NobelParallel™ Conical Connection Procedures manual

NobelParallel™ Conical Connection Procedures manual
NobelParallel™ Conical Connection
Procedures manual
Note: In order to improve readability, Nobel Biocare does
not use ™ or ® in the running text. By doing so, however,
Nobel Biocare does not waive any right to the trademark
or registered mark and nothing herein shall be construed
to the contrary.
Disclaimer: Some products may not be regulatory
cleared/released for sale in all markets. Please contact
the local Nobel Biocare sales office for current product
assortment and availability.
NobelParallel™ Conical Connection Manual
3
Contents
Introduction
Quick guide
Color-coding for accurate component identification
Technical specifications
Implant specifications
4
6
7
8
Surgical procedure
Important considerations
Surgical access
Drill sequence
Dense bone situations
Implant insertion
10
11
12
15
19
Restorative procedure
Important considerations
Finalization of implant surgery and temporary restorations
23
25
Product information
Flowcharts32
Surgery kits
36
Implants39
Surgical components
40
Temporary restorations
42
Appendices
Manual torque wrench
Drill stops
Cleaning and sterilization
Customer service worldwide
44
45
46
51
4
NobelParallel™ Conical Connection Manual // Introduction
Quick guide
Flap technique
Twist Drill with Tip ∅ 2 mm
Twist Step Drill
∅ 2.4/2.8 mm
Twist Step Drill
∅ 3.2/3.6 mm
Cortical Drill
∅ 4.3 mm
Flapless technique
Twist Drill with Tip ∅ 2 mm
Note: The illustrations show the drill sequence for NobelParallel
Conical Connection RP 4.3 in medium bone. For other implant
diameters and bone densities, see drill protocols on page 13.
NobelParallel™ Conical Connection // Introduction
Two-stage
delayed function
Screw Tap
∅ 4.3 mm
optional
Implant placement
One-stage
Immediate Function
One-stage
delayed function
5
6
NobelParallel™ Conical Connection Manual // Introduction
Color-coding for accurate
component identification
The color of the implant vial cap refers to the
diameter of the implant.
The color of the sticker on the implant vial
cap refers to the implant platform size.
All prosthetic components are color coded
accordingly.
Implant platform
NP
RP
RP
WP
Implant diameter
3.75
4.3
5.0
5.5
Color coding
NobelParallel™ Conical Connection // Introduction
Technical specifications
∅ 3.5
∅ 5.1
Platform concept
– To facilitate treatment planning, clinical procedures, and
component identification, NobelParallel Conical Connection
implants are organized according to a “platform concept”.
The platform marking corresponds to the implant-abutment
interface.
– For accurate component identification prosthetic components are color-coded as follows: magenta for Narrow
Platform (NP), yellow for Regular Platform (RP), and blue
for Wide Platform (WP).
Platform
Platform
diameter
Lengths
∅ 3.5
Implant
diameter
Abutment
interface
∅ 3.75­
∅ 3.0
7
8.5
10
11.5
13
15
18
Narrow Platform: Limited interdental space. Not enough alveolar bone for an RP implant.
Caution: Narrow Platform implants are not recommended for use in the posterior region.
∅ 3.9
∅ 5.1
All measurements are in mm.
∅ 4.3­
∅ 3.4
7
8.5
10
11.5
13
15
18
∅ 5.0­
∅ 3.4
7
8.5
10
11.5
13
15
18
∅ 5.5­
∅ 4.4
7
8.5
10
11.5
13
15
–
7
8
NobelParallel™ Conical Connection Manual // Introduction
Implant specifications
C
A B
E
D
G
J
F
I
E
H
NobelParallel™ Conical Connection // Introduction
A
B
C
D
E
F
G
H
I
J
Bevel height
Rim height
Bevel angle
Thread pitch
(double
thread)
Major
diameter
1
Major
diameter
2
Overall
length
Tip
diameter
Abutment
interface
Bridge
interface
3.75×7 mm
0.1
0.5
45°
1.2
3.75
3.5
6.5
2.0
3.0
3.5
3.75×8.5 mm
0.1
0.5
45°
1.2
3.75
3.5
8.0
2.0
3.0
3.5
3.75×10 mm
0.1
0.5
45°
1.2
3.75
3.5
9.5
2.0
3.0
3.5
3.75×11.5 mm
0.1
0.5
45°
1.2
3.75
3.5
11.0
2.0
3.0
3.5
3.75×13 mm
0.1
0.5
45°
1.2
3.75
3.5
12.5
2.0
3.0
3.5
3.75×15 mm
0.1
0.5
45°
1.2
3.75
3.5
14.5
2.0
3.0
3.5
3.75×18 mm
0.1
0.5
45°
1.2
3.75
3.5
17.5
2.0
3.0
3.5
4.3×7 mm
0.2
0.5
45°
1.2
4.3
4.1
6.5
2.4
3.4
3.9
4.3×8.5 mm
0.2
0.5
45°
1.2
4.3
4.1
8.0
2.4
3.4
3.9
4.3×10 mm
0.2
0.5
45°
1.2
4.3
4.1
9.5
2.4
3.4
3.9
4.3×11.5 mm
0.2
0.5
45°
1.2
4.3
4.1
11.0
2.4
3.4
3.9
4.3×13 mm
0.2
0.5
45°
1.2
4.3
4.1
12.5
2.4
3.4
3.9
4.3×15 mm
0.2
0.5
45°
1.2
4.3
4.1
14.5
2.4
3.4
3.9
4.3×18 mm
0.2
0.5
45°
1.2
4.3
4.1
17.5
2.4
3.4
3.9
5.0×7 mm
0.2
0.6
25°
1.6
5.0
4.7
6.5
2.7
3.4
3.9
5.0×8.5 mm
0.2
0.6
25°
1.6
5.0
4.7
8.0
2.7
3.4
3.9
5.0×10 mm
0.2
0.6
25°
1.6
5.0
4.7
9.5
2.7
3.4
3.9
5.0×11.5 mm
0.2
0.6
25°
1.6
5.0
4.7
11.0
2.7
3.4
3.9
5.0×13 mm
0.2
0.6
25°
1.6
5.0
4.7
12.5
2.7
3.4
3.9
5.0×15 mm
0.2
0.6
25°
1.6
5.0
4.7
14.5
2.7
3.4
3.9
5.0×18 mm
0.2
0.6
25°
1.6
5.0
4.7
17.5
2.7
3.4
3.9
5.5×7mm
0.2
0.6
45°
1.6
5.5
5.3
6.5
3.0
4.4
5.1
5.5×8.5 mm
0.2
0.6
45°
1.6
5.5
5.3
8.0
3.0
4.4
5.1
5.5×10 mm
0.2
0.6
45°
1.6
5.5
5.3
9.5
3.0
4.4
5.1
5.5×11.5 mm
0.2
0.6
45°
1.6
5.5
5.3
11.0
3.0
4.4
5.1
5.5×13 mm
0.2
0.6
45°
1.6
5.5
5.3
12.5
3.0
4.4
5.1
5.5×15 mm
0.2
0.6
45°
1.6
5.5
5.3
14.5
3.0
4.4
5.1
Platform
NP
3.75
RP
4.3
RP
5.0
WP
5.5
All measurements in mm. Sectional measurements do not necessarily add up to total length.
9
10
NobelParallel™ Conical Connection Manual // Surgical procedure
Important considerations for implant placement
NobelParallel Conical Connection is an endosseus threaded
dental implant made from biocompatible commercially pure
grade 4 titanium with TiUnite surface.
Indications
NobelParallel Conical Connection implant restorations range
from single tooth to fixed-removable full dental arch overdenture applications to restore chewing function. This can be
achieved by a one-stage or two-stage surgical technique in
combination with immediate, early or delayed loading protocols, recognizing sufficient primary stability and appropriate
occlusal loading for the selected technique. Implants allow
also for bi-cortical anchorage in cases of reduced bone density to obtain high primary stability.
− in whom adequate sizes, numbers or desirable positions of
implants are not reachable to achive safe support of functional or eventually parafunctional loads.
− allergic or hypersensitive to commercially pure titanium
grade 4 or titanium alloy Ti-6Al-4V (titanium, aluminum,
vanadium).
Warnings
Failure to recognize actual lengths of drills relative to radiographic measurements can result in permanent injury to
nerves or other vital structures. Drilling beyond the depth
intended from lower jaw surgery may potentially result in
permanent numbness to the lower lip and chin or lead to a
hemorrhage in the floor of the mouth.
Contraindications
It is contraindicated placing NobelParallel CC implants
in patients:
− who are medically unfit for an oral surgical procedure.
−w
ith inadequate bone volume unless an augmentation
procedure can be considered.
Besides the mandatory precautions for any surgery such as
asepsis, during drilling in the jaw bone, one must avoid
damage the nerves and vessels by referring to anatomical
knowledge and preoperative radiographs.
Narrow platform: Limited inter-dental space. Not enough
alveolar bone for an RP implant.
Regular platform: From single anterior tooth loss to fullarch
restorations.
Wide platform: In molar areas a wider platform might be appropriate to maintain proper emergence profile to support the
soft tissue.
Caution
Particular caution should be used when placing narrow
platform implants in the posterior region due to risk of
prosthetic overload.
Minimal distances
Approximate minimal distances between implants (in mm) for
restorative simplicity taking the average size of the final restoration (incisors, canines, premolars and molars) into account.
6.0
NP 3.75
3.5
NP 3.75
7
7.5
RP 4.3
8
RP 5.0
4.5
WP 5.5
NobelParallel™ Conical Connection Manual // Surgical procedure
11
Surgical access
Standard flap procedure
Used when it is necessary:
– to observe the underlying alveolar bone and adjacent
anatomical structures.
– to place bone and/or connective tissue grafts.
Flapless procedure
May be used when:
– there is sufficient quantity and quality of alveolar bone
and soft tissue.
– it is not necessary to raise a flap to safely direct the drilling
procedure in relation to the anatomy.
Caution:
– When using a flapless approach add soft tissue height
to drill depth.
– Confirm available bone and significant anatomical landmarks, such as blood vessels, nerves, and concavities. Use
conventional diagnostic tools, such as radiographic imaging, probing and palpation and 3D imaging if indicated.
12
NobelParallel™ Conical Connection Manual // Surgical procedure
Drill sequence
15 mm
13 mm
10 mm
7 mm
1 mm
0 mm
Caution: Twist Drills and Twist Step Drills extend up
to 1 mm longer than the implant when seated. Allow
for this additional length when drilling near vital anatomical structures.
Drills are made of stainless steel with a diamond like carbon
(DLC) coating, which gives them their black color. They are
used with external irrigation and are available in three
lengths: 7–10, 7–15 and 10–18 mm.
– In dense bone situations, drill with continuous back and
forth motion.
– Move the drill up without stopping the handpiece motor.
This allows the irrigation to flush away debris.
– Proceed until the desired depth reference line is reached.
– Screw taps are available for dense bone situations to avoid
excessive torque during implant insertion (max. 45 Ncm).
Notes:
– In situations where adjacent natural teeth interfere with the
contra-angle head and prevent the drill from reaching the
desired depth, a drill extension shaft may be used.
– Stop drilling if there is no irrigation.
– When using a drill extension shaft, it is important to supplement cooling at the tip of the drill with manual irrigation.
– Drills and Screw Taps are delivered sterile and are for single
use only. Do not resterilize.
Depth measurement system
All drills and components are marked to prepare the site to the
correct depth and obtain a secure and predictable ­position.
The marks on the Twist Drills and Twist Step Drills indicate
actual millimeter lengths and correspond to the top of the implant collar.
Final vertical positioning depends on several clinical
parameters such as:
– Esthetics
– Tissue thickness
– Available vertical height
– Flapless procedure: Measure soft tissue thickness with a
probe. Add tissue thickness to drilling depth for correct site
preparation.
NobelParallel™ Conical Connection Manual // Surgical procedure
Drill protocols according to bone quality
During drilling procedures bone quality should be considered.
Recommended drill sequences are based on bone quality to
ensure optimal primary stability when applying Immediate
Function. Drills are used to the full drilling depth.
Drill data are stated in mm.
13
Optional Drills
The drill protocol has been developed to achieve an implant
­insertion torque between 35 and 45 Ncm for all bone densities.
This is to ensure sufficient primary stability to enable
­Immediate Function where appropriate.
If bone density is inconsistent (varying between medium and
soft or medium and dense bone), optional drills can be added
to the drill protocol to ensure the torque level does not
­exceed 45 Ncm. These optional Twist Step Drills and Screw
Taps are denoted below in parentheses.
Caution: Never exceed an insertion torque of 45 Ncm for the
implants. Overtightening may damage or fracture the implant
and could cause necrosis of the bone site.
Platform
Implant ∅
Soft bone
Medium bone
Dense bone
Type IV
Type II–III
Type I
NP
3.75
2.0
[2.4/2.8]
2.0
2.4/2.8
Cortical Drill 3.75
[Screw Tap 3.75]
2.0
2.4/2.8
2.8/3.2
Cortical Drill 3.75
Screw Tap 3.75
RP
4.3
2.0
2.4/2.8
[3.2/3.6]
2.0
2.4/2.8
3.2/3.6
Cortical Drill 4.3
[Screw Tap 4.3]
2.0
2.4/2.8
3.2/3.6
Cortical Drill 4.3
Screw Tap 4.3
RP
5.0
2.0
2.4/2.8
3.2/3.6
[3.8/4.2]
2.0
2.4/2.8
3.2/3.6
3.8/4.2
Cortical Drill 5.0
[Screw Tap 5.0]
2.0
2.4/2.8
3.2/3.6
3.8/4.2
Cortical Drill 5.0
Screw Tap 5.0
WP
5.5
2.0
2.4/2.8
3.2/3.6
4.2/4.6
[4.2/5.0]
2.0
2.4/2.8
3.2/3.6
4.2/5.0
Cortical Drill 5.5
[Screw Tap 5.5]
2.0
2.4/2.8
3.2/3.6
4.2/5.0
Cortical Drill 5.5
Screw Tap 5.5
Note: All data are in mm and the drills within square brackets denoted as optional.
Drilling must proceed at high speed (max. 2’000 rpm for
Twist Drills and Twist Step Drills) under constant and ­profuse
irrigation by sterile saline at room temperature.
14
NobelParallel™ Conical Connection Manual // Surgical procedure
Drill protocols / product reference lines
Demonstration of the drill protocol for a ∅ 4.3 × 13 mm
implant in soft, medium and dense bone.
Soft bone
13 mm
0 mm
Precision
Drill
[optional]
∅ 2.0
Twist Drill
Direction
Indicator
∅ 2.4/2.8
Twist Step
Drill
Direction
Indicator
∅ 3.2/3.6 Twist Step
Drill
[optional]
Implant
4.3 × 13
Medium bone
13 mm
0 mm
Precision
Drill
[optional]
∅ 2.0 Twist Drill
Direction
Indicator
∅ 2.4/2.8 Twist Step
Drill
Direction
Indicator
∅ 4.3
∅ 4.3
∅ 3.2/3.6 Twist Step Cortical Drill Screw Tap
[optional]
Drill
Implant
4.3 × 13
Dense bone
13 mm
0 mm
Precision
Drill
[optional]
∅ 2.0 Twist Drill
Direction
Indicator
∅ 2.4/2.8 Twist Step
Drill
Direction
Indicator
∅ 4.3
∅ 4.3
∅ 3.2/3.6 Twist Step Cortical Drill Screw Tap
Drill
Implant
4.3 × 13
NobelParallel™ Conical Connection Manual // Surgical procedure
15
Dense bone situations
Use of a Cortical Drill
In situations with dense bone or a thick cortex, it is mandatory to use the cortical drill to avoid compression.
Note: It is not recommended to use a cortical drill for sinus lift procedures. This is in order to maximize the potential for primary stability.
Courtesy of Dr. Claude Authelain, Strasbourg
Use of a Screw Tap
In situations with dense bone or a thick cortex, it is mandatory to use the screw tap in order to fully seat the implant.
Note: When the depth marking of the screw tap is aligned
with the implant length the apical portion is not pretapped to allow direct engagement in the apical portion.
Courtesy of Dr. Claude Authelain, Strasbourg
16
NobelParallel™ Conical Connection Manual // Surgical procedure
Flapless procedure
Choose between the following two options and continue
with the drill sequence on page 17, starting with step 3.
Option A
– Drill to the appropriate depth using the Twist Drill with Tip
∅ 2 mm. A drill stop can be used.
Maximum speed
2000 rpm
Note: Measure the soft tissue thickness with a probe. Add
this tissue thickness to the drilling depth for correct site preparation. Be aware of anatomical landmarks.
Option B
– To facilitate initial soft tissue penetration and creation of a
crestal starting point (also after flap preparation), the Precision Drill can be used before Twist Drill with Tip ∅ 2 mm.
– Drill with the precision drill through soft tissue and into the
alveolar crest.
Maximum speed
2000 rpm
∅ 2 mm
10 mm
NobelParallel™ Conical Connection Manual // Surgical procedure
Flap procedure
The following ilustrations show the drill sequence for
­NobelParallel Conical Connection RP 4.3 in medium and
dense bone. For other implant diameters and bone densities,
see page 13.
1 Raise a flap
When using a flap procedure, make an incision and raise a
flap.
2 Drill with Precision Drill
To facilitate creation of a crestal starting point, the Precision
Drill can be used before Twist Drill with Tip ∅ 2.0mm.
Maximum speed
2000 rpm
3 Drill with Twist Drill with Tip ∅ 2 mm
Drill to the appropriate depth using the Twist Drill with Tip
∅ 2 mm. A drill stop can be used.
Maximum speed
2000 rpm
4 Check osteotomy direction
Check correct direction using Direction Indicator
∅ 2.0/2.4–2.8 mm.
Notes:
– If applicable, take a radiograph to verify correct direction.
– When placing multiple implants, proceed to the next implant site before continuing to next drill sequence.
5 Drill with Twist Step Drills
– Continue site preparation using Twist Step Drill ∅ 2.4/2.8 mm.
–C
heck orientation using Direction Indicator ∅ 2.0/2.4-2.8 mm.
– Continue site preparation using Twist Step Drill ∅ 3.2/3.6 mm.
Maximum speed
2000 rpm
17
18
NobelParallel™ Conical Connection Manual // Surgical procedure
6 Drill with Cortical Drill
Finalize site preparation using Cortical Drill RP 4.3 mm.
Notes:
– It is mandatory to use a Cortical Drill in medium/dense bone
and with thick cortical layers in order to fully seat the implant and release pressure around the implant neck.
– It is not recommended to use a Cortical Drill for sinus lift
procedures in order to maximize the potential for primary
stability.
Maximum speed
2000rpm
For more information about the use of a Cortical Drill, please
refer to page 15.
7 Determine implant length
Use the Depth Probe to verify the desired depth has been
achieved (including soft tissue thickness, if applicable).
8 Use of Screw Tap in dense bone
– It is mandatory to use a Screw Tap in dense bone and with
thick cortical layers in order to fully seat the implant.
– Place Screw Tap RP 4.3 mm into prepared implant site using
low speed to appropriate reference line of implant.
– When the threads engage, allow Screw Tap to f­ eed without
pressure to defined depth.
– Switch the handpiece to reverse mode and back the Screw
Tap out.
– Continue with implant installation until desired position
achieved using max. 45 Ncm installation torque.
Low speed 25 rpm
For more information about the use of a Screw Tap, please
refer to page 15.
NobelParallel™ Conical Connection Manual // Surgical procedure
Implant insertion
1 Unpack implant
Each implant is packaged in a double sterile vial system. The
outer package has a printed label with product data including diameter and length. Its cap is color-coded to identify the
implant diameter. The inner casing is also marked with implant
diameter and length.
– Pull the red tab to disengage the plastic shrink-rap film and
unscrew the color-coded lid.
– Take out the sterile inner casing and lift off the plastic cap to
gain access to implant.
– Record the implant size and LOT number on the patient’s
chart with the two peel-off labels from the outer vial.
Note: The Cover Screw is co-packed with the implant.
2 Choose insertion instrument
Depending on the clinical situation and accessibility, there are
two different options to insert the implant:
A With a drilling unit and contra-angle
B With Manual Torque Wrench Surgical
A Drilling unit with contra-angle
Note: It is possible to start the implant insertion manually, using the Manual Torque Wrench.
Caution: Over tightening of implant may lead to damage ­of
the implant, fracture or necrosis of the bone site. If a Surgical
Driver is used to insert the implant, special care needs to be
taken to avoid over tightening.
B Manual Torque Wrench Surgical
19
20
NobelParallel™ Conical Connection Manual // Surgical procedure
3 Pick up implant
– Connect the appropriate Implant Driver to the insertion
instrument.
– Pick up the implant from the inner casing by applying light
pressure on the implant driver and carefully turning the casing counter-clockwise until Implant Driver is fully seated.
Tip: The Implant Drivers have markings to facilitate the insertion of the driver into the implant.
A
B
Caution: Make sure that the Implant Driver is fully seated.
4 Insert implant
– Begin inserting the implant into the osteotomy.
– When using a drilling unit, start inserting the implant using
low speed.
Low speed 25 rpm
Max. torque 45 Ncm
Notes:
– Caution: Never exceed insertion torque of 45 Ncm for the
implants. Overtightening an implant may lead to damage of
the implant, fracture or necrosis of the bone site. If a Surgical
Driver is used to insert the implant, special care needs to be
taken to avoid overtightening.
– Caution: If the implant gets stuck during implant installation
or 45 Ncm of insertion torque is achieved before it is fully
seated, rotate the implant counterclockwise using drilling
device (reverse mode) or Manual Torque Wrench and remove the implant from site. Replace the implant back into
the inner casing before proceeding further.
– Use Screw Tap to widen the osteotomy as outlined in step
8 (page 18) of the drill section.
– Pick up and insert the implant again as outlined in steps 3
and 4 above.
A
B
NobelParallel™ Conical Connection Manual // Surgical procedure
5 Tighten manually
– Connect the Manual Torque Wrench Surgical to the Manual
Torque Wrench Adapter and place the implant to final
depth.
– For Immediate Function, the implant should withstand a final
insertion torque of at least 35 Ncm. Do not exceed 45 Ncm.
– Remove Implant Driver.
– If the Implant Driver is difficult to remove, slightly rotate it
counter-clockwise before disengagaing.
In case of strong resistance
Excessive torque while inserting the implant must be avoided.
It can cause deformation of the implant or connection and
may result in excessive compression of the bone.
If strong resistance (max 45 Ncm) is encountered at any
point during insertion, remove the implant and place it back
into the inner casing. Widen the implant site ­according to the
drill protocol or use Screw Tap matching
the diameter of the implant.
Markings for 15, 35 and 45 Ncm.
21
22
NobelParallel™ Conical Connection Manual // Surgical procedure
6 Final implant placement
– For maximum esthetic results, place the implant on the level
of the buccal bone or 0.5 – 1 mm below (A).
– When placing the implant, align one of the black hex indicators on the implant driver parallel to the buccal wall. This
ensures that one of the flat sides of the hexagon is parallel to
the buccal side (B), ensuring preferred prosthetic abutment
orientation.
A
Notes:
– The implant driver has a 3 mm height indicator to facilitate
vertical implant positioning and six black lines correlating
to the flat sides of the implant hexagon (C).
B
C
Hex indicators
{
{
3 mm
Hex and height indicators on implant driver
NobelParallel™ Conical Connection Manual // Restorative procedure
Important considerations
Prosthetic interface
– Restorative flexibility with dual-function prosthetic connection: internal conical connection for abutments and external
platform for implant-level bridge restorations.
– Built-in platform shifting improves the soft-tissue interface
for natural-looking esthetics.
Conical seal for abutments
Impression coping seating
Proper seating of the impression coping is essential for a
correct impression.
To verify that the impression copings are properly seated,
check that the groove on the impression coping sits right at
the level of the implant shoulder. Use a perpendicular radiograph if necessary.
Shoulder seating for
NobelProcera Implant Bridge
23
24
NobelParallel™ Conical Connection Manual // Restorative procedure
Abutment seating
Correct positioning of the abutment is essential for the
prosthetic outcome and long-lasting function. Verify correct
vertical abutment seating by using radiographic imaging.
–Position the abutment into the implant head and make sure
the hexagonal extension engages properly by gently turning and pushing.
–Make sure the abutment feels secure in place horizontally
and vertically.
– Tighten the screw, but not to full torque.
–Take a radiograph to verify proper and full abutment seating:
- No apparent bone interference
- Alignment of long axes of implant and abutment
- No gap in conical interface
– Space at the bottom of the connection should appear
parallel and measure less than 1 mm.
– Tighten the abutment screw to final torque. Tightening
torque for NP, RP and WP abutments is 35 Ncm.
2.3 mm
<1 mm
Final abutment position with
space less than 1 mm
NobelParallel™ Conical Connection Manual // Restorative procedure
25
Finalization of implant surgery and
temporary restorations
There are three options for finalizing the implant surgery.
Two-stage delayed function
One-stage delayed function
One-stage Immediate Function
Use Screwdriver Unigrip to connect
the cover screw to the implant. Suture
the tissue flap using the desired
technique.
Use Screwdriver Unigrip to connect ­­
the healing abutment to the implant.
If applicable, suture back the soft tissue.
Provisionalize the implant for
immediate esthetics and function,
­using Nobel Biocare temporary or ­
final abutments.
Note: If the final restoration is an implant-level NobelProcera Implant Bridge or a non-engaging GoldAdapt Abutment, use ­
a Healing Abutment Bridge to prevent tissue overgrowth on the horizontal implant platform.
26
NobelParallel™ Conical Connection Manual // Restorative procedure
Two-stage delayed function
1 Uncover the implant
––Make an incision to expose the Cover Screw or use the
Soft Tissue Punch if there is sufficient amount of attached
mucosa.
––Remove the Cover Screw using a Screwdriver Manual ­Unigrip.
2 Remove bone overgrowth
––In cases of bone growing over the Cover Screw, remove the
bone with a rotating instrument and/or a curette. Be careful
not to damage the seating for the Screwdriver Manual Unigrip.
––After removing the Cover Screw, remove any bone around
the implant platform that will hinder an abutment being fully
seated on the implant platform. This is often the case when
the implant has been placed below the bone crest. For bone
removal, use the Bone Mill Guide and Bone Mill for the corresponding platform.
––The Bone Mill can be handled either manually (with the handle
for machine instruments) or with the drilling ­machine.
One-stage delayed function
1 Connect healing abutment
––Connect a suitable healing abutment to the implant using
the Screwdriver Manual Unigrip.
––If a flap is prepared, suture back the soft tissue.
Alternative: If possible, connect the final abutment using
corresponding Screwdriver.
NobelParallel™ Conical Connection Manual // Restorative procedure
One-stage Immediate Function procedures
Temporary single-unit restoration, cement-retained
(chair-side procedure)
The following illustrations show the use of the Immediate
Temporary Abutment. Please see also Instructions For Use for
Immediate Temporary Abutment.
Provisionalization must be done in Immediate Function cases
and is also a common option to altering the soft tissue after a
healing abutment has been used (soft tissue management).
1 Connect abutment to implant
– Attach the abutment onto the implant and tighten with the
Screwdriver Machine Multi-unit and the Manual Torque
Wrench Prosthetic.
– If the implant rotates while tightening the abutment,
re-evaluate primary stability of the implant and consider
­a submerged healing.
Caution:
– Tighten abutment screw to max. 35 Ncm.
– Never exceed recommended max. 35 Ncm tightening
torque for the abutment screw. Overtightening may lead to
a screw fracture.
2 Adjust the abutment
––Connect appropriate abutments and check inter-occlusal
space.
––Adjust the height of the abutment post if applicable using
copious irrigation.
––Try in plastic coping and check occlusal clearance.
––If abutment post height has been adjusted, perform
corresponding adjustment also on the plastic coping.
3 Fabricate and cement temporary crown
– Fabricate a chair side temporary crown with usual methods.
– Cement temporary crown. Remove any excess cement.
– Check occlusion.
Warning: Do not use Plastic Temporary Coping with polyurethane cements. The cement will not cure.
Caution: In a fresh/open wound, avoid getting any cement
below the soft tissue or remove it carefully. Consider using a
­
rubber dam or other options to prevent excess cement.
27
28
NobelParallel™ Conical Connection Manual // Restorative procedure
Temporary multiple-unit restoration, cement-retained
(chair-side procedure)
The following illustrations show the use of the QuickTemp
Abutment Conical. Please see also Instructions For Use for
QuickTemp Abutment.
Provisionalization must be done in Immediate Function cases
and is also a common option to altering the soft tissue after a
healing abutment has been used (soft tissue management).
1 Connect abutments to implants
Attach the abutments onto the implants and tighten with the
Screwdriver Unigrip and Manual Torque Wrench Prosthetic.
Caution:
– Tighten abutment screw to max. 35 Ncm.
– Never exceed recommended max. 35 Ncm tightening torque
for the abutment screw. Overtightening may lead to a screw
fracture.
2 Try-in plastic copings
Try-in the plastic copings; they should securely “snap” onto
the abutments.
3 Fabricate a temporary bridge
––Fabricate a temporary bridge using traditional methods with
either acrylic or composite.
––If the laboratory has made a pre-fabricated provisional
bridge, adjust it and reline it to the abutments.
––Trim and polish the restoration. It is important to have a
smooth surface adjacent to the surrounding soft tissue.
4 Cement bridge on to abutments
Cement temporary bridge using temporary cement. Remove
any excess cement.
Warning: Do not use polyurethane cement with plastic/
temporary copings. The cement will not cure.
Caution: In a fresh/open wound, avoid getting any cement
below the soft tissue or remove it carefully. Consider using
rubber dam or other options to prevent excess cement.
NobelParallel™ Conical Connection Manual // Restorative procedure
Temporary multiple-unit restoration, screw-retained
(chair-side procedure)
The following illustrations show the use of the Temporary Abutment
Non-Engaging (for multiple splinted restorations). For individual implants, use Engaging abutments. Please see also Instructions For Use
for Temporary Abutment.
Provisionalization must be done in Immediate Function cases and is
also a ­common option to altering the soft tissue after a healing abutment has been used (soft tissue management).
1 Connect abutments to implants
––Attach the abutments onto the implants, check inter-occlusal space and
adjust for height and clearance if necessary.
––Modifications of abutments can be performed with a carborundum
disk or carbide bur using copious irrigation. Extra-oral modification
of abutment is recommended.
––Fasten the abutments with Guide Pins that extend beyond the occlusal plane with the Screwdriver Manual Unigrip.
Note: Abutment screw is included with the abutment. The Guide Pin
shown on image ­(available in two lengths: 20 mm [standard length] and
30 mm) has to be o
­ rdered separately.
2 Make acrylic template
––Fabricate the template from acrylic or composite for chair-side
­temporization.
––Make access holes to allow guide pins to protrude.
––If the laboratory has made a prefabricated provisional bridge, make access holes to allow the guide pins to protrude (if not already done)
and adjust it to the abutments.
––Fill template with acrylic or composite and seat it over the temporary
abutments.
29
30
NobelParallel™ Conical Connection Manual // Restorative procedure
3 Adjust temporary restoration
––After seating, loosen the guide pins to remove the restoration.
––Trim and polish the restoration. It is important to have a smooth
surface adjacent to the surrounding soft tissue.
4 Connect temporary restoration
– Connect the provisional restoration with the abutment screws.
– Tighten Abutment Screw using Manual Torque Wrench Prosthetic
and ­Screwdriver Machine Unigrip.
– Fill the screw access holes with suitable material.
Caution:
– Tighten abutment screw to max. 35 Ncm.
– Never exceed recommended max. 35 Ncm tightening torque for the
abutment screw. Overtightening may lead to a screw fracture.
NobelParallel™ Conical Connection Manual // Restorative procedure
31
Temporary single-unit restoration, cement-retained
(chair-side procedure)
The following illustrations show the use of the Anatomical
PEEK Temporary Abutment (available for Wide Platform only).
Please see also Instructions For Use for Anatomical PEEK
Healing/ Temporary Abutment.
Indications:
The Anatomical PEEK Temporary Abutments are pre-manufactured, adjustable prosthetic components directly connected to
the implant and are intended for temporary use up to 180
days as an aid in prosthetic rehabilitation.
Provisionalization must be done in Immediate Function cases
and is also a common option to altering the soft tissue after a
healing abutment has been used (soft tissue management).
1 Connect abutment to implant and modify if necessary
– Select appropriate Temporary Abutment and check inter-occlusal
space. Height and gingival margin may be adjusted by the use of
rotary instrument (e.g. carbide or acrylic bur).
– Cut a small axial "flat" or "groove" into the Temporary Abutment to
assure correct position of temporary crown during cementation.
– Attach the abutment onto the implant and tighten with the
Unigrip Screwdriver.
Caution: Tighten abutment screw to max. 15 Ncm.
2 Block the screw access hole
– Place a resilient material of choice (gutta-percha, silicone or temporary filling material) into the screw access hole and fill the remaining
channel with composite or another material of choice. This allows for
easy access to the abutment screw in the future.
– Apply a separating solution onto the plastic abutment in preparation
for fabricating the temporary crown.
3 Fabricate temporary crown
– Try-in the shell crown and modify following conventional
procedures.
– Fill the shell crown with acrylic in preparation for doing a reline.
– Remove the excess acrylic and polish modified areas.
4 Cement the temporary crown
Make final adjustments, polish and secure with temporary cement.
Caution: In a fresh/open wound, avoid getting any cement below the
soft tissue or remove it carefully. Consider using rubber dam or other
options to prevent excess cement.
32
NobelParallel™ Conical Connection Manual // Product information
Flowcharts
Implant
Drill
Drill Stop
NobelParallel™ Conical Connection NP
Length mm
7
8.5
10
11.5
13
15
18
Precision Drill
36118
∅ 3.75 mm 37963 37964 37965 37966 37967 37968 37969
Cover screw included
∅ 2 mm
33063
∅ 2.8 mm 33064
∅ 3.2 mm 33077
Twist Drill
∅ 2, 7–10 mm 32296
∅ 2, 7–15 mm
32297
∅ 2, 10–18 mm
32299
Twist Step Drill
∅ 2.4/2.8, 7–10 mm
32260
∅ 2.4 / 2.8, 7–15 mm
32261
∅ 2.4 / 2.8, 10 –18 mm 32262
∅ 2.8/3.2, 7-10mm
37873
∅ 2.8 / 3.2, 7–15 mm
34638
∅ 2.8 / 3.2, 10 –18 mm 34639
NobelParallel™ Conical Connection RP
Length mm
∅ 4.3 mm
7
8.5
10
11.5
13
15
18
Precision Drill
36118
Cover screw included
∅ 2 mm
33063
∅ 2.8 mm 33064
37970 37971 37972 37973 37974 37975 37976
∅ 3.6 mm 33084
Twist Drill
∅ 2, 7–10 mm 32296
∅ 2, 7–15 mm
32297
∅ 2, 10–18 mm
32299
Twist Step Drill
∅ 2.4/2.8, 7–10 mm
32260
∅ 2.4 / 2.8, 7–15 mm
32261
∅ 2.4 / 2.8, 10 –18 mm 32262
∅ 3.2/3.6, 7–10 mm
32263
∅ 3.2/3.6, 7–15 mm
32264
∅ 3.2/3.6, 10–18 mm 32265
NobelParallel™ Conical Connection Manual // Product information
Healing Abutment
Cover Screw
Cortical Drill
Screw Tap
Implant Driver
∅ 3.75 mm
NP 7–13 mm
37990
NP 28 mm
36718
Height mm
NP 7–18 mm
37991
NP 37 mm
36719
∅ 3.6 mm
36639 36640 36867
∅ 5.0 mm
36641 36642 36868
Healing Abutment
38000
3
5
7
Healing Abutment Bridge*
3
Height mm
∅ 4.0 mm
5
7
36864 36865 36866
Cover Screw
NP
36649
Healing Abutment
∅ 4.3 mm
38001
3
5
7
RP 4.3 7–13 mm
37992
RP 28 mm
36720
Height mm
RP 4.3 7–18 mm
37993
RP 37 mm
36721
∅ 3.6 mm
36643 36644 36872
∅ 5.0 mm
36645 36646 36873
∅ 6.0 mm
36647 36648 36874
Healing Abutment Bridge*
3
Height mm
∅ 5.0 mm
* Used for multiple-unit restorations with NobelProcera Implant Bridge
and GoldAdapt Non-Engaging.
7
36869 36870 36871
Cover Screw
RP
5
36650
33
34
NobelParallel™ Conical Connection Manual // Product information
Implant
Drill
Drill Stop
NobelParallel™ Conical Connection RP
Length mm
∅ 5.0 mm
7
8.5
10
11.5
13
15
18
Precision Drill
36118
∅ 2.8 mm 33064
37977 37978 37979 37980 37981 37982 37983
Cover screw included
∅ 2.0 mm 33063
∅ 3.6 mm 33084
Twist Drill
∅ 4.2 mm 33081
∅ 2, 7–10 mm 32296
∅ 2, 7–15 mm
32297
∅ 2, 10–18 mm
32299
Twist Step Drill
∅ 2.4/2.8, 7–10 mm
32260
∅ 2.4 / 2.8, 7–15 mm
32261
∅ 2.4 / 2.8, 10 –18 mm 32262
∅ 3.2/3.6, 7–10 mm
32263
∅ 3.2/3.6, 7–15 mm
32264
∅ 3.2/3.6, 10–18 mm 32265
∅ 3.8/4.2, 7–10 mm
32275
∅ 3.8/4.2, 7–15 mm
32276
∅ 3.8/4.2, 10–18 mm 32277
NobelParallel™ Conical Connection WP
Length mm
∅ 5.5 mm
7
8.5
10
11.5
13
15
Precision Drill
36118
∅ 2.8 mm 33064
37984 37985 37986 37987 37988 37989
Cover screw included
∅ 2.0 mm 33063
∅ 3.6 mm 33084
Twist Drill
∅ 4.2 mm 33081
∅ 2, 7–10 mm 32296
∅ 2, 7–15 mm
32297
∅ 2, 10–18 mm
32299
Twist Step Drill
∅ 2.4/2.8, 7–10 mm
32260
∅ 2.4 / 2.8, 7–15 mm
32261
∅ 2.4 / 2.8, 10 –18 mm 32262
∅ 3.2/3.6, 7–10 mm
32263
∅ 3.2/3.6, 7–15 mm
32264
∅ 3.2/3.6, 10–18 mm 32265
∅ 4.2/4.6, 7–10 mm
37874
∅ 4.2/4.6, 7–15 mm
34582
∅ 4.2/4.6, 10–18 mm 34583
∅ 4.2/5.0, 7–10 mm
37875
∅ 4.2/5.0, 7–15 mm
37876
NobelParallel™ Conical Connection Manual // Product information
Healing Abutment
Cover Screw
Cortical Drill
Screw Tap
Implant Driver
∅ 5.0 mm
RP 5.0 7–13 mm
37994
RP 28 mm
36720
Height mm
RP 5.0 7–18 mm
37995
RP 37 mm
36721
∅ 3.6 mm
36643 36644 36872
∅ 5.0 mm
36645 36646 36873
∅ 6.0 mm
36647 36648 36874
Healing Abutment
38002
3
5
7
Healing Abutment Bridge*
3
Height mm
∅ 5.0 mm
5
36869 36870 36871
Cover Screw
RP
36650
Healing Abutment
∅ 5.5 mm
38003
5
WP 7–10 mm
37996
WP 28 mm
37859
Height mm3
WP 7–15 mm
37997
WP 37 mm
37860
∅ 5.0 mm
37813 37814
∅ 6.5 mm
37815 37816
Healing Abutment
Anatomioal PEEK
WP 6×7 mm
37819
WP 7×8 mm
37820
Healing Abutment Bridge*
Height mm3
∅ 6.0 mm
* Used for multiple-unit restorations with NobelProcera Implant Bridge
and GoldAdapt Non-Engaging.
5
37817 37818
Cover Screw
WP
7
37812
35
36
NobelParallel™ Conical Connection Manual // Product information
Surgery kits
38004 NobelParallel™ Conical Connection Surgery Kit
37859
37860
38003*
38005
37996*
37997*
36118*
32297**
32261**
36718
36719
34638**
38000*
32264**
37990*
32276**
37991*
34582**
37791
28839
37876**
36720
29149
36721
29164
38002*
32112
37994*
38001*
37992*
37993*
* Article not included in this kit
** Article not included in this kit and also available in other lengths
37995*
NobelParallel™ Conical Connection Manual // Product information
NobelParallel™ Conical Connection Surgery Kit 38004
(The articles below can also be purchased individually.)
Kit includes
NobelParallel™ Conical Connection Surgery Kit Box 38005
Implant Driver Conical Connection NP 28 mm
36718
Implant Driver Conical Connection NP 37 mm
36719
Implant Driver Conical Connection RP 28 mm
36720
Implant Driver Conical Connection RP 37 mm
36721
Implant Driver Conical Connection WP 25 mm
37859
Implant Driver Conical Connection WP 37 mm
37860
Screwdriver Manual Unigrip™ 28 mm
29149
Drill Extension Shaft 29164
Direction Indicator ∅2/∅2.4–2.8 mm × 4
32112
Implant/Prosthetic Organizer 29532
NobelReplace® Manual Torque Wrench Surgical 28839
Depth Probe 7–18mm Z-shaped 37791
Implant Sleeve Holder 29543
NobelParallel™ Conical Connection Wall Chart 38007
NobelParallel™ CC Radiographic Template
37792
Note: Drills and Screw Taps are available for separate purchase and are not included in the kit.
Bone Mill Kit Conical Connection 37888
Kit includes
Bone Mill Kit Box Conical Connection 37889
Bone Mill with Guide Conical Connection 3.0 ∅4.0 37861
Bone Mill with Guide Conical Connection NP ∅4.4 37863
Bone Mill with Guide Conical Connection NP ∅5.2 37864
Bone Mill with Guide Conical Connection RP ∅5.2 37866
Bone Mill with Guide Conical Connection RP ∅6.2 37867
Bone Mill with Guide Conical Connection WP ∅6.7 37869
37
38
NobelParallel™ Conical Connection Manual // Product information
Nobel Biocare® Flapless Surgery Kit
32304
(The articles below can also be purchased individually.)
Kit includes
Nobel Biocare® Flapless Surgery Kit Box
32317
Tissue Punch NP
29628
Tissue Punch RP 29629
Tissue Punch WP 29630
Tissue Punch 6.0
32672
Tissue Punch Guide NP 29631
Tissue Punch Guide RP 29632
Tissue Punch Guide WP 29633
Tissue Punch Guide 6.0
32673
Drill Guide NP 29634
Drill Guide RP 29635
Drill Guide WP
29636
Drill Guide 6.0
32674
Prosthetic Kit
37448
(The articles below can also be purchased individually.)
Kit includes
Prosthetic Kit Box 37443
Manual Torque Wrench Prosthetic 29165
Screwdriver Machine Unigrip 20 mm 29151
Screwdriver Machine Unigrip 30 mm 29153
Screwdriver Machine Multi-unit 21 mm 29158
Omnigrip Screwdriver Machine 20 mm 37379
Omnigrip Screwdriver Machine 30 mm 37381
Manual Torque Wrench Prosthetic 29165
NobelParallel™ Conical Connection Manual // Product information
Implants
NobelParallel™ Conical Connection NP 3.75 × 7 mm
NobelParallel™ Conical Connection NP 3.75 × 8.5 mm
NobelParallel™ Conical Connection NP 3.75 ×10 mm
NobelParallel™ Conical Connection NP 3.75 ×11.5 mm
NobelParallel™ Conical Connection NP 3.75 ×13 mm
NobelParallel™ Conical Connection NP 3.75 ×15 mm
NobelParallel™ Conical Connection NP 3.75 ×18 mm
37963
37964
37965
37966
37967
37968
37969
NobelParallel™ Conical Connection RP 4.3 × 7 mm
NobelParallel™ Conical Connection RP 4.3 × 8.5 mm
NobelParallel™ Conical Connection RP 4.3 ×10 mm
NobelParallel™ Conical Connection RP 4.3 ×11.5 mm
NobelParallel™ Conical Connection RP 4.3 ×13 mm
NobelParallel™ Conical Connection RP 4.3 ×15 mm
NobelParallel™ Conical Connection RP 4.3 ×18 mm
37970
37971
37972
37973
37974
37975
37976
NobelParallel™ Conical Connection RP 5.0 × 7 mm
NobelParallel™ Conical Connection RP 5.0 × 8.5 mm
NobelParallel™ Conical Connection RP 5.0 ×10 mm
NobelParallel™ Conical Connection RP 5.0 ×11.5 mm
NobelParallel™ Conical Connection RP 5.0 ×13 mm
NobelParallel™ Conical Connection RP 5.0 ×15 mm
NobelParallel™ Conical Connection RP 5.0 ×18 mm
37977
37978
37979
37980
37981
37982
37983
NobelParallel™ Conical Connection WP 5.5 ×7 mm
NobelParallel™ Conical Connection WP 5.5 × 8.5 mm
NobelParallel™ Conical Connection WP 5.5 ×10 mm
NobelParallel™ Conical Connection WP 5.5 ×11.5 mm
NobelParallel™ Conical Connection WP 5.5 ×13 mm
NobelParallel™ Conical Connection WP 5.5 ×15 mm
37984
37985
37986
37987
37988
37989
39
40
NobelParallel™ Conical Connection Manual // Product information
Surgical components
Drills
Precision Drill
36118
Guide Drill
35426
Twist Drill with Tip 2 × 7–10 mm
Twist Drill with Tip 2 × 7–15 mm
Twist Drill with Tip 2 × 10–18 mm
32296
32297
32299
Twist Step Drill 2.4/2.8 7–10 mm
Twist Step Drill 2.4/2.8 7–15 mm
Twist Step Drill 2.4/2.8 10–18 mm
Twist Step Drill 2.8/3.2 7–10 mm
Twist Step Drill 2.8/3.2 7–15 mm
Twist Step Drill 2.8/3.2 10–18 mm
Twist Step Drill 3.2/3.6 7–10 mm
Twist Step Drill 3.2/3.6 7–15 mm
Twist Step Drill 3.2/3.6 10–18 mm
Twist Step Drill 3.8/4.2 7–10 mm
Twist Step Drill 3.8/4.2 7–15 mm
Twist Step Drill 3.8/4.2 10–18 mm
Twist Step Drill 4.2/4.6 7–10 mm
Twist Step Drill 4.2/4.6 7–15 mm
Twist Step Drill 4.2/4.6 10–18 mm
Twist Step Drill 4.2/5.0 7–10 mm
Twist Step Drill 4.2/5.0 7–15 mm
32260
32261
32262
37873
34638
34639
32263
32264
32265
32275
32276
32277
37874
34582
34583
37875
37876
Cortical Drills
Cortical Drill NobelParallel™ CC 3.75 mm
Cortical Drill NobelParallel™ CC 4.3 mm
Cortical Drill NobelParallel™ CC 5.0 mm
Cortical Drill NobelParallel™ CC 5.5 mm
38000
38001
38002
38003
Screw Taps
Screw Tap NobelParallel™ CC 3.75 7–13 mm
Screw Tap NobelParallel™ CC 3.75 7–18 mm
Screw Tap NobelParallel™ CC 4.3 7–13 mm
Screw Tap NobelParallel™ CC 4.3 7–18 mm
Screw Tap NobelParallel™ CC 5.0 7–13 mm
Screw Tap NobelParallel™ CC 5.0 7–18 mm
Screw Tap NobelParallel™ CC 5.5 7–10 mm
Screw Tap NobelParallel™ CC 5.5 7–15 mm
37990
37991
37992
37993
37994
37995
37996
37997
Direction Indicator ∅2/∅2.4–2.8 mm
32112
Implant Drivers
Implant Driver CC NP 28 mm
Implant Driver CC NP 37 mm
Implant Driver CC RP 28 mm
Implant Driver CC RP 37 mm
Implant Driver CC WP 28 mm
Implant Driver CC WP 37 mm
36718
36719
36720
36721
37859
37860
NobelParallel™ Conical Connection Manual // Product information
Bone Mills and Guides
Bone Mill with Guide CC NP ∅4.4 mm
Bone Mill with Guide CC NP ∅5.2 mm
Bone Mill Guide CC NP
Bone Mill with Guide CC RP ∅5.2 mm
Bone Mill with Guide CC RP ∅6.2 mm
Bone Mill Guide CC RP
Bone Mill with Guide CC WP ∅6.7 mm
Bone Mill Guide CC WP
37863
37864
37865
37866
37867
37868
37869
37870
Cover Screws
Cover Screw CC NP
Cover Screw CC RP
Cover Screw CC WP
36649
36650
37812
Manual Torque Wrench
Manual Torque Wrench Surgical
Manual Torque Wrench Adapter Surgical
Manual Torque Wrench Prosthetic Manual Torque Wrench Adapter Prosthetic 28839
28840
29165
29167
Screwdrivers
Unigrip Screwdriver Machine 20 mm
Unigrip Screwdriver Machine 25 mm
Unigrip Screwdriver Machine 30 mm
Unigrip Screwdriver Machine 35 mm
Unigrip Screwdriver Manual 20 mm
Unigrip Screwdriver Manual 28 mm
Unigrip Screwdriver Manual 36 mm
Omnigrip Screwdriver Machine 20 mm
Omnigrip Screwdriver Machine 30 mm
29151
29152
29153
29154
29148
29149
29150
37379
37381
Surgical Drape Kit 2-pack
12T7400
Drill Extension Shaft
29164
Surgical Driver
32180
Nobel Biocare® Osteotome Kit
32321
Soft Tissue Punches
Soft Tissue Punch ∅ 4.1 mm, 5/pkg
Soft Tissue Punch ∅ 5.2 mm, 5/pkg
Soft Tissue Punch ∅ 6.2 mm, 5/pkg
32Z2000
32Z2002
32Z2004
41
42
NobelParallel™ Conical Connection Manual // Product information
Temporary restorations
For the full assortment of abutments, see the Nobel Biocare product catalog.
Temporary Abutments
Immediate Temporary Abutment CC NP 1.5 mm
Immediate Temporary Abutment CC NP 3.0 mm
Immediate Temporary Abutment CC RP 1.5 mm
Immediate Temporary Abutment CC RP 3.0 mm
36653
36655
36654
36656
Plastic Coping Immediate Temporary Abutment
31656
QuickTemp™ Abutment CC NP 1.5 mm
QuickTemp™ Abutment CC NP 3.0 mm
QuickTemp™ Abutment CC RP 1.5 mm
QuickTemp™ Abutment CC RP 3.0 mm
36659
36657
36660
36658
Plastic Coping QuickTemp™ Abutment Conical
33404
Temporary Abutment Engaging CC NP
Temporary Abutment Engaging CC RP
Temporary Abutment Engaging CC WP 1.5 mm
Temporary Abutment Engaging CC WP 3 mm
Temporary Abutment Non-Engaging CC NP
Temporary Abutment Non-Engaging CC RP
Temporary Abutment Non-Engaging CC WP 1.5 mm
Temporary Abutment Non-Engaging CC WP 3 mm
36663
36664
37823
37824
36661
36662
37825
37826
Temporary Abutment Anatomical PEEK WP 6×7 mm
Temporary Abutment Anatomical PEEK WP 7×8 mm
37821
37822
Slim Temporary Abutment NP 6.5 mm
Slim Temporary Abutment NP 7.5 mm
Slim Temporary Abutment RP 6.5 mm
Slim Temporary Abutment RP 7.5 mm
37671
37672
37673
37674
NobelParallel™ Conical Connection Manual // Appendices
Healing Abutments
Healing Abutment CC NP ∅ 3.6 × 3 mm
Healing Abutment CC NP ∅ 3.6 × 5 mm
Healing Abutment CC NP ∅ 3.6 × 7 mm
Healing Abutment CC NP ∅ 5 × 3 mm
Healing Abutment CC NP ∅ 5 × 5 mm
Healing Abutment CC NP ∅ 5 × 7 mm
Healing Abutment CC RP ∅ 3.6 × 3 mm
Healing Abutment CC RP ∅ 3.6 × 5 mm
Healing Abutment CC RP ∅ 3.6 × 7 mm
Healing Abutment CC RP ∅ 5 × 3 mm
Healing Abutment CC RP ∅ 5 × 5 mm
Healing Abutment CC RP ∅ 5 × 7 mm
Healing Abutment CC RP ∅ 6 × 3 mm
Healing Abutment CC RP ∅ 6 × 5 mm
Healing Abutment CC RP ∅ 6 × 7 mm
Healing Abutment CC WP ∅ 5 × 3 mm
Healing Abutment CC WP ∅ 5 × 5 mm
Healing Abutment CC WP ∅ 6.5 × 3 mm
Healing Abutment CC WP ∅ 6. 5 × 5 mm
36639
36640
36867
36641
36642
36868
36643
36644
36872
36645
36646
36873
36647
36648
36874
37813
37814
37815
37816
Healing Abutment CC NP Bridge ∅ 4 × 3 mm
Healing Abutment CC NP Bridge ∅ 4 × 5 mm
Healing Abutment CC NP Bridge ∅ 4 × 7 mm
Healing Abutment CC RP Bridge ∅ 5 × 3 mm
Healing Abutment CC RP Bridge ∅ 5 × 5 mm
Healing Abutment CC RP Bridge ∅ 5 × 7 mm
Healing Abutment CC WP Bridge ∅ 6 × 3 mm
Healing Abutment CC WP Bridge ∅ 6 × 5 mm
36864
36865
36866
36869
36870
36871
37817
37818
Healing Abutment Anatomical PEEK WP 6×7 mm
Healing Abutment Anatomical PEEK WP 7×8 mm
37819
37820
Slim Healing Abutment NP 5 mm
Slim Healing Abutment NP 7 mm
Slim Healing Abutment RP 5 mm
Slim Healing Abutment RP 7 mm
37666
37665
37667
37668
43
44
NobelParallel™ Conical Connection Manual // Appendices
Manual torque wrench
For the surgeon, the torque required to place implants
provides insight into the primary stability of the implant.
For restorative procedures, tightening the abutment and
prosthetic screws to the recommended torque specifications
will more effectively control screw-joint integrity d
­ uring
patient function.
The manual torque wrench is a convenient tool for achieving
the desired torque.
Manual Torque Wrench – Surgical
Intended for tightening or adjusting implant position.
– Insert Implant Driver NobelReplace or Conical Connection.
Manual Torque Wrench – Prosthetic
Intended for retaining screws with a tightening torque of
15–35 Ncm. Compatible with all machine screwdrivers.
– Insert the applicable driver.
Use of the Manual Torque Wrench Surgical
––Assemble the torque wrench by inserting the implant driver.
––To tighten an implant, adjust the direction indicator so
that the arrow is pointing toward the level arm and rotate
clockwise.
––To loosen an implant, adjust the direction indicator so that
the arrow is pointing away from the level arm and rotate
counterclockwise.
Warning: Using the wrench body instead of the level arm
may result in excessive torque being transferred to the screw
and/or implant site.
Max
45 Ncm
NobelParallel™ Conical Connection Manual // Appendices
45
Drill stops
Drill Stop Kit
32430
Kit includes
Drill Stop Kit Box 33062
Drill Stop ∅ 2 mm 33063
Drill Stop ∅ 2.8 mm 33064
Drill Stop ∅ 3 mm 33075
Drill Stop ∅ 3.2 mm 33077
Drill Stop ∅ 3.4 mm 33078
Drill Stop ∅ 3.6 mm 33084
Drill Stop ∅ 4.2 mm 33081
The drill stops allow for a safe and accurate surgical procedure by predetermining the drill depth of twist drills and twist step
drills. The kit is used to store, autoclave and facilitate the mounting of the drill stops.
1 Mount drill stop
– Slide drill stop onto corresponding drill.
–Place drill in mounting hole corresponding to desired drill
depth. Use large holes for drills ∅ 3.4 and above.
∅ 3.4/3.6 mm
∅ 4.2 mm
2 Tighten drill stop
Tighten the screw on the drill stop using the Screwdriver Unigrip.
3 Drill to drill stop
Drill until predetermined drill depth is reached.
46
NobelParallel™ Conical Connection Manual // Appendices
Cleaning and sterilization
Sterile components
The devices delivered sterile have a “Sterile” marking on
the label. See current cleaning and sterilization guidelines for
details: www.nobelbiocare.com/sterilization.
Note: Implants must never be re-sterilized.
Implants
Implants are delivered sterile, are for single-use only, and
must be used prior to the labeled expiration date. Do not use
implants if the packaging has been damaged or p
­ reviously
opened.
Twist and Twist Step Drills, Precision Drill and Screw Taps
Twist Drills, Twist Step Drills, Cortical Drills and Screw Taps are
delivered sterile and for single use only.
Abutments and plastic copings
Multi-unit Abutment, Snappy Abutment, QuickTemp
Abutment and Immediate Temporary Abutment are
delivered sterile. If resterilization is required.
See current cleaning and sterilization guidelines:
www.nobelbiocare.com/sterilization.
Notes:
––For resterilization of the straight Multi-unit Abutment,
­remove the plastic holder prior to the procedure.
––Sterile plastic copings are for single-use only and
should not be re-sterilized.
NobelParallel™ Conical Connection Manual // Appendices
Non-sterile components
Care and maintenance of reusable instruments are crucial for
successful treatment. Well-maintained instruments not only
safeguard your patients and staff against infection, b
­ ut are
also essential for the outcome of the total treatment.
See current cleaning and sterilization guidelines for details:
www.nobelbiocare.com/sterilization.
Contra-angle
For cleaning and sterilization procedures, see specific
instructions from the respective manufacturer.
Abutments and plastic copings
Some abutments made of titanium, gold alloy, and plastic
(PEEK) are delivered non-sterile. For more information refer
to the label on the specific abutment. It is recommended to
sterilize the abutment prior to placing it in the oral cavity. For
sterilization, see current cleaning and sterilization guidelines:
www.nobelbiocare.com/sterilization
Notes:
––If modifications have been made to the abutment, clean the
abutment prior to sterilization.
––Non-sterile plastic copings should not be re-sterilized, as
they are for single use only.
47
48
NobelParallel™ Conical Connection Manual // Appendices
NobelParallel™ Conical Connection Manual // Appendices
49
50
NobelParallel™ Conical Connection Manual // Appendices
NobelParallel™ Conical Connection Manual // Appendices
Customer service worldwide
Americas
Europe, Middle East and Africa
Russia
Brazil
Austria
Nobel Biocare Russia
Nobel Biocare Brazil
Nobel Biocare Austria
Phone: +7 495 974 77 55
Phone: 0800 16 999 6
Phone: +43 1 892 89 90
South Africa
Canada
Belgium
Nobel Biocare South Africa
Nobel Biocare Canada
Nobel Biocare Belgium
Phone: +27 11 802 0112
Phone: +1 800 939 9394
Phone: +32 2 467 41 70
Spain
Chile
Denmark
Nobel Biocare Spain
Dental Biocare
Nobel Biocare Denmark
Phone: +34 900 850 008
Phone: +56 220 19282
Phone: +45 39 40 48 46
Sweden
Colombia
Finland
Nobel Biocare Sweden
Hospimedics S.A.
Nobel Biocare Finland
Phone: +46 31 81 88 00
Phone: +57 1 640 0608
Phone: +358 20 740 61 00
Switzerland
Mexico
France
Nobel Biocare Switzerland
Nobel Biocare Mexico
Nobel Biocare France
Phone: 0800 211 424
Phone: +52 55 524 974 60
Phone: +33 1 49 20 00 30
United Kingdom
USA
Germany
Nobel Biocare UK
Nobel Biocare USA
Nobel Biocare Germany
Phone: +44 208 756 3300
Phone: +1 800 322 5001
Phone: +49 221 500 850
Hungary
Nobel Biocare Hungary
Asia Pacific
Phone: +36 1 279 33 79
Australia
Ireland
Nobel Biocare Australia
Nobel Biocare Ireland
Phone: 1800 804 597
Phone: 1800 677 306
China
Italy
Nobel Biocare China
Nobel Biocare Italy
Phone: +86 21 5206 6655
Phone: +39 800 53 93 28
Hong Kong
Lithuania
Nobel Biocare Hong Kong
Nobel Biocare Lithuania
Phone: +852 2845 1266
Phone: +370 5 268 3448
India
Netherlands
Nobel Biocare India
Nobel Biocare Netherlands
Phone: 1800 266 9998
Phone: +31 30 635 49 49
Japan
Norway
Nobel Biocare Japan
Nobel Biocare Norway
Phone: +81 3 6717 6191
Phone: +47 23 24 98 30
New Zealand
Poland
Nobel Biocare New Zealand
Nobel Biocare Poland
Phone: 0800 441 657
Phone: +48 22 549 93 52
Singapore
Portugal
Nobel Biocare Singapore
Nobel Biocare Portugal
Phone: +65 6737 7967
Phone: +351 800 300 100
Taiwan
Nobel Biocare Taiwan
Phone: +886 080 00 779
nobelbiocare.com/contact
v 15.1
Distributor markets
Bulgaria, Croatia, Cyprus, Czech
Republic, Greece, Iran, Jordan, Kuwait,
Lebanon, Malta, Romania, Saudi Arabia,
Serbia, Slovenia, Turkey, United Arab
Emirates
Phone: +48 22 549 93 55
51
nobelbiocare.com
78041 Lot ”GB 1503” Printed in Sweden © Nobel Biocare Services AG, 2014. All rights reserved.
Nobel Biocare, the Nobel Biocare logotype and all other trademarks are, if nothing else is stated or is evident from the context in a certain case, trademarks of Nobel Biocare. Product images are not necessarily to scale.
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