dental implant prosthetics and abutments

Prosthetics

The prosthetic procedure shall be presented on simple examples of different types of
prosthetic constructions.

Choosing the Right Abutment Height

The proper height of the transgingival part of the abutments is very important for the final
result. It determines not only the proper function of the whole prosthetic construction but
aesthetic outcome as well.
When choosing proper abutment height it is helpful
to determine the gingiva height (GH = distance
between gingival margin and the implant.). This
should be done after healing period (full gingiva
maturation) using grooves on the healing abutment
(2mm, 4mm and 6mm the abutment top).

For overdentures it is important to choose the
lowest abutment possible (the higher the abutment
the higher the lateral-leverage forces on the
implant). Therefore, in some cases it would be
indicated to do gingiva correction rather than
choose higher abutments!

When choosing the right abutment hygiene should be taken into
consideration. It is extremely important to enable the patient
proper cleaning of the prosthetic construction. Therefore, in some
situations too short abutment may be an obstacle for good hygiene
(especially for bar overdentures).
Bite relation can also influence the abutment choice. In cases
when there is not sufficient space between the maxilla and the
mandible using certain types of abutments or even type of
restoration may be impossible or strongly contraindicated!
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For fixed constructions it is the general rule to choose the abutment so that the future margin of
the crown be hidden under the gingiva. This because of higher aesthetic demands for crown and
bridge works. For Octalock system, however, which has a range of abutments that can be easily
prepped to fit particular clinical situation, the dentist can choose a higher abutment and let his lab
correct margins in height to follow exactly the contour of the gingiva.
Every situation should be judged individually and the prospective decision should be a balanced
choice between local bite relations, implant mechanics, patient’s motivation and possibility to
keep the prosthesis clean.

Transgingival height - OCTA

Dyna Octalock System has been design to be flexible and universal. All
abutment lines are compatible with both implant diameters, which in practical term
means, that any of the Octalock abutments will fit either Ø3.6 or Ø4.0
interchangeably. Such solution does not require colour coding system for different
diameters. It saves also the need to have excessive
stock of prosthetic parts.
However, when choosing the proper abutment one
should remember that the effective transmucosal
height for the same abutment placed on different
implants will be different. To understand this
clearly please see the picture below.
Given the same total height of abutments placed on
different implant diameters there will be a
discrepancy in height between the top of the
implant and the margin of chamfer preparation (or
the top of the abutment). This discrepancy is
caused by the fact that the same abutment “fits
somewhat deeper” in the Ø4.0mm implant.
When using the product catalogue please notice information
between ( ) giving the exact transgingival height for Ø3.6 and
Ø4.0mm.

Screwing the Abutment
All final abutments must always be torqued onto the implants with 32
Ncm using the torque wrench instrument and adequate screwdriver. Every
abutment should be checked for fit (X-ray photo). This will prevent undesired
loosening and possibility of the abutment fracture.
The abutment must be screwed in full contact with the implant without any debris
between.
All final abutments, must be checked for loosening after a few weeks, meaning
that the final restoration may only be produced/finally cemented after re-screwing
(Torque Wrench) of the abutment.

Torque Wrench Use

The Dyna Torque Wrench is a special instrument used to screw Dyna
abutments to the torque of 30 or 35Ncm*. It should be used with all Dyna
abutments to screw them into implants definitively and prevent from
unscrewing. (see also instruction for use delivered with the Dyna Torque
Wrench).
*Apply 35 Ncm indication for all abutments placed directly on implant level
Apply 30 Ncm indication for all abutments placed on extension level
The Dyna “S” drivers can also be used in combination with the ITI
Straumann Torque Wrench.*(see also 5.3)
Dyna Torque Wrench should be calibrated once a year for proper torque.
*ITI Straumann is a registered name of the ITI Straumann(CH)

Anti-rotation IMPLANT-ABUTMENT
It has been proven that loosening of the
abutments, especially with single tooth
replacements, can be prevented by screwing the
abutment into the implant with sufficient torque.
This torque will result in an upward force (preload)
onto the implant threads so friction will
prevent the abutment from rotating.


Research showed the torque of 32Ncm to be ideal to prevent the Dyna abutments
form loosening without overloading them. The desired amount of torque depends on the
materials used and the quality of the threads, No compromises are in the production of
Dyna products. All implants and abutments are made of Ti grade 5 and are equipped
with the most accurate threads (6H/6h).

It is recommended to reapply the same torque to the abutment, after one or two
weeks, before cementing the prosthesis. As there is some relaxation in every material,
causing a reduction of the pre-load. Retightening can prevent the abutments from
unscrewing.
Therefore, in cases of fixed constructions producing a temporary crown or bridge
has two major advantages:
-possibility to screw the abutment again
-possibility to form the gingiva in desired way and achieve maximally aesthetic
result.

Octalock System has been designed to achieve 0 degree rotation in the clinical use,
as well as to enable easy transfer of the situation in the patients mouth to the lab model. The use
of the octagon and conical connection has been carefully chosen.

Any antirotation is of no use when there exists a significant freedom of movement between an
abutment and an implant. Most of the systems present on the market, nowadays, have a rotational
freedom of 4 to 12 degrees. This may influence clinical performance of any prosthetic
construction and make the accurate transfer mouth-model virtually impossible. Only a 0 degree
rotational freedom can guarantee the best results, as only then the implant analogue position in the
model will be the same as in the mouth.
Dyna Octalock system has been designed to the make transfer procedure as precise as possible.
To assure this, the octagon connection has been planned so that the external octagon has slightly
tapered walls (around 1 degree). Due to this modification by means of micro deformation,
abutments are prevented from any rotation once seated and screwed in the implant. This 0 degree
rotational freedom results in a perfect , trouble-free transfer from mouth to the model and vice
versa. This means in terms of practical usage, no more problems with taking impressions. The
fixed prosthesis is made in the lab on the same abutment as the one placed later in the mouth of the
patient, and therefore, it will always have a prefect fit.
Because of the fact that the tapered octagon suffers only minor deformations, the conical
connection placed above it provides a perfect seal from the outside environment. Choosing two
different angulations always results in a 100% closed connection between the implant and the
abutment. At the same time this conical connection provides a stable fit in the implant, which
makes the whole construction very solid an generates the ideal distribution of the applied forces.
To protect the fixation screw from braking and unscrewing it has been added a conical head. This
provides the same stability as the conical connection and makes the whole system self centring.
Due to friction forces only a small amount of the applied torque will be transferred to the thread of
the screw resulting in a considerable tension relaxation. This, in combination with the conical
connection, makes it almost impossible to overload, and brake the screw during normal
physiological use.
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The internal octagon has been introduced for several reasons:
 Increase of the implant wall strength (comparing with the hexagon design) – allowing for
the same diameter of the fixating screw and the hexagon\octagon wall, the minimal
thickness of the implant wall for hexagon design is about 30% thinner than for analogue
situation with octagon design.

 improved aesthetics – the octa has been chosen to be internal instead of external so that no
space is lost from the connection upwards. In this way it is possible to use a very low
abutment in all those situations where the gingiva thickness is insufficient, so that no
compromise in aesthetics has to be made.
 possibility of adding the morse taper above it – in this way the new connection joins the
best features of the other renowned implants systems in one, giving the security of equal
force distribution, brake protection and the best aesthetics.
 increase of the prosthetic positions for e.g. the angulated abutment

Antirotation ABUTMENT-CROWN
Dyna Octalock System has been provided in a reliable system
preventing loosening of the abutments during clinical function.
Combination of internal octagon and conical surfaces gives the
guarantee for precise fit and stabilisation. Nevertheless, when
restoring single elements its is important not to forget about
antirotation for the crown (crown-abutment antirotation). Dyna
OCTALOCK abutments have no special antirotational structures
solving that problem (contrary to all-in-one Dyna abutments that
have standard either special grooves or castellated parts).
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It is the user’s responsibility to provide the finally prepared
abutments in antirotational structures.
In case of using standard abutments it is possible to create a “side
groove” on it or prepare the upper part so that it would have sort of
U formed cuts. In case of using Universal abutments it is the
technician who makes antirotational structures.

Impression Technique

There are several impression techniques that can be used for the Dyna
abutments:
8.5.1 Transfer technique/pick up technique (ball abutment)
Special standardized transfer copings for transferring the position of the abutment exactly
and reliably onto the master model are needed in this technique.
Once the gingiva has healed the healing abutment is unscrewed and replaced by the proper
ball abutment. The transfer coping is than clicked onto the abutment and the usual
impression with individual tray can be taken. As the impression material has set the
impression is pulled out and the position of the coping in it is checked. Ball laboratory
analogues are then clicked into the copings and the master model is casted.
8.5.2 Open-tray technique (bar abutment, alternatively medical or fixed abutment)
An alternative method (transferring the position of the implant) is to use an open tray
technique. In this case the individual tray is provided with opening(s) over the implants The
impression copings are screwed in with the long fixation screws, replacing the healing
abutments. The tray is checked in the mouth. There should be enough space for impression
material, and the screws should stick out of the opening(s). The opening(s) should be
covered with soft wax and the impression may be taken. Once the material has set the long
fixation screws are unscrewed and the impression is pulled out. Using the same screws the
lab implant analogue is connected by the dentist or technician to the impression copings, and
the master model poured out. It is important not to change the position of the copings in the
impression material during manipulation.
When taking the impression over more implants we recommend splinting the impression
copings with one another before actual impression taking.
For Octalock system, designed so that both the technician and the dentist could work on the
same abutment, the open tray technique is the method of choice.
8.5.3 Standard impression (fixed abutment)
Some situations demand taking a standard impression as for eg. crowns and bridges on
natural dentition. In such cases first the healings have to be replaced by chosen abutments
and the impression can be taken as usual. After pulling out, the model can be cast directly
after repositioning of the laboratory abutment analogues.*
*more details about this technique will be given on Dyna courses

Sterilization
All prosthetic components are supplied clean but not sterile. Operator is
obliged to sterilize them or disinfect in appropriate manner

Shape of the Fixed and Memory Abutments GG GN

Transgingival part.
The transgingival shape is made according to the aesthetic principle* The GG abutments, with a
diameter of 6mm for the Ø 3,6mm and Ø 4mm implants and 7mm for the Ø 5mm implants, are
indicated for central incisors and first and second molars. The GN abutments for the Ø3.6mm and
the Ø4.0mm implants have a diameter of 5mm and a diameter of 5,5mm for the Ø5mm implants.
The GN abutments are available in a trans-gingival height of 2, and 3mm and are meant for all
crown & bridge indications. Ø 3.6, 4.0, 5.0 GG and GN memory abutments can be screwed into
the implants by means of the special GG instrument and torque wrench. Ø3.0 memory abutments
have the outer diameter Ø5.0 and are produced without the castellated part. They should be
screwed with the universal memory instrument.
*The abutments are designed with a convex shape offering the following advantages:
1. the different diameters allow the technician to produce fixed prosthetics with better
aesthetics
2. the convex shape provides more freedom for the papillae
3. there is no downward pressure on the surrounding gingiva, so the margins of the crown
or bridge stay more subgingivaly.
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Supragingival part (abutment-head)
The height of the abutment head is always 6mm. Because of the castellated design of the GG
abutments and the GN Memory abutments the Torque Wrench can be used to obtain the optimal
torque. The GN fixed abutments are screwed into the implant by means of the Memory instrument
without Torque Wrench and therefore are not meant to be used for single tooth restorations*.
*This limitation can be solved with Dyna Octalock implants and abutments. Please refer to Dyna Octalock Manual.
Note:
Always bend the Torque Wrench twice manually before use! Read the instructions of use!
The new GG instrument (art. code 5383) that can be used in combination with the Torque Wrench
(art. code 5083) exactly matches the castellated shape of the abutments.
Note:
The previous (concave) healing abutments for crown & bridge for Ø4.0mm implants (5815) can
not be used with the new (convex) GG and GN abutments!

Memory Abutment

In many clinical situations it is not possible to obtain an ideal path of insertion
(especially in the maxilla) for fixtures, corresponding with the loading axis of the prosthetic
construction. Bone quality and quantity limitations, position of anatomical structures are one of
the reasons influencing potential choice of implantation place. The main reason, however, seems
to be the protrusive shape of the anterior maxillary part which develops due to the horizontal
resorption of the alveolar bone.
In such cases the clinician faces two options: applying advanced bone remodelling techniques or
using angulated abutments. The latter solution though biomechanically unfavourable seems to be
much easier and more useful in everyday practice.
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One of the solutions is to offer besides standard straight abutments also pre- angulated ones.
They can be angulated between 5o and 20o . Consequently, there is a necessity to have whole
range of these abutments, available at the moment of abutment installation, to meet all possible
modalities. Moreover, they often have to be additionally adjusted to achieve desired parallelism.
Dyna memory abutment is an adjustable abutment system based on the use of shape memory
alloy allowing to avoid aforementioned problems. The system consists generally of one type of
abutment that can be angulated between 0o to 20o .
This eliminates the need to have very expensive stock in hand and allows for obtaining
uncompromised parallelism.
The world wide patented Dyna memory abutment is an assembled two part implant abutment to
be used in all types of fixed prosthetic appliances together with Dyna Implant System. The
transmucosal matrix part is produced out of titanium and the patrix out of nitinol.. Both parts
create a sort of a ball joint and thanks to sufficient friction are rigidly connected in body
temperature. When the temperature of the patrix decreases to around 0o the abutment head can
be moved with Memory Instrument to the desired angle.
The idea of this abutment is based on a friction force, strong enough to create sufficient retention
between two elements, that can be changed (using the memory shape effect). Memory effect is
used in such a way that the two parts of the patrix ball that in room temperature are under
considerable pressure (high friction) inside the matrix would move to each other when cooled to 0
degree, thus releasing internal pressure (low friction) and allowing the abutment head to rotate
inside the cup. With an increase of temperature the two halves of the ball regain their pressure by
going back to their primal position (shape memory) and fix rigidly matrix and patrix.
A similar idea though achieved by applying sufficient mechanical force is used to fixate the
abutment itself in the implant. Screwing it with around 32 Ncm torque creates friction force
between screws of the abutment and implant that can be in physiological conditions considered as
antirotation protection.

Hygiene Requirements
Every construction made on implants should include in its design hygiene aspects.
This means that patient should be able to keep the prosthesis clean. It is the dentist task to access
patient’s ability and motivation to perform everyday hygiene and afterwards decide on type of the
prosthesis. On the other hand it is the technician task to produce a construction easy to clean
arranging e.g. interproximal spaces to be easily accessible with interproximal brushes.
Proper hygiene is conditio sine qua non for predictable functioning of the implant supported
prostheses.

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surgical phases of dental implant

The complete implantation technique with Dyna implants consists of two
surgical phases and following prosthetic procedure. All elements should be performed as
atraumatic as possible with use of the proper Dyna instruments. This manual contains
only the description of simple surgical procedures used for placing implants in the
mandible for overdentures. For more advanced procedures (use of membranes, sinus
lifting, tissue management) we recommend participating in special training courses and
reading available literature
Anyone wishing to perform implantations should have proper surgical training
and experience in the field of dentoalveolar surgery. It is highly recommended for
inexperienced dentists, at the beginning, to work under supervision of other qualified
operators. It is also important to remember about requirements for equipment that have
to be fulfilled to place implants in aseptic conditions. The surgery theatre should be
thoroughly disinfected. Patient, unit and instruments should be covered with sterile
sheets. Operator and his assister should wear sterile cloth and gloves.

Sterilization
Only the implants are supplied sterile. Expiry date is clearly marked on
every package and should always be checked before implantation. The Dyna instrument cassette
is supplied non sterile and therefore should be sterilized, in the appropriate manner, before use.
Please notice:
All parts must be removed from their packaging before sterilization. Implants are supplied in a
double peel pouch packaging which means that the implant itself (in a plastic bottle) is covered by
three protective layers of packaging.
Do not sterilize or re-sterilize implants.

Instrumentation
A suitably equipped operation room is prerequisite for complete success of any
implant treatment. It is important to have such an instrumentation that allows for secure handling
of all possible situations. The choice is rather personal and depends on individual preferences as
well as techniques performed. Herewith we give an example of basic surgery instrumentation :
Dental mirror, Dental probe, Cotton pliers , Fine tissue pliers, with teeth and flat,
Scalpel, Bone file, Curette, Needle holder, Dissection scissors, Suture scissors, Lip
retractor, Bone ronguer, Suture material, Straight handpiece and contra-angle for
surgical unit.

Premedicatio 
Premedication is necessary only in particular situations. Patients belonging to the
“risk group”, or patients with planned extended operation procedures may be premedicated in an
adequate manner – following all general rules. Premedication with atropine has proved to be
useful for diminishing saliva production and can be used as standard. Anxious patients seem to
be indicated for sedative medication.

Anaesthesia 

 There are several possible way of anaesthetising the patient before implantation.
- Nerve block
- Local anaesthesia
- General anaesthesia
The choice depends on the particular situation and dentist’s preferences. However, in most of the
cases local infiltration anaesthesia seems to be most recommendable. Addition of constructive
agent reduces bleeding in place of implantation. Moreover, patients can feel some pain when
approaching the mandibular canal

First surgical phase.  

When carrying out late implantation (after disinfection and
giving the anaesthesia) the bone is exposed by making an incision along the
alveolar ridge.
The mucosal flaps and periosteum are then reflected.
Now, the shape of the bone can be properly judged, eventual sharp ridges
removed (using a crestotom drill or preferably bone ronguer), and the
definitive location of implantation marked with rose drill (using additionally
e.g. drilling guide).
The minimum buccal-lingual thickness of osseous tissue, required to successfully place an
implant, is 5.0 mm. The anterior ridge crest of the mandible often resorbs to a peak
superiorly, leaving inappropriate ridge morphology for implant placement.
In order to achieve demanded 5.0 mm "flat" base, either the anterior ridge crest peak must
be removed (which effectively lowers the level at which the implants are placed), or a bone
graft must be considered.
Prior to selecting implant sites, the osseous tissues should be evaluated with appropriate
radiographic studies such as panoramic x-rays, tomograms, or CAT scans.
When using particular implants the minimal transversal thickness of the bone after
removing inappropriate structures should be as follows:

 With the pilot drill the first drilling is made. Using the drilling guide is here

recommendable. The depth of the preparation should be determined before
operation (see 6.3) but it is possible and advisable to change it if the existing
situation allows for, or demands using a longer or shorter implant.
Thereafter, the Lindemann frees can be used to make the preparation wider
and if required slightly change the angulation.



Enlarging of the site depends on the diameter of the implant to be used. The following
sequence of drilling should be applied for different final preparations::

The grooves on drills allow to prepare the site to the exact depth corresponding with the
implants’ length (markings must be fully covered beneath the bone). All preparations should be
done under excessive cooling (preventing possible thermal trauma) with sterile saline solution that
additionally may be cooled before operation. All preparations should be done in a pump-up-anddown
movement with moderate pressure force. To avoid perforations or further prosthetic
problems it is important to control continuously the direction and the depth of drilling. To do so
we advise using parallel/depth instruments and drilling guides. The dental assistant can also be of
use as she or he see the drill from a different angle.


Once the site has been widened to the desired diameter it is ready

to receive implants. The Dyna parallel and depth instruments are used to
control the preparation. If the instrument fits without any problems one
can be sure that the implant will fit as well (see also product catalogue).
To begin with, however, the site should be carefully cleaned (saline
solution) with any debris and the entrance of the preparation controlled
and adjusted if necessary.
The implant is removed from the sterile packaging and introduced
into the receptor site making certain not to contaminate it. (It may only
have contact with the bone and the blood of the patient.)
The implant should be seated by:
-first inserting it into the site, then bending the inserting handle off, and
Final preparation Max. Rounds per min. Drills sequence
Ø 3.0 mm
Pilot
2000 rpm/min pilot→ (lindemann)→Ø3.0
Ø 3.6 mm pilot →(lindemann)→Ø3.0→ Ø3.6
Ø 4.0 mm pilot →(lindemann)→Ø3.0→ Ø3.6 →Ø4.0
Ø 5.0 mm
All spade drills
800 rpm/min
pilot →(lindemann)→Ø3.0→ Ø3.6 →Ø4.0→ Ø4.7→ Ø5.0
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-finally pushing it to “the end” with an instrument (e.g. elevator) or the handle
itself touching only the covering screw.
A properly seated implant should be placed slightly (together with the
covering screw) under the bone level. Implants should not be forced to fit
into the site.
If any obstacle exists (when pushing the implant) the handle should be
bent off, covering screw unscrewed, implant using the implant puller removed
and the site once more controlled and adjusted (widening and cleaning). The
implant should be secured in a sterile place and after the site adjustment
reinserted. Next, the puller is unscrewed and the covering screw screwed
back. 
The flap is sutured into place.


Please notice:
1 Never overforce the implant into the site-it may lead to destroying the coating and
further failures. With softer type of bone ( Maxilla ) it is, however, possible to knock, but
very gently, the implants into the prepared site, that can be even slightly narrower than
the real implant diameter*.
2 Always stick to the fixed pattern of drilling:
- sequence of drills,
- intermittent drilling technique,
- avoidance of excessive force during preparation,
- use of sharp drills (maximal 20 times per drill depending on bone quality)
- excessive cooling with chilled saline
- adequate rational speed
*see the Dyna training courses
3 Never touch the implant by hand. Avoid contaminating the implant with substances
other than the blood and bone of the patient. If it happens or if the implant has been in
any other way damaged never place it. (see guarantee)
4 Never and in no way sterilize or re-sterilize the implant yourself neither with or
without the packaging. An implant taken out only of its outer pouch can be stored, but
not more than one month, in a clean and sterile place.
5 Always try to prevent perforating or destroying vital anatomical structures.
6 Always try to place the implants in the most favourable position (possibly parallel to
one another and axial to bite forces). When placing more than two implants for fixed
constructions try not to position them in one straight line, and if this is not possible try to
use different diameters. For the overdentures try placing the implants following the
curvature of the alveolar ridge. Remember about the minimal distance from one another
biological width, type of prosthetic construction. The depth of placing should include
consideration of biological height and possible initial bone resorption – which influences
the papilla formation and the final aesthetic result.
7 Try to suture the flap so the healing occurs per primam intentione. Preferably use non
resorbable sutures (000 or thinner)
9 Always tight the covering screw with the hex screwdriver before suturing the flap!

After care.
After every operation each patient should be told to follow certain rules.
Consequently the patient should:
- cool the operation area with extraoral dry ice compress for several hours
(overcooling should be avoided)
- use a “soft” diet
- in some cases it is preferable that the denture is not worn before final wound
healing.
- if necessary use following medications e.g.
Antibiotics
Anti-inflammatory agents (not based on acetylsalicylates)
Analgetic agents
- rinse mouth with 0.2%chlorhexidine solution (40second rinses) for the
whole healing period
Sutures can be removed after 7-10 days, however, the time may vary depending
on particular clinical cases. The existing prosthesis should be adjusted and relined
so that the implants are not loaded during the integration phase. The integration
time of 3 months for the mandible and 6 months for the maxilla should be seen as an
advisory period rather than a fixed time. Operator is always obliged to check for
successful

 Second surgical phase

Once the healing period has elapsed, the area is locally
anaesthetised (infiltration) implants are located and recovered with scalpel
or tissue punch. In most cases it is enough to make small incision(s)

parallel to the ridge.
The colour coded titanium covering screw is unscrewed from the
implant and replaced with the chosen healing screw of the same colour. In
some situations a layer of the bone covering the implant has to be
removed first. It is important then to remove enough bone to screw the
healing abutment tightly to the implant
 Please notice:
For Octalock healing abutments use Dyna Sulcus reamer

Dyna Sulcus Reamer 
 
 The Dyna Sulcus Reamer is a special instrument designed especially for
shaping the bone around Dyna Octalock® implants and simplifying the
placement of the healing abutments during the second surgical phase.
The Reamer is available as hand sulcus reamer (art.no. 18PD1)




Notice:
Using Dyna Sulcus Reamer is limited to Dyna Octalock® Implants. The use of Dyna Sulcus
Reamer during second surgical phase is strongly recommended.

1. Anaesthetise locally the area
2. Identify and expose the cover screws either with separate incisions or
with one supracrestal incision.
Incision should always be done whenever possible in the attached
mucosa even though this should not be exactly over the implants.
Optionally punch can be used to remove tissue above the cover
screws
3. Unthread the cover screws (hex driver, art.no. 5181S)
4. Head the reamer into the implant. Remove the overgrowing bone
around the implants
PLEASE NOTE:
Take all necessary measures not to damage the implant. Make sure to
replace the reamer when it is worn out
5. Screw the healing abutments into place. If necessary suture the
mucosa between abutments. Check the fit with an x-ray.

The inside of the fixture should also be checked for any debris and if necessary cleaned
(e.g. saline).
The type of healing abutment depends on the type of prosthetic construction to be applied.
To achieve better gingival adaptation suturing the wound may be recommended.
During the healing period (usually 7 – 10 days) the healing abutment enables the gingival margin
to adapt and form properly. To ensure favourable aesthetics and emergence profile we
recommend a longer maturation.
Please notice:
The interdental papilla is very important for determining the final aesthetic result within fixed
constructions. It is therefore possible to extend the healing period by producing the temporary
restoration. The contact points should be designed so that the papilla fills in spaces between the
teeth fully. According to the literature regaining 100% of the papilla’s height is possible only
when the distance between the contact point and the bone is not longer than 5mm. (see tab.
below). Having done the temporary construction it is easy to determine the proper position of the
contact points and design the final restoration.

 

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clinical uses of dental implant

Indications
Dyna Implant System can be used in the following clinical
situations:
 Retention of overdentures in the maxilla or the mandible.
 Restoring shortened maxillary or mandibular arch with fixed
constructions (with possible connection with natural
elements).
 Restoring edentulous patients with fixed constructions.
 Restoring edentulous patients with fixed-detachable
prostheses.
 Retention of maxillo-facial prostheses.
Octalock System was developed primarily for enhancing construction of the crown and
bridge works. Therefore, it is additionally indicated for:
 Restoring single missing teeth.

Contraindications

The Dyna System is a multipurpose implant system allowing
for easy construction of different prostheses. Simplicity of use, however,
can be often seen as a universal solution to all kinds of prosthetic
problems. Such an approach may lead to failures. These, are not
connected with the system.*
When using any implant system following contraindications
should be taken into consideration:
1 local
-local infections
-inadequate quality or quantity of bone in place of implantation
-inadequate hygiene
-unfavourable bite relation
-mucosa infections
-jaw defects
-macroglossia
2 systemic
-systemic diseases of bone, endocrine system, homeopoetic system
-rheumatic disease
-cardiac disease
-nephritises or nephroses
-cirrhosis hepatis
-psychic diseases
-defective immune response
-allergic diseases
3 age related limitations
-children
-juvenile patients with not finished growth of maxillo-facial bones
-elderly patients with:
-insufficient bone quantity or quality
-unfavourable morphological conditions
-difficult bite relation
-trauma of the mandible or the maxilla
-lack of motivation
4 other
-pregnancy
-planned radiotherapy
-drugs and tobacco abuse
-inability to perform adequate surgery operation
-diseases treated with large doses of steroids
-limited mouth opening
-lack of motivation to perform adequate hygiene
Most of the contradictions listed above are now viewed more as conditional and temporary
rather then absolute.
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The following contraindications for the Dyna Implant System should be taken into consideration:
-placing the Dyna implant directly after extraction
-using 3.0mm implants for fixed constructions subjected to heavy or moderate loads;
-constructing cantilevers
-joining implants with natural elements.
In most cases, it is the severity of the condition and the patient’s residual ability to tolerate
treatment that determine whether or not implant therapy is contraindicated.
In addition, there are a number of systemic medical conditions that can cause complications
during the postoperative healing stage, and may contribute to implant failure.
These factors must also be assessed by the implant surgeon.
Dyna Dental Engineering disclaims any reliability for failures subject to
contraindications that have not been aforementioned but which are described in the
world literature. Therefore, we recommend careful study of adequate available
research material.

Planning

Planning is one of the most important factors in
successful rehabilitation of edentulous or partially
edentulous patients with dental implants. Full success
depends on a balanced judgment of patient’s expectations
on the one hand, and surgical and prosthetic possibilities on
the other.
This manual provides a framework of concepts and ideas to
facilitate the evaluation of prospective implant patients.
The information presented should also help to promote
successful planning and co-ordination of treatment for the
implant restored patients

Principles of patient selection
Preliminary evaluation
The evaluation of a patient as a suitable candidate for implants should follow the same basic
format as the standard patient evaluation, although some areas require additional emphasis and
attention. In particular, the patient’s medical history may reveal a number of conditions that could
complicate or even contra-indicate implant therapy.
The following aspects are relevant when examining a patient as a prospective recipient of dental
implants:
1 initial consultation;
Prior to any medical examination, or local conditions evaluating, patient should clearly formulate:
 his problems with existing prosthesis or dentition (aesthetic, lack of stability, lack of
retention etc)
 wishes and expectations in respect to the future restoration.
Dentist on his side should explain:
 existing treatment possibilities
 benefits and risk of implants
2 medical examination
 general health situation (current and past)
Patient should be physically and mentally healthy. Patients age is less important though it
should not be underestimated. Implantation in an early age is per se not a real
contraindication. Contrary, young patients have a bigger chance for successful
osteointegration. However, because of the fact that the bone growth with those patients is
still an active process, and the connection between the implant and the bone has ancylotic
type, the chances are, that the potential operator will be confronted with unfavourable
prosthetic situations after biological maturation of such patients. Namely implanted
fixture and surrounding it bone (which could not grow) will be somewhat “deeper” than
the rest of the dentition (e.g. adversely influencing the emergency profile of the
restoration).
On the other hand elderly patients having matured bones may present contrary process –
bone resorption, making it difficult to find favourable position for implants. Additionally,
all factors that may interfere with good implant healing and functioning (see
contraindications) should be noted.
Contraindications presented above are generalized and valid for every surgery. It
does not mean, however, that for instance patients who smoke can not have implants.
They do, but the risk of implant failure is much higher. Similar is valid for the rest.
Therefore, it is very important to discuss the problems with the patient before the
operation and explain to him everything in detail.
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 specialist care
In cases where the patient is under the specialist care it is strongly recommended to
consult him, even if the cause of this care seems to have no direct connection with implant
treatment.
 medical and social history
3 local conditions evaluation
 effective oral hygiene and motivation to perform such
 local diseases (bruxism, periodontal problems, allergy etc)
 quality and thickness of mucosa
 intermaxillary relations
 bone quantity and quality
4 general aspects
 patient’s habits: smoking, diet, drugs abuse etc
 finding local and systemic contraindications
 evaluation of potential implant sites
5 psychic status
Even if a patient is found to be a suitable candidate for implant therapy, he or she must be
apprised of two additional factors before being considered for treatment:
 Patients receiving implant therapy for a mandibular bar over-denture may potentially
experience approximately four to six months of discomfort and diminished function
before any benefits become apparent. They are frequently required to go without their
removable prosthesis for significant periods of time following initial surgery.
 Implant failures can occur at any time, despite everyone’s best efforts. Current success
rates in the anterior mandible are very high. However, even here, implant fixtures can
and do fail.
If the patient cannot come to terms with the possibility of failure, or four to six months of
potential discomfort and inconvenience, then he or she is not a suitable candidate for implant
therapy.
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Pre-operative planning
Before selecting the most suitable type of implant restoration, the practitioner should
review and be guided by the patient’s previous dental history. It is also vital to evaluate the
patient’s chief complaint, as it may have an equal bearing on treatment outcome.
1 surgical criteria
Proper length and diameter selection of implants is crucial for their uneventful placement
and functioning. The definitive site should be carefully chosen bearing in mind optimal support
of prosthetic construction and load distribution. As a general rule implants should be surrounded
at least by 1mm of the bone from each side. However, in order to prevent bone resorption
between implants or implants and natural elements following minimal distances should be kept:
implant – implant - 3mm
implant – tooth - 2mm
The violation of the sinus maxillaris, canalis mandibularis or the mandible itself, should be
avoided (2mm of bone are advisable between those structures and implants!).
The design of final prosthetics should be considered prior to implant surgery. CT scans,
radiographs, study casts, wax-ups an overall clinical evaluation should be utilized to determine
the optimal position and angulation of all implants at the time of placement. Drilling guides (or
surgical stents), particularly in case of fixed constructions, are strongly recommended. Total case
planning including eventual prosthetic-restorative modalities is essential for proper use of Dyna
Implant Design.
To help choosing the proper implant size and implantation site the following planning
steps are important:
Intraoral inspection
Intraoral inspection and palpation of mucosa is the first step to give general information
about anatomical situation, available bone, muscles and fraenula attachments. In many
cases it can correct our first impression that bony conditions are favourable.
Jaws relation should be noticed.
Looking at the edentulous mandible over time, it loses height and width of bone. As this
occurs, the width of attached gingiva narrows considerably, the tongue increases in size
and activity, and the buccinator and mylohyoid muscles become more active. In addition,
the genial tubercles become more prominent and in the severely resorbed mandible, they
can often be superior to the height of the ridge crest.
With successive denture treatments, it is common for the vertical dimension of occlusion
to decrease as bone resorbs. This promotes an increased tendency toward a skeletal Class
III relationship.
Posteriorly, poor ridge height inadequate attached gingiva, and compromised ridge shape
cause increased horizontal movement of the prosthesis. This increases the lateral forces
that are brought to bear on the anterior implants, and may affect overdentures retained on
implants in the anterior part.
It is also important to notice the dentition. For example: a full natural arch in
some situations can be contraindicated for placing fixed construction in the
opposing jaw whereas, full denture seems to have no influence on this type of
prosthetic construction. Given the fact that occlusal forces in the molar region
1601-01.04 Dyna Pushin Implant Manual GB 70 / 144
are in the range of 150 to 250 psi, and knowing that parafunctions increase
these occlusal forces to as high as 900 psi it is clear why it is so important to
assess the situation properly, though in the edentulous patient, the average
occlusal force drops to just 50 psi.
Natural dentition opposing implants is always a situation of special
consideration. In those cases the load forces transferred onto the implants will
be greater and a small fault in prosthetics (allowing for perfect planning and
following surgery) may lead to serious consequences including implant failure.
Maximum occlusal forces in such situations may increase as much as 300 per
cent compared with pre-treatment values.
X-ray examination
X-ray photos help to get more adequate information about anatomical situation
and the position of important structures. Different radiographic techniques are
available.
The most accurate is Computer Tomogram scanning (CT). This technique
gives exact information about position of the sinus maxillaris, canalis
mandibularis, vertical horizontal and transversal dimensions of available bone.
An orthopanthomogram (OPG) is a very popular and frequently used
technique. However, it is not as precise as CT scans and it can only supply
information about vertical and horizontal dimensions of the bone. To avoid
faults in measurements (connected with size deformation usually in scale
1:1,20; 1:1,25) OPG can be taken with special templates that patient wears in
the mouth during taking the X-ray. By placing round, metal markers over
potential implant sites in those templates we can calculate (knowing their
dimensions) the real height of the bone.
Another way of choosing the implant size is placing a special X-ray tracing
over the OPG. It is a fast method but not fully accurate. Therefore, to make
the procedure safer Dyna Dental Engineering produces it in scale 1:1,3.
Models analysing
By analysing study models of the patient one can determine intermaxillary
relations as well as bone configuration. The same models can be used to
visualize bone in so called bone mapping technique. This technique allows to
transfer the thickness of the mucosa to be transfer onto the model and in this
way gain information about the transversal shape of the bone.
Different methods of measuring the thickness of the gingiva are available.
The simplest is to use a thin needle or endodontic instrument with endostopper
to punch gingiva in the place of potential implantation on different
levels and then transfer measurements to the anatomical model. More
advanced is using an ultrasonic instruments which measures the thickness
automatically.
Diagnostic set-up in wax.
To provide information about favourable angulation and positioning of
implants diagnostic set-ups can be used. The angle between the long axis of
the implant and the direction of bite load should be as low as possible and not
bigger than 15o .
Furthermore set-ups can be used to produce a drilling guide. After
consultation with your technician concerning the type of desired prosthesis,
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location and number of implants, insert angulation an acrylic or metal stent
can be produced (type of it depends on personal preferences of the operator).
This stent serves as a drilling guide and is used intra-operatively. This
solution seems to be especially useful for less experienced operators who may
find preparing parallel implant beds problematic. It has also another
advantage. Relations between neighbouring implants as well as between
implants and natural elements are decided before the operation and chosen so
that the best esthetical effect can be achieved.
2 prosthetic criteria
The type and design of prosthetic construction should be determined before
implantation. X-rays, models, wax set-ups may be useful to determine implant
position and angulation. It is also possible to use earlier prepared drilling guides.
Total case planning including surgical and prosthetic planning is indispensable for
proper use of Dyna Implant Design.
 It is recommended for overdentures in the mandible, 2 to 4 implants to be placed
between foramina mentalae .. In the maxilla 4 to 6 should be placed remembering
about position of the sinus maxillaris. Eventual sinus lifting may be considered.
For fixed bridges in edentulous patients minimum of 6 implants, and preferably 8,
must be used. The diameter of the used implants for fixed (single crowns, bridges
also with memory), and bar constructions should be at least 3,6mm, and the length
at least 10mm.
 In relation to the diameter of used abutments the sufficient distance between
neighbouring implants should be kept in order to achieve satisfactory aesthetics.
Implants placed too close to one another or neighbouring teeth may be a serous
problem during prosthetic reconstruction. Using drilling guides during surgery
and choosing proper implant diameter prevents such problems.
 In relation to prosthetic design rules of biomechanics should be taken into
consideration. In order to minimize excessive compressive/transverse forces
coming on the final restoration, to reduce off-axis loads, reduce occlusal tables by
one third. Create shallow incline planes to change the direction of unfavourable
forces. Avoid creating cantilevers as they multiply the forces due to moment arm.
Group function occlusal scheme is recommended and the centric occlusion
contacts should be light. Night guards for bruxers, clenchers or heavy biters is
strongly recommended.

To determine the ideal diameter and place for
implants use the study models. Implants
should be chosen so that the minimal distance
between an implant and a tooth (A, C) should
be at least 2mm, whereas between two
neighbouring implants(B) 3mm. Buccolingual,
and mesio-distal position must be
chosen in relation to the shape and position of
natural teeth.

MEMORY AND FIXED ABUTMENTS

The Cawood and Howell classification.

The importance of preparing the accurate treatment plan for successful implant
restoration is unquestionable. The aim of the modern implantology is to prevent, or delay bone
mass loss in edentulous and partially edentulous ridges and restore the function of the
stomatognathic apparatus. Resorption of the alveolar ridge after tooth extraction is a continuing
process and manifests itself by anatomic changes that occur in a vertical as well as a horizontal
plane.
It is very important to the practitioner to realise what changes the edentulous ridge may undergo.
Different classification has been proposed to divide edentulous jaws but the most popular at the
moment seems to be the classification of Cawood and Howell. It gives the operator a chance to
visualise different forms of the ridge and set indications for e.g. the type, number or length of the
implants. It may be used to provide guidelines for the use of implants in the prevention of bone
loss, and function restoration in the edentulous jaws.
However, our idea of using this classification was to make the cooperation between the surgeon
and the prosthetist easier by setting clear indications for particular prosthetic solutions in
connection with the form of the ridge. When referring the patient to the surgeon it can become
extremely useful tool in establishing mutual cooperation.
Cawood and Howell classified edentulous jaws according to a three-dimensional analysis of the
anatomy. Three different cross sections were used:
 in the symphysis region,
 through the mental foramen
 in the molar region.
They found the following dependences:
- the alveolar ridge resorbs in the anterior and premolar regions horizontally as well as in
vertically
-the resorption process was almost entirely confined to the alveolar ridge of the mandible
and that
-the basal part, which is the part caudal to the mental spina, does not significantly change
after extraction.

Cawood and Howell proposed the following resorption stages:
Class I. Dentate ridge.
Class II. Ridge directly after extraction.
Class III. Broad and rounded ridge with adequate height and width.
Class IV. Knife-edge ridge with sufficient height but insufficient width.
Class V Flat ridge with insufficient height and width.
Class VI. Depressed ridge with a cup-shaped surface.
Additionally two classes are added:
Class VII, the labial part at the site of the symphysis has been resorbed in a vertical direction to a
height of 10 mm,
Class VIII, a further reduction of the height to a value of 5 mm.

Read More

Product Catalogue of Implant System

The following catalogue contains, apart from elements overview, basic
information about products made by Dyna Dental Engineering. It is intended to give
the user a clear overview of our products, extra general technical data, as well as
practical tips concerning clinical and technical procedures. It is, however, not the full
product description and it may serve only as a guide through our products.
Dyna Implant SystemBecause of the fact that all Dyna implants are produced in four different
diameters there exist four different lines of implants (Ø3.0, Ø3.6, Ø4.0, Ø5.0mm) and
corresponding with them prosthetic elements. To facilitate the dentist and the
technician recognition of a particular line all elements are colour coded.
The following colours have been chosen for particular implant diameters:
Ø 3.0 White (no colour, colour of titanium)
Ø 3.6 Magenta
Ø 4.0 Blue
Ø 5.0 Yellow
The colour is achieved in the process of titanium
oxidation and therefore has the same properties as
titanium in relation to biocompatibility and tissue
response.
All products are coloured in such places that they do
not influence the final aesthetic result, but at the
same time offer easy recognition of diameter during
all phases of surgery and prosthetic construction

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Planning aids
X-ray tracing
To facilitate implant choice in a particular clinical situation the X-ray tracing can be used. Thin
transparent plastic foil with all fixtures contours in 1:1 and 1:3 (for OPG!) scale put over the X-ray
photo allows to determine implant type and right position.
Please notice:
Because of the fact that X-ray photos are rarely exact it is important to
remember that this method is not entirely precise. In more demanding
situations we recommend using CT scans.

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Implants
Dyna implants are two-stage, endosseous, push-in dental
fixtures. They are sterilized in the process of gamma irradiation
and supplied in sterile double peel-pouch packaging.
The current concept of Dyna is based on the full, reverse Edisonscrew
implants covered fully (without polished collar) with
hydroxylapatite. The essential features of this design are:
-fast osteointegration
-good physiological loadability
-direct bone apposition
-simple and time-saving implantation technique
-favourable load distribution.
-good results in bad quality bone
Coating titanium implants with HA, besides excellent
biocompatibility, favours direct bone growth to the implant
surface. In contrast to the other non-HA implants the process of
the bone apposition occurs not only from the bone side but from
the implant surface as well.
The implants are already provided with a titanium
cover screw (height 0,4mm)and suspended on a plastic, colourcoded
holder, facilitating manipulation during the surgery.
The implants are available in diameters 3,0; 3,6; 4,0; 5,0
and lengths 6 (only for maxillo-facial purposes) 8,10,13,15mm
and 17mm(for Ø3, Ø3,6).

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Planning aids

Implant X-ray tracing 5472

Implants HA Coated Ø3.0

Implants HA Coated Ø3.6

Implants HA Coated Ø4.0

 

Implants HA Coated Ø5.0

Closing screws

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Drills
Together with the system a special set of drills is supplied. All drills supplied by
Dyna Dental Engineering, produced for Dyna Implant System, are made of surgical stainless
steel and apart from the pilot drill internally irrigated.
Depending on the quality of the bone they can be used for maximum of 20 implantpreparations.
All drills have markings corresponding with the several implant lengths.
They are, however, positioned slightly higher than the real implant length in order to prepare
a bone bed ready to accommodate an implant together with the covering screw (0,4mm). In
this way the implant shoulder does not protrude over the bone ridge and there is some space
for possible initial bone resorption.
Please notice:
Always prepare the implant site so that the desired length marking is covered slightly under the bone
ridge.
Dyna drills are intended to be used with the surgical contra angle with internal cooling
system, and a special surgical unit.

Pilot drills
are used to make the initial drilling. With these drills the depth of the drilling and insert
angulation are defined. (see also 6.3 and 7)
In situations where conditions do not allow for further drilling the initial holes can be left
empty and the new more favourable place for the implant found

.

Spade drills

are intended to be used for final bone bed preparation. Five different types of internally
cooled drills allow preparation to the desired diameter.
Please Notice:
It is obligatory to follow the sequence of widening of the preparation (see chapter 7).
All drills have special markings corresponding with the implants’ lengths and facilitating orientation
in the depth of drilling.

Special drills

are to be used to prepare a place for initial drilling, remove sharp bone edges or slightly
change the primary insert angulation. Lindemann fraise may additionally be used instead of
a pilot drill.

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Surgical instruments
All surgical instruments are made of surgical stainless steel or titanium ELI 5 (TiAlV).
In order to obtain parallel preparations, the parallel/depth instrument can be placed in the
implant socket, thus visualizing the direction of the preparation. The instrument is colour
coded and serves also for measuring depth and diameter of the preparation.
To pull out implants that have been accidentally placed too deep Dyna implant puller
should be used.
In order to remove the problematic implant the covering screw must be unscrewed and
replaced by proper implant puller (corresponding diameter; colour coding!). With the
implant puller, turning clock wise, it is possible to carefully remove the implant without
touching or contaminating it.
For screwing or unscrewing elements during the surgery surgical screwdrivers should be
used.
A hole in the screwdriver’s handle serve as an extra protection against aspiration ( after
fixing it on e.g. dental floss)
Auxiliaries
Locking drill extender
The locking drill extender is a drill holder used to extend the length of drills in demanding situations.
Cleaning wire
To clean the internal cooling system of spade drills use a cleaning wire.
To organize in an easy way all Dyna surgical instruments and drills use sterilizable cassette for
surgical instruments and drills.
Please note:
This product is manufactured from coloured anodised aluminium. The colour of the product may be
damaged by the use of some chemicals.
Remember:
-do not use dish washer
-do not use ultrasonic bath
-be careful when using disinfecting liquids
-do not use chemicals too alkaline or too acid; pH between 4 and 8 is safe
-for sterilizing follow the following process: autoclave (134o), chemiclave (132 o) or dry heat
(180o). For cycles and time please refer to the manufacturer’s instructions.

----------------------------------------------------

Dyna Parallel/Depth Instrument

Dyna Pull out instrument

Auxiliaries

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Drivers
In order to screw final prosthetic abutments to 30 or 35Ncm* or unscrew them Dyna torque
wrench prosthetic screwdrivers should be used.
S - Drivers were designed to facilitate handling of Dyna products. This line of screwdrivers, besides
better mechanical properties, has additionally a special connection for the Straumann® Torque
Wrench. In this way both Dyna and Straumann® instruments may be used interchangeably. The new
connection part facilitates grip of the instrument as well.
Dyna Hex Driver T.W.-S serves for screwing and unscrewing all elements with hex opening. It can
be used with Dyna or Straumann Torque Wrench*.
Dyna Single Slot Driver T.W.-S serves for screwing and unscrewing all elements with slot opening.
It can be used with Dyna or Straumann Torque Wrench*.
Castellated driver TW-S serves for screwing and unscrewing “castellated” abutments. It can be
used with either Dyna or Straumann® Torque Wrench*.
Notched driver serves for screwing fixed GN and memory GN abutments and adjusting the
angulation of the memory abutments.
Torque Wrenches
Torqe wrench Is a special instrument intended to screw all final abutments with 30 or 35Ncm*
torque. This torque prevents abutments, subjected to physiological bite forces, from unscrewing.
(see also instructions for use delivered with the Dyna Torque Wrench)
* Apply 35 Ncm indication for all abutments placed directly on implant level
Apply 30 Ncm indication for all abutments placed on extension level
Other Instruments
Grip Device
To make the grip of T.W. instruments easier a special holder can be applied.

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Healing Abutments
Healing abutments are a special type of titanium screws used in the second stage surgery to
heal and form the gingiva. They have height markings on 2mm, 4mm and 6mm (the top)
allowing for gingiva height determination after the healing period.
Depending on the type of prosthetic construction different healings should be used for
overdentures and crown and bridge works.
Shape difference was designed not only because of hygienic requirements but because of the
fact that for crowns and bridges special aesthetic aspects should be taken into consideration
(emergency profile).
The height of healing abutments is 6 mm (without the screw).
Extension Posts
These abutments are used to extend bar or ball abutments above their standard lengths. They should
be screwed with single slot screwdriver.

------------------------------------------------------------------------------------

Dyna magnetic attachment consist of:
 magnet
 ferromagnetic part (medical abutment,
prefabricated Dyna Direct keeper, Dyna alloy for
casted keepers)
Magnetic abutments are specially designed abutments for use with Dyna magnets.
They are produced from PdCoPt alloy.
They should be screwed with using Dyna TW-S screwdriver and torque wrench.
Dyna Dental produces also magnetic abutments for other systems.

Magnets

Dyna magnets are permanent rare earth magnets supplied in two attraction forces
(Normal Strength, Extra Strong) and two heights(1,5mm/NSS/ and 2,5mm/NS, ES/).
To prevent any corrosion they are encapsulated with 316L stainless steal. For full
magnet description please see the Dyna Magnet Manual.
Magnet Bond
To fix the magnets into the dentures use Dyna Magnet Bond, a specially designed
resin material. Its features enable to achieve chemical connection between the
magnets and a denture acrylic. Therefore, no discolouration appears around the
magnets.
Dyna Magnet bond may be used additionally in all situation when perfect bonding of
acrylic to metal is necessary.

------------------------------------------------------------------

Ball attachment consist of:
 Ball abutment (Ti)
 Matrix (Au/Pd/Pt)
 PVC ring
 Impression transfer
 Tin foil ring
 Lab analogue
To screw the abutment use a hex screwdriver TW-S and torque wrench.
Please notice
The ball abutment is supplied together with impression transfer. Other elements must be ordered separately
Ball abutment instruments.
To activate or deactivate (increase or decrease the grip force) ball attachment two separate
instruments are required :
-activator and
-deactivator.
During the activation lamellae of the matrix are symmetrically bent closer increasing the
retention whereas during deactivation it is pushed aside.
Please notice:
When activating make sure that there is no PVC ring around lamellae of the matrix

  ------------------------------------------------------------------

Dyna ball inserting instrument

Dyna ball space retainers (PVC rings) are specially designed for retaining space around the matrix
during waxing and finishing of a denture. They are supplied together with the matrix (placed around
the lamellae). It is recommended to leave them in place in ready prosthesis. In some situations,
however, they have to be removed (e.g. activation, rebasing). To put them easily back without
destroying the matrix one should use the Dyna Ball Inserting instrument.
It consist of two parts. To place the PVC ring around the matrix follow the next procedure
 separate the handle and the core
 put two pvc rings on the core (they can be
inserted only from one side)
 put the handle back on the core
 place the instrument inside the matrix
 gently push on the handle sliding the ring around lamellae.

Impression copings.

Impression coping is a special element used during impression taking. It was designed for open
tray technique. It transfers exactly the implant position into the model.
Please notice:
These impression copings are meant to be used when producing bar overdentures. In certain clinical
situations they can be also used for other constructions.

---------------------------------------------------------------------------------

Bar attachment consist of:

 Bar abutment (consist of two parts the titanium sleeve and the
dentist screw)
 Lab screw
 Lab analogue
 Castable plastic ring
The Dyna bar abutment allows the dentist to decide on the type of the bar in a particular case.
Cemented bar guarantees totally stress free construction that can be still retrievable. In this way
there are no destructive lateral forces transferred onto the implants. Dyna Dental does not supply
any pre-fab bar itself giving the operator free choice.
Please notice:
Bar Abutment is supplied together with the castable plastic ring and screw. Other elements have to be ordered
separately!

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The Universal (cast to) Abutment.

This versatile abutment expands the prosthetic possibilities and may be used in almost all
clinical situations. Custom fabrication from the top of the implant is a great advantage in
those cases where optimal emergence profile and crown design is necessary. Prosthetic
correction of the implant divergence or unfavourable angulation improvement is easy to
realize. Both screw-type and cemented constructions can be produced with help of this
universal abutment.
After taking the impression it is the technician who waxes up the desired
abutment first, and than produces planned prosthetic construction. The
castable sleeve can be easily prepared and adjusted to every desirable shape.
Low metal collar allows for achieving perfect aesthetics (for diameter 4mm
only a fully castable plastic sleeve is available) and achieve optimal
contouring of soft tissue, for an even more natural looking restoration.
The abutment is available for Dyna implants diameter 3, 3.6 and 4 mm.
Material: POM and Gold Alloy (61.5%Au, 20,1%Pt, 17.5%Pd, 0,5%Ag),
melting interval 1340oC -1470oC,
thermal expansion coefficient (25-500oC) 13.0μm/m.K,
recommended solders – Orion 1120oC white
general indication:
1. For soldering with Elephant I 850oC, II 800oC, III 750oC or Pallas II 830oC or III 750oC
2. To cast against with precious alloys
3. To cast against both precious or non-precious alloys
4. To cast against with non-precious alloys
POM needs to be burned out during 20 minutes with a minimum temperature of 260 and
maximum of 300 °C. Heatingcyclus of the oven is recommended on a maximum of 30 °C
per minute. If burning out is done faster than recommended there is a risk of burning POM
causing porous casting.
Variations: The universal abutment is for the Dyna Implant system (not Octalock)
available in one form
- metal basis without octagon and plastic sleeve (soldering)
The universal abutment can be used for single or multiple unit (splint) crown and bridge
restorations or bar supported overdenture restorations. Highly aesthetic custom restoration
attached directly to the implant may be realized with this type of abutment.
Abutment Screw
Each abutment has its own abutment screw. Conical design guarantees optimal anti-loosening
properties.
Material: Titanium grade 5.
Laboratory Screw
Each abutment has its own laboratory screw.
Material: brass

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Abutments for fixed constructions.

These abutments are intended to be used for
cemented crowns and bridge constructions.
They have been designed according to gingiva
guiding idea. The outer transmucosal part of the
Dyna Fixed Abutment is highly polished whereas
the crown part is roughened. The abutments can be
shaped to realise highly aesthetical prostheses.
GG abutments have diameter 6mm for Ø3,6, and Ø4,0 mm implants and 7mm for Ø5mm implants.
GN abutments have Ø5mm for Ø3,6 and Ø4,0mm implants and 5,5mm for Ø5mm implants.
All abutments for Ø3.0 implants have one diameter 5.0mm.
These variations allows easier interdental placement and avoiding unfavourable emergency profile
and together with the possibility of adjusting to the gingiva height achieve a pleasing effect.
The GG shape has following advantages:
-possibility to hide crown margin under gingiva
-no pressure on papillae
-possibility to produce highly aesthetical prostheses

Dyna fixed abutment (0o)

These abutments may be used when implant positioning is parallel or almost

parallel. Different trans-gingival heights and types, GG and GN, allow to
achieve excellent aesthetic effects. GG abutments with bigger diameter are
provided to replace more “massive” teeth, whereas GN, with smaller
diameter, may replace lower incisors or premolars.
The total height and transgingival height are presented in the form of two
digits e.g. 2/5. The first means transgingival (polished) height whereas the
second total height.

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Dyna memory abutment

This abutment can be used in situations where the positioning of the implants is not
favourable (angulation more than 6o). The outer transmucosal portion (cup) of the
memory abutment is made from highly polished titanium. This portion of the
abutment is the only part which, in clinical application, will contact the body tissue.
The abutment head (patrix) that is contained within the
transmucosal cup is made from nitinol (shape memory alloy: see
chapter 3.3)
A special shape-memory metal used in this abutment allows the
abutment head to be bent from 0o to 15o after spraying it with a
special Dyna cooling spray. GG shape of the transgingival part
allows for constructing highly aesthetical prostheses.
GG abutments have diameter 6mm for Ø 3,6, Ø 4,0 mm implants
and Ø 7mm for Ø 5mm implants. GN abutments have Ø 5mm
for Ø 3,6 and Ø 4,0mm implants and Ø 5,5mm for Ø 5mm
implants. All abutments for Ø 3.0 implants have one diameter
5.0mm
By using these variations unfavourable emergency profile can be
avoided. The possibility of adjusting to the gingiva height allows
to achieve pleasing effect.
The GG shape has the following advantages:
 possibility to hide crown margin under gingiva
 no pressure on papillae
 possibility to produce highly aesthetical prostheses
Cooling aids
Memory abutments can be cooled down in the mouth of the patient with help of the Memory
Cooling Aid. The aid resembles in its shape saliva ejector tip. To use it properly the long end
should be connected to the ejector whereas the wider opening of the ball part should be positioned
around the memory patrix. Please make sure that the patrix is placed totally inside the ball. If it is
not the case you can easily adjust it by cutting it to shape. Subsequently connect the cooling spray
with the smaller hole and cool the abutment for around 3-5 seconds. Wait a moment and with the
Dyna Position Instrument change the angulation.

Laboratory elements (fixed)

The laboratory analogue is intended to be used by the technician as an abutment analogue
in the working model. This model can only be poured in after previous positioning of the
analogue in the impression. See also 8.5 and 8.11

.

GG/GN Laboratory Analogues “fixed”

GG/GN Laboratory Analogues “memory”

Laboratory parts – implant analogue

Laboratory parts (bar)

Laboratory parts (ball)

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Dyna Octalock

Because of the fact that Dyna Octalock implants are produced only in three

different diameters (3.6mm, 4.0mm and 5.0mm) and all abutments can be fitted on both
implant types, there is no need for special colour coding. Therefore, none of the Octalock
products is specially coloured.
Implants
Two-stage, endosseous, push-in dental fixtures.
Sterilized in the process of gamma irradiation and supplied in
sterile double peel-pouch packaging.
The concept of Octalock implants is based on the full, reverse
Edison screw implants covered, either fully or with 1mm
machined polished collar, with hydroxylapatite. The essential
features of this design are:
-fast osteointegration
-good physiological loadability
-direct bone apposition
-simple and time-saving implantation technique
-favourable load distribution.
-good results in bad quality bone
Coating titanium implants with HA, besides excellent
biocompatibility, favours direct bone growth to the implant
surface. In contrast to the other non-HA implants the process of
the bone apposition occurs not only from the bone side but from
the implant surface as well.
The implants are already provided with a titanium
cover screw and suspended on a plastic, colour-coded holder,
facilitating manipulation during the surgery.
The implants are available in diameters 3.6, 4.0 and 5.0
and lengths 8, 10, 11.5, 13 and 15mm.

Straight abutment

Ideal for all those situations where the implants are placed parallel or almost parallel.
The unique simplicity of this abutment makes all the connected procedures easy and
fast. The possibility of the abutment trimming gives a chance to get always the best
aesthetic result.
Both the single tooth reconstructions and bridges can be realized with this abutment.
The straight abutment can only be used with cemented crowns and bridges.
Material: Titanium grade 5.
Variations : Straight Abutment is available in different transgingival lengths
L2=2mm*, L3=3mm*, L4=4mm*. All abutments have the octagon. It is indicated for
single and multiple unit cemented restorations where no angulation correction is
necessary.
*depends on the implant diameter see product catalogue
Memory abutment.
The memory abutment employs the idea of using the memory
metal to change the angulation of the abutment’s head. Cooling it
with a special Dyna Coolspray enables easy adjustment of the
head to the particular clinical situation.
For more information please see Dyna Implant Manual.
Material: Titanium, Nitinol
Variations: Memory Abutment is available in two transgingival
lengths L2=2mm*, L3=3mm*.
*depends on the implant diameter see product catalogue
Temporary Abutment
The temporary Abutment is intended to be used after second stage surgery to provide
the patient with a temporary restoration. The titanium sleeve offers a textured surface
for better connection with the covering material, when constructing provisional
restorations on Dyna Octalock implants.
Materials: Titanium grade 1
Variations: Temporary Abutment is available in one form to be trimmed individually
either by dentist or by technician.

The Universal (cast to) Abutment.

This versatile abutment expands the prosthetic possibilities and may be used in almost all
clinical situations. Custom fabrication from the top of the implant is a great advantage in
those cases where optimal emergence profile and crown design is necessary. Prosthetic
correction of the implant divergence or unfavourable angulation improvement is easy to
realize. Both screw-type and cemented constructions can be produced with help of this
universal abutment.
After taking the impression it is the
technician who waxes up the desired
abutment first, and than produces planned
prosthetic construction. The castable sleeve
can be easily prepared and adjusted to every
desirable shape. Low metal collar allows
for achieving perfect aesthetics (it is also
possible to choose fully castable plastic
sleeve) and achieve optimal contouring of soft tissue, for an even more natural looking
restoration.
The abutment is available for single tooth reconstructions and cemented bridges with
octagon, and for screwed bridges without.
Material: POM and Gold Alloy (61.5%Au, 20,1%Pt, 17.5%Pd, 0,5%Ag),
melting interval 1340oC -1470oC,
thermal expansion coefficient (25-500oC) 13.0μm/m.K,
recommended solders – Orion 1120oC white
general indication:
5. For soldering with Elephant I 850oC, II 800oC, III 750oC or Pallas II 830oC or III 750oC
6. To cast against with precious alloys
7. To cast against both precious or non-precious alloys
8. To cast against with non-precious alloys
POM needs to be burned out during 20 minutes with a minimum temperature of 260 and
maximum of 300 °C. Heatingcyclus of the oven is recommended on a maximum of 30 °C
per minute. If burning out is done faster than recommended there is a risk of burning POM
causing porous casting.
Variations: The universal abutment is available in three forms
A. metal basis with octagon and plastic sleeve (soldering)
B. metal basis without octagon and plastic sleeve (soldering)
C. plastic abutment (to be casted totally by the technician)
The universal abutment can be used for single or multiple unit (splint) crown and bridge
restorations or bar supported overdenture restorations. Highly aesthetic custom restoration
attached directly to the implant may be realized with this type of abutment.
Fixation Screw
Universal fixation screw fits on all abutments types. Conical design guarantees optimal antiloosening
properties.
Material: Titanium grade 5.
Variations: Short fixation screw is available only in one form.

Ceramic\Titanium Abutment (trimmable)

The aesthetic abutment was developed in order to meet high aesthetic demands posed by
patients nowadays. The use of ceramic abutment besides excellent aesthetics creates
optimal biocompatibility, which is mandatory for a long-term success. Ideal mechanical
and biological properties of the Zirconium Oxide guarantee predictable and stable
results. Conical design of the abutment allows for individual trimming and therefore,
the best
adaptation to the individual mouth conditions.
*Example of the ceramic abutment after preparation.
The abutment can be trimmed to the desired form by the dental technician. The use of
ceramic material gives the prosthodontist a chance to adapt the colour of the restoration
to the natural situation.
The ceramic abutment is supplied in the trimmable form (see. catalogue) so that
both straight and angulated abutments can be easily realised. Such solution gives more
versatility and saves the need to have different abutment lines.
Material: Zirconium Oxide
Variations: Ceramic Abutment is available only in one form. The total height of the
abutment together with octa is 13mm, whereas the upper diameter is 8mm. It is
indicated for single and multiple unit, cemented restorations where the high level of
aesthetics is required.
Dyna Octalock® Titanium Abutment (Ti)
In order to increase the mechanical strength of the abutment in challenging though
demanding clinical situation, besides the ceramic abutment, Dyna Dental produces the
titanium trimmable abutment. It has the same form as the ceramic abutment and is
ideal for situations where strong and resistant prosthetic constructions are indicated.
Material: Titanium grade 1
Variations: The titanium Abutment is available only in one form. The total height of
the abutment together with octa is 14mm, whereas the upper diameter 11.5mm. It is
indicated for single and multiple unit, cemented restorations.

Impression abutment and implant analogue

The impression abutment is used when transferring the
position of the implant in the mouth to the model. It has the
same octa features as other abutments and provide exact
replication of the octagon position to the working model. It is
intended to be used with open-tray impression technique. For
more information about impression taking please see Dyna
Implant Manual.
Materials: Titanium
Variations: The Impression Abutment is available in one
form. It can be individually adjusted if the interocclusal space
is too small. It is intended to be used for single and multipleunit
restorations and bar retained overdenture restorations.
Dyna Octalock® Healing Abutment (Ti)
Healing abutments are used in the second stage surgery to heal and form the gingiva .
They have special height markings helpful in reading the gingiva height after the
healing period.
Depending on the type of prosthetic construction different healings should be used for
overdentures and crown and bridge works.
Different height of the healing abutments allows better tissue management especially
for fixed constructions.
Materials: Titanium
Variations: The Healing Abutment is available in two basic forms:
 for overdentures
 for fixed constructions
Abutments for fixed constructions are additionally available in high, medium and low
version

1.4.7 Abutments for overdentures.

The abutments for overdenture have only been adjusted to fit the new Octalock
connection. They are almost the same as for the old system. Therefore, please refer to
Dyna Implant Manual for further clinical details.
Materials: bar abutment and ball abutment – titanium, magnet abutment EFM alloy
Variations: all overdentures are available in different heights
-bar - L2=2mm, L3=3mm, L4=4mm, L5=5mm, L6=6mm
-ball - L2=2mm, L3=3mm, L4=4mm, L5=5mm, L6=6mm
-magnet - L3=3mm, L4=4mm, L5=5mm
*depends on the implant diameter see product catalogue
Explanation of the used codes.
AS abutment screw
CP ceramic abutment
HE healing abutment
IA implant analogue
IC impression coping
IS impression screw
MY memory abutment
ST straight abutment
TA temporary abutment
TP titanium abutment
UA universal abutment
UP universal plastic abutment
US universal sleeve
BE bar extension
BL bar abutment
BS bar screw
MG magnet abutment
81 fixed constructions
82 overdentures
The last number in the abutments code means either the abutment
length(2-6), or the presence of the octagon (0-1), exceptionally it
means that the product is only in one design (0)
830 implants 3.6mm
840 implants 4,0mm
The last two numbers in the implant code represents the length of the
implant.

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