Straumann Guided Surgery Manual PDF

Basic information on
Straumann® guided surgery.
X
Straumann is the industrial partner of the ITI (International Team for
Implantology) in the areas of research, development, and education.
X
Contents.
About this guide 3 3.5 Guided implant placement 35

3.5.1 Opening the implant package 35
1. Preoperative planning and guided surgery for 3.5.2 Placing the implant 35
Straumann® D ental Implant System 4 3.6 Soft tissue management 39
Step 1 – Treatment plan 4
Step 2 – Scan prosthesis fabrication 4 4. Product specifications 40
Step 3 – CT scanning 5 4.1 Sleeve-position implant-length matrix 40
Step 4 – Software-based planning and f abrication 4.1.1 Sleeve-position implant-length matrix for
of the surgical template (open s ystem approach) 5 Ø 5.0 mm sleeves in the surgical template 40
Step 5 – Surgery with Straumann® guided instruments 4.1.2 Sleeve-position implant-length matrix for
& guided implant insertion 5 Ø 2.8 mm sleeves (narrow interdental spaces)
Step 6 – Prosthetic procedures 5 in the surgical template 40
4.2 Straumann® guided drill design 41
2. Planning and clinical solutions 6 4.3 Color-coding and labeling of Straumann®
2.1 Surgical template 6 cutting instruments for guided surgery 42
2.1.1 Surgical template fixation 6 4.4 Overview of cutting instruments for guided
2.1.2 Sleeves for surgical templates 7 surgery with depth control 43
2.1.3 Sleeve positions 9 4.5 Overview of guided implants 44
2.1.4 Surgical template fabrication 10 4.6 Surgical protocol template for completing
2.1.5 Surgical template pre-processing 10 manually (to be copied) 45
2.2 Straumann® Guided Surgery concept 11
2.2.1 Drill handles for basic implant bed 5. Additional information 46
preparation 11 5.1 Additional information
2.2.2 C-handles for final implant bed preparation 13 on surgical instruments 46
2.2.3 The surgical protocol for guided surgery 14 5.2 Care and maintenance of instruments 47
2.2.4 Straumann® guided implants 15 5.3 Labeling and color-coding of the
2.2.5 Straumann® Guided Surgery Cassette 16 Straumann®
2.2.6 Precautions 17 Dental Implant System 48
5.4 Related documentation 50
3. Surgical procedures 18 5.5 Important guidelines 52
3.1 Use of the mucosa punch 18
3.2 Basic implant bed preparation for situations 6. Index 54
with sufficient interdental space 19
3.3 Basic implant bed preparation for narrow
interdental spaces 26
3.4 Final implant bed preparation 28
3.4.1 Profile drilling for situations with sufficient
interdental space 29
3.4.2 Tapping for situations with sufficient
interdental space 31
3.4.3 Overview guided instruments for final
implant bed preparation 34
About this guide.
The Basic Information on Straumann® Guided Surgery for the Straumann® Dental Implant
System provides dental professionals and related specialists with the e
ssential steps for
surgical treatment planning, and procedures for guided surgery.
The manual is divided into the following main parts:
• Preoperative planning and guided surgery for Straumann Dental Implant System
• Planning and clinical solutions
• Surgical procedures
• Product specifications
• Additional information
The following information is not sufficient to allow immediate use of the Straumann Dental
Implant System. Knowledge of dental implantology and instruction in the handling of the
Straumann Dental Implant System p rovided by an operator with the relevant experience and
by the brochure for c onventional procedures “Straumann Dental Implant System: Basic Infor-
mation on the Surgical Procedures” (NAMLIT 1017) are always necessary. For detailed informa-
tion on products supplied by third parties, please contact these c ompanies directly.
Please note that not all products are available in all markets.
Please contact your local Straumann representative for more details.
3
1. Preoperative planning and guided surgery for Straumann® D
ental Implant System
1. Patient Evaluation 2. Fabrication scan prosthesis 3. CT scanning 4. Software based planning

(if required)
Straumann® guided instruments are intended for Step 2 – Scan prosthesis fabrication
treatments planned preoperatively with 3D planning Depending on the software being used, a scan prosthesis
software. They are designed to prepare the implant may be required. A scan prosthesis is a radiopaque
bed for implants of the Straumann® Dental Implant duplicate of the current situation or the provisional teeth
System using surgical templates. set-up. It supplies the clinician with additional informa-
tion for implant planning. When the patient is scanned
The recomended planning software complementing the with the scan prosthesis, the desired tooth set-up is
Straumann® guided instruments is called coDiagnostiX ™ visible in the CT images. The scan prosthesis is also used
by Dental Wings. However, execution of template-based to visualize the soft tissue situation in the planning
surgery preoperatively planned may be performed with software. Furthermore, reference marks (e.g. Pins or Gut-
other commercially available planning software systems. tapercha) are incorporated in the scan prosthesis for the
For further information, please contact your Straumann identification of its position in the planning software.
representative.
The procedure for fabricating the scan prosthesis is
Computer Guided (Static) Surgery can be subdivided into dependent on applied software and chosen template
six main steps (see figure above). They are described in fixation (bone, teeth or mucosa supported). Refer to the
the following. detailed documentation of the software suppliers for
further information.
Step 1 – Treatment plan
Diagnosis and patient specific requests influence the Step 3 – CT scanning
treatment plan. The type of final restoration, patient’s re- Regardless of imaging technology used, scanning with
quest for a provisional, number of implants and imaging the correct parameters is the basis for accurate planning
procedure need to be taken into account for the patient’s in the software and for correct implant placement.
treatment plan for guided surgery. In order to get the optimal scan data, the radiologist and
the patient need to be instructed correctly and scanning
Note instructions/parameters must be followed according to
For a template based surgery, the patient’s mouth open- the software supplier guidelines.
ing c apability needs to be sufficient to accommodate the
instruments for guided surgery.
4 1. Preoperative planning and guided surgery for Straumann® Dental Implant System
5. Fabrication of surgical 6. Surgery with Straumann® 7. Prosthetic procedures
template guided instruments
Step 4 – Software-based planning and fabrication Step 6 – Prosthetic procedures

of the surgical template For the prosthetic procedure, Straumann offers a wide
Software-based planning allows for implants to be planned range of solutions in both stock abutments and CADCAM
virtually within the planning software. When completed designed customized abutments with original Straumann
successfully, the case plan is sent to the surgical template connections offering the Straumann Guarantee.
manufacturer. The software company may act as the
surgical template manufacturer or the dental laboratory
may fabricate the surgical template depending on the
software concept used.
Note
In this step, the surgical template manufacturer ensures
the compatibility with the Straumann® guided instru-
ments by utilizing Straumann® sleeves for guided surgery
positioned according to Straumann parameters.
tep 5 – Surgery with Straumann® guided i nstruments &

S
guided implant insertion
After fixing the surgical template in the patient’s mouth,
the implant bed for Tissue Level and Bone Level implant
lines can be prepared with the guided instruments includ-
ed in the portfolio of Straumann® Guided Surgery Instru-
ments. The surgical protocol, provided together with the
surgical template, recommends which instruments are
required to prepare each implant site. The Straumann®
guided implants allow for insertion through the surgical
template including a physical depth control.
1. Preoperative planning and guided surgery for Straumann® Dental Implant System 5
2. Planning and clinical solutions
2.1 Surgical template
2.1.1 Surgical template fixation

Bone-, mucosa- and teeth-supported surgical template fixations (see figures below) are
possible depending on the clinician’s preferences and the planning system used.
Bone-supported Mucosa-supported Teeth-supported
Note
In order to stabilize the surgical template, it can additionally be fixed with fixation pins (see
chapter 3), fixation screws, or it can be positioned on temporary implants.
6 2. Planning and clinical solutions

2.1.2 Sleeves for surgical templates
Depending on the anatomical situation and the planned axis of
adjacent implants, two different sleeve diameters are available.
• Ø 5.0 mm sleeves for regular situations with sufficient space for

sleeve placement. 5.0 mm inner diameter
• Ø 2.8 mm sleeves for narrow

interdental spaces. 2.8 mm inner diameter
Sleeve collision due to inclination

or narrow interdental space
Use a Ø 2.8 mm sleeve instead
Furthermore, the sleeves are available in two different designs:
• cylindrical.
• cylindrical with an additional rim at the top (T-sleeve).
Which sleeve design is used depends on the surgical template

manufacturer. The graphics in this brochure show the cylindrical
sleeves as example (see specifications in the following table).
2. Planning and clinical solutions 7

Sleeve inner Sleeve outer Use of drill
Art. No. Article Sleeve height
diameter diameter handle
Dmin
Dmax
Ø 5.0 mm Dmin = 5.7 mm
034.050V4 d = 5.0 mm H = 5.0 mm Yes
Sleeve Dmax = 6.3 mm
d
H
Dmin
No
(Direct
Dmax
guidance of
Ø 2.8 mm Dmin = 3.2 mm
034.052V4 d = 2.8 mm H = 6.0 mm milling
Sleeve Dmax = 3.8 mm
d
cutters and
H
guided drills
Ø 2.8 mm)
Dmin
Dcollar
Dmin = 5.7 mm
Ø 5.0 mm H = 5.0 mm
d
034.053V4 d = 5.0 mm Dcollar = 7.0 mm Yes

T-sleeve h = 4.5 mm
Dmax= 6.3 mm
H h
ax
Dm
Dmin
No
Dcollar
(Direct
Dmin= 3.2 mm guidance of
d
Ø 2.8 mm H = 6.0 mm
034.055V4 d = 2.8 mm Dcollar= 4.4 mm milling
T-sleeve h = 5.5 mm
H h Dmax= 3.8 mm cutters and
guided drills
Ø 2.8 mm)
ax
Dm

2.1.3 Sleeve positions
The system allows for flexible sleeve placement in the
surgical template. The three distinct sleeve positions are
2.0 mm (H2), 4.0 mm (H4), 6.0 mm (H6) above bone level
(see figure).
Ø 5.0 mm sleeve Ø 2.8 mm sleeve

H2 H4 H6 H2 H4 H6
sleeve height
sleeve height
6.0 mm
5.0 mm
6.0 mm 6.0 mm
4.0 mm 4.0 mm
2.0 mm 2.0 mm
While determining the corresponding sleeve position

for each implant in the planning software, the following
requirements need to be considered for favorable
conditions during surgical procedures.
• The surgical template fixation (mucosa-, bone- or

teeth-supported) and the mucosa thickness
determine the sleeve position.
• The sleeve position in the surgical template must
allow for ample access for instrument irrigation.
• Sleeve contact with tissue must be avoided.
Notes
Place the sleeve as close to the bone / soft tissue as
anatomic conditions allow in order to reduce overall

instrument height.

2.1.4 Surgical template fabrication
The surgical template must allow for proper irrigation of the surgical site. For this purpose,
windows can be included in the surgical template.
For a correct fit of the cylinder of the handles in the sleeve (see chapter 2.2.1) remove additional
material around the sleeve.
Caution
• Ensure the sleeves are firmly fixed into the surgical template.
• Radial and axial load on the sleeves must be avoided to help ensure proper retention of
the sleeves in the surgical template and reduce abrasion of the rotating instruments in the
sleeve.
• Prior to starting the surgical procedures, evaluate the fit and stability of the surgical
template on the model and in the patient’s mouth as well as size and localization of the
openings for irrigation after receiving it from the manufacturer. Verify if the position and
orientation of the sleeves in the surgical template correspond with the preoperative plan.
Check product documentation (if available) from the surgical template manufacturer.
2.1.5 Surgical template pre-processing

For disinfection/sterilization of the surgical template before surgery use an appropriate liquid
chemical disinfectant (e.g. betadine) or a sterilizing agent that follows the instructions from
the template manufacturer. Do not damage the material of the surgical template.

2.2 Straumann® Guided Surgery concept
2.2.1 D rill handles for basic implant bed preparation

Straumann® drill handles direct milling cutters and guid- Drill handle with cylinders
for drill guidance
ed drills based on the sleeve-in-sleeve concept (see ad-
jacent figure). The cylinder of the drill handle is inserted
into the sleeve (Ø 5.0 mm) fixed to the surgical template.
For each instrument diameter, Ø 2.2 mm, Ø 2.8 mm, Ø 3.5
mm and Ø 4.2 mm, an ergonomic drill handle is available.
Sleeve fixed to the
surgical template
Every drill handle features one cylinder with an additional

height of +1.0 mm at one end and a second cylinder with
an extra cylinder height of +3.0 mm at the other end (see
figure below).
+1.0 mm +3.0 mm
∆ 2.0 mm in
osteotomy depth
The surgical protocol (see chapter 2.2.3) lists which cylinder

of the drill handle (+1.0 mm, +3.0 mm) should be used for
each implant.

For identification during surgery, Straumann® drill handles for guided surgery are color-coded and
symbol-marked (see following figure).
+1 mm
+3 m
m
Instrument
Art. No. + 1.0 mm + 3.0 mm
diameter
3.0 mm
1.0 mm
Drill handle cylinder
034.150 Ø 2.2 mm
034.250 Ø 2.8 mm
Color-coding and
symbol
034.450 Ø 3.5 mm
034.650 Ø 4.2 mm

2.2.2 C-handles for final implant bed preparation
Straumann® C-handles for final implant bed preparation
are also designed according to a sleeve-in-sleeve concept.
The cylinder of the C-handle is inserted into the sleeve
(Ø 5.0 mm only) fixed to the surgical template. Each C-handle
corresponds to one distinct sleeve position (H2, H4 and
H6) as shown in the chart below.
Art. No. Article Sleeve position
H2
034.750 C-handle H2
2.0 mm above bone level
H4
034.751 C-handle H4
H6
034.752 C-handle H6
The Straumann® C-handles direct guided profile drills and

guided taps (see figure).
H2 H4 H6
034.752
034.751
034.750
6 .0 mm
4.0 mm
2.0 mm

2.2.3 The surgical protocol for guided surgery
The implant bed preparation with guided instruments follows the surgical protocol normally
delivered together with the surgical template by the manufacturer or exported from the plan-
ning software. Based upon the virtual plan where sleeve diameter and sleeve position were
selected, the surgical protocol provides the correct combination of drill handle cylinder and
Straumann® guided instruments to be used for each implant. The following chart shows an
example of a surgical protocol in this brochure.
Basic implant bed Final implant bed

preparation preparation
Implant Implant Implant Sleeve Sleeve Milling Guided drill Cylinder of Profile drill C-handle Tap
position Art. No. height position cutter drill handle
21 033.052G SP, RN
Ø 4.1 mm,
5.0 mm H4 Ø 3.5 mm
= • RN,
Ø 4.1 mm
H4 SP,
Ø 4.1 mm
long, +1.0 mm
10 mm
guided
SLActive
Legend:
4 mm

Caution
• Verify if the surgical protocol corresponds to your
preoper-atively defined treatment plan before you
start surgery.
• All Straumann® guided drills and guided profile drills
(see chapter 4.4) feature a collar. In order to reach the
required depth for each implant, drilling must always
be continued until the collar hits the cylinder of the
handle. The combination of guided instruments listed
in the surgical protocol is recommended under this
presumption.
• The surgical protocol represents a suggestion for your
treatment. The clinician is responsible for adjusting
the surgical protocol in case the clinical situation
varies from the virtual planning.
Notes
• The surgical protocol might differ in appearance
depending on the planning software used.
• Refer to the sleeve-position implant-length matrix
in the product specifications (see chapter 4.1) for
consistency check.
2.2.4 Straumann® guided implants

Straumann® guided implants can be inserted fully guided
through the Staumann® sleeves with an inner diameter
of 5.0 mm. For physical depth control, the stop key en- Stop key Transfer piece
gages with the transfer piece.
The only difference between the guided and standard

Straumann® implants is the transfer piece. The implant
itself and the prosthetic components are identical.
Only select Straumann implants are available as guided

implants. Please see page 44 for the current portfolio of
Straumann Guided Implants.

2.2.5 Straumann® Guided Surgery Cassette
The Straumann® Guided Surgery Cassette (see figure) is
used for the secure storage and sterilization of the surgi-
cal instruments and auxiliary instruments of the Strau-
mann® D ental Implant System (see chapter 5.2).
The color-coded sequences on the cassette help ensure

a reliable working process during surgery. Clear illustra-
tions allow for checking the arranged instruments for
correctness and completeness at a glance. The instru-
ments are positioned securely in the silicone grommets
for sterilization and storage.

2.2.6 Precautions
• Guided instruments must only be used together with
the c orresponding sleeves fixed in templates and
handles.
• Inspect the instruments for operational reliability
prior to each surgery and replace if necessary.
• Cutting instruments must not rotate during insertion
into and removal from sleeves or handles (see adjacent
figure).
• Avoid lateral pressure on instruments which may
lead to damage of the instruments, the cylinder of
the handle and the sleeve. Hold the drill handle while
drilling.
• During and after implant bed preparation, the patient‘s
mouth must be thoroughly rinsed and aspirated.
• Pilot and twist drills have an apical overlength (up
to 0.4 mm) at the drill tip compared to the insertion
depth of the implant.
No rotation Only start rotation
• Use intermittent drilling technique. when inserted
• Use handles only in combination with guided instru-
ments, as indicated on the package labeling.
• Do not bend handles.
• Ensure ample cooling of cutting instruments with
sterile saline solution (NaCl). This applies for instru-
ments used with handles as well.
• Guided instruments must not be used in combination
with drill sleeves with collar (049.810V4), thermoplastic
drill templates (040.526 and 040.527) or drill stops
(040.460, 040.454S-040.457S).

3. Surgical procedures
3.1 Use of the mucosa punch

As an option, the mucosa punch can be used through the 5.0 mm sleeves before using the
milling cutter. The following table lists the available mucosa punches with its specifications.
Art. No. Article Max rpm.
034.010 Mucosa punch, Ø 3.4 mm, guided 15
The three depth marks indicate the distance from bone level
to the upper border of the respective sleeve (H2, H4, H6).
18 3. Surgical procedures
3.2 Basic implant bed preparation for situations with sufficient interdental space
After opening the gingiva, position the surgical template. Verify the fit and s tability of the
surgical template before starting with the osteotomy preparation. Start the basic implant bed
preparation with preparing the alveolar ridge (Step 1 on page 20). After that, the implant bed
preparation with pilot and twist drills follows (Steps 2–5 beginning on page 21) according to the
endosteal implant diameter chosen in the preoperative planning.

21 033.052G SP, RN
Ø 4.1 mm,
5.0 mm H4 Ø 3.5 mm
= • RN,
Ø 4.1 mm
H4 SP,
Ø 4.1 mm
long, +1.0 mm
10 mm
guided
SLActive
Step 1 Steps 2-5
3. Surgical procedures 19
Step 1 – Prepare the alveolar ridge
The correct milling cutter as indicated in the surgical protocol provides a flat bone surface and
a sufficiently wide area of bone. In case of hard cortical bone conditions, milling cutters with
increasing diameters can be used. The following table lists the milling cutter to be selected for
the respective implant bed.
Art. No. Article Max rpm. Endosteal implant diameter (mm)
Ø 3.3 Ø 4.1 Ø 4.8
Milling Cutter,
034.215 600
Ø 2.8 mm, guided
Milling Cutter,
034.415 500
Ø 3.5 mm, guided
Milling Cutter,
034.615 400
Ø 4.2 mm, guided
Note
034.250 Drill handle Ø 2.8 mm
Milling cutters have no physical stop.
Step 1a – Identify bone level

Choose the milling cutter and the corresponding drill
handle* as indicated in the surgical protocol. Place the
c ylinder of the drill handle (recommended: +1.0 mm) into 2 mm
the sleeve in the surgical template. Insert the m
illing cut-
ter into the cylinder until it hits bone level. Use the laser
marks on the milling cutter for depth reference (2.0 mm
intervals).
* The Drill Handle Ø 2.8 mm, and the corresponding Ø 2.8 mm Milling C
utter are
shown as an example.
Step 1b – Prepare the alveolar ridge 034.250
Prepare the alveolar ridge to the intended depth with the
milling cutter. Use the laser marks on the milling cutter
(2.0 mm intervals) as depth reference.
Note
Milling cutters must only be used for flattening the al-
veolar ridge.
Step 2 – Prepare implant bed to Ø 2.2 mm

034.150
Pre-drill the implant bed with the Ø 2.2 mm Pilot Drill for
Guided Surgery using the corresponding drill handle for
guidance. Always make sure to use the correct cylinder
of the drill handle (+1.0 mm or +3.0 mm) and the respec-
800 rpm max.
tive drill length (short, long or extra-long) as indicated in
the surgical protocol recommended by the software (see
table on page 19).
Caution
Start drilling only after inserting the drill into the cylinder
of the drill handle completely.
Note
Always drill until the collar of the drill hits the cylinder of
the drill handle in order to reach the required osteotomy
depth. Conventional depth gauges can additionally be
used to check the osteotomy depth.
Step 3 – Widen implant bed to Ø 2.8 mm
034.250 Drill handle Ø 2.8 mm
Continue with the basic implant bed preparation using
the Ø 2.8 mm Twist Drill PRO for Guided Surgery.
For an implant with an endosteal diameter of Ø 3.3 mm,

600 rpm max.
basic implant bed preparation ends here. Either continue
with the basic implant bed preparation of the remain-
ing implant sites, optionally using template fixation
pins. Or proceed with the final implant bed preparation
(see chapter 3.3).
Option – Template fixation pins

034.255 Template Fixation Pin Ø 5.0 mm/ Ø 2.8 mm
Additional stabilization of the surgical template can be
achieved by anchoring it with template fixation pins.
Secure the pins against aspiration.
Caution
In case of flapless surgery, to avoid damage to the soft
tissue do not apply force onto the surgical template fixa- H6
H4
tion pins.
H2
For Ø 4.1 mm and Ø 4.8 mm implants 034.450 Drill handle Ø 3.5 mm

Continue with the Ø 3.5 mm Twist Drill PRO for Guided
Surgery.
500 rpm max.
For an implant with an endosteal diameter of Ø 4.1 mm,

basic implant bed preparation ends here. Either continue
with the basic implant bed preparation of the remain-
ing implant sites, optionally using template fixation
pins. Or proceed with the final implant bed preparation
(see chapter 3.3).

034.455 Template Fixation Pin Ø 5.0 mm/ Ø 3.5 mm
Caution
tissue, do not apply force onto the surgical template H6
H4
fixation pins.
H2
For Ø 4.8 mm implants
034.650 Drill Handle Ø 4.2 mm

Finish basic implant bed preparation with the Ø 4.2 mm
Twist Drill PRO for Guided Surgery.
400 rpm max.
Either continue with the basic implant bed preparation

of the remaining implant sites, optionally using template
fixation pins or proceed with the final implant bed prepa-
ration (see chapter 3.4).
Option – Template fixation pins 034.655 Template Fixation Pin Ø 5.0 mm/ Ø 4.2 mm
Caution
tissue do not apply force onto the surgical template fixa- H6
H4
tion pins. H2
The following table summarizes the instruments used for basic implant bed preparation
according to endosteal implant diameter. All guided drills are available in short, long and
extra-long.
Instrumentation for guided basic implant bed preparation
Endosteal implant
Steps Art. No. Article Max rpm.
diameter (mm)
Ø 3.3 Ø 4.1 Ø 4.8
034.215 Milling Cutter, 600

Ø 2.8 mm, guided

Ø 3.5 mm, guided

Prepare ridge
Ø 4.2 mm, guided
1
Prepare implant 034.123 Pilot Drill, 800 *

bed to Ø 2.2 mm
034.126 Ø 2.2 mm,
2
034.129 16/20/24 mm-guided
Widen implant 034.223 Twist Drill PRO, 600 *

bed to Ø 2.8 mm
034.226 Ø 2.8 mm,
3
034.229 16/20/24 mm-guided

bed to Ø 3.5 mm
034.426 Ø 3.5 mm,
4
034.429 16/20/24 mm-guided

bed to Ø 4.2 mm
034.626 Ø 4.2 mm,
5
034.629 16/20/24 mm-guided
3.3 Basic implant bed preparation for
narrow interdental spaces
With Ø 2.8 mm sleeves for narrow interdental spaces,
no drill handles are required. After opening the gingiva
and placing the surgical template, start the basic implant
bed preparation by preparing the alveolar ridge using the
Milling Cutter Ø 2.8 mm (Step 1 below). Then, the implant
bed is directly prepared with the Twist Drill PRO Ø 2.8 mm
(Step 2 below). No pilot drilling is required. Ø 2.8 mm sleeve Ø 2.8 mm T-sleeve
Step 1 – Prepare the alveolar ridge

The Milling Cutter Ø 2.8 mm provides a flat bone surface
and a sufficiently wide area of bone.
No drill handle
necessary for guidance
Step 1a – Identify bone level
Insert the Ø 2.8 mm Milling Cutter into the sleeve in the
surgical template until it hits bone level. Use the laser
marks on the milling cutter as depth reference (2.0 mm
intervals).
Notes for Ø 2.8 mm sleeves

• No drill handle required.
• The height of the Ø 2.8 mm sleeve is 6.0 mm.
Step 1b – Prepare the alveolar ridge

Prepare the alveolar ridge to the intended depth with the
600 rpm max.
milling cutter. Use the laser marks on the milling cutter
(2 mm intervals) as depth reference, since milling cutters
have no physical stop.
Note
Millin cutters must only be used for flattening the alveo-
lar ridge.
Step 2 – Drill implant bed to Ø 2.8 mm
No drill handle
Continue the implant bed preparation with the Ø 2.8 mm necessary for guidance
Twist Drill PRO for Guided Surgery.
The guided basic implant bed preparation for narrow

600 rpm max.
interdental spaces ends here. Either continue with the
guided basic implant bed preparation of the remaining
implant sites, optionally using template fixation pins or
remove the surgical template and follow the convention-
al procedure for widening the implant bed (if necessary),
for the final implant bed preparation and the implant
placement of the current implant site. The conventional
procedure without surgical template is described in the
brochure “Straumann® Dental Implant System: Basic
Information on the Surgical Procedures” (NAMLIT 1017).
Notes for Ø 2.8 mm sleeves

• Always drill until the collar of the drill hits the sleeve in
order to reach the required osteotomy depth.
• Final implant bed preparation cannot be executed with
guided instruments, when Ø 2.8 mm sleeves are used
in the template. Make sure to have the instruments
for conventional procedures ready for use.

Additional stabilization of the surgical template can be 034.256 Template Fixation Pin Ø 2.8 mm / Ø 2.8 mm
achieved by anchoring the surgical template with tem-

plate fixation pins. Secure the pins against aspiration.
H6
H4
H2
3.4 Final implant bed preparation
Final implant bed preparation encompasses profile drilling and subsequent tapping. The pro-
cedure depends on implant type, endosteal implant diameter, and bone class.
Caution
• Final implant bed preparation (profile drilling and tapping) is not possible through Ø 2.8
mm sleeves. Remove the surgical template instead and follow the conventional
procedure without the surgical template as described in the brochure “Straumann®
Dental Implant System: Basic Information on the Surgical Procedures” (NAMLIT 1017).
• Instruments for guided profile drilling for WN implants are currently not available.
Remove the surgical template instead and use the profile drills following the conventional
procedure without the surgical template as described in the brochure “Straumann®
Dental Implant System: Basic Information on the Surgical Procedures” (NAMLIT 1017).
• Make sure to have the instruments for conventional procedures ready for use.
The surgical protocol lists the necessary instruments for final implant bed preparation.

21 033.052G SP, RN
Ø 4.1 mm,
5.0 mm H4 Ø 3.5 mm
= • RN,
Ø 4.1 mm
H4 SP,
Ø 4.1 mm
long, +1.0 mm
10 mm
guided
SLActive
3.4.1 Profile drilling for regular situations with
034.235 SP Profile Drill, Ø 3.3 mm, RN, guided
sufficient interdental space
Profile drilling prepares the implant bed for the shape of a
specific Straumann® implant. Straumann® Standard Plus,
Tapered Effect, and Bone Level implants require profile 034.752 C-Handle H6
drilling, independent of bone class. Straumann® Standard
implants are inserted without prior profile drilling.
Note
Due to the neck portion, Straumann® Standard Plus NN
implants, Ø 3.3 mm, and Straumann® Standard Plus RN
implants, Ø 4.8 mm, are inserted without prior profile
drilling.
Step 1 – Insert the guided profile drill into the C-handle

Insert the guided profile drill sideways into the cylinder
of the C-handle. Engage the guiding part by pushing the Guiding part
inserted guided profile drill downwards.
Step 2 – Place the instruments
034.235 SP Profile Drill, Ø 3.3 mm, RN, guided
Insert the assembly of C-handle and guided profile drill into
the 5.0 mm sleeve fixed to the surgical template.
034.751 C-Handle H4
Step 3 – Profile drilling 034.235 SP Profile Drill, Ø 3.3 mm, RN, guided
Shape the coronal part of the implant bed with the corre-
sponding guided profile drill. The maximum recommended
034.751 C-Handle H4
rpm for SP profile drills is 400 rpm and 300 rpm for BL/TE
profile drills.
Note
Always drill until the collar of the guided profile drill hits the
cylinder of the C-handle in order to reach the required depth.
3.4.2 Tapping for situations with sufficient interdental space
Tapping prepares the implant bed for a specific thread type. This optional step gives the sur-
geon the flexibility to adjust the surgical protocol to bone class to achieve optimal primary
implant stability. It is recommended in dense bone and for large diameter implants to keep
the insertion torque for the implant to a maximum of 35 Ncm. The table below summarizes
suggested tap usage.
Note
With Straumann® guided instruments increased insertion torques can appear due to precise
osteotomy preparation. Thus, the guidelines below should be carefully considered.
Tapping according to bone class
Bone classes* S, SP implants BL, TE implants
Endosteal diameter Endosteal diameter
Ø 3.3 mm Ø 4.1 mm Ø 4.8 mm Ø 3.3 mm Ø 4.1 mm Ø 4.8 mm
Class 1 Full Full Full Full Full Full
Class 2 Coronal Coronal Full Full Full Full
Class 3 Full Full
Class 4 Full Full
*Class 1: hardest bone, Class 4: softest bone

Coronal = thread tapping in the coronal area of the implant bed
Full = thread tapping over full depth of the implant bed
Step 1 and 2 – Insert the guided tap into the
C-handle and place the instrument
Insert the guided tap sideways into the cylinder of the C-
handle and engage the guiding part by pushing it down-
wards (see figure below). Place the assembly of C-handle
and guided tap into the sleeve (Ø 5.0 mm) fixed to the
surgical template. 034.245 S/SP Tap for handpiece, Ø 3.3 mm, guided
034.751 C-Handle H4
12
10
8
6
Guiding part
Step 3 – Tapping the thread

034.245 S/SP Tap for handpiece, Ø 3.3 mm, guided
Pre-tap the implant bed according to bone class and
endosteal diameter. Use the laser marks on the guided
taps as depth reference (2.0 mm intervals). 034.751 C-Handle H4
Caution
Do not apply torque greater than 60 Ncm. Torque values
15 rpm max.
above 60 Ncm can result in damage to the tap.
Straumann® guided taps can be used in two different
ways: coupled directly to the handpiece or to the ratchet
using the connector for ratchet (see f igures below).
Tapping with handpiece Tapping with ratchet

Connect the guided tap to the handpiece. For tapping with the ratchet use the connector for ratch-
et. The thread is tapped with slow rotating movements.
Holding key
Ratchet
Handpiece
034.245 15 rpm max.

S/SP Tap for handpiece,
Ø 3.3 mm, guided
034.005
Guided tap Connector for ratchet
Guided tap
034.245
For handpiece,
Ø 3.3 mm, guided
3.4.3 Overview guided instruments for final i mplant bed preparation
Art. No. Article Max rpm. Endosteal implant diameter (mm)
034.235 SP Profile Drill,

Ø 3.3 mm, RN, guided
400
034.435 SP Profile Drill,
034.245 S/SP Tap for Handpiece,

Ø 3.3 mm, guided

15
Ø 4.1 mm, guided

Ø 4.8 mm, guided
034.237 TE Profile Drill,

034.437 TE Profile Drill,

026.2503 BL Profile Drill,

300
Ø 3.3 mm, guided

Ø 4.1 mm, guided

Ø 4.8 mm, guided
026.251 BL/TE Tap for Handpiece,

Ø 3.3 mm, guided

15
Ø 4.1 mm, guided

Ø 4.8 mm, guided
3.5 Guided implant placement
To reach maximum precision, it is recommended to use the Straumann® guided implants in
combination with guided surgery procedures. Guided implant placement encompasses guided
implant insertion through the Straumann® Ø 5.0 mm s leeves and visual or physical depth
control. Physical depth control is achieved through usage of the stop key.
As an alternative it is also possible to remove the surgical template and place the implant
following the conventional procedure without surgical template described in the brochure
“Straumann® Dental Implant System: Basic Information on the Surgical Procedures” (NAMLIT
1017).
The following chapters describe the placement of a Straumann® Guided Implant through the
surgical template.
3.5.1 Opening the implant package
Note
Guided implant insertion is only possible through Straumann Ø 5.0 mm sleeves.
Opening of the implant packaging follows the same steps as for the non-guided implants.
Therefore, please consult the brochure “Straumann® Dental Implant System: Basic Information
on the Surgical Procedures” (NAMLIT 1017).
3.5.2 Placing the implant

A Straumann® implant can be placed either manually with the ratchet or with the aid of the
handpiece.
The following step-by-step instruction shows how a Straumann® Guided Standard Plus Implant
is placed with the handpiece (left column on the following pages) and how a Straumann®
Guided Bone Level Implant is placed with the ratchet (right column).
Note
• When using the physical depth control with the stop key, avoid making additional
adjustments that result in excessive pressure on the template or implant via the implant
and stop key. These adjustments can lead to damage of the surgical template and the
implant bed.
• Straumann® Bone Level implants must be rotationally oriented for both hand-piece and
ratchet insertion.
• Make sure that the surgical template fits firmly in the patient’s mouth before starting
guided implant insertion.
Placement with the handpiece Placement with the ratchet
Example: Straumann® Guided Standard Plus Implant Example: Straumann® Guided Bone Level Implant
Step 1 – Find the relevant information for depth

c ontrol in the surgical protocol
The guided implant transfer piece have depth marks for
the sleeve heights H2, H4 and H6, respectively. Before
implant placement, consult the surgical protocol and
confirm the sleeve height for the corresponding implant
site.
Step 2 – Attach the handpiece adapter Step 2 – Attach the ratchet adapter
Grasp the closed part of the implant carrier. Attach the Grasp the closed part of the implant carrier. Attach the
handpiece adapter to the implant transfer mount. A click is ratchet adapter to the implant transfer mount. A click is
heard when the handpiece adapter is attached correctly. heard when the ratchet adapter is attached correctly.
Step 3 – Remove the implant from the carrier Step 3 – Remove the implant from the carrier
Pull the implant carrier slightly downward to remove the Pull the implant carrier slightly downward to remove the
implant from the implant carrier. At the same time, lift implant from the implant carrier. At the same time, lift
the implant from the carrier with a slight twisting move- the implant from the carrier with a slight twisting move-
ment (while supporting your arms). ment (while supporting your arms).
Step 4 – Place the implant Step 4 – Place the implant

Place the implant with the handpiece into the respective Place the implant with the adapter into the respective
sleeve of the surgical template. Align the cylindrical part sleeve of the surgical template. Align the cylindrical part
of the guided implant transfer mount with the axis of the of the guided implant transfer mount with the axis of the
sleeve. sleeve.
Step 5 – Insert the implant with the handpiece and the Step 5 – Insert the implant with the ratchet and the
stop key stop key
Attach the stop key at the correct height to the guided im- Attach the stop key at the correct height to the guided
plant transfer piece. Insert the implant with a maximum implant transfer piece.
of 15 rpm, turning it clockwise. The final implant position
is indicated by the physical stop provided by the stop key. The clockwise arrow on the rotary knob signals the
direction of insertion (see package insert). Insert the
When using the physical depth control with the stop implant with slow movements of the ratchet. The final
key, avoid placing excessive pressure on the template or implant position is indicated by the physical stop provided
implant via the implant and stop key. Excess pressure can by the stop key.
lead to damage of the surgical template and the implant
bed. When using the physical depth control with the stop
key, avoid placing excessive pressure on the template or
As an alternative, the implant can be inserted without implant via the implant and stop key. Excess pressure can
the stop key by means of a visual depth control. lead to damage of the surgical template and the implant bed.
Caution As an alternative, the implant can be inserted without

Avoid corrections of the vertical position using reverse the stop key by means of a visual depth control.
rotations (counterclockwise). This can cause loosening of
the transfer part and may lead to a decrease in primary Caution
s tability. Avoid corrections of the vertical position using reverse
rotations (counterclockwise). This can cause loosening of the
Please make sure to use the stop key with the flat side transfer part and may lead to a decrease in primary s tability.
pointing towards the sleeve.
Please make sure to use the stop key with the flat side pointing
Note towards the sleeve.
With Straumann guided instruments, increased implant
insertion torques can appear due to precise osteotomy Note
preparation. Thus, the guidelines for tapping of the With Straumann guided instruments, increased implant
implant bed (see page 31) should be carefully considered. insertion torques can appear due to precise osteotomy
preparation. Thus, the guidelines for tapping of the
implant bed (see page 31) should be carefully considered.
Step 6 – Correct implant orientation (only needed for
Bone Level implants, not needed for S/SP/TE)
While approaching the final implant position, make
sure that one of the four laser markings on the transfer
part is exactly oriented orofacially. This positions the
four protru-sions of the internal connection for ideal
prosthetic abutment orientation. A quarter turn to the
next mark corresponds to a vertical displacement of 0.2 mm.

Step 7 – Loosen the transfer part Step 7 – Loosen the transfer part
Before removing the transfer part, set the motor on the Change the direction of the ratchet. The arrow on the
handpiece to “reverse”. During the first few turns, hold rotary knob now points counterclockwise (see package
the im-plant with the holding key which is used for insert). Use the holding key to counter the octagon and
stabilizing (countering) the hexagon. loosen the transfer part counterclockwise using the
ratchet.
3.6 Soft tissue management

Soft tissue management (and implant closure) follow the conventional procedures described
in the brochure “Straumann® Dental Implant System: Basic Information on the Surgical Proce-
dures” (NAMLIT 1017).
4. Product specifications
4.1 Sleeve-position implant-length matrix

The planning software calculates the surgical protocol based on the virtual planning of
implant placement and choice of sleeve types and positions. The surgical protocol recommends
which cylinder of the drill handle (+1.0 mm or +3.0 mm) and which drill length (short, long,
extra-long) are required for preparing the osteotomy for each specific implant.
4.1.1 Sleeve-position implant-length matrix for Ø 5.0 mm sleeves in the surgical template

Implant length 6.0 mm 8.0 mm 10.0 mm 12.0 mm 14.0 mm 16.0 mm
H2 short drill short drill long drill long drill extra-long drill extra-long drill
2.0 mm +3.0 mm +1.0 mm +3.0 mm +1.0 mm +3.0 mm +1.0 mm
drill handle drill handle drill handle drill handle drill handle drill handle
Sleeve position
H4 short drill long drill long drill extra-long drill extra-long drill
4.0 mm +1.0 mm +3.0 mm +1.0 mm +3.0 mm +1.0 mm
drill handle drill handle drill handle drill handle drill handle
H6 long drill long drill extra-long drill extra-long drill

6.0 mm +3.0 mm +1.0 mm +3.0 mm +1.0 mm
drill handle drill handle drill handle drill handle
Example: The implant bed is to be prepared for a 10.0 mm implant with a sleeve fixed to the
surgical template positioned at 4.0 mm above bone level (H4). Accordingly, the long drill and
the +1.0 mm cylinder of the drill handle must be used in order to achieve the required implant
bed depth.
4.1.2 Sleeve-position implant-length matrix for Ø 2.8 mm sleeves (narrow interdental spaces)
in the surgical template
While using Ø 2.8 mm sleeves, no drill handle is required.
Implant length 6.0 mm 8.0 mm 10.0 mm 12.0 mm 14.0 mm 16.0 mm
H2 short drill long drill extra-long drill

2.0 mm Ø 2.8 mm Ø 2.8 mm Ø 2.8 mm
no drill handle no drill handle no drill handle
Sleeve position
H4 short drill long drill extra-long drill

4.0 mm Ø 2.8 mm Ø 2.8 mm Ø 2.8 mm
no drill handle no drill handle no drill handle
H6 long drill extra-long drill

6.0 mm Ø 2.8 mm Ø 2.8 mm
no drill handle no drill handle
Example: The implant bed is to be prepared for an 8.0 mm implant with a sleeve fixed to the
surgical template positioned at 2.0 mm above bone level (H2). Accordingly, the short drill must
be used in order to achieve the required implant bed depth.
40 4. Product specifications
4.2 Straumann® guided drill design
Straumann® guided instruments have depth marks Symbol for drill length
in 2.0 mm intervals that correspond to the available

implant lengths. Compared to the Straumann® conven-
tional instruments, Straumann® guided drills are color-
coded according to the instrument diameter and denoted
according to the drill overall length on the shaft part (see
Overall length
figures below).
Guided Overall Symbol for Guided length

Drill name
length length drill length
Short 16.0 mm 32.0 mm

–
Long 20.0 mm 36.0 mm
= PRO design
for drills Ø2.8 mm,
Ø 3.5 mm, Ø 4.2 mm
Extra-long 24.0 mm 40.0 mm
Caution
Guided instruments must not be used without the indi-
cated sleeves fixed to the surgical template in order to
ensure guidance.
4. Product specifications 41
4.3 Color-coding and labeling of Straumann® cutting instruments for guided surgery
Color-coding guided instruments
Color sequence
Instrument diameter Endosteal implant diameter
blue Ø 2.2 mm Pilot drill
yellow Ø 2.8 mm Ø 3.3 mm
red Ø 3.5 mm Ø 4.1 mm
green Ø 4.2 mm Ø 4.8 mm
Overview instruments for guided basic implant bed preparation
Overall Guides Max

Art. No. Article Name Symbol
length length rpm.
034.215 Milling Cutter, Ø 2.8 mm 600
034.123 Pilot Drill, Ø 2.2 mm short – 32.0 mm 16.0 mm 800
034.126 Pilot Drill, Ø 2.2 mm long = 36.0 mm 20.0 mm 800
034.129 Pilot Drill, Ø 2.2 mm extra-long 40.0 mm 24.0 mm 800
034.223 Twist Drill PRO, Ø 2.8 mm short – 32.0 mm 16.0 mm 600
034.226 Twist Drill PRO, Ø 2.8 mm long = 36.0 mm 20.0 mm 600
034.229 Twist Drill PRO, Ø 2.8 mm extra-long 40.0 mm 24.0 mm 600
4.4 Overview of cutting instruments for guided surgery regarding depth control
Guided instruments with collar Guided instruments without collar
Guided drills Guided profile drills Milling cutters Guided taps
Depth control with physical stop Depth control with laser marks
4.5 Overview of guided implants
Art. No. Article Dimensions Specifications
033.431G Standard, guided RN, 8.0 mm, Ø 3.3 mm SLActive, Roxolid®*

033.432G Standard, guided RN, 10.0 mm, Ø 3.3 mm SLActive, Roxolid
033.451G Standard Plus, guided RN, 8.0 mm, Ø 3.3 mm SLActive, Roxolid
033.571G Tapered Effect, guided RN, 8.0 mm, Ø 4.1 mm SLActive, Roxolid
021.2208G Bone Level, guided NC, 8.0 mm, Ø 3.3 mm SLActive, Roxolid
021.4308G Bone Level, guided RC, 8.0 mm, Ø 4.1 mm SLActive, Roxolid
*TiZr
4.6 Surgical protocol template for completing manually (to be copied)
Basic implant bed preparation Final implant bed preparation
lmplant lmplant lmplant Sleeve Sleeve Milling Guided Cylinder of Guided C-handle Guided tap
position Art. No. height position cutter drill drill handle profile drill
5. Additional information
5.1 Additional information on surgical instruments

Instruments must be inspected for completeness and safe
function. An adequate stock of implants and spare sterile
instruments should always be available. The instruments
must be disassembled for sterilization. Well maintained
instruments help prevent development of infections that
could endanger patients as well as the practice team.
To help ensure patient safety, all instruments and products

used must be sterile and secured against aspiration in the
patient’s mouth. To prevent contamination of the sterile
instruments, they should be removed from the surgical
cassette and put into the handpiece or ratchet with sterile
forceps. The forceps (Art. No. 046.110) was developed
and shaped specially to allow round instruments to be
gripped securely.
46 5. Additional information
5.2 Care and maintenance of instruments
Most Straumann® components are not sterile when delivered. Use only solvents designed for
stainless steel. Follow the solvent directions for use. Do not use any disinfectants or cleaning
agents with high chlorine content or containing oxalic acid. Do not apply temperatures above
134 °C for machine cleaning or sterilization.
Guidelines for sterilizing the guided instruments utilizing the Straumann® Guided Surgery
Cassette
Fractionated vacuum method: At least 20 min. at 121 °C/250 °F or at least 3 min. (18 min. for prion
inactivation) at 132 °C/270 °F or 134 °C/273 °F.
Gravitation method: At least 5min. at 132 °C/270 °F or 134 °C/273 °F.
*No dry heat sterilization! Instruments that are not thoroughly dried may corrode.
Before sterilization, the cassette is packed (e.g. sealed in foil or wrapped in towels) in order to
maintain sterilization of product.
Precaution
• Do not use chemical sterilization.
• Do not use dry heat sterilization.
In order to avoid damaging the surgical cassette during autoclaving, it must be placed correctly
in the autoclave (see figure).
Note
All steps related to the maintenance of Straumann® surgical instruments are part of a dental
practice hygiene plan (see also “Care and Maintenance of Surgical and Prosthetic Instruments”
(USLIT 119) and “Straumann® Dental Implant System: Basic Information on the Surgical
Procedures” (NAMLIT 1017)).
5. Additional information 47
5.3 Labeling and color-coding of the Straumann® Dental Implant System
Naming and labeling explanations
Color sequence
yellow Endosteal implant diameter 3.3 mm
red Endosteal implant diameter 4.1 mm
green Endosteal implant diameter 4.8 mm
Implant types
S: Standard Implant
SP: Standard Plus Implant
TE: Tapered Effect Implant
BL: Bone Level Implant
Connection types
Ø 3.5 mm
NNC: Narrow Neck CrossFit Ø 3.5 mm
Ø 4.8 mm
RN: Regular Neck Ø 4.8 mm
Ø 6.5 mm
WN: Wide Neck Ø 6.5 mm
Ø 3.3 mm
NC: Narrow CrossFit Ø 3.3 mm
Ø 4.1 mm Ø 4.8 mm
RC: Regular CrossFit Ø 4.1 and Ø 4.8 mm
Naming and Labeling Explanations
Example of Label on Implant Packaging
Connection type Length of the SLA®/SLActive® surface
SP, Ø 4.1 mm RN, SLActice® 8 mm, Guided

Catalog number
Implant type
Standard Plus Implant, Guided 033.051G
Endosteal diameter Batch code
Ø 4.1 mm RN, SLActice® 8 mm XXXXX
JJJJ-MM
DE Implantat, geführt Use by
FR Implant, guidé
IT Impianto, guidato
PT Implante, guiado
ES Implante, guiado
Keep away from sunlight 128 Barcode

1234567891234567891234
950.206
Caution, consult accompanying
documents
SP RN
Surface type
Do not re-use Guided Ti SLActive®
Ø 4.1 8
Sterilized using 950.206
irradiation
STERILE R
Caution: U.S. Federal law restricts this device to

sale by or on the order of a licensed dentist
Manufacturer Institut Straumann AG
CH-4002 Basel 0123
Switzerland
Straumann Products with the CE mark fulfill the requirements of

The Green Dot the Medical Devices Directive 93/42 EEC
Examples
Ø 3.3 SP TE BL
SP NN
8
Ø 4.1 RN
SLActive®
10Ti
Ø 4.8 RN
SLActive®
12Ti
Ø 4.1 RC
SLActive®
12Ti
Straumann® Straumann® Straumann® Straumann®

Standard Plus Implant Standard Plus Implant Tapered Effect Implant Bone Level Implant
Endosteal diameter 3.3 mm Endosteal diameter 4.1 mm Endosteal diameter 4.8 mm Endosteal diameter 4.1 mm
Narrow Neck Regular Neck Wide Neck Regular CrossFit®
8.0 mm SLA® 10.0 mm SLActive® 12.0 mm SLActive® 12 mm SLActive®
5.4 Related documentation
Note
Our detailed documentation will help you in carefully planning and performing your implant-
based restorations:
• “Straumann® Narrow Neck: Prosthetic Options for Narrow Neck Implants” (USLIT 112)
• “Straumann® synOcta Prosthetic System: Crown and Bridge Restorations” (USLIT 187)
• “Straumann® Solid Abutment Prosthetic System: Cement-retained Crowns and Bridges
with the Solid Abutment System” (USLIT 045)
• “Straumann® Bone Level Implant Line: Basic Information on the Prosthetic Procedures”
(USLIT 232)
Instrument care and maintenance

Well-maintained instruments are a basic requirement for successful treatment. You will find
detailed information in the brochure “Care and Maintenance of Surgical and Prosthetic Instru-
ments“ (USLIT 119).
The Straumann® Guarantee

As a Swiss company, we attach the greatest importance to manufacturing our products to the
highest quality. We are firmly convinced of the scientific and clinical basis of our Straumann®
Dental Implant System and draw on the fund of know-how from nearly 30 years of quality
production. The Straumann guarantee determines the warranty of all c omponents of the
Straumann® Dental Implant System. For more information, contact your local Straumann
representative or call Straumann Customer Service at 800/210 1139.
References
The Straumann® Dental Implant System has been comprehensively clinically documented
for over 25 years. You can find references to the current research literature on our website
www.straumann.com or by contacting your local Straumann representative.
Courses and training

Continuing education promotes long-term success! Please, ask your Straumann representa-
tive directly for information on the Straumann® Dental Implant System courses and training.
Further information at www.straumann.com.
Custom-made products
Under certain circumstances, custom-made products can be supplied for special indications
or cases that cannot be treated with standard products.
A custom-made product is defined according to as being any product fabricated specifically

for a specific patient according to specific characteristics and prescribed in writing by an
appropriately qualified doctor, who assumes the responsibility.
If you require a custom-made product, please contact your customer service.
List of abbreviations
SCS Screw Carrying System
HDD Horizontal Defect Dimension
Sand-blasted, Large grit, Acid-etched,

SLActive®
chemically active and hydrophilic
SLA® Sand-blasted, Large grit, Acid-etched
NN Narrow Neck (3.5 mm)
RN Regular Neck (4.8 mm)
WN Wide Neck (6.5 mm)
Narrow CrossFit® Connection

NC
(for BL implants)
Regular CrossFit® Connection

RC
(for BL implants)
S Standard
SP Standard Plus
TE Tapered Effect
BL Bone Level
5.5 Important guidelines
Please note
Please note Explanation of the symbols on labels and instruction leaflets
Practitioners must have appropriate knowledge and instruction
Practitioners must have appropriate knowledge and instruc-
in the handling of the Straumann CADCAM products or other Batch code
tion in theproducts
Straumann handling of the Straumann®
(“Straumann Products”) fordental implants,
using the
Straumann Products
Straumann CADCAM safelyproducts,
and properly in accordance
Straumann with the
regenerative
instructions Catalogue number
products orfor use. Straumann products (“Straumann Prod-
other
ucts”) for usingProduct
The Straumann the Straumann Products
must be used safely and
in accordance withproperly
the
in accordance Sterilized using irradiation
instructions for with the instructions
use provided for use. It is the
by the manufacturer.
practitioner’s responsibility to use the device in accordance with
these instructionsfor use and to determine, if the device fits to
The Straumann Product must be used in accordance with
the individual patient situation.
the instructions for use provided by the manufacturer. It is Lower limit of temperature
the practitioner’s
The Straumann responsibility
Products are part of to
an use the
overall deviceand
concept in must
accor- …min.
be usedwith
dance only in conjunction
these with the
instructions forcorresponding original
use and to determine, if
components and instruments distributed by Institut Straumann
the device fits to the individual patient situation.
AG, its ultimate parent company and all affiliates or subsidiaries …max.
of such parent company (“Straumann”), except if stated Upper limit of temperature

otherwise
The in this document
Straumann Products orareinpart
the instructions for concept
of an overall use for theand
respective Straumann Product. If use of products
must be used only in conjunction with the correspondingmade by third
parties is not recommended by Straumann in this document or in
original components
the respective andforinstruments
instructions use, any suchdistributed
use will void by
anyInsti- …max.
tut Straumann AG, its ultimate parent company and

warranty or other obligation, express or implied, of Straumann. all affil-
iates or subsidiaries of such parent company (“Straumann”). Temperature limitation
Availability …min.
Use of products made by third parties, which are not distrib-

Some of the Straumann Products listed in this document may not
uted by Straumann,
be available will void any warranty or other obliga-
in all countries.
tion, express or implied, of Straumann. Caution: Federal law restricts this device
Caution
to sale by or on the order of a dental
In addition to the caution notes in this document, our products
Availability professional.
must be secured against aspiration when used intraorally.
Some of the Straumann Products listed in this document
Validity
may not be available in all countries.
Upon publication of this document, all previous versions are Do not re-use
superseded.
Caution
In addition to the caution notes in this document, our
Documentation
For detailedmust
instructions on the against
Straumann Products contact Non-sterile
products be secured aspiration when your
used
Straumann representative.
intraorally.
Copyright and trademarks Caution, consult accompanying documents
Validity
Straumann® documents may not be reprinted or published, in
whole publication
Upon or in part, without
of thisthe written authorization
document, all previousofversions are
Straumann. Straumann® and/or other trademarks and logos
superseded.
from Straumann® mentioned herein are the trademarks or Use by
registered trademarks of Straumann Holding AG and/or its
affiliates.
Documentation
For detailed instructions on the Straumann Products contact
Keep away from sunlight
your Straumann representative.
Copyright and trademarks Straumann Products with the CE mark fulfill

Straumann® documents may not be reprinted or published, the requirements of the Medical Devices
in whole or in part, without the written authorization of Directive 93/42 EEC
Straumann. Straumann® and/or other trademarks and logos
0123
from Straumann® mentioned herein are the trademarks or
registered trademarks of Straumann Holding AG and/or its
affiliates.
Consult instructions for use
53
Index
alveolar ridge 19, 26 Guided instruments 5, 14, 15, 17
Basic implant bed preparation for narrow interdental spaces 26 Color-coding 42
Basic implant bed preparation for regular situations 19 Overview 43
Bone classes 31 Guided profile drilling 29
Care and maintenance of instruments 47 Guided profile drills 43
Chemical sterilization 47 Guided taps 32
Cleaning agents 47 Guttapercha 4

Disinfection/sterilization of the surgical template 10 Implant closure 39
Dry heat sterilization 47 Instrument irrigation 9
Steam Sterilization Prevacuum Cycle 47
Intermittent drilling technique 17
Sterilization 16, 47
Labeling 42
C-handles for fine implant bed preparation 13
Lateral pressure 17
Clinical solutions 6
Milling cutters 11, 20, 26, 43
Color-coding of drill handels 12
Mucosa 6
Connector for ratchet 33
Mucosa punch 18
Contamination 46
Narrow interdental spaces 7, 26
Cooling of drills 17
Open system 5
CT scanning 5
Osteotomy preparation 19
Dental practice hygiene plan 47
Overall length 41
Drill handles for basic implant bed preparation 11
Overlength 17
Color-coded 12
Patient safety 46
Cylinder of the drill handle 11
Patient’s mouth opening 4
Symbol-marked 12
Planning 6
Drill sleeves with collar 17
Planning software 4
Drill stops 17
Preoperative planning 5, 19
Drill tip 17
PRO design 41
Endosteal implant diameter 19, 25
Profile drilling for regular situations 29
Fabrication scan prosthesis 4
Prosthetic procedures 5
Fine implant bed preparation 28
Reference marks 4
Flapless surgery 22, 23, 24
Regular situations with sufficient space 7, 19, 29, 31
Guided basic implant bed preparation for narrow interdental spaces
26 Scanning instructions 5
Guided basic implant bed preparation for regular situations 19 Scan prosthesis fabrication 4
Guided drills 11, 25, 41, 43 Sleeve-in-sleeve concept 11, 13
Guided length 41, 42

Straumann® guided drill design 41
Guided fine implant bed preparation 28
54 6. Index
Sleeve-position implant-length matrix 15, 40
Sleeve-position implant-length matrix for Ø 2.8 mm sleeves in
the surgical template 40
Sleeve-position implant-length matrix for Ø 5 mm sleeves in the
surgical template 40
Sleeve positions 9
H2 9, 13
H4 9, 13
H6 9, 13
Sleeves for surgical templates 7

Ø 2.8 mm sleeves 7
Ø 2.8 mm T-sleeve 8
Ø 5.0 mm sleeves 7
Ø 5.0 mm T-sleeve 8
Sleeve collision 7
Sleeve diameter 8
Sleeve height 8
Soft tissue management 39
Software based planning 5
Straumann® Bone Level Implant Line 5
Straumann® Dental Implant System 3, 4, 47
Straumann® Guided Surgery Cassette 16
Straumann® Guided Surgery concept 11
Surgical procedures 18
Surgical protocol for guided surgery 14
Surgical template 6
Surgical template fabrication 10
Surgical template fixation 9
Surgical template manufacturer 5, 7
Surgical template pre-processing 10
Symbol-marked of drill handles 12
Tapping for regular situations 31
Tapping with handpiece 33
Tapping with ratchet 33
Teeth 6
Template fixation pins 22, 23, 24, 27
Thermoplastic drill templates 17
Tooth set-up 4
Treatment plan 4
T-sleeve 7
Virtual plan 14
Windows in the surgical template 10
6. Index 55
NOTES
56
International Headquarters Straumann North American Headquarters
Institut Straumann AG Straumann USA, LLC
Peter Merian-Weg 12 60 Minuteman Road
CH-4002 Basel, Switzerland Andover, MA 01810
Phone +41 (0)61 965 11 11 Phone 800/448 8168 (US)  800/363 4024 (CA)
Fax +41 (0)61 965 11 01 Fax 978/747 2490
7/14
www.straumann.us  www.straumann.ca
NAMLIT 1006
© Straumann USA, LLC 2014. All rights reserved.

Straumann® and/or other trademarks and logos from Straumann® that are mentioned herein are the trademarks or registered trademarks of Straumann Holding AG
and/or its affiliates. All rights reserved.

Straumann Guided Surgery Manual PDF

Uploaded by

Copyright:

Available Formats

Straumann Guided Surgery Manual PDF

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Straumann Guided Surgery Manual PDF

Uploaded by

Copyright:

Available Formats

Basic information on

Straumann® guided surgery.

About this guide 3 3.5 Guided implant placement 35

The manual is divided into the following main parts:

Please contact your local Straumann representative for more details.

1. Patient Evaluation 2. Fabrication scan prosthesis 3. CT scanning 4. Software based planning

Step 4 – Software-based planning and ­ fabrication Step 6 – Prosthetic procedures

 tep 5 – Surgery with Straumann® guided i­ nstruments &

2.1 Surgical template

2.1.1 Surgical template fixation

Bone-supported Mucosa-supported Teeth-supported

6 2. Planning and clinical solutions

• Ø 5.0 mm sleeves for regular situations with sufficient space for

• Ø 2.8 mm sleeves for narrow

Sleeve collision due to inclination

Use a Ø 2.8 mm sleeve instead

Furthermore, the sleeves are available in two different ­designs:

Which sleeve design is used depends on the surgical ­template

2. Planning and clinical solutions 7

034.053V4 d = 5.0 mm Dcollar = 7.0 mm Yes

8 2. Planning and clinical solutions

Ø 5.0 mm sleeve Ø 2.8 mm sleeve

While determining the corresponding sleeve position

• The surgical template fixation (mucosa-, bone- or

2. Planning and clinical solutions 9

2.1.5 Surgical template pre-processing

10 2. Planning and clinical solutions

2.2.1 D rill handles for basic implant bed preparation

Every drill handle features one cylinder with an additional

The surgical protocol (see chapter 2.2.3) lists which cylinder

2. Planning and clinical solutions 11

12 2. Planning and clinical solutions

Art. No. Article Sleeve position

The Straumann® C-handles direct guided profile drills and

2. Planning and clinical solutions 13

Basic implant bed Final implant bed

14 2. Planning and clinical solutions

2.2.4 Straumann® guided implants

The only difference between the guided and standard

Only select Straumann implants are available as guided

2. Planning and clinical solutions 15

The color-coded sequences on the cassette help ensure

16 2. Planning and clinical solutions

2. Planning and clinical solutions 17

3.1 Use of the mucosa punch

Art. No. Article Max rpm.

034.010 Mucosa punch, Ø 3.4 mm, guided 15

034.011 Mucosa punch, Ø 4.0 mm, guided 15

034.012 Mucosa punch, Ø 4.7 mm, guided 15

Basic implant bed Final implant bed

Step 1 Steps 2-5

Art. No. Article Max rpm. Endosteal implant diameter (mm)

Ø 3.3 Ø 4.1 Ø 4.8

Step 1a – Identify bone level

Step 2 – Prepare implant bed to Ø 2.2 mm

For an implant with an endosteal diameter of Ø 3.3 mm,

Option – Template fixation pins

Step 4 – Widen implant bed to Ø 3.5 mm

For an implant with an endosteal diameter of Ø 4.1 mm,

Option – Template fixation pins

Step 4 – Software-based planning and fabrication Step 6 – Prosthetic procedures

tep 5 – Surgery with Straumann® guided i nstruments &

Furthermore, the sleeves are available in two different designs:

Which sleeve design is used depends on the surgical template

2.2.1 D rill handles for basic implant bed preparation