Two Stage Surgical Technique: Keys to Success

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Pilot Drill

Pilot Drill Markings

Prior to using a pilot drill, it is imperative that its markings are identified and understood.
No assumption should be made about the height of the first marking.


Ideal Drilling Depth for Different Implant Lengths

Drilling Depths

If the trajectory is appropriate, continue drilling with the pilot drill to the depth marking, which will allow for the chosen implant to be seated below the bone. For aesthetic areas, the implant should be placed 5.0mm below the buccal gingiva. In non aesthetic areas, implants may be placed at the crest of bone level.


 

Maxillary Anterior Extraction Site

Initially drill into the palatal wall of the socket more perpendicularly than the proposed trajectory of the intended restoration. Immediately upon the pilot drill’s engagement of the bone, change the drill’s trajectory to be more parallel with the adjacent teeth and the proposed restoration.

 

 

Latch Reamer Markings

Latch Reamer Markings

The reamers are used sequentially beginning with a 2.5mm diameter and ending with the diameter of the intended implant. Reamers have horizontal markings at 6.0, 8.0, 11 and 14mm, whereas older reamers may have different markings. It is imperative that the depth indicators on the latch reamers are known prior to surgery. No assumptions should be made about the height of the first marking on any latch reamer. If there is any doubt about the markings on any drill or reamer, take a measurement prior to using the reamer.

 

 

Ideal Drilling Depth for Different Implant Lengths

Drilling Depth

Drill to the depth that will allow the chosen implant to be seated 1.0–3.0mm below the crest of bone. For optimal aesthetics in the anterior region, the implant should be placed 5.0mm below the buccal gingiva.

 

 

 

 

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