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INFORMATIONS : [email protected]

The differenT PerSO-C® and PerSO-B®- imPlanT and aBuTmenT fOrmS and Their meaSureS

PAGE 3

inTrOduCTiOn and hinTS fOr The uSe Of The PerSO-PeeK- manual PAGE 4

PILOT DRILLING fOr PerSO-C® –imPlanTS PAGE 5

DPrOCedure Cd 2-STeP lOading Of PerSO-C®-imPlanTSsurGicAl PArt

ProsthEticAl PArt

PAGEs 6 - 13

PrOCedure Bd 2-STeP lOading fOr PerSO-B®-imPlanTS fOr mandiBulasurGicAl PArt

ProsthEticAl PArt

PAGEs 14 - 21

PROCEDURE BIT The TemPOrary immediaTe imPlanT PrOCedure wiTh PerSO-C032® PAGEs 22 - 23

IPrOCedure Ci immediaTe lOading Of PerSO-C®-imPlanTS PAGEs 24 - 29

PrOCedure Bi immediaTe lOading Of PerSO-B®-imPlanTS fOr mandiBula PAGEs 30 - 31

PrOCedure Of ParTial Or unilaTeral PrOSTheTiCal reCOnSTruCTiOn Of aTrOPhiC jaw zOneS

PAGEs 32 - 33

OSTERI PACK PAGE 34 - 35

www.sisomm.com/peek/video/pee

PERSO-B001 UNIVERSAL PERSO-B101L Monobloc standard

PERSO-C001 UNIVERSAL PERSO-C047 Medium standard PERSO-C032

OABU1 OABU2

OAXE

CO

nTe

nT

3

The differenT PerSO-C® and PerSO-B®- imPlanT and aBuTmenT fOrmS and Their meaSureS

This presentation of the PEEK-PERSO-Technic has to be seen as a help to summarize your knowledge during your participation in a Familiarization- and Operation-course. We try to provide knowledge as far as possible – but those written resumees can have lacks.

Only the authorization by our partner, the scientific society IsoSS (www.isoss.eu), to whom we have delegated the educational duties concerning the PEEK-PERSO-technic, qualifies customers to use SisoMM-products made from PEEK.

En complément d’informations vous trouverez aussi sur ce facsicule des liens url qui indiquent des vidéos visibles sur internet.

With pleasure we see forward to receive suggestions from our customers what aspects have to be displayed in a more sophisticated manner.

Here we want to thank Michele Flanagan (Graphic), Myriam Broche (Communication), the translators: Dr Ádám Dávid (Hungari), Mirella Filippini (Italy), Balgat Merkez (Turkey), Dr Fahrhad Ghazaei-Motlagh (Canada), Dr Elena Fokeeva, Irina Nemeth, (Russia), Panos Pagratis (Greece), Dr Vlad Petrescu (Romania), Bettina Rode, (Germany), Caroline Wallis (Spain) for their cooperation and comprehension in working out this Manual.

Claudia StrinellaCEO SisoMM

5

PilOT drilling for

PerSO-C® –imPlanTS

4

PERSO-C001 UNIVERSAL

PERSO-C047 Medium standard

PERSO-C032

CFP-1 CFP-2 CFP-3

(Ø 1,8 mm) 1200 rpm (Ø 2,2 mm) 900 rpm (Ø 2,5 mm) 750 rpm

Before starting the drilling determine the needed depth of the insertion channel and the exact postion needed in the space – considering prosthetical rerestoration and position of antagonist.In function of these findings make the drilling with pilot-drills CFP1, CFP2 and CFP3 with reduced and decreasing speeds, using a contra-angle “green” handpiece 20:1.

CF1

CFC

CFCC

CD-2aIn the case of even larger alveolar crest: finish the conical part with a bigger diameter (5,5 to 8,0 mm) and use the drill CFCC. (less than 20 rpm or manually)

CD-1After the pilote drilling (page 5), form the insertion channel for the straight part of the implant PERSO-C® (less than 50 rpm) with form-drill CFI.

CD-2Drill in bone the conical part of theimplant. (less than 20 rpm or by hand) For an implant of Ø 4,7 mm, use the form-drill CFC47. If other diameters are indicated use the different diameters of drills between 3,6mm and 5,5mm. (see catalogue)

OFR1

DiamondBurr

CD-4 Insertion of the implant in the channelEventually assisted by needle-holder or OPORTE-C

oPortE-c

www.sisomm.com/peek/video/tec

CD-3 Adjust the implant in length with a hard-metal-bur holding it by hand or in the OBOCK.En cas d’os en classe I (d’après Misch) il faudra recouper (supprimer) avec une fraise en tungstène les cotes de l’implant dépassant 3,0 mm de Ø et les 2 ailettes au pied du conus. Ceci sera fait par une fraise en tungstene.

hAMMEr

OFIX

OPORTE

DD

6

2-STeP lOading Of PerSO-C®-imPlanTS

7

CD AuxiliAry instruMEnts

Eventually treat surface with Plasma-Spray

PERSO-C001 univErsAl PERSO-C047 MEdiuM stAndArd PERSO-C032

OFR1

OFR 645

CD-5

OFR 645

CD-6

AuxiliAry instruMEnts odyn, ocliP, oPortE

After waiting as long as you would for loading a rigid implant (titanium/circonium), open the gingiva to find the implant emergence.Make an opening in the center of the implant, using OZIEL and the rotative instruments OFR7 and OFR8 or OFR7-L and OFR8-L.Eventually use a gingiva-former as esthetically necessary. (Adapt OAXE to the local needs)

CD-9

Cut the implant-emergence - or on the level of the bone - or 2-3mm above the surface of bone and close the woundflap - or let heal transmucosally

CD-6

CD-8CD-7

CD-7a CD-8a

CDPERSO-C001 UNIVERSAL PERSO-C047 Medium standard PERSO-C032D D

8 9

2-step loading of peRso-C®-implants

abutments

OABU1UNIVERSAL

CD-11Fix the bridge with resine-cement after equilibration of occlusion

OABU2STANDART

OAXESPECIAL

Use for extended distance between implant and superstructure (13-27 mm)

Use for a stub-height from 1 to 12 mm and with angulation up to 6°

Use for stub-height from 3 to 14 mm and for an angulation up to 20°

Peut servir deUse for- healing screw- additional OABU2composed with upper portion of OAXE

Use for- gingiva-former- additional OABU2 composed with upper portion of OABU2

AuxilliAry instruMEnts

OCOH OC1H

CDProsthetics fixed by cements

* for screwing Procedure switch over to Page 12 (cd-10a)CD-10*

CD-12Last controls and corrections of occlusion

D

10

PERSO-C001 UNIVERSAL PERSO-C047 Medium standard PERSO-C032 D

11


CD-10a* Use for screwing exclusively OAXE-abutment.

CD-10bAfter equilibration of occlusion pass with OFR7 through opening (Ø 2 mm) in crown which was installed by dental technician on some crowns into the stubs OAXE.This opening is horizontal and has to be easily accessible for the dentist.

CD-10cForm the opening in the stub with the OFR-8 drill for reduced contra-angle, 50 rpm.

Occlusion Control

CD-10dInstall the thread with OT25 with 5 to 25 rpm or manually.

CD-10e CD-10f CD-10g CD-10hLast controls and corrections of occlusion

Prosthetics fixed by screwing

CD

www.sisomm.com/peek/video/fix

AuxiliAry instruMEnts

OCOH OC1H

D

ODYN 212

OCLIP OPORTE

PERSO-C001 UNIVERSAL PERSO-C047 Medium standard PERSO-C032 D

13


BD-1 Create the insertion canal, and pay attention to situationof antagonists, with CUCA4522 or 4532 (4000-40000 rpm) and cut through transverse till in the opposite lingual corticalis.

BD-2 Enlarge the basal cut to 7 mm Ø with CUCA9732or 9722.(4000-20000 rpm)

BD-2a View on the channel in position 31 made by a 7mm cutter.

BD-1a View on the channel in position 31 made by a 5 mm cutter.

www.sisomm.com/peek/video/bd

BD-3 Enlarge the basal cut to 9mm Ø with CUCA9932 or 9922. (4000-20000 rpm)


D 2-STeP lOading Of PerSO-C®-imPlanTS fOr mandiBula

14

D

15

BDPERSO-B001 univErsAl PERSO-B101L Monobloc stAndArd

BD

BD-6 Pass with the form-cutter CUCADEF for the definite form of the vertical cut. (Ø 2,3mm being larger than the inferior part of the vertical post, measuring 2,0mm)

BD-6aView on the cut done by CUCADEF at position 31.

OPORTEOFIX HAMMER

BD-4Enlarge the cut of the base to 10 mm Ø with CUCA 91032 or 91022. (4000-20000 rpm)


BD-5Enlarge the cut of the base to 12 mm Ø with CUCA 91032 or 91022. (4000-20000 rpm)


- if bAd bonE quAlity

- if thE rEtEntionAl bonE

structurEs ArE fAr AwAy

- if thErE is iMPossiblE to fix An iMPlAnt with lowEr diAMEtEr

to EnlArGE thE cut for thE bAsE to 10 MM or 12 MM

PERSO-B001 UNIVERSALD PERSO-B101L Monobloc standard D

16 17

2-step loading of peRso-C®-implants foR mandibula


D

18

D

19

www.sisomm.com/peek/video/cut

PERSO-B001 UNIVERSAL PERSO-B101L Monobloc standard BD2-step loading of peRso-C®-implants foR mandibula

BD-7Install implants with help of OFIX and the impactation instrument OPORTE.

Shaping of implant on OBOCK

BD-8For full security we consult to respect the sames delays of bone healing before loading of the implants as in rigid implantologie (titanium, circonium)

Insert basal implant with OFIX

D

20

PERSO-B001 UNIVERSAL PERSO-B101L Monobloc standard D

21

BD-8aIn order to avoid an immediate loading, use our immediate temporary implants PERSO-C032.

BD-8bStubs in situ after 6 weeks

BD

OCOH OC1H

BD-8After the usual healing time, choice the stubs and screw them on the implants.If you would avoid to work in two steps but also avoid an immediate loading , please refer to the procedure BIT (page23)

BD-9The stubs may be charged after at least 6 weeks but better up to 8 months after intervention; the moment to choice depends from the personal skills of the practitioner for titanium implants.

2-step loading of peRso-C®-implants foR mandibula


OABU1 OABU 2 OAXE

D

22

The TemPOrary immediaTe imPlanT PrOCedure wiTh PerSO-C032®

D

23

BIT-1 Create the insertion canal, and pay attention to situatio-nof antagonists, with CUCA4522 or 4532 (4000-40000 rpm) and transverse till in the opposit lingual corticalis.

The PrOCedure BiT deSCriBed in The graPhS 1 TO 7 (Bi-1 à Bi-7) iS The Same aS deSCriBed in The ChaPTer COnCerning The TwO-STeP TeChniC wiTh The imPlanTS PerSO-B (PageS 14-18)

BIT-7Install implants with help of OFIX and the impactation instrument OPORTE.

...«The procedure may concern parts of the jaws or the full arches. It is important to avoid the immediate loading by insertion of immediate temporaries implants which will be extracted after having served in the osseointegration period of the permanent implants. We could as well join this implants au natural posts which are eventually disponible for fixation of a temporary provisional bridge»

PERSO-C032PERSO-B001 UNIVERSAL PERSO-B101L Monobloc standard

BIT-8aFor to avoid an immediate loading, use our immediate temporary implants PERSO-C032.

BIT-8cAll stubs are srewed in the implants not earlier than after 6 weeks ; this date is fixed in function of the prosthetic works for the loading and depends from the habit of the profes-sional in rigid implantology. the healing delay is the same.

BIT-8For highest security we recommend to respect the delays of bone healing before loading of implants as you do in rigid implantology (titanium, circonium)

BIT-8bOnly the temporary immediate implants will be loaded by a fixed prosthesis. Installing that bridge be sure to have an equilibrated occlusion, type PLANAS. When charging the definitive implants verify the temporary implants ;eventually the one or other may stay in bone, when not affected by any pathology. Those which show one deficiency in the interface will be ablated.

BIT

OFR1

DiamondBurr

CI-3 Adjust the implant in length with a hard-metal-bur holding it by hand or in the OBOCK.

OFR1

Diamond Burr

OBOCK

OPORTE-C

OPORTE

OFR1

OFR655 OFR643

Diamond Burr

OBOCK

OPORTE-C

OPORTE

CI-3bPrepare the perimeter and the diameter of the implant following the anatomical site. Use OFR655 to OFR640 with decreasing diameters or shape the stub with a diamond bur.

OFR1

OFR655 OFR643

Diamond Burr

OBOCK

OPORTE-C

OPORTE

CI-3cGive eventually the needed angulation of the stub for optimized positioning opposite to the antagonist and adjust the enosseous length.

CI-2aIn the case of even larger alveolar crest: finish the conical part with a bigger Ø (5,5 to 8,0 mm) and use the drill CFCC. (less than 20 rpm or manually)

CI-1After pilot drilling (page 5), form the insertion channel for the straight part of the implant PERSO-C®. (less than 50 rpm)

www.sisomm.com/peek/video/ci

www.sisomm.com/peek/video/pre

www.sisomm.com/peek/video/per

PERSO-C001 UNIVERSAL PERSO-C047 Medium standard PERSO-C032I IimmediaTe lOading Of PerSO-C®-imPlanTS« We understand by CI (immediate or early loading) the loading of implants- between the implant insertion and the 3 month for the lower jaw- between the implant insertion and the 6th month for the upper jaw.In this interval the bone structures around the implant are in the processus of

24 25

CI

osteointegration, néoformation of bone is developing;there is a strong sensibility for micro-mouvements.It is necessary to install and to maintain from the first day of loading till the 12th month a bilaterally equilibrated, balanced occlusion known as PLANAS occlusion.This has to be maintained for the time of mineralization and remineralization of the old and new bone tissues.It is necessary to control regularly the maintenance of the PLANAS occlusion, in particular if we have to do with a case of edentation since a longue time or having had full dentures. This processus will last at least 12 months.In cases of Myoarthropathie, luxation or subluxation should be installed a narrow recall. We don’t recommend to work in immediate or early loading with patients where is a doubt on their compliance for to follow the procedures ; the same valid for individual cases where probably an equilibrated occlusion cannot be obtained immediately. The loss of implants could be the consequence »


CI-2Drill in bone the conical part of the implant. (less than 20 rpm or by hand) For an implant of Ø 4,7 mm, use the form-drill CFC047. If other diameters are indicated use the different diameters of drills between 3,6 mm and 5,5 mm. (see catalogue)

CI-3aFor insertion in the opening the two cervical wings have to be horizontal. Hold the implant on the straight part with a finger; use the transparent sheet as to avoid to contaminate the surface with talc from gloves. Cut the parts of implants which have to be adapted with hard metal-burs.

OFIX

OPORTE

CI-5If you have used the OBOCK shape the stub like a natural tooth with a diamant bur and make last corrections after insertion.

Permanent Cemet

Permanent Cemet

Occlusion Control

Diamond Burr

CI-6Fix the bridge with resin cement after equilibration of occlusion.

Occlusion Control

CI-7Last controls and corrections of occlusion.

Prosthetics fixed by cements*

CI-4 Insertion of the implant in the channelAssisted by needle-holder or OPORTE-C

* fOr SCrewing PrOCedure SwiTCh Over TO Page 26 (Ci-6a)

I I

26 27

CIPERSO-C001 UNIVERSAL PERSO-C047 Medium standard PERSO-C032


ImmedIate loadIng of PeRSo-C®-ImPlantS

The day of operation and some days after, use Alginate for impression and avoid silicones because of their penetration potential in the wounds and potential infections because of residuals staying in the wounds.

CI-6a* After equilibration of occlusion pass with OFR7 through opening (Ø 2 mm) in crown which was installed by dental technician on some crowns into the stubs OAXE. This opening is horizontal and has to be easily accessible for the dentist.

CI-6b Form the opening in the stub with the OFR-8 drill for reduced counter-angle, 50 rpm.

CI-6cInstall the thread with OT25 with 5 to 25 rpm or manually.

Occlusion Control

CI-6gLast controls and corrections of occlusion

CI-6f

CI-6eCut OABU1 with a bur in tungsten.

CI-6d

Prosthetics fixed by screwingwww.sisomm.com/peek/video/fix

I I

28 29

CIPERSO-C001 UNIVERSAL PERSO-C047 Medium standard PERSO-C032ImmedIate loadIng of PeRSo-C®-ImPlantS

BII I

30 31

The PrOCedure Bi fOr The graPhS 1 TO 8 (Bi-1 TO B1-8) iS Similar TO ThaT deSCriBed in The ChaPTer « 2-STeP lOading Of imPlanTS PerSO-B (PageS 14 TO 18)

BI-8For all security we recommend to respect equivalent delays as in rigid implantology (titanium and circonium) for bone healing before loading implants.

...

BI-9For specialists in occlusion it is not excluded to have success with immediate loading of PERSO-implants.In deed, you have to install an occlusion type PLANAS and this from the 1st dayof loading.The immediate loading requires that the implants are fixed by a bridge as by a splint or external fixator from the end of the operation and on its last after 12 days.

BI-1 Create the insertion canal, and pay attention to situationof antagonists, with CUCA4522 or 4532 (4000-40000 rpm) and cut through transverse till in the opposite lingual corticalis.

immediaTe lOading Of

PerSO-B®-imPlanTS

PERSO-B001 univErsAl PERSO-B101L Monobloc stAndArd

PrOCedure Of ParTial Or unilaTeral PrOSTheTiCal reCOnSTruCTiOn Of aTrOPhiC jaw zOneS

Parallize the emergence of implants and the stubs with a diamond burr or a bellforme grinder.

32 33

For the places with reduced bone height in the near of obstacles (<10mm) and of bad quality or with reduced crestal width (<3,6mm) please use PERSO-B implants in the place of crestal implants. Use PERSO-C for insertions in pterygomaxillary and zygoma-regions.

Whilst choosing implant techniques for atrophiques zones, you have to consider that there will be often longues distances between the zones of anchoring in bone and the superstructure and that there will be only little bone volumina for to stand constraints. A basal implant which is not inserted in all its height in bone (at least 8mm) will not develop sufficient lateral stability for to counter the important scissors forces rising up in such a case ; that is why it must be associated to a crestal implant which will stabilize with its leaning against the lateral corticalis or by connection with a natural parodontally intact tooth.If they are integrated in weak bone structures, even 2 basal implants in position 5,6 or 7 could not be enough . It might bet hat a crestal implant has to be associated, eventually a pterygo-maxillary implant. It is important in any case to wait a good osseointegration before loading.Per unity of replaced teeth it is important to calculate a an interface of the implant of 7 sqmm at least, better 9 or 10 sqmm.

www.sisomm.com/peek/video/pte

Drills and milling cutters

-for dynamometrical keys-For create and parallelize stubs

OFR651

OFR647

OFR620 OFR625

OFR5

CFP1 CFP2 CFP3

CFI

CFC047 CFC051

45-2245-32

97-22 97-32

910-22910-32

912-22912-32

CUCADEF CUTUDEF

99-2299-32

To put the implant in its insertion channel

For to cut and grind the PEEK-material and rigid materials (metal/circonium)

For creating external and internal threads in PEEK or in fractured rigid implants.

Manual milling adapters

OPORTE-B OPORTE-C OFIX

OBOCK

OFR1 OP25 OP45

OT25 OT45

OCLIP OCOH OC1H

CUCAfor Contre-Angle

OFR6ABU

OSTERI

OKRON 1

ODYN 1

For to prepare surgical and prosthetical work

OLANGOFR630 OFR632

OFR636 OFR643

OFR655

45-2245-32

97-22 97-32

910-22910-32

912-22912-32

99-2299-32

OFR640

ODYN 2

OKRON K

TOOlS & inSTrumenTS fOr The 2 imPlanTS TyPeS PerSO-B® and PerSO-C® + Repairs

www.sisomm.com/peek/video/too34

CFC036 CFC040

CFC043 CFCC

CuttersCUTU

for Turbine

OZIEL040 OZIEL051

OFR2 OFR3

OFR4 OFR7 OFR8

For treat surface with Plasma-Spray

PB2

35

CFP1-L

CFI-L

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