Overview
The Neoss Implant System comprises implants and abutments offering a logical and simplified approach for all treatment protocols including immediate and early loading, immediate placement and one or two stage placement.
The Neoss implant system is available in 5 diameters Ø3.5, 4.0, 4.5, 5.0 and 5.5mm and in addition there is a narrow Neoss Ø 3.25mm implant.
The packaging for Neoss implants and instruments used for a specific implant diameter (countersinks and screwtaps) have the following colour coding:
- Ø3.25mm Royal Blue
- Ø3.5mm Green
- Ø4.0mm Yellow
- Ø4.5mm Blue
- Ø5.0mm Peach
- Ø5.5mm Lilac
The Neoss implant has an internal connection. The implant is ‘picked up’ from a sterile glass vial with an Implant Inserter. The surgical drills provided are for single use and are delivered in a sterile condition for immediate use.
There is only one screwdriver connection in the assortment which is used for all components including covers screw, healing abutment screws and final abutment screws.
All Neoss implants, except Ø3.25, have a single abutment connection as there is a single platform for all standard implant diameters – simplifying the restorative phase, stock and instrument requirements.
Neoss implants are provided in kits which include a cover screw, two healing abutments (only 5mm with Ø3.25mm implant) and a healing screw. This complete delivery method allows the clinician to undertake either one or two stage surgery at time of placement without the need to have pre-ordered individual components.
There are also two stickers provided in the implant kit to assist in recording information on the patient’s chart.
Treatment Options
The Neoss implant may be placed using a Single/One Stage (which may involve immediate loading/function) or a Two Stage surgical protocol.
- Single/One Stage Surgery – this procedure involves placing a healing abutment, a provisional abutment or prosthesis at time of implant placement.
- Two Stage Surgery – this procedure involves placing a cover screw at the time of implant placement, then after a designated healing time a second surgical procedure to uncover the implant and place a healing/provisional or other form of abutment.
Surgical Procedure
The surgical procedure may entail a range of procedures including minimally invasive surgery and raising a full thickness flap and exposing the bone in the proposed site. A series of increasing diameter drills are used to enlarge the preparation osteotomy for implant placement – this may involve the use of countersinks and bone taps depending on individual preference and/or the quality of bone.
If the procedure is to be carried out in a hospital environment then the preparation of the theatre and surgical staff should conform to the established protocols of each individual hospital.
It is desirable to have both a sterile and non-sterile assistant throughout the procedure.
All bone preparation drilling is carried out under profuse irrigation using either saline or sterile water to avoid overheating of the bone.
If a surgical guide/stent is to be used for implant placement then follow the manufacturer’s recommendation for the sterilisation procedure.
The drilling sequence for bone preparation is outlined in the Neoss System Drilling Guide however individual preferences or bone quality may require a deviation from this guide. It is therefore recommended that additional/optional components only be opened when indicated by the surgeon.
Oral Hygiene and Patient Aftercare
As with natural dentition, dental implant/prosthesis are susceptible to plaque build-up which may have a detrimental affect on the long term success of the prosthesis.
It is therefore of vital importance that the patient is carefully instructed on the importance of regular check-ups and ‘home care’. Following insertion of the final prosthesis the patient should be instructed in the routine for home care.
When instructing patients how to maintain their implant supported prosthesis it should be remembered that some patients may not have had natural teeth for some time. Therefore individualised and thorough instruction on ‘how to clean’ should be developed for each patient.
This may include the recommendation of certain toothbrushes, mouth rinses, dental floss or interdental cleaning aids.
Titanium is a soft metal and therefore the use of abrasive toothpastes or instruments which may scratch the abutment should be avoided.
In addition to ‘home care’ it is recommended that the patient be checked regularly in the first 12 months after prosthesis insertion. The dentist would include in the check-up the stability of the prosthesis, the occlusion, surrounding soft tissues and the patient’s ability to maintain a high level of ‘at home’ oral hygiene.
Restorative Assistants
The principles for restoring dental implants are very similar to conventional crown and bridge techniques.
Interestingly many restorative dentists and assistants find the restorative aspects of Implant dentistry simpler and more rewarding than conventional crown and bridge.
Generally the patient will present to the restorative surgery with a healing abutment in place.
In the majority of cases the impression will be taken at ‘Implant Level’, however some abutments allow for their preparation intraorally – similar to that of a natural tooth – in these cases a conventional crown and bridge impression protocol would be followed.
