Straumann Bone Level Implant in D1 bone: how to proceed?
I treatment planned a patient for installation of a 4.1 mm x 12mm Straumann bone level implant in very dense D1 bone. I attempted a straight surgical pathway using a profile drill and tapped the osteotomy. When the implant reached a depth of 10mm, the mount broke and I could not advance it any more. I have never experienced this problem with Straumann tissue level implants. Have any of you experienced this problem? How do you recommend that I proceed?
3 Comments on Straumann Bone Level Implant in D1 bone: how to proceed?
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DR J
5/10/2018
It has never happened to me, but i do know some colleagues who experienced the exact same thing. Some of them had extra mounts and all of them broke and he had to trephine the implant out and use another. The mount has its advantages and disavantages. D1 bone is really something hard to manage.
omar guillen
5/10/2018
I have had this happened. What i do know for very dense bone is over prepare by 2 mm and profiling and bone tapping. That should do the trick. Be mindful of anatomy of course. I also now set my implant motor to max out at 25 n-cm, so it will sound off when approaching it. If so reverse and proceed and repeat. Once st close full depth go ahead and max out torque. It’s a useful way to proceed.
Frank
5/10/2018
When placing the implant, if torque reaches 30 Ncm, unscrew and use bone tap.
Remember that by hands you can easily reach 100 Ncm which is the breaking point of the mount.
Straumann Bone level is not a self taping implant.
You could also have at hand a larger diameter drill to be used. Rather tahn finish with 3.5 drill, go to 3.7mm. Astratech has a 3.7, other companies too. Nobel has 3.6. Sometimes you have to find a way to cope.
If someone had to trephine to remove such an implant, it was probably torqued manually way over the limit!
Good luck!
