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                      EARLY LOADING
    PITT-EASY    ®

       Insertion Technique
         PITT-EASY®       Indication

    The Application – distinguished like human beings

    Pitt-Easy implants correspond      of 10 mm and complete bone                complete mandible as well as                  can, of course, be inserted in
    to the normal indications for      enclosure of the implant by at            the maxilla, especially                       D1 and D2 bone with the
    rotosymmetric and cylindrical      least 1 mm is guaranteed. The             anterior and mesial of the                    same security.
    implants. They can be used         implant can be inserted into              sinus region, in some cases
    both as a twophase implant         fresh extraction sockets if the           also subsinus and in the
    and in a onephase technique        alveolar socket entrance is               tuberosity area. The FBR
    if gingival formers are used       completely filled out and can             implant surface is especially
    for the healing phase, thus        be slightly expanded, if                  effective in bone quality D3
   avoiding surgical reentry.         necessary.                                and D4, i.e. in severely
    Pitt-Easy implants can be                                                    spongeous cancellous bone
    inserted in atrophied jaws if a    Basically, the Pitt-Easy                  or in substance with rich
    minimum alveolar bone height       implants can be applied in the            bone marrow. FBR implants

      l Implant Variety

      Ø 3.25                                  ●	                    ●	                 ●	                            ●	                 ●

      Ø 3.75                                  ●	                    ●	                 ●	                            ●	                 ●

      Ø 4.00                                  ●	                    ●	                 ●	                            ●	                 ●

      Ø 4.90                                  ●	                    ●	                 ●	                            ●

      Ø 6.50                                   	                         	                   	

      Length mm                                8                    10                  1                           14                 16

       V-TPS      FBR      PURETEX
                                              ●	   	mplantats available in all
                                                   I                                         l Important
                                                                                             Pitt-Easy implants with a diameter of 3.25 mm
                                                   Implants available with                   are not suitable for single tooth replacement in
                                                   V-TPS surface or with                     the molar area (except if splinted with several
                                                   additional FBR surface                    additional implants).

                      Our products are certified according to Annex II of Regulation 93/42/EEC and DIN EN ISO 13485:2003.
    The implant must be used only by doctors who are suitably familiar with the system. The instructions (in this brochure and in
    the instructions for use) must be strictly complied with. Continuing training in this implant system is absolutely essential. We
    reserve the right to modify or improve the products in line with technical progress.
                                                                                                            Diagnosis          PITT-EASY®
                                                                                                                               BICORTICAL       ®

The Determination – an excellent diagnosis
As with all implants, a clinical examination including ascertaining   radiograph to determine the optimal implant lengths and
the true alveolar width, i.e. diagnosis regarding bone quality and    diameters for the bone sites, as much as possible, prior to the
quantity, is required. Prior to surgery, please read the general      actual implant insertion.
and specific contraindications carefully, contained in the            The final selection can take place after exposure of the alveolar
instructions for use. The alveolar bone width can be measured         bone, as the actual bone width as well as any cavities or areas
during the first consulting visit with an osteometer under topical    of resorption, can only then be determined.
surface or infiltration anaesthesia. Furthermore, a panoramic X-      An adequate selection of sterile implants of different diameters
ray – or in selected cases also a computer-tomographic                and lengths should, therefore, be readily available to
radiograph, should be taken. An X-ray indicator of the                accommodate any anatomical situation.
corresponding magnification factor is placed on the panoramic

The Color Code System – easy handling
All posts, impression posts        provides additional security
                                                                                                      l Tip
and model analogs of the Pitt-     in the application of the Pitt-
Easy system are color coded        Easy system – for the com-                                         The prosthetics – multiple simplicity
for the implant diameters          plete team in the dental office                                    Please see the survey of all prosthetic
3.75 mm and 4.90 mm. Cover         and the laboratory.                                                components on page 10 – 11 and in
screws and gingiva formers                                                                            the product patalog.
are diameter color coded.
This color guide system

The Instruments – safety all around
The small version of the surgi-    the depth gauge respectively
cal tray offers an efficient al-   provides the safety for implant
ternative to the large tray with   insertion by laser markings.
the complete set of simulta-       For the insertion of the 6.50 mm
neous drills. It contains all      implants the corresponding
components required for an         set of drills can be ordered
insertion of Pitt-Easy implants    separately and inserted in the
of diameters 3.25/3.75/4.00        unused inserts.
and 4.90 mm. The new design
of the universal drills and
         PITT-EASY®    Insertion Technique and Instruments

      Insertion Technique and Instruments
    Exposure of the alveolar bone

    The incision is made on the crest of the ridge within the limits of the fixed keratinized gingival
    and the mucosa and periosteum are carefully loosened to reveal the bone ridge.

4                                                            Preparation of the alveolar crest

                                                             Any remaining tissue is removed from the bone surface. If the crest is very
                                                             narrow or knife-edge, an osteoplasty is performed using a Crestotom at slow
                                                             speed and with copious amounts of sterile cooling liquid to remove any unsuit-
                                                             able protruding bone and shape the implant site.

                                                                               l Tip
                                                                               Preoperative planning is the guarantee for an esthetic
                                                                               restoration: For the preparation of drilling guides which offer
                                                                               safety at insertion and facilitate the parallel adjustment, a
                                                                               corresponding drilling guide set is available (Item No. 90317).

                                                             Initial perforation of the cortical bone entrance

                                                             Insertion markings should be made in distances of at least 8 mm to each other.

                                                             If the alveolar crest consists of compact, cortical bone, the short, small-caliber,
                                                             IP Drill (Initial Perforation), used in conjunction with a reduced contraangle
                                                             handpiece (1:16 to 1:20, green ring), is recommended. Insert the drill into the
                                                             centre of the alveolar crest, at the rate of 800 to 1,200 rotations per minute,
                                                             with attention to the direction of the preparation. Constant irrigation with cold
                                                             sterile saline solution is imperative.

                                                                               l Important
                                                                                Please take care to perform the bone preparation only with
                                                                                sharp drills. We recommend to use a drill no more than 15
                                        Insertion Technique and Instruments          PITT-EASY®
                                                                                     BICORTICAL      ®

        Pilot preparation (for bicortical support only)

        If bicortical support is aimed at, the Pilot Drill should be used
        slowly (800–1,200 rpm), after penetrating the entrance of
        the cortical bone with parallel rotations to expand the width
        slightly to allow free movement in and out of the osteotomy.
        The channel is deepened millimeter by millimeter with the drill
        being brought in and out of contact with the bone.

        With depth preparation, the basal or, in the mandible, also
        lingual cortical bone should be reached if possible to provide
        bicortical support for the implant, feeling the resistance with
        the free moving drill within the bur channel. In the maxilla, the
        bone of the nasal floor or sinus floor provides support.

        The method of passive elevation of the sinus is also possible
        with Pitt-Easy implants.

        Preparation with the Twist Drill                                                                 

        For initial depth preparation or to enlarge the        l Tip
        prepared pilot channel to a diameter of two
                                                               The drill should be periodically
        millimeters, the Twist Drill is used with a maxi-
                                                               removed from the bur channel in order
        mum of 1,800 to 2,400 rotations per minute
                                                               to clean off bone particles before
        under sufficient irrigation.
                                                               being rotated again. The valuable
                                                               bone material can be collected with
        If the dental technician has prepared a drilling
                                                               the special Bone Collector (Item No.
        template with Pitt-Easy Drilling Guides, the IP
                                                               1465) and used for immediate defect
        drill and the pilot drill are not required. The
                                                               augmentation (for example with
        depth drilling is performed with the Twist Drill
                                                               Bioresorb) after implant insertion.

        Implant length

        The implant length can initially be determined by using the X-
        ray Indicator guide onto the panoramic radiograph. After
        preparation, the graduated markings on the twist drill will
        indicate the exact length required. This is controlled using the
        2.0 mm diameter depth gauge, also with graduated markings
        (the length graduation starts with 8 mm and continues in 2 mm
16 mm
14 mm
        steps up to 16 mm).
12 mm
10 mm
 8 mm
         PITT-EASY®           Insertion Technique and Instruments

                                                                    Direction Indicator

                                                                    When inserting two or more implants, the parallel relationship
                                                                    between all of the implants is an important factor to ensure a
                                                                    tension-free fit of the implant-borne mesio- or superstructure.

                                                                    Before advancing to the next drilling stage, carry out a check
                                                                    procedure by inserting the thin shaft of the Direction Indica-
                                                                    tors into the prepared 2.0 mm twist drill channels. The protrud-
                                                                    ing thick shaft will serve as a parallel control.

                                                                    Widening the bur channel

                                                                    The 2 Caliber Drill enlarges the 2 mm bur channel to a diameter
                                                                    of 3 mm. Increase the upper portion of each preparation in turn
                                                                    using the 2 Caliber Drill on slow rotation (800 – 1,200 rpm) and
                                                                    with sufficient cooling liquid.

                                                                    The direction indicators with sides 3-mm in diameter are used
6                                                                   to check these already extended bur channels.

                                                                    Step by step preparation with the Final Precision Drills

                                                                    After increasing the bur channel with the 2 caliber drill to 3 mm, the step-
                                                                    by-step expansion is performed with the next larger Final Precicion Drill or
                                                                    Simultaneous Drill. The color ring indicates the diameter size (color guide
                                                                    system). Advantages especially in the mandible if the cortical bone plate is
                                                                    very strong: Considerable trauma reduction, improved cooling possibility and
                                                                    exact drill guidance for the next larger diameter. The Final Precision Drills are
                                                                    graduated from 8-16 mm, corresponding with the different implant lengths, and
                                                                    are used for preparation of the depth of the bone site according to the length
                                                                    of the implant. By inserting the last drill which corresponds with the diameter
                                                                    of the implant, the site is prepared for the implant final implant diameter.

                                                                    Simultaneous drills with stop serve for easy and precise preparation of the
                                                                    site. The depth stop is 1 mm above the graduation fort he implant length, in
                                                                    order to enable a depth preparation also with uneven alveolar crests.
    l Important
                                                                    The final preparation is made with simultaneous or final precision drills on a
    For insertion of the 4.90 mm
                                                                    high torque, but low rotation setting (800 – 1,200 rpm), cooling intensively but
    Ø Pitt-Easy implant, we
                                                                    without pressure. The drill should repeatedly glide up and down freely over the
    recommend for the larger
                                                                    entire length of the bur channel, depending on bone density, in strong cortical
    diameter difference the
                                                                    mandibular bone repeatedly. In the case of highly cancellous bone, e.g. in the
    additional use of the
                                                                    maxilla, a single deep-drilling procedure will often suffice. An implant with the
    Interspace Drill, and for the
                                                                    next largest diameter is sometimes indicated.
    implant diameter 6.50 mm
    two Interspace Drills (5.10
    mm and 5.60 mm), to enable
    a careful preparation.
                                 Insertion Technique and Instruments   PITT-EASY®
                                                                       BICORTICAL   ®

Cortical Drill

The special Cortical Drill can be inserted once or twice at 800
– 1,200 rpm in addition to the final precision drill respectively
simultaneous drill in the presence of compact, basal bone to
facilitate insertion of the Pitt-Easy implants, especially for the
FBR double-coated implants.

Implant insertion

The Pitt-Easy implant is mounted in the cover of the internal package on a hex          
insertion device. Pull of the cap and immediately place the sterile implant into the
bone preparation which should not be rinsed. Do not touch the implant. Perform
two or three clockwise rotations with your fingers applying slight apical pressure
until the threads grasp the bone and begin self-tapping, finding stability in bone.
In order to enable a direct cell apposition, the implant should come in contact
only with the patient’s blood.

During the insertion of an implant with FBR surface attention must be paid that
no saline solution and no saliva comes into contact with the FBR surface. Just
wait until blood from the bone preparation is absorbed and covers the
complete highly porous FBR surface. This spontaneously induces the bioactive
integration phase.

Once the implant is stable, the vial top with the insertion hex can easily be
removed by pulling the cap off the implant. Continue insertion slowly using
the finger key with the separate hexagonal insert (note various hex sizes).
The marking on the Finger Key indicates one complete turn of 360° which
corresponds with a depth insertion of 1.1 mm. The implant inserted into the
prepared bone is slowly screwed into position by applying slight apical pressure,
rotating approximately 180° per second for promoting the selftapping property
and maintaining the blood circulation.

According to the tension resistance, the implant should be rotated slowly back
and forth (counter-clockwise and clockwise) several times by hand, i.e. only
using the finger key in order to achieve the self-tapping effect while the bone
is being expanded. If the osteotomy has been properly prepared, the bone will
adapt to the implant under the slight but gradually increased pressure in the
bur channel. Final positioning occurs with the last two thread rotations and will
require slightly stronger forward and backward torque, but do not force now,
to avoid damage to the prepared threads in the bone.
A ratchet generates too much uncontrolled stress to the implant site and
cannot perform the necessary forward and backward movements. It should,
therefore, not be employed for the self-tapping Pitt-Easy implant insertion
    PITT-EASY®   Insertion Technique and Instruments


                                 Prior to suturing, it is advisable to insert the straight or angulated
                                 acrylic Trial Posts (Item No. 90345) for orientation. Slight turns of
                                 the implants back and forth can facilitate the parallel adjustment
                                 of the posts for the laboratory. The hexagonal implant opening
                                 should be closed tightly with the implant cover screw of cor-
                                 responding diameter supplied with the implant or by applying the
                                 required single-phase technique with a gingival forming or an
                                 A.G.T. post, for papilla forming and esthetic temporary restoration.
                                 Defects in alveolar bone or extraction sites should be augmented
                                 at the same time. Additional mattress or simple sutures are used
                                 for safe, primary closure, depending on the position of the muscle
                                 attachment and condition of bone atrophy. After inserting Pitt-
                                 Easy implants, a control panoramic radiograph should be taken
                                 before carrying out the temporary procedure.


                                                       Healing time

                                                       Based on experience acquired to date, cylindrical implants should be allowed
                                                       to heal without loading for 3 months in the mandible, and approx. 5 – 6 months
                                                       in the maxilla. Thanks to the bone substance simultaneous resorption property
                                                       of the FBR surface the originally required healing time to achieve osseointe-
                                                       gration can now be reduced to 6 – 8 weeks post-op. Please estimate a longer
                                                       healing phase for elder patients and consider the risk of jaw bone growth with
                                                       young persons of less than 18 years. In order to check the healing process,
                                                       please use a perio test.

                                                       Depending on the gingival coverage, it is recommended to use gingiva form-
                                                       ers. In the case of premature pressure in the 6 weeks after surgery, adjacent
                                                       implants must be splinted using a bar connection until the final prosthesis is
                                                       inserted. The implants must not be exposed to direct pressure from a final
                                                       superstructure. Gingiva formers should have no contact to the antagonist jaw!
                                                       This applies in particular to distal free-end restoration with gingival support. In
                                                       the subsequent healing period, clip connections can be used on round bars in
                                                       order to hold the upper structure in place. Prosthesis resilience must, however,
                                                       be guaranteed and all forms of prosthetic pressure or tensile strength or labial
                                                       pressure, even from base material, must be avoided.

                                                       Pressure and invasion of food residues etc. could trigger inflammation, result-
                                                       ing in cervical bone loss, or complete failure of the implant.

                                                       Check-ups and replacing of the soft liner should be performed at intervals of
                                                       10 to 20 days with gradual smoothing of the prosthetic support surfaces and
                                                       removal of sharp edges.
                                                                 Insertion Technique and Instruments            PITT-EASY®
                                                                                                                BICORTICAL    ®


                After the healing period, if the keratinized zone is very thick, the implants can
                be exposed with a tissue punch in reduced contra-angle or manually with the
                centering punch. If the gingival coverage is thin, or if there are several im-
                plants in a row, exposure is best attained by one or several small crestal inci-
                sions. (A soft laser can be utilized in either case. Avoid electro-surgery in the
                area of the implant post without covering the titanium sections due to possible
                current contact or contamination through a metal-to-implant contact). After
                exposure but prior to impression taking, insert individualized gingiva formers
                respectively A.G.T. posts in order to remodel a new gingival cuff.

                After insertion of the final prosthesis, prior to cementing, an-
                other panoramic radiograph should be taken for documenting
                and the marginal fit evaluated. At this point all titanium posts
                                                                                        l Ratchet
                and central screws should be thoroughly tightened (using 25
                Ncm) again due to the ductility of the titanium. The prospective         For tightening and unscrewing of all Pitt-Easy
                time for insertion of the final prosthetic construction is depen-        prosthetics components.
                ding upon the quality of the bone substance, the bicortical
                support of the implants at the opposite cortical plate, and the          The defined torque is infinitely variable, offering
                healing condition of the surrounding gingiva as well as of aug-          controlled security – the high quality design
                mented defects according to the augmentation material used,              (stainless steel) and the easy handling enables
                or of resorption areas.                                                  you to insert the prosthetic posts with the
                                                                                         required torque.                                      
The occlusion must be carefully equilibrated and checked and may not have
any early contact points which might place extensive load on the implants in             As an option, and for additional safety for final
the beginning. Free-end or extension bridge abutments should be avoided if               tightening, the counter screw can be replaced
distal support can be provided. For single tooth replacement for early loading,          by the “Setting screw 25 Ncm”.
the implants must receive temporary crowns as primary prosthetics which are              • Setting range individually from 10 to 30 Ncm,
not in direct occlusion and are reduced in dimension or anatomical shape. In             • Display at 10, 15, 20, 25, 30 Ncm and at ∞
some cases, especially in spongeous bone, if implants are placed immediately               (infinitely variable).
after extraction and provided with augmentation, tension-free adhesive con-
nections to neighboring teeth are indicated.

                                 Impression taking and healing

                                 With straight screw-in standard posts, the original posts are used for direct
                                 impression. The impression posts with hex guidance are available for open or
                                 closed impressions for antirotation posts.
                                 This enables the exact transfer of the hex position of the oral situation to the
                                 model. This is especially important if using the 15° and 25° angulated posts.
                                 The parallel adjustment of all prosthetic abutments is facilitated for tensionfree
                                 insertion of the implant-supported superstructure.
                                 Once the impressions have been taken, the impression posts for closed
                                 impression are removed from the mouth and the gingiva formers respectively
                                 A.G.T. posts re-inserted until the final bridge is incorporated. The impression
                                 posts are screwed onto model analogs of the corresponding diameter and
                                 repositioned in the impression in order to establish the accurate oral-identical
                                 transfer also of the hex position for the laboratory. When using the open
                                 impression technique, the central screws are removed from the impression
                                 prior to removal from the mouth. Prior to preparation of the model, the analogs
                                 are connected with the impression posts which are in the impression, by using
                                 the central screws.
     PITT-EASY®     Selection of Posts

     Selection of Posts
                  The Pitt-Easy implant system offers a large variety of definitive prosthetic posts for all
                  different indications:

                  A.G.T.®-Line                      Paracentric Line                  Locator System
10                for esthetic temporary treat-     with permucosal extension in      The Locator post is an
                  ment, at the same time ana-       3 different heights, especially   attachment with a self-alig-
                  tomical gingiva forming post      suited for bar constructions,     ning feature. This feature will
                                                    enables a compensation of         aid patients in seating their
                  Ball Head Posts                   up to 40° divergency              denture and eliminate addi-
                  the economical solution                                             tional wear from improper
                  without bar connection            C.A.S. (Castable Abutment         seating.
                                                    System) Esthetic
                  Standard Posts                    castable, with antirotation       With the Locator’s minimal
                  antirotation-safe, straight or    safety by hexagonal               vertical height, it is ideal
                  angulated, 15° and 25°,           connection                        where interocclusal space
                  especially for the cementable                                       is limited. This post can also
                  single tooth re-placement, but    C.A.S. Novobase®                  accommodate up to 40° bet-
                  also for partial and total jaw    for cast-on of all precious       ween implants.
                  reconstructions, for              metal alloys with CNC milled
                  compensation between              margin for precisely fitting
                  optimal insertion direction and   and individual preparation of
                  preferred post position           esthetic implant constructions
                                                                                              Selection of Posts   PITT-EASY®
                                                                                                                   BICORTICAL   ®


V.D.L. Anatomic Line               Individual posts
straight or angulated (15° and     titanium, for the preparation
25°), with cervical shoulder       of individual primary parts for
which guarantees an exact          telescopic or cone crowns or
crown margin. Special              non-standardized (15° and
indication for the fixed single    25°) angulations and gingiva
tooth replacement, but also        contours. After trimming and
for complete jaw bridge            direct veneering with titanium
constructions, for compen-         ceramics suitable for occlusal
sation of divergency between       screw-on single crowns
optimal insertion direction        or individual tooth-colored
and preferred post direction –     abutments
a guarantee for functional
antirotation security and
esthetic results in the anterior

Please see our separate Prosthetic Catalogs for the individual post modalities for details.

           FBR             V-TPS      PURETEX

                                                                  PATENTED              V-TPS
                                                  EARLY LOADING
PATENTED                                            SUCCESS PATENTED
                  EARLY LOADING

  Innovative products                       INNOVA – ORALTRONICS – ATTACHMENTS INTERNATIONAL
                                            A World of Implant Solutions
                                            The dental implant platform of Sybron Dental Specialties (SDS)
                                            brings together three organizations that have been leaders
                  BICORTICAL®               in implant manufacturing, design and development since the
                                            inception of implant dentistry.
                  CYTOPLAST®                Delivering two of the most respected, leading-edge dental
                                            implants on the market – ENDOPORE® and PITT-EASY® – we
                                            are giving you access to a world of implant solutions.

  ORALTRONICS® Dental Implant Technology GmbH
  Herrlichkeit 4 · 28199 Bremen · Germany
  Phone +49 421 43939-0 · Fax +49 421 443936
                                                                                                             06-0021: 06/07 · HDS1-01-GB ·

  Distributed in North America:
  Innova Corporation
  522 University Ave Suite 1200
  Toronto, ON M5G 1W7 · Canada

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