Implantation – as stress-free as possible
Source: ZWP 1+2 / 2014
Author: Susan Oehler, Christin Bunn / Oemus Media AG
Implantological procedures are not only an extraordinarily stressful situation for the person being treated in the chair – the pressure placed on the dentist during the operation must also not be underestimated. Consequently, in addition to an efficient, well trained practice team, reliable and optimally coordinated equipment is also of considerable importance.
Even though it may be years since you performed your first implantation on your own and you have long since mastered all the steps, no operation ever becomes mere routine. This is due to a number of factors, not least the patient's individual diagnostic situation with the associated requirements for pre-treatment, preparation and performance of the operation. In the course of the treatment, the dentist may also be faced with unexpected complications, which need to be resolved competently and objectively. Even the least complicated standard procedures require a high degree of concentration, focus and precise actions at all times.
There is already a wide range of options for practice equipment to make the treatment situation as comfortable as possible for the patient, from decorating the treatment room with warm colours to employing atmospheric lighting concepts and playing calming music. For the dentist, in contrast, stress-free working is largely the result of not only being able to rely on the skills of the staff, but also on the correct functioning and efficacy of all devices and instruments.
The dental product manufacturer W&H sees it as its obligation to implement this in the day-to-day work of the practice. Renowned and valued by experts for its skills in the field of restorations and prosthetics in particular, the Austrian manufacturing company also offers a specific product portfolio for implants and surgery to meet the high demands of the speciality. After all, surgical instruments and devices are not only subject to special benchmarks in terms of their ergonomics and material characteristics but the dentist also requires them to comply with the applicable hygiene regulations.
Specially for implantologists
Against this backdrop, W&H offers dentists working in implantology and oral surgery a device with specifications tailored perfectly for the requirements of day-to-day dental treatment. With the Implantmed unit, the dentist has a high-quality system that unites high performance with practicality.
The large, easily readable display provides information about the applied settings at all times and allows intuitive configuration of the programmes in combination with the easy-to-use plus and minus keys. To allow greater freedom for your hands, the device can be operated with a multifunctional foot control, which also guarantees sterile working.
The high-performance motor can operate at speeds of between 300 and 40,000 rpm and cranks a maximum motor torque of 5.5 Ncm. In combination with a 20:1 gear reduction of the contra-angle handpiece (e.g., WS 75 LG) , a highly precised automatic torque limitation can be set between 5 and 70 Ncm, following the implant manufacturer's drill and placement protocols. The Implantmed's automated thread-tapping function is particularly designed to support placing implants in dense bone tissue. Pre-tapping reduces the compression of the jawbone during the implant placement.
However, the system is not only atraumatic to the patient's bone but also to the dentist's comfort with the well-balanced combination of motor and handpiece. The harmoniously coordinated balance of the assembled elements means that they can be held and manoeuvred comfortably even when being used for long periods of time. This means that you can always perform procedures with high precision.
The precisely coordinated accessories for Implantmed are made of high-quality stainless steel and furnished with a scratch-resistant coating. The models are characterized by their robustness and the fact that they retain their value for longer as a result. To ensure the safety of the application even at higher torques, they employ the manufacturer's patented hexagon chuck system, which was developed in-house. In addition, the treatment site can also be cooled very accurately with the use of spray clips, which are available separately for both the left and right sides. The range of straight and contra-angle handpieces particularly recommended for use with Implantmed includes the WS-75 LG, WS 75, S-11 LG, S-9 LG, S-11 and S-9 models. All models can be disassembled in accordance with the stringent hygiene regulations for easy cleaning and are also suitable for thermo washer disinfection and sterilization.
An addition highlight are the new WS-91 and WS-91 LG surgical contra-angle handpieces with 45° heads, which unite the advantages of straight and contra-angle handpieces for the first time. The 45° angle allows considerably better access and considerably better visibility of the treatment site. This is particularly helpful in the surgical extraction of wisdom teeth, precise tooth separations and apical resections. Access to the maxillary molars is much simpler, even with a small mouth opening. In contrast, in buccal applications, there is more space between the cheek and the operating site. At the same time, the view is barely affected. Depending on the drive speed, the ratio of 1:2.7 makes it possible to achieve speeds of up to 135,000 revolutions per minute with the rotating instrument. A tripple irrigation outlet guarantees sufficient cooling of the tooth and the rotating instrument.
Visibility of the treatment field is another decisive factor in the success of the treatment, which can lead to difficulties in the posterior area of the mouth in particular. Good illumination of the area, which is poorly lit due to the natural conditions, is indispensable for being able to prepare the anatomical structures safely and with little stress. For example, when performing an augmentation of the antral floor, it is only possible to abrade the bone atraumatically and make a minimally invasive preparation of the Schneiderian membrane under optimal visual conditions.
The surgical straight and contra-angle handpieces from W&H are optionally available with mini LEDs+, which are positioned close to the tip of the instrument and provide excellent daylight-quality illumination of the operation site. In contrast to standard LEDs, the LED+ has a colour rendering index value of above 90 (standard LEDs achieve around 70), which comes very close to the ideal value of 100. This means that the contrast is rendered better and red tones in particular are reproduced in their natural spectrum in the mouth, which makes it easier to identify bleeding and unusual colouration of the gingiva. The mini LEDs+ are just half the size of normal LEDs and are powered independently by an integrated generator. All LG models are equipped with LED+ technology and can be easily disassembled without the use of any tools.
Minimally invasive and atraumatic
With the aim of a particularly atraumatic treatment, the therapeutic approach is predominantly measured based on its level of invasiveness. For this reason, the progressive development of minimally invasive procedures offering the patient less pain and shorter recovery periods is even more welcome.
In daily surgery these methods are particularly effective in situations where the basic anatomical requirements demand a procedure prior to the implantation. For example, in case of a razor-sharp alveolar ridge, the possibility of piezoelectrical bone splitting can be considered to spare the patient a time-consuming bone augmentation procedure.
With the Piezomed W&H also offers a surgical device specially designed for delicate procedures on the alveolar ridge. This device is of particular use to the surgeon in the structures which require optimal precision as it uses innovative ultrasound technology to remove only bone substance. If the surrounding soft tissue is accidentally touched, it remains unaffected. This leads to less bleeding at operating sites, nerves and vessels remain intact and the healing process is considerably accelerated.
Thanks to Piezomed's automatic instrument detection function, the attachments are identified as soon as they are installed and assigned to the correct power class, which reduces the risk of overloading and increases their useful service lives.
This innovative function is complemented by an LED ring for shadow-free illumination of the operating field, a special cutting instrument tooth design for even more precise working and a boost function, which can be used to increase the set basic output by up to 20 per cent for short periods of time. This extra function, which can be used as and when required, is available in two of the three operating modes, adding a particularly convenient feature to the device. In "Power" mode, Piezomed automatically increases the power of the handpiece as soon as the user exerts more pressure on the instrument. In contrast, the power of the handpiece is reduced when more pressure is applied in the "Smooth" setting. If the dentist selects the "Basic" operating mode, the power applied remains constant irrespective of the pressure exerted on the instrument.
If we consider day-to-day work in dental surgeries as a whole, there are a number of obvious possibilities for making implantological treatments more effective, less traumatic and as such less stressful for the patient and dentist alike. If more importance is attached to high quality and application-specific functions when selecting devices and instruments to be used in the practice, this foresight can greatly simplify the procedures for which they are used over the long term.
System overview of the W&H surgical instruments: