1. Preparation of the operating room for surgery
First, the medical staff preparing the operating room must wear a cap, mask, gloves, shoe cover, and a gown.
Every surface must be disinfected and cleaned. The staff has to make sure that every required equipment for the surgery is functioning well. All the necessary materials should be placed within reach.
2. Preparation of the surgical staff
- Wear a surgical cap and mask
- Use the nail pick to clean your nails under running water
- Wet the brush and the arms
- Brush the nails with the brush after adding soap for 15 seconds
- Wet hands and arms
- Wash the hands, arms, and forearms with antiseptic soap for one minute
- Rinse for 10-15 seconds
- Re-wash for 90 seconds
- Dry with a sterile cloth
- Wear the surgical gown and sterile gloves
3. Preparation of the patient
- The patient must use an antiseptic mouthwash for one minute before the surgery
- He must wear a cap, shoe cover, and a clean gown
- The patient is then installed in a comfortable position and covered with a sterile surgical drape
- The perioral region is disinfected with betadine
Premedication:
- If the patient is very anxious, an anxiolytic can be prescribed and taken the day before or an hour before the procedure
- Antibiotherapy: begins an hour before the surgery and continues for 7 days
- Anti-inflammatory: begins a day or two before the surgery and continues for 5 days
4.First chirurgical time
Incision and mucoperiosteal flap detachment
5. Preparation of the implant site
Osteotomies should be completed under cool saline and using new osteotomy drills at high torque and slow speed to minimize mechanical and thermal injuries to the bone. The bone temperature should not exceed 47 degrees during an osteotomy to avoid irreversible changes (e.g. bone necrosis).
- Placement of the surgical guide
- Penetration of the cortical bone with a Ø 2 mm round bur at a speed of 2000 t/min
- Determination of the depth of the implant site
- Ø 2 mm drill at a speed of 2000 t/min until the depth required is reached (a gauge allows you to check the drilling depth)
- Verification of the preparation axis in the three planes of space with a direction indicator
- Intermediate drilling 2/3 mm (widens the cavity)
- Drilling of 3 mm with a Ø 3 mm drill
- The coronal section of the site is flared using a conical drill (Flaring allows the total burial of the implant and sealing screw)
- Placement of the implant (after having opened the tube, place the extremity of the key or the mandrel directly on the implant holder without taking it out of the tube. The rotation speed must not exceed 20-40 t/min)
- The burial is concluded manually using a manual wrench
- Disinsertion of the wrench
- Placement of the sealing screw (the screw is placed using a screwdriver mounted on a contra-angle (20-40 t/min) after cleaning the implant head)
- The final tightening is done manually
- Flap repositioning and suturing (the surgical site must be irrigated and thoroughly cleaned)
- Prescription:
Antibiotic
Anti-inflammatory
Analgesic
Mouth wash (starting the day after the surgery)
6. Second surgical time
- A retro alveolar X-ray is taken to verify the absence of radiolucent areas or lesions around the implant
- Incision and mucoperiosteal flap detachment
- Elimination of the bone formation on the screw
- Elimination of any tissue on the implant head
- Placement of the healing abutment, with the Hex Screwdriver using light finger force, while making sure no tissue is in between
- Flap repositioning and suturing
