Transcription

Technical InformationStraumann TLX Implant SystemBasic Information702854.indd 129/07/2021 12:52

702854.indd 229/07/2021 12:52

Table of Contents1. The Straumann TLX Implant System 32. Implant 52.1Design and specification 3. Connection 64. Instruments 84.1VeloDrill 94.2Drill extender 94.3Alignment Pin and Depth Gauges 104.4Implant depth gauge 104.5Implant driver 114.6Ratchet and torque control devices 124.7Straumann Modular Cassette 134.8Setup for TLX freehand surgery 135. Surgical procedure 145.1Preoperative planning 145.2Implant bed preparation 195.3Implant pick up 255.4Implant placement 265.5Gap management 285.6Primary implant closure 296. Prosthetic workflow overview 306.1Abutment overview 306.2Laser Marking 316.3Prosthetic components overview 337. Important considerations 367.1How to verify correct impression post seating 367.2Removal of the TLX NT Screw-retained Abutments 368. Soft tissue management 702854.indd 15378.1Submucosal healing 378.2Transmucosal healing 389. Temporary restoration 399.1 Prefabricated healing cap made of Titanium grade 4 399.240Temporary abutment – titanium alloy (TAN) 29/07/2021 12:52

10. Impression taking 4210.1 Conventional implant level impression taking 4210.2 Closed-tray impression procedure “Screwed” 4310.3 Open-tray impression procedure “Screwed” 4510.4 Digital impressions: Straumann CARES Mono Scanbody 4711. Final restoration 4811.1 Straumann Variobase 4811.2 Straumann Novaloc Abutments 5011.3 Straumann Cementable Abutments straight and angled for crowns and bridges 5211.4 Straumann Gold Abutments 5411.5 Straumann Screw retained Abutments 5611.6 Straumann CARES Abutments 5811.7 Straumann Pre-milled abutment blanks (PMAB) 5811.8 Straumann Screw-retained Bars and Bridges (SRBB) 5911.9 Straumann CARES Scan & Shape 6011.10 Smile in a Box 6212. Further Information 6313. Product reference List 6413.1 TLX Standard Plus Implants 6413.2 TLX Standard Implants 6513.3 Closure Caps 6613.4 Healing Caps 6613.5 Impression 6713.6 Analogs 6713.7 Repositionable Analogs 6713.8 Scanbody 6713.9 Basal Screws 6713.10 Temporary Restoration 6813.11 Variobase for Crown 6813.12 Variobase for Crown AS 6913.13 Variobase for Bridge/Bar Cylindrical 6913.14 Variobase C 7013.15 Cementable Abutments 7013.16 Screw-retained Abutments 7013.17 Gold Abutments 7113.18 Pre-Milled Abutment Blanks 7113.19 Novaloc Abutments 7113.20 Instruments 74About this guideThis surgical and prosthetic procedure describes the steps required for implantation and restoration of the Straumann TLXImplant System. The Straumann TLX Implant System is recommended for use only by clinicians with advanced surgicalskills. It is assumed that the user is familiar with placing dental implants. Not all detailed information will be found in thisguide. Reference to existing Straumann procedure manuals will be made throughout this document.Not all products shown are available in all markets.702854.indd 229/07/2021 12:52

1. The Straumann TLX Implant SystemThe Straumann TLX Implant System offers fully tapered tissue level implants (TLX) that are designed for high primary stability and immediate treatment procedures.The Straumann TLX Implants are made from the material Roxolid with the SLActive surface and are available in themaximum endosteal outer diameters 3.75 mm, 4.5 mm, 5.5 mm and 6.5 mm, with length options from 6 mm to18 mm for the maximum endosteal outer diameter 3.75 mm and 4.5 mm, and 6 mm to 12 mm for diameters 5.5 mm and 6.5 mm. A unified color code simplifies identification of instruments and implants for the available maximum endostealouter diameters. The Straumann TLX implants are available with either a 1.8 mm shoulder (Standard Plus - SP) or with a2.8 mm shoulder (Standard - S).The Straumann TLX prosthetic components are identified with NT (Narrow TorcFit /one dot), RT (Regular TorcFit /twodots) and WT (Wide TorcFit /three dots), corresponding to the implant shoulder diameters of 3.5 mm, 4.8 mm and 6.5 mm respectively.Straumann TLX SP Implant 3.75 mmStraumann TLX SP Implant 4.5 mmShoulder HeightStraumann TLX SP Implant 6.5 mmStandard Plus - Implant shoulder 1.8mmColor code(red)Prosthetic BaseStraumann TLX SP Implant 5.5 it ImageSLActive Availablelengths6 .3806S8 .3808S10 .3810S12 .3812S14 mm035.3014S035.3114S035.3414S035.3514S16 mm035.3016S035.3116S035.3416S035.3516S18 mm035.3018S035.3118S035.3418S035.3518S–To obtain more information about the indications and contraindications related to each implant, please refer to the cor responding instructions for use. Instructions for use can be found at www.ifu.straumann.com.Some items of the Straumann Dental Implant System are not available in all countries.3702854.indd 329/07/2021 12:52

Straumann TLX S Implant 3.75 mmStraumann TLX S Implant 4.5 mmShoulder HeightStraumann TLX S Implant 6.5 mmStandard - Implant shoulder 2.8mmColor code(red)Prosthetic BaseStraumann TLX S Implant 5.5 it ImageSLActive Availablelengths6 .1806S8 .1808S10 .1810S12 .1812S14 mm035.1014S035.1114S035.1414S035.1514S16 mm035.1016S035.1116S035.1416S035.1516S18 mm035.1018S035.1118S035.1418S035.1518SN/ATo obtain more information about the indications and contraindications related to each implant, please refer to thecorresponding instructions for use. Instructions for use can be found at www.ifu.straumann.com.Some items of the Straumann Dental Implant System are not available in all countries.702854.indd 429/07/2021 12:52

2. Implant2.1StandardStandard PlusDesign and specificationABEEF1FCAIIMMDLLPPTTGGHStraumann TLX SP Implant 4.5 mmStraumann TLX Implant 3.75 mm NT[A] Maximum outer diameterStraumann TLX Implant 3.75 mm RTHStraumann TLX S Implant 4.5 mmStraumann TLX Implant 4.5 mm NT 3.75 mmStraumann TLX Implant 4.5 mm RT 4.5 mmStraumann TLX Implant 5.5 mm WTStraumann TLX Implant 6.5 mm WT 5.5 mm 6.5 mm[B] Shoulder diameter 3.5 mm 4.8 mm 3.5 mm 4.8 mm 6.5 mm[C] Platform diameter 2.9 mm 3.7 mm 2.9 mm 3.7 mm 5.0 mm[D] Connection diameter 2.7 mm[E] 45 bevel height0.5 mm[F] Smooth shoulder height* Standard Plus (SP)1.8 mm[F1] Smooth shoulder height* Standard (S)2.8 mm[G] Apical diameter, body[H] Apical diameter, threads 1.9 mm 2.9 mmNumber of apical cutting edges 3.6 mm2 2.0 mm 3.0 mm 4.0 mm 5.2 mm4[L] Implant lengths: 6 mm, 8 mm[I] Threads to shoulder height1.0 mm[M] Micro threads height0.5 mm[P] Thread pitch**1.7 mm2.0 mm2.1 mm2.5 mm[T] Thread spacing0.85 mm1.0 mm1.05 mm1.25 mm[L] Implant lengths: 10 mm, 12 mm, 14 mm[I] End of threads to shoulder distance1.7 mm[M] Micro threads height0.85 mm[P] Thread pitch**2.2 mm2.5 mm2.8 mm[T] Thread spacing1.1 mm1.25 mm1.4 mm[L] Implant lengths: 16 mm, 18 mm[I] Threads to shoulder height2.0 mm[M] Micro threads height1.0 mm[P] Thread pitch**2.6 mm2.8 mm[T] Thread spacing1.3 mm1.4 mm* This quote refers to height of the shoulder with a smooth non-SLActive surface** Implant advances by this distance with every full rotation (360 )702854.indd 5NA529/07/2021 12:52

3. ConnectionThe Straumann TLX Implant features the intuitive TorcFit connection. This connection supports self-guiding insertion, for clear-cut tactile feedback. Six positions enable a simple yet flexible alignment and outstanding protection against rotation.All TLX Implants have the same inner geometry regardless of the diameter of the implant. This allows theuse of the same implant driver for all implants.Improved Torx with six positions:ѹ Allows transmission of high torquesѹ Simple yet flexible implant and abutment alignmentѹ Clear-cut and guided component insertionvia cylindrical guidance7 conical prosthetic connection:ѹ High mechanical stability45 shoulder prosthetic connection:ѹ High mechanical stabilityѹ Exact implant-abutment fitѹ Extra wide emergence profiles(implants with diameter 5.5 mm)ѹ Divergence compensation for bridgesFlat Top portion:ѹ High accuracy for scanbody6702854.indd 629/07/2021 12:53

Same inner geometry regardless of the diameter of the implant. Same implant driver for all implants. Precisely machinedshoulder. 3.75 mmNT 3.75 mmRT 4.5 mmNT 4.5 mmRT 5.5 mmWT 6.5 mmWTPictures above refer to Straumann TLX SP Implants.7702854.indd 729/07/2021 12:53

4. InstrumentsThe Straumann TLX Implant Systemis supplied with a specific set of instruments.The instruments have depth marksat 2 mm intervals that correspond tothe available implant lengths. Thefirst bold mark on the drills represents10 mm and 12 mm, where the loweredge of the mark corresponds to 10 mmand the upper edge to 12 mm. The second bold mark on the long drills rep-18 mm16 mm14 mm12 mm10 mm8 mm6 mm4 mmresents 16 mm and 18 mm, where thelower edge of the mark corresponds to16 mm and the upper edge to 18 mm.12345671. Needle Drill: 026.00562. Pilot Drill, long: 066.17013. Alignment Pin: 046.7994. Drill 6, long: 066.17065. Depth Gauge: 046.8046. TLX Implant 4.5 RT / 12 mm: 035.3512S7. Implant Depth Gauge: 066.2000Warning: Due to the function anddesign of the drills, the drill tip is upto 0.5 mm longer than the insertiondepth of the implant. For example,if you drill until the 10 mm markingthe actual osteotomy has a depth of0.5 mm10.5 mm.8702854.indd 829/07/2021 12:53

4.1VeloDrill All TLX VeloDrill in the Straumann Implant System are delivered color-coded, the color corresponding to the specific implant diameter. For precise depth control, VeloDrill are compatible with a disposable drill stop (refer to Straumann DrillStop – Basic Information (702874/en)).Needle drillColorDrillNo. 1 (pilot)DrillNo. 2DrillNo. 3DrillNo. 4DrillNo. 5DrillNo. 6DrillNo. 7DrillNo. 8DrillNo. 9–Image(short)Diameter 1.6 mm 2.2 mm 2.8 mm 3.2 mm 3.5 mm 3.7 mm 4.2 mm 4.7 mm 5.2 mm 6.2 mmStepdiameterNANA 2.5 mm 3.0 mm 3.3 mm 3.6 mm 3.9 mm 4.4 mm 4.9 mm 5.7 steelStainlesssteel4.2 Drill extenderThe stop ring reduces the effectiveness of the irrigation when a drill extender is used. In this caseuse additional external irrigation (e.g with a syringe) to ensure proper cooling of the osteotomyduring drilling.9702854.indd 929/07/2021 12:53

4.3Alignment Pin and Depth GaugesAlignment pins and depth gauges are available for accurate depth measurements and alignment of orientation and position of the osteotomy. Their diameters and color correspond tothe drill diameters and are compatible with all Straumann implant systems.The tip and the groove are both 1.0 mm long. This allows distortion measurements on aninteroperative radiograph.Drill No. 1(pilot) 2.2 mmAlignment Pin 2.2 mmDrill No. 2 2.8 mmDepth Gauge 2.8 mm18 mm16 mm14 mm12 mm10 mm8 mm6 mm4 mm1 mm1 lant depth gaugeImplant depth gauge for accurate depth measurement and tactile examination of the osteotomy.Blue end: use to examine osteotomy made by drill No. 1 ( 2.2 mm)Yellow end: use to examine osteotomy made with drill No. 2 ( 2.8 mm) and wider.Made of titanium-alloy (TAN). Compatible with all Straumann implant systems.12 mm10 mm2.0 mm1.5 mmImplant depth gauge, 066.200010702854.indd 1029/07/2021 12:53

4.5Implant driverSpecific Implant Driver to use for pick-up and insertion of the Straumann TLX Implants.Implant Driver typeImplant Driver for HandpieceImplant Driver for Ratchet,screw-retainedImplant Driver for Ratchetshortmediumlongextra longshortmediumlongshortlongLength 21 mmLength 26 mmLength 31 mmLength 36 mmLength 21 mmLength 26 mmLength 31 mmLength 21 mmLength 31 mm066.4207066.4202066.4205066.4206Stainless steel066.4101066.4107066.4102066.4108066.4201Note: Consider the available intra-oral space when selecting the implant driver. The long and extra-long versions arerecommended for anterior only.Surgical Handle for TorcFit Implant DriverStainless steel066.4000The Implant Driver for handpiece (long (066.4102), extra long (066.4108)) is compatible with the Surgical Handle, for TorcFit Implant Driver. If manual surgical Implant drivers are used to insert the implant, special attention is required to avoid overtightening.4 mm3 mm2 mm1 mm0 mm (implant neck flat top level)The round markings on the Implant Drivers indicate the distance to the implant flat top in 1 mm steps. As the SP implant hasa 1.8 mm implant shoulder, the distance of the first round marking to the SLActive surface margin is 1.8mm 1mm 2.8mm,that of the second round mark is 3.8 mm, that of the third round mark is 4.8 mm.702854.indd 111129/07/2021 12:53

4.6Ratchet and torque control devicesThe ratchet is a two-part lever arm instrument with a rotary knob for changing the direction of force. It is supplied witha service instrument, which is used to tighten and loosen the head screw. The Holding Key (046.064) can be used tostabilize the ratchet.Two different Torque Control Devices are available for defined torque transmission or for torque measurements, withmarkings of 15Ncm / 35Ncm and 35-50Ncm / 80Ncm respectively. Choose the appropriate device depending on theintended use.Ratchet and Torque Control DevicesHolding KeyRatchetTorque Control Devicefor RatchetTLX Torque Control Devicefor Ratchet, SurgicalIntended useAuxilliaryTorque transmissionProstheticSurgicalTorque markingsNANA0 / 15 / 35Ncm0 / 35 / 50 / 80NcmArticle ss steelStainless steelStainless steelStainless steel, DLC coatedNote: To ensure prolonged perfect function and cleanability, the ratchet must always be taken apart and the individualparts disinfected, cleaned and sterilized after use. Its function must be checked in good time before each use.Always use the Service Instrument to tighten the bolt of the ratchet before use.Torque reading on Torque Control Device:35 Ncm50 Ncm12702854.indd 1229/07/2021 12:53

4.7Straumann Modular CassetteThe Straumann Modular Cassette is used forthe sterilization and the secure storage of thesurgical instruments and auxiliary instruments.For guidelines on how to clean and sterilize thecassette, please refer to Straumann ModularCassette, Basic Information (702527/en).4.8 Setup for TLX freehand surgeryA ModuleFully Tapered Tray041.761041.777Ratchet TrayImplant Depth Gauge Tray041.766Ratchet046.119041.771Holding Key046.064BLX TorqueControl066.1100Implant Depth Gauge066.2000Implant Driver for Ratchet066.4201066.4202AlignmentPin046.799Depth Gauge046.801Depth Gauge046.803Depth Gauge046.805Depth Gauge046.807Implant Driverfor Handpiece066.4101066.4102DrillExtender040.563Depth Gauge046.800Depth Gauge046.802Depth Gauge046.804Depth Gauge046.806longshortDrill No. 2066.1702066.1302RT Profile Drill036.3300036.3301WT Profile Drill036.3302036.3303SCS Screwdriverfor Ratchet046.400046.401046.402Drill No. 6066.1706066.1306Drill No. 8066.1308Round Bur044.004044.003RT/WT Profile Drill SetGrommet Tray, 6 small041.762Drill No. 4066.1704066.1304Needle Drill026.0056Drill No. 1(pilot)066.1701066.1301Drill No. 3066.1703066.1303Drill No. 5066.1705066.1305Drill No. 7066.1707066.1307Drill No. 9066.1309SCS Screwdriverfor Handpiece046.410046.411046.412SCS Screwrdiver SetGrommet Tray 3 small 3 large041.764For more information refer to Straumann Modular Cassette Selection Guide (702824/en).13702854.indd 1329/07/2021 12:53

5. Surgical procedureThe workflow for the surgical procedure for the Straumann TLX Implant System involves 3 steps:ѹ Preoperative planningѹ Implant bed preparationѹ Implant insertion5.1Preoperative planningProsthetic-driven planning is recommended, and close communication between the patient,dentist, surgeon and dental technician is imperative for achieving the desired esthetic result.To determine the topographical situation, axial orientation and the appropriate implants, makinga wax-up / set up using the previously prepared study cast is recommended. Subsequently, thetype of superstructure can be defined. The wax-up / set-up can later be used as the basis for acustom-made X-ray or drill template and for a temporary restoration.Note: Abutments should always be loaded axially. Ideally, the long axis of the implant is alignedwith the cusps of the opposing tooth. Extreme cusp formation should be avoided as this can leadto unphysiological loading.The mesiodistal bone availability is an important factor when choosing the implant type anddiameter as well as the inter-implant distances if multiple implants are placed. The point ofreference on the implant for measuring mesiodistal distances is always the largest diameter ofthe implant.14702854.indd 1429/07/2021 12:53

The following three rules should be regarded as minimum guidelines:Rule 1Rule 2 1.5 mmRule 3 3 mm 1.5 mmRule 1: Distance to adjacent tooth atRule 2: Distance to adjacent implantsRule 3: The facial and palatal bone lay-implant shoulder levelat bone level.er must be at least 1.5 mm thick in or-A minimum distance of 1.5 mm from theA minimum distance of 3 mm betweensue conditions. Within this limitation,implant shoulder to the adjacent toothtwo adjacent implant shoulders (me-a restoration-driven orofacial implant(mesial and distal) is recommended.siodistal) is recommended.position and axis should be chosender to ensure stable hard and soft tis-such that screw-retained restorationsare possible.Caution: An augmentation procedure is indicated if the orofacial bone wall is less than 1.5 mm or a layer of bone is missing on one or more sides. This technique should be employed only by dentists with adequate experience in the use ofaugmentation procedures.15702854.indd 1529/07/2021 12:53

5.1.1 X-ray reference foilThe vertical bone availability determines the maximum allowable length of the implant thatcan be placed. For easier determination of the vertical bone availability, we recommend theuse of an X-ray reference foil with X-ray Reference Sphere (Art. No. 049.076V4).The TLX X-ray reference foils (Art No. 036.3400) are used for measurement and comparison.They assist the user in selecting the suitable implant type, diameter and length. Similar to thedistortions that occur in X-rays, the implant dimensions are shown on the individual referencefoils with the corresponding distortion factors (1:1 to 1.7:1). Determining each magnificationfactor or scale is facilitated by showing the X-ray Reference Sphere on the reference foil. First,compare the size of the X-ray Reference Sphere on the patient’s X-ray with the size of the Reference Sphere on the reference foil. Superimpose the two pictures to find the correct scale.Next, determine the spatial relations around the implant position, and establish the implantlength and insertion depth.For more information regarding the preparation of a X-ray jig with the Reference Spheres seethe Straumann Dental Implant System, Basic Information (702084/en).0246 4.5 mmRT 5.5 mmWT 6.5 mmWT81012141618 3.75 mmNT2Straumann TLX S Implant 4.5 mmNT 3.75 mmNT 5.0 mmStraumann TLX SP Implant 3.75 mmRT 4.5 mmNT 4.5 mmRT 5.5 mmWT 6.5 mmWT0246810121416181.1 : 10 5.0 mm 3.75 mmRT 5.5 mmStraumann TLX S Implant 3.75 mmRT 4.5 mmNT 4.5 mmRT 5.5 mmWT 6.5 mmWT0 3.75 mmNT 5.5 mmStraumann TLX SP Implant 3.75 mmRT 4.5 mmNT024 4.5 mmRT 5.5 mmWT6Note:6 For Straumann TLX Implants use only the X-ray referencefoil specific to the TLX Implant48101214161881012141618(Art No. 036.3400).To calculate the effective bone availability, use the following formula:X-ray Reference sphere 5 mm bone availability (X-ray*)Reference sphere diameter on the X-ray24681012141618 6.5 mmWT02468101214161802/20 3.75 mmNT036.3400/C/021.0 : 1effective boneavailability* Taking into consideration all implant-related anatomic structures(e.g. mandibular canal, sinus maxillaris, etc.)16702854.indd 1629/07/2021 12:53

5.1.2 Planning softwareAnother possibility is digital planning with e.g. coDiagnostiX . This 3D diagnostics and implantplanning software is designed for the image-guided surgical planning of dental implants,including TLX Implants, which are included in the system’s digital library. Working with thesoftware is based on a patient’s medical image data, such as a CT (Computed Tomography)or DVT (Digital Volume Tomography) scan processed by coDiagnostiX .Planning includes the calculation of several views (such as virtual OPG or a 3-dimensional reconstruction of the image dataset), analysis of the image data and the placement of implants,abutments and drilling sleeves.coDiagnostiX software is designed for use by professionals with appropriate knowledge inimplantology and surgical dentistry. For further information, please refer to the coDiagnostiX Manual.CARES Synergy workflowCARES Synergy provides real-timecommunication between the implantplanning software (coDiagnostiX )and the lab software (i.e. Straumann CARES Visual) and improves implantplanning by visualizing the relationship between the proposed implantposition and the proposed restoration.17702854.indd 1729/07/2021 12:53

5.1.3 Straumann Pro Arch GuideFor intraoperative visual and three-dimensional orientation of the implant angulation (mesial/distal) and oral parallelization, use the Straumann Pro Arch Guide.The Pro Arch Guide is used in edentulous jaws for surgical implant placement. The Pro ArchGuide can be easily bent to adapt to the dental arch. It is secured by drilling into the symphysiswith a 2.2 mm Drill No. 1 and a pin in the jaw. The drilling depth for the bone cavity of thepin is 10 mm. The drilling depth can be checked optically using the depth markings on the drills.For adjustment and disassembly use the TS Hexagonal Screwdriver (046.420).Straumann Pro Arch Guide (026.0016)For further information about treatment of edentulous patients and angulated placement ofTLX Implants, please refer to the Straumann Pro Arch, Basic Information (702166/en).5.1.4 Bone density definitionCross sectional view of different types of bone quality*Type IType II / IIIType IVHardMediumSoftThick cortical bone with marrow cavityThin cortical bone with densetrabecular bone of good strengthVery thin cortical bone with low density trabecular bone of poor strength* Lekholm U, Zarb G. Patient selection and preparation in Tissue Integrated Prostheses. Branemark P I, Zarb G A,Albrektsson T (eds). pp199–210. Quintessence, 1985.18702854.indd 1829/07/2021 12:53

5.2 Implant bed preparationThe Straumann Modular Cassette with specific instruments is used to prepare the implantbed. Different drill protocols should be employed depending on the bone density. This offersthe flexibility to adapt the implant bed preparation to the individual bone quality and anatomical situation.A quick guide to the surgical drill protocol is printed on the cassette and indicates the finaldrill recommended for each implant diameter and bone density.Numbers in brackets (): to a depth of 4 mm (for implant lengths 6 mm and 8 mm) and 6 mm(for implant lengths 10 mm and longer) only in order to widen the coronal part of the implantbed.Implant diameters of 3.5, 4.0 and 5.0, printed on the cassette, are only available forBLX Implant System and not for TLX Implant System.Bone densityFinal drill diameterImplant maximum endosteal outer diameterCortical bone widening drill diameterNote: Every implant bed has to be initiated with the pilot drill ( 2.2 mm) to full implant length.On the quick guide only the final drill is displayed. The clinician can decide whether or not a sequence of drills with increasing diameters is used. Due to the self-cutting properties of theTLX Implant the implant bed can be underprepared in length by 2 mm with the final drills in softbone. Use the drills in a clockwise drill rotation direction, use intermittent drilling techniqueand provide ample cooling with pre-cooled (5 C, 41 F) sterile saline solution. Do not exceed therecommend drill speeds, as indicated on the next page.19702854.indd 1929/07/2021 12:53

5.2.1 Workflow for TLX 3.75 mmImplant bed preparation, illustrated with a TLX Implant 3.75 mm / 12 mm RTMark theimplantation siteNeedle Drill 1.6 mmPilot drillingCheck implant axisPilot Drill 1 2.2 mmDecide onbone densityAlignment Pin 2.2 mmFinalize Implant Bedaccording to bone densityDrill 2 2.8 mmDrill 3 3.2 mmDrill 4 3.5 mmImplantplacementDrill 5 3.7 mmSoftcMediumcHardc800 rpm800 rpm800 rpm800 rpm800 rpm800 5TLX 3.75 mmSLActive 12 mm,RXD15 rpmPreparation for cortical bone only:- do a depth of 4 mm for implants with a length of 6 mm and 8 mm- do a depth of 6 mm for implants with a length of 10 mm to 18 mmWarning: Due to the function and design of the drills, the drill tip is up to 0.5 mm longer than the insertion depth of theimplant. For example, if you drill until the 10 mm marking, the actual implant bed has a depth of 10.5 mm.Cortical bone treatment: in the presence of a hard cortical bone layer, it is recommended to widen the implant bed in thisarea using drill number 5 ( 3.7 mm) for 3.75 mm and 4.5 mm implants and drill number 7 ( 4.7 mm) for 5.5 mm and 6.5 mm implants, independent of the overall bone-quality.Subcrestal implant placement: consider final implant position for drill depth, never undersize in length with the pilot drill #1.Immediate placement: In extraction sites where the implant only engages the apical part, drill # 2 ( 2.8 mm) is recommended as the final drill.20702854.indd 2029/07/2021 12:53

5.2.2 Workflow for TLX 4.5 mmImplant bed preparation, illustrated with a TLX Implant 4.5 mm / 12 mm RTMark theimplantation siteNeedle Drill 1.6 mmPilot drillingCheck implant axisDrill No. 1 2.2 mmDecide onbone densityAlignment Pin 2.2 mmFinalize Implant Bedaccording to bone densityDrill No. 2 2.8 mmDrill No. 3 3.2 mmDrill No. 5 3.7 mmImplantplacementDrill No. 6 4.2 mmSoftTLX 4.5 mmSLActive 12 mm,RXDMediumHard800 rpm800 rpm800 rpm800 rpm800 rpm800 615 rpmWarning: Due to the function and design of the drills, the drill tip is up to 0.5 mm longer than the insertion depth of theimplant. For example, if you drill until the 10 mm marking, the actual implant bed has a depth of 10.5 mm.Cortical bone treatment: in the presence of a hard cortical bone layer, it is recommended to widen the implant bed in thisarea using drill number 5 ( 3.7mm) for 3.75mm and 4.5mm implants and drill number 7 ( 4.7mm) for 5.5mm and 6.5mm implants, independent of the overall bone-quality.Considerations for hard bone in healed sites: application of the hard bone drill protocol for a TLX implant diameter withwider threads ( 4.5 mm, 5.5mm and 6.5 mm) in healed sites results in a small gap between the implant shoulder andthe surrounding crestal bone. In such situations it is recommended to consider minor bone grafting around the implantshoulder. This may be accomplished by scraping a small amount of bone with a surgical chisel from the area surrounding theosteotomy (already exposed) and applying it between the implant and the osteotomy.Subcrestal implant placement: consider final implant position for drill depth, never undersize in length with the pilot drill #1.Immediate placement: In extraction sites where the implant only engages the apical part, drill # 2 ( 2.8 mm) is recommended as the final drill.21702854.indd 2129/07/2021 12:53

5.2.3 Workflow for TLX 5.5 mmImplant bed preparation, illustrated with a TLX Implant 5.5 mm / 12 mm WTMark theimplantation siteNeedle Drill 1.6 mmPilot drillingCheck implant axisDrill No. 1 2.2 mmDecide onbone densityAlignment Pin 2.2 mmFinalize Implant Bedaccording to bone densityDrill No. 3 3.2 mmDrill No. 6 4.2 mmDrill No. 7 4.7 mmImplantplacementDrill No. 8 5.2 mmSoftTLX 5.5 mmSLActive 12 mm,RXDMediumHard800 rpm800 rpm800 rpm800 rpm800 rpm800 815 rpmWarning: Due to the function and design of the drills, the drill tip is up to 0.5 mm longer than the insertion depth of theimplant. For example, if you drill until the 10 mm marking, the actual implant bed has a depth of 10.5 mm.Cortical bone treatment: in the presence of a hard cortical bone layer, it is recommended to widen the implant bed in thisarea using drill number 5 ( 3.7mm) for 3.75mm and 4.5mm implants and drill number 7 ( 4.7mm) for 5.5mm and 6.5mm implants, independent of the overall bone-quality.Considerations for hard bone in healed sites: application of the hard bone drill protocol for a TLX implant diameter withwider threads ( 4.5mm, 5.5mm and 6.5 mm) in healed sites results in a small gap between the implant shoulder andthe surrounding crestal bone. In such situations it is recommended to consider minor bone grafting around the implantshoulder. This may be accomplished by scraping a small amount of bone with a surgical chisel from the area surrounding theosteotomy (already exposed) and applying it between the implant and the osteotomy.Subcrestal implant placement: consider final implant position for drill depth, never undersize in length with the pilot drill#1 and #3.22702854.indd 2229/07/2021 12:53

5.2.4 Workflow for TLX 6.5 mmImplant bed preparation, illustrated with a TLX Implant 6.5 mm / 12 mm WTMark theimplantation siteNeedle Drill 1.6 mmPilot dri

Implant System. The Straumann TLX Implant System is recommended for use only by clinicians with advanced surgical . skills. It is assumed that the user is familiar with placing dental implants. Not all detailed information will be found in this . guide. Reference to existing Straumann