References: Two Stage Surgical Technique References

Two Stage Surgery Implant Insertion Technique

1. Extraction site (left),
Narrow keratinized tissue (center) and Wide keratinized tissue (right).
2. Drill 2.0mm pilot hole with external irrigation to a depth 2.0mm-5.0mm deeper than chosen implant.
3. Use paralleling pins to facilitate alignment when placing multiple implants.
4. Place abutment into pilot hole and confirm appropriateness with a vacu-press template.
5. Widen socket with reamer burs without irrigation at a maximum of 50 RPM.
6. Harvest bone debris from reamer flutes and socket.
7. Remove implant from plastic bag.
8. Seat implant by tapping gently on healing plug or directly into the implant well.
9. Cut healing plug.
10. Place harvested bone graft over shoulder of implant.
11. Close and wait a minimum of nine weeks for osseointegration.

Two Stage Surgery Implant Uncovering Technique with Non-Shouldered Abutment

1. Expose the implant in aesthetic areas with a semilunar crestal incision.
2. Use a 60˚ beaver blade or any blade to make split thickness buccal flap.
3. Remove healing plug with a healing plug removal instrument or small forceps.
4. Place guide pin to check integration and angulation.
5. Remove excess bone with sulcus reamer corresponding to the
chosen abutment with either threaded knob or straight handle. Use extended guide pins for long shafted abutments.
6. Flush and dry implant well and proceed to step 7 or to 6a below.
7. Insert chosen abutment.
8. Use a template to confirm appropriateness of abutment prior to engagement of locking taper connection, then tap on abutment in long axis of abutment shaft to engage locking taper.
9. Place an acrylic emergence cuff or temporization sleeve and modify, if necessary.
10. Inject acrylic around emergence cuff or temporization sleeve and into vacu-press template.
11. Place template to form
temporary crown.

12. Remove and polish acrylic confluent with emergence cuff or temporization sleeve to form sulcus.

13. Wait for soft tissue healing prior to taking final impression.

Two Stage Surgery Implant Uncovering Technique with Temporary Abutment

6a. Place temporary abutment.
2. Allow for soft tissue healing before proceeding with
step 2 of one stage uncovering technique.