical abutment does not have an anti-rotational system (the external hexagon is intended for tightening
the abutments in the implant). This solution is therefore reserved exclusively for the plural prosthesis.
®
32
Necessary material :
Manual tightening
Conical abutment
Tightening wrench
(ref. IN CHIP)
Impression
transfer
Laboratory
analog
Short tightening
wrench
(ref. IN CHECV)
Long tightening
wrench
(ref. IN CHELV)
Castable
abutment
Short mandrel
(ref. IN MHECV)
Protection
cap
Long mandrel
(ref. IN MHELV)
Mandrel
(ref. IN MHICV)
Mandrel
(ref. IN MHILV)
Select the appropriate abutment for the implant base diameter: refer to the table below :
Ossfit® IMPLANT
Implant Ø 3.5 mm
Platform
Implant Ø 4.2 mm
Implant Ø 5.0 mm
Ø 4.8 mm
Ø 6.5 mm
Cover screw
OSPC001
OSPC005
Healing screw
OSPC002
OSPC003
OSPC004
OSPC006
OSPC007
Transfers
OSTR006
OSTR007
OSAN003
OSAN004
OSCO001
OSCO002
OSCO005
OSCO006
OSCO003
OSCO004
Analogs
Conical abutments
Protecting caps
Castable caps
OSPC008
33
P R O S T H E T I C
G U I D E
O S S F I T
Stages of restoration
For the practitioner :
Remove the healing screw with the screwdriver ref. IN CHECV or IN CHELV.
Manually tighten the conical abutment in mouth using the wrench ref. IN CHIP.
Then tighten to 35 N.cm using the mandrel IN MHICP or IN MHILP mandrel and the Torq Control® ref.
15500.
Take an impression using the Pick-up technique with an open impression tray.
The transfer is screwed using the wrench ref. IN CHECV. X-ray to verify that transfers are properly
secured on the implant. When the impression is complete, place the protection cap on the abutment
using the same wrench. (Note *)
®
34
Reposition the abutment analog in the inner surface of the impression.
In laboratory :
Cast the model. Select the castable cylinder that matches the conical abutment.
Then screw the castable cylinder onto the model using the laboratory screw or the screw supplied with the
analog.
or
Assemble the wax frame.
Cast the frame and make the prosthesis in accordance with current procedures.
For the practitioner :
Screw the prosthesis in the mouth using the screwdriver ref. IN CHELV.
Tighten the prosthesis to 15 N.cm using the mandrel ref. IN MHELV or IN MHECV
and the prosthetic dynamometrical wrench ref. IN CCD or Torq Control® ref.
15500.
Notes
(*) To avoid problems with assembly or with pain linked to friction of the gum against the implant flange, it is
advisable to replace the transfers as quickly as possible after exposing the implant.
35
P R O S T H E T I C
G U I D E
O S S F I T
5. Stabilisation of complete prosthesis
Complete
prosthesis
Taking an impression
on conical abutment
Impression taking
on ball attachment
Bar on conical
abutment
Ball attachment
Instruction for use
> The bar prosthesis is for stabilisation of the complete maxillary or mandibular prosthesis.
> With this treatment, the prosthesis support is essentially the mucous membrane.
The degree of resillience of the prosthesis depends on the number of staples and how they are distributed on the arch.
> The prosthesis on a attachment is basically intended to stabilise full mandibular prostheses.
> In this therapeutic option, the prosthesis support is mucous membrane and the stability of the prosthesis is ensured by
the ridges. The ball attachment prosthesis should be designed should be designed for resilience.
Manual tightening
A/ MOVABLE BAR PROSTHESIS
Conical abutment
Tightening wrench
(ref. IN CHIP)
Impression
transfer
Short tightening wrench
(ref. IN CHECV)
Laboratory
analog
Long tightening wrench
(ref. IN CHELV)
Castable
abutment
Short mandrel
(ref. IN MHECV)
Protection
cap
Long mandrel
(ref. IN MHELV)
®
36
Select the appropriate abutment for the implant base diameter: refer to the table below :
Ossfit® IMPLANT
Implant Ø 3.5 mm
Platform
Implant Ø 4.2 mm
Implant Ø 5.0 mm
Ø 4.8 mm
Ø 6.5 mm
Cover screw
OSPC001
OSPC005
Healing screw
OSPC002
OSPC003
OSPC004
OSPC006
OSPC007
Transfers
OSTR006
OSTR007
OSAN003
OSAN004
OSCO001
OSCO002
OSCO005
OSCO006
OSCO003
OSCO004
Analogs
Conical abutments
Protecting caps
Castable caps
Stages of restoration
For the practitioner :
Remove the healing screw with the screwdriver ref. IN CHECV or IN CHELV.
Manually tighten the conical abutment in mouth using the wrench ref. IN CHIP.
OSPC008
37
P R O S T H E T I C
G U I D E
O S S F I T
Tighten to 35 N.cm using the mandrel ref. IN MHICP or IN MHILP and the prosthetic dynamometrical
wrench ref. IN CCD or Torq Control® ref. 15500.
With an open impression tray, proceed to impression taking using the pick-up technique.
The transfer is screwed using the wrench ref. IN CHECV.
X-ray to verify that transfers are properly secured on the implant. When the impression is complete,
place the protection cap on the abutment by means of the same wrench.
Reposition the abutment analog in the inner surface of the impression.
or
In laboratory :
Cast the master model.
Then screw the castable cylinder onto the model using the laboratory screw or the screw supplied
with the analog.
®
38
Prepare the castable bar using the cut castable bar, attached to the cylinder with castable wax.
Cast the bar.
For the practitioner :
Test and validate with the bar in the mouth. Select and, if necessary, correct the bar using DURALAY resin, in
such a way that the former is completely passive.
Then take another impression with the bar in place (Pick-up technique) and the long screws supplied initially
with the transfers.
In the laboratory :
If necessary, make corrections to the soldered bar.
Make the prosthesis according to the conventional protocol.
Insert retaining staples according to the manufacturer’s instructions.
For the practitioner :
Tighten the bar in mouth with the Black Tite® M1.4 screws and the screwdriver ref. IN CHECV or IN CHELV.
Apply 15 N.cm with the mandrel IN MHECV or IN MHELV and the prosthetic dynamometrical wrench ref. IN CCD
or with Torq Control® ref. 15500.
Insertion of the prosthesis in mouth.
39
P R O S T H E T I C
G U I D E
B/ MOVABLE PROSTHESIS ON BALL ATTACHMENTS
O S S F I T
Manual tightening
Necessary material :
Mandrels
Short tightening wrench Long tightening wrench Tightening screw
(ref. IN CHECV)
(ref. IN CHELV)
(ref. IN COIO) (ref. IN MOICO & IN MOILO )
Ball attachment
Mandrel
(ref. IN DLB001)
Select the appropriate abutment for the implant base diameter: refer to the table below :
Ossfit® IMPLANT
Implant Ø 3.5 mm
Platform
Implant Ø 4.2 mm
Ø 4.8 mm
Cover screw
OSPC001
Healing screw
OSPC002
OSPC003
Analogs
OSAN003
Ball attachement
OSDA001
DALBO System
OSCO005
OSPC004
Dalbo system
®
40
Stages of restoration
For the practitioner :
Remove the healing screw with the screwdriver ref. IN CHECV or IN CHELV.
Insertion of the ball attachment using the wrench ref. IN COIO.
Final tightening to 35 N.cm using the mandrel ref. IN MOILO or ref. IN MOICO and the Torq Control®
ref. 15500.
41
P R O S T H E T I C
G U I D E
O S S F I T
Take the impression using an Elastomer material.
To do this, it is possible to use the transfer (red cap) delivered with the Dalbo system.
Remove the impression tray and replace the ball attachment analog in the inner surface of the
impression or in the red cap.
In laboratory :
Cast the master model.
Make the prosthesis according to current protocols and the Dalbo pack instructions (available on
the Cendres et métaux company website) (www.cmsa.ch).
For the practitioner :
Insertion of the prosthesis in mouth.
®
42
Complications
Complications
Bleeding while drilling
Raisons possibles
- Lesion of an arteriolar
Solutions
- Rapidly place the implant in order to stop the
bleeding
Insufficient primary stability of the implant
Exposure of threads at end of surgery
- Low bone density
- Plan for the placing of an implant of bigger
- Maladapted crestal flattening
diameter
- Excessive tapping
- Postpone the implant placement
- Crest too thin
- If dehiscence of a few mm: cover the threads
- Maladapted positioning of the implant on the
with bone fragments collected during drilling
vestibular-lingual side
- If more important dehiscence: withdrawal
of implant followed by graft or Guided Bone
Regeneration
Persistent post surgery pains
- Osteitis due to over-aggressive bone prepa-
- Remove the implant
ration or bacterial contamination
Lack of sensitivity on an adjacent tooth
- Apex touched
- Radio control and endodontic treatment of
the tooth
Lack of or difficult labial or foramen sensibility
- Alteration or crushing of the dental nerve
- Radio control
- Coronal repositioning or immediate withdrawal of the implant
- Immediate withdrawal of the implant if the
nerve is touched
Operculisation after a few weeks
- Implant insufficiently buried
- Leave the screw as it is
- Maladapted flap closing
- Prescribe very thorough hygienic measures
- Gingiva too thin
to the patient
- Compression of the temporary prosthesis
- Prosthetic rebasing
Infectious complication
- Defective asepsis
- Radio control to assess the absence of bone
Excessive bone loss or regular presence of
- Infection
- Withdrawal of the implant
- Sub-lingual artery section
- Emergency treatment at the hospital
- Lack of safety measures
- Radio control until expulsion
Accidental inhalation of an instrument by the
patient
- Lack of safety measures
- Emergency treatment at the hospital
Painful and mobile implant a few months post
surgery
- Unsatisfactory osteo-integration
- Withdrawal of the implant
Slightly sensitive yet perfectly immobile
implant during the second surgical phase
- Imperfect osteo-integration
- Withdrawal of the implant
Difficult tightening of a component
- Thread component damaged
- Change the component
- Internal boring of the implant with the
alteration kit
lesion coupled with an antibiotic treatment
fistula
Soaring of the lingual floor in the hours after
surgery
Accidental swallowing of an instrument by the
patient
- Implant’s internal thread damaged
43
P R O S T H E T I C
G U I D E
O S S F I T
Instructions for care of the Anthogyr implant product range
The protocol for treatment of instruments of the ANTHOGYR re-sterilisable implant range contains three main stages: pre-disinfection,
cleaning-disinfection and sterilisation.
The parts needing to be re-sterilised before each intervention should go through the complete protocol of pre-disinfection, cleaning-disinfection and sterilisation after each use.
The parts supplied non-sterile and to be used in a sterile state should undergo the two stages of cleaning-disinfection and sterilisation
before the first intervention.
GENERAL INFORMATION
SETTING UP THE PROTOCOL
The protocol for sterilisation of reusable medical instruments should be undertaken by properly trained and protected personnel, respecting
regulations in force.
Wear proper protective clothing. To avoid all risk of infection and injury, it is imperative to wear protective gloves.
To set up the protocol, respect all valid regulations in vigour (for example look at the recommendations in «Good Practice in Hospital
Pharmacy», «Good Disinfection Practice Guide», «Good Sterilisation Practices Guide» and the «Guide to mastering treatments of
reusable medical equipment» reference FD S98-135 of April 2005).
The re-sterilisation protocol should be adapted to the risk of infection.
The user should ensure that the treatment protocol under way attains its sterility objective. The protocol must limit chemical residues
remaining on the treated material (take care in particular to properly rinse the products used).
COMPATIBILITY OF MATERIALS
Only use cleaning and decontamination products that are compatible with the different combinations of material treated.
Only use detergent-disinfectant solutions with a neutral pH or that are slightly alkaline. Beware! For aluminium alloys, the use of soda is
prohibited. The use of sodium hypochlorite (bleach) is proscribed for stainless steel elements: high risk of corrosion.
Below is a list of the materials composing the different elements of the implant range concerned by this treatment and re-sterilisation.
®
44
materials
references
descriptions
titanium
alloys
stainless
steel
NiTi
Peek
IN JPA
paralleling pin
IN GPPA
drill guide
IN MRMI
mandrel extension
IN COERI
short octagonal wrench
IN COECI
standard octagonal wrench
X
X
X
X
IN COELI
long octagonal wrench
X
X
X
X
IN CHECV
short hexagonal wrench
X
X
IN CHELV
long hexagonal wrench
X
X
IN MOERI
short octagonal mandrel
X
X
X
X
X
X
IN MOECI
standard octagonal mandrel
IN MOELI
long octagonal mandrel
IN MHECV
short hexagonal mandrel
IN MHELV
long hexagonal mandrel
IN EXM
mandrel extension
IN CC
ratchet wrench
IN CCD
dynamometrical ratchet wrench
IN COIT
manual tap wrench
IN FB20
round bur
IN FH20080 to 20150
pilot drill
IN JPFG
graduateed depth gauge
IN FC35080 to 50130
conical drills
IN TC35 to 50
taps
IN FA30120 to 45150
twist drills
IN TA 35150 to 50130
taps
INFEOI / INFEHE
countersinks
INCOIO
wrench for ball attachment
IN MOICO
short mandrel for ball attachment
IN MOILO
long mandrel for ball attachment
IN CHIP
wrench for conical abutment
IN MHICP
short mandrel for conical abutment
IN MHILP
long mandrel for conical abutment
IN OITI003 to 008 (resp. HETI001 to 007)
fitting abutments
IN OITR001 to 005 (resp. HETR001 to 003)
Pick-up transfers
IN OITR006 to 010 (resp. HETR004 to 006)
Pop-in transfers
IN OITR018 and 019 (resp. HETR007)
Conical abutment’s transfers
X
X
PTFE
aluminium
alloys
45
P R O S T H E T I C
G U I D E
O S S F I T
CHOICE AND USES OF PRODUCTS
Detergent-disinfectant products
Depending on the risk of infection and to guarantee sufficient decontamination before sterilisation, choose products adapted to
the activity domain: normed antimicrobial activity (bactericide, fungicide, virucicide ...) and apt for cleaning. For example, the
user can refer to the guide FD S98-135 and the list of recommended dental disinfectant products 2005-2006 published by the
SFHH and ADF.
Use detergent-disinfectant solutions adapted to the cleaning technique used.
Watch out for the compatibility of the products with the instruments’ materials.
Do not use substances that may fix proteins (alcohol, aldehydes). For each cleaning and disinfecting product used, refer to the
manufacturer’s instructions. In particular: respect the concentrations, temperatures and exposition durations, renewal of solutions
and usable life of the products. Never mix the products. Respect the instructions for elimination of the products used.
Water
To choose the water quality used for pre-disinfection, cleaning-decontamination, rinsing and sterilisation: refer to the regulatory
documents in vigour (for example, refer to the FD S document 98-135, §9.4). The water quality must be compatible with the sterility
objective and equipment used. Take care with conductivity parameters, in concentrations, impurities and microbiological pollution.
PRECAUTIONS
During the different stages of the procedure, take care not to bump the cutting instruments, which could alter their cutting qualities.
Particular attention should be paid by the user to cleaning dirt and deposits from the hollow areas of instruments.
A visual control should be made on each instrument before sterilisation. Worn-out or damaged instruments should be treated separately.
Refer to the legislation in force to eliminate the medical waste.
Instruments used to cut bone should be replaced after 10 uses maximum.
TREATMENT PROTOCOL
PRE DESINFECTION
Pre-disinfection should take place immediately after the intervention.
Each instrument part should be pre-disinfected separately: multiple component instruments (racket wrench for example) and
instruments assembled during the intervention (for example: wrench added to ratchet wrench) should be taken apart.
Instruments and their sequencer and associated boxes should be pre-disinfected separately.
®
46
By soaking
- Disassemble instruments before soaking and totally submerge the instruments.
- We advise against use of products that may fix proteins (alcohol, aldehydes ...).
- Rinse with water and carefully dry each element (using disposable towels for example).
CLEANING-DISINFECTION
Each part of the instruments should be cleaned separately. The instruments and their sequencer and associated boxes should be pre-disinfected separately. We advise against use of products that may fix proteins (alcohol, aldehydes ...).
Drying can take place with disposable towels, then by drying any eventual water residues with compresssed air (wear glasses and a mask).
> Brushing / Immersion
- Brush each element meticulously with a soft brush (nylon for example).
- Immerge completely the instruments. Respect the soaking duration recommended by the product manufacturer.
- Rinse with water and dry carefully each element.
> Or by cleaning in an ultrasound bath
- Cutting instruments should not be in contact with each other during sonic cleaning.
- Elements rubbing together or against the bath may be damaged.
- Submerge the instruments completely. Use a low-frequency ultrasound bath (25 to 50 kHz).
Take care that the detergent-disinfectant solution is compatible with this procedure.
- Rinse with water and carefully dry each element.
STERILISATION
Only sterilise instruments that have been pre-disinfected, cleaned and dried. Use sterilisation bags in accordance with requirements and
standards in force adapted to the instruments and ancillaries or to the sequencer or associated boxes and compatible with the mode of
sterilisation. The bag sealing instructions must be respected along with the normative requirements.
The insturments and ancillaries are sterilisable by steaming at 135°C for at least 20mn (French Circular DGS/5C/DHOS/E2 n°2001-138
of 14 March 2001). We strongly advise using class B autoclaves. All other modes of sterilisation are proscribed.
Please respect the autoclave manufacturer’s usage and maintenance instructions.
Respect in particular the spaces between bags and do not overload the autoclave.
Multiple component instruments should be taken apart before being sterilised.
Instruments that cannot be taken apart can be sterilised in their sequencer and associated box.
Respect the conservation conditions communicated by the bag manufacturer.
Each practitioner should define the sterility product’s time limit, taking into account the type of packaging used and its stocking conditions.
Sterilisation and expiration dates should be indicated on the bags.
PRODUCTS RETURNS
All products or components returned to Anthogyr must be accompanied by a signed certification confirming they have been cleaned, disinfected/decontaminated and sterilized (with proof of sterilization).
47
P R O S T H E T I C
G U I D E
O S S F I T
Recommended bibliography
With thanks to their authors :
> Decision making in implant practice
> Aesthetics and emergence profile in implantology
> Manual of clinical implantology
F. Renouard & B. Ranger
V.Bennani & C-A. Baudoin
M.Davarpanah & H. Martinez
> Efficiency in implantology
> Managing implant complications
Hervé Berdugo
Marc Bert
®
48
Whether you are experienced,
or an expert in implantology, we would
invite you to choose the training
which suits you best in your everyday practice
and development in implantation surgery.
YOUR
R
O
F
K
AS
MME !
A
R
G
O
R
OWN P
NEW !
Online registration
www.anthogyr.com
Regional training sessions
Training sessions on-site Anthogyr
Confirmed speakers
Live surgery
Practical work
Informations : +33 (0)4 50 58 57 68 or +33 (0)4 50 93 78 60
49
P R O S T H E T I C
ANTHOGYR
2 237 Avenue André Lasquin - 74 700 Sallanches - FRANCE
Tel. : +33 (0)4 50 58 02 37
Fax : +33 (0)4 50 93 78 60
e-mail : sales@anthogyr.com
www.anthogyr.com
INTERNATIONAL NETWORK :
please contact our exclusive representatives for further informations.
G U I D E
O S S F I T
®
Notes
P R O S T H E T I C
G U I D E
O S S F I T
®
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ANTHOGYR, SERVICE INCLUDED
Further information, advice, contacts :
our marketing, sales and R&dD
departments will be happy to answer
all your enquiries.
Let’s meet !
© Anthogyr - NOT OSS 2_GB - 2013-03
2 237 avenue André-Lasquin
74700 Sallanches - France
Tél. +33 (0)4 50 58 02 37 - Fax +33 (0)4 50 93 78 60
www.anthogyr.com