USER MANUAL:

DENTAL IMPLANT SYSTEMS

Contents

1. ADIN Dental Implant Systems Products 3

1.1 ADIN Dental Implant Systems Description 3
1.2 ADIN Dental Implants Intended Use 3
1.3 ADIN Dental Implants Contraindications 3
1.4 Preoperative Considerations and Precautions 3
1.5 Intraoperative Considerations and Precautions 3
1.6 Prosthetics Considerations and Precautions 4
1.7 Implant Packaging 4
1.8 Product Sterility and Maintenance 4
1.9 Product Training and Education 4
1.10 General Warnings 4
2. Surgical Procedures 5
2.1 Examination and Treatment Planning 5
2.2 Bone Quality 5
2.3 Vertical Bone Quantity 5
2.4 Horizontal Bone Quantity 5
2.5 Implant Insertion 5
2.6 The Flapless Technique 5
3. Drilling Protocol 6
3.1 Drills Description and Properties 6
3.2 Drills Intended Use 6
3.3 Depth Measurement System 6
3.4 Depth of Drilled Site 6
3.5 Step-by-Step Clinical Procedure 6
3.6 Drills Cautions and Warnings 7

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1. Adin Dental Implant Systems products
1.1 ADIN Dental Implant Systems Description: • Routine treatment is not recommended for under-aged
children until growth has stopped and epiphyseal closure
ADIN Dental Implant Systems Ltd. designs and manufactures has occurred.
technologically advanced dental implants solutions.
ADIN’s dental implant system includes Implants, abutments, • If the above contraindications exist, special
associated restorative and dental laboratory components, accommodations should be considered.
instruments and accessories.
Note: Please refer to appropriate clinical manuals and
The dental implant systems include the lines listed below: textbooks for information about treatment planning and
Swell™ medical evaluation.
Touareg™
Touareg™-S
1.4 Preoperative Considerations and Precautions:
Touareg™-OS
Touareg CloseFit™ • Prior to any surgical procedure, a comprehensive patient
Triple™ evaluation is necessary in order to determine factors
that may put the patient at risk, due to the implantation
One™ procedure itself, or factors that may affect the healing
process of either the bone and/or the soft tissue.

1.2 ADIN Dental Implants Intended Use: • Patients must be carefully examined and evaluated to
determine proper radiographic, psychological and physical
ADIN dental implants are intended for surgical placement status.
in the maxillary and/or mandibular arch, to support
crowns, bridges, or overdentures, in edentulous or partially • Patient’s teeth and any associated bone or soft tissue
edentulous patients. Restorations range from a single tooth deficits that can influence final results should also be
restoration to a full mouth restoration. ADIN dental implants evaluated.
may be immediately loaded when good primary stability is • Constant communication and cooperation between the
achieved and with appropriate occlusal loading. dental surgeon, the restorative dentist and dental laboratory
technician is essential to achieve desired success.

1.3 ADIN Dental Implants Contraindications: • The use of improper techniques in either the implant
placement or restoration process can result in implant
• Dental implants should not be used in patients who failure and a substantial loss of surrounding bone.
are considered medically unfit for general oral surgical
procedures. • Do not reuse implants, cover screws, temporary
abutments and abutments. Reusing these items may lead
• Patients who exhibit underlying factors that might affect to increased risk for product failure and/or contamination,
the healing process of either the bone or the soft tissue as functionality cannot be guaranteed.
(e.g., connective tissue disorder, steroid treatments, bone
infections, cigarette smoking), should carefully evaluate • Sufficient residual bone volume is necessary in order to
the potential risks and benefits associated with the achieve high primary and secondary implant stability, for
recommended treatment. the implant to be able to handle prosthetic rehabilitation.
In cases of inadequate bone volume, certain bone
• The use of wrong implant sizes, insufficient amount of augmentation procedures should be considered.
implants and/or improper implant positioning for prosthetic
rehabilitation, may lead to mechanical failures, such as
fatigue fractures in the implants, prosthetic and/or abutment 1.5 Intraoperative Considerations and Precautions:
screws.
• All efforts must be made to minimize damage to the host
• Inadequate volume and/or quality of remaining bone or tissue, paying special attention to thermal and surgical
soft tissue, infections and general diseases, may result trauma, and to the elimination of contaminants and sources
in compromised esthetic results or unfavorable implant of infection.
angulation, and cause osseointegration failure, both
immediately after surgery, or after osseointegration is • Implantation surgical procedures require a high degree
initially achieved. of precision and care. The limits for acceptable tissue
handling are much narrower in implantation than in general
• Extra precaution should be taken when implanting a oral surgery. Any divergence from the surgical plan during
narrow platform internal hex implant in the posterior region. implant placement increases the risk of osseointegration
• Implant placement and prosthetic design must failure.
accommodate each individual patient’s conditions, such as • It is imperative to pay close attention that tools and
bruxism or unfavorable jaw conditions, in order to reduce instruments are not swallowed or aspirated by the patient.
the risk of implant overload or fatigue failure.

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• After the implant is surgically placed, the surgeon will 1.9 Product Training and Education:
evaluate the bone quality and the implants initial stability, in
order to determine when implant loading is possible. • Proper preoperative planning and dental implant
placement require special evaluation and consideration,
compared to general dentistry. It is highly recommended
that dental practitioners take specific courses with hands-
1.6 Prosthetics Considerations and Precautions: on training in order to learn proper implantation techniques,
including biomechanical requirements needed and proper
• Each ADIN implant system has a unique characteristic
radiographic evaluation.
design for matching implants, abutments and prosthetic
components. Loading implants with incorrect or missized • We strongly recommend that dental professionals, both
abutments and/or prosthetic components, can lead to beginners and experienced implantologists, always go
implant failure, damage to tissue, and undesired esthetic through special training before undertaking a new treatment
results. method, and consult with an experienced colleague. ADIN
offers a wide global network of mentors available for this
• Successful prosthetic restorations require proper stress
purpose.
distribution, passive adaptation and fitting of the bridge to
the implant abutments, adjusting occlusion to the opposing • Surgical and restorative products used to achieve and
jaw, and avoiding excessive transverse loading forces maintain osseointegration, as described by Prof. Brånemark
(particularly in immediate loading cases). et al., should be utilized by personnel trained in these
methods. Proper training is offered at several education
• Prosthetic metal substructures that are made out of gold-
centers. Please contact your local ADIN representative for
alloy should have a high gold content.
more information regarding certified training centers.

• ADIN conducts a wide range of implantology courses at

1.7 Implant Packaging: various levels. For additional information on courses offered
by ADIN, please contact your local ADIN representative.
• Each implant is packaged in a double vial. Product
information is printed on a label on the outer package, • This manual and the general Instructions for Use (IFUs)
and includes the lot number, product description, catalog should be carefully read and precisely followed prior to
reference number, manufacturing date and expiration date. starting treatment, in order to ensure the desired successful
Make sure to record implant size and lot number in patient’s outcome.
chart.

• Two ‘peel-off’ labels are included in the package, and can

1.10 General Warnings:
be directly fixed to the chart.
Note: ADIN dental implants have not been evaluated
• The outer implant vial cap is color coded for easy
for safety, compatibility, heating or migration in the MR
identification of the implant platform size. An outer label is
environment.
added to indicate implant diameter and length.
Note: The following caution text “Federal (USA) law restricts
• Prior to using ADIN dental implants, inspect the package
the sale of this device to, or on the order of, a licensed
and labeling for integrity. If the device is opened, damaged
physician or dentist” refers to labels with “Rx Only”.
or contaminated in any way, it must not be used.

1.8 Product Sterility and Maintenance:

• All instruments used in surgery must be properly taken

care of and maintained in good condition. Failure to do so
may cause unwanted damage to the implant and/or other
components.

• All implants are provided sterile (by gamma radiation), and

are intended for single use only. To ensure sterility, dental
implants must be used before the end of the expiration date
indicated on the outer package label.

• Never reuse, reclean or resterilize a dental implant. These

activities can adversely affect implant materials and alter the
surface characteristics, which may result in poor function
and implant failure.

• All abutments are supplied non sterile and must be

sterilized before use. Steam sterilize the abutments in
sterilization pouch, for 4 min at 132°C/270° F.

• Kits are supplied non-sterile. For sterilization use steam

sterilization for 4 minutes at 132°C/ 270°F.
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2. Surgical Procedures

2.1 Examination and Treatment Planning: 2.5 Implant Insertion:

• Examination and treatment planning should be carried out • It is possible to start implant insertion manually by using
according to the clinic’s routine. a Fixture Mount or Implant Driver and Surgical Wrench. The
maximum tightening torque for implants is 50Ncm, and
• In many cases, ADIN implants can be placed and stabilized may be measured with the Surgical Torque Wrench.
in minimal bone volume, and bone augmentation can be
carried out at the same time. • Using the Surgical Torque Wrench, the Surgical Driver and
a drilling unit can help avoid over-tightening of the implant.

• Implants are ideally installed at a stable and constant rate;

2.2 Bone Quality: however, using excessive insertion torque (greater than
50Ncm) in order to overcome bone resistance, may lead to
• Ideally, dense compact bone provides good initial
damage of the implant, fracture or necrosis of the bone site
stabilization for the implant, while a more porous bone
(see appropriate clinical manuals).
provides less retention, and therefore more bone-to-implant
contact is necessary for a sufficient initial stability. Caution: Over-tightening may compromise the integrity
of the internal hex connection, and over-compress the
surrounding bone, which will compromise osseointegration.
2.3 Vertical Bone Quantity:
• Implant Full Seating
• The amount of bone available for implant retention differs The unique thread design of the Touareg-S, Touareg-OS,
from site to site. Touareg CloseFit, One and Triple implants lines allow the
implant to be repositioned during insertion.
• The unique design of the Touareg™, Touareg-S, Touareg-
OS, Touareg CloseFit, One and Triple implant lines allows Note: Due to this desired feature, the implant might not
excellent anchorage and stabilization in minimal bone necessarily stop at the bottom of the prepared site, and
volume anywhere along the jaw line. surgeons must pay close attention during implant insertion.

• The Touareg™, Touareg-S, Touareg-OS, Touareg CloseFit, • Implant Insertion Speed

One and Triple implants lines is especially designed to The thread pitch design of the Touareg-S, Touareg-OS,
enable angle changes during insertion. In order to change Touareg CloseFit, One and Triple implants lines allows the
angle, the implant must be inserted parallel to the palatal implant to be inserted up to four times faster compared to
bone walls allowing the expansion of the palatal aspect of other implants. This means that less turns are required to
the socket in the facial direction. fully position and situate the implant.

• Tilted Implants
ADIN’s Implants may be tilted up to 45°. If the angulation is
2.4 Horizontal Bone Quantity: 30° or more, it is necessary to splint the tilted implants.
• To maintain vertical tissue dimension, make sure to allow
at least 1.5mm of bone, lingual and buccal to the implant
collar. The special narrowing of the implant collar diameter 2.6 The Flapless Technique:
allows for favorable ridge adaptation, when crestal ridge
• A flapless technique should be used when sufficient
width is limited.
quantity and quality of underlying alveolar bone and soft
tissue are available.

• For correct site preparation, measure soft tissue thickness

with a probe, and add the tissue thickness to the drilling
depth.

• Following thorough preparation of the site, bone and/or

connective tissue grafts should be placed.

Note: Caution! Prior to proceeding with a flapless

procedure, you must confirm available bone and significant
anatomical structures such as blood vessels, nerves, and
concavities, with conventional diagnostic tools, such as
radiographic imaging, probing and palpation.

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3. Drilling Protocol
3.1 Drills Description and Properties Note: Caution! If strong resistance (close to 50Ncm) is
encountered at any point during insertion, rotate the implant
• ADIN’S drills are produced from surgical stainless steel counter-clockwise approximately 1/2 a turn to enable the
and are used with external irrigation. self-tapping capacity of the implant, then continue to insert
the implant. If strong resistance (close to 50Ncm) persists,
• Drills are available in two length variations: Short 6-13mmL,
remove the implant, place implant back in sterile vial; at
and Long 8-18mmL.
this point, sufficient depth of site can be verified with depth
gauge or drill, and further widening of the site to either the
cortical bone or to full depth can be considered.

• Implant self-drilling should not be attempted in dense

bone.
3.2 Drills Intended Use: • The drill preparation should be extended up to 1mm
longer than the implant length.
• ADIN’s drills are bone cutting instruments intended for use
in reconstructive oral surgery to drill or cut into the upper or Note: This drilling sequence is recommended to ensure
lower jaw to prepare the bone to insert an implant. optimal primary implant stability, when proceeding with
Immediate Loading procedure.

3.3 Depth Measurement System:

3.5 Step-by-Step Clinical Procedure:
• Each ADIN implant line has unique measuring
characteristics, allowing proper implant positioning at • When drilling, use an “in-and-out” motion, and drill in the
desired bone depth. bone for 1–2 seconds. Take the drill out without stopping
the handpiece motor, allowing the irrigation to flush away
• Dental practitioners should review and be thoroughly debris. Proceed with this method to drill to the desired
familiar with the measurement system in the clinical manual depth, in accordance with the bone quality and implant
associated with the selected implant system, prior to diameter. Stop drilling if there is no irrigation.
making any drill preparations around vital bone structures,
in order to achieve proper safety margins adjacent to any • All drilling procedures should be performed at low speed
tooth and vital bone structures. (800rpm -2000rpm). Pre-tapping (threading of the bone) and
implant placement procedures should be accomplished at
• All drills and drill components are marked to enable very low speed (~ 25-30rpm) or manually. All drilling and
adequate site preparation to the correct desired depth, and pre-tapping procedures require the use of dedicated,
obtain a secure and predictable position. sharp instruments, under constant and profuse irrigation
Note: The marks on the twist drills indicate actual millimeter for cooling.
lengths, and correspond to the top of the implant collar. • Drill Extension Shaft
• Final vertical positioning depends on several clinical When using the Drill Extension Shaft, it is important to
parameters, such as: esthetics, tissue thickness, available supplement cooling at the tip of the drill with manual
vertical height, flapless procedure. irrigation as necessary. The Drill Extension Shaft is intended
to be used with a Twist Drill used for site preparation; it is
• Failure to properly diagnose drill depth recommended not recommended to be used with screw taps or implant
by appropriate radiographic measurement tools can drivers.
result in permanent injuries to nerves and other vital bone
structures, by drilling beyond recommended depth. This • Parallel Implant Positioning
can potentially lead to permanent numbness of the lower lip * Parallel Pin is used during surgeries to indicate implant
and chin, when conducting lower jaw surgery. position and angulation, and to make implant placements
as parallel as possible. A parallel pin should be used to
check the drilling angle.
3.4 Depth of Drilled Site:
* When inserting multiple implants, proceed to the next
• When drilling in soft bone, the self-drilling feature of the implant site before continuing to the next drill sequence
implant allows the implant to be inserted into sites that have section. Place a parallel pin in each hole before proceeding
been prepared to a reduced depth. This feature becomes to the next site. Align the next drill in the sequence parallel
very useful in clinical cases that present close proximity to to the previous pin when available bone permits.
vital anatomical structures. It can also be utilized in softer
* If applicable, radiographic evaluation of the implant sites
bone when maximum condensation is desirable.
should be used, for precise surgical implant placement.
• When applying the self-drilling feature of the implant, drill
• If the drill becomes plugged, remove the drill from the
to 1–2mm less than the total implant length, insert implant
headpiece and clear the irrigation hole using a needle.
to drilled depth and continue to insert. The implant will drill
its way into the final depth.
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Note: Caution! The drill preparation should extend up to • Twist Drill 2.8mm:
1mm longer than the implant. It is important to allow for * Max 2000 rpm, High Speed.
this additional length when drilling near vital anatomical
structures. • Continue the site preparation procedure using Twist Drills
according to the drilling protocol table below:
• Twist Drill:
Drill to the appropriate desired depth using the Twist Drill
(Drill Stops can be used).

• Pilot Drill:
* Max 2000 rpm, High Speed.

* A Tip Drill can be used before the Pilot Drill in order to

facilitate initial site penetration and the creation of a crestal
start point.

BONE TYPE D-IV BONE TYPE D-II-III BONE TYPE D-I

3.0mmD 1. 2.0 1. 2.0 1. 2.0

2. (2.8) 2. 2.8

3.5mmD 1. Tri-Step* 1. Tri-Step* 1. Tri-Step*

2. (3.2) 2. 3.2

3.75mmD 1. Tri-Step* 1. Tri-Step* 1. Tri-Step*

2. (3.2) 2. 3.2

4.2 / 4.3mmD 1. Tri-Step* 1. Tri-Step* 1. Tri-Step*

2. (3.6) 2. (3.6) 2. 3.6

5.0mmD 1. Tri-Step* 1. Tri-Step* 1. Tri-Step*

2. 3.6 2. 3.6 2. 3.6
3. (4.2) 3. 4.2 3. 4.2
4. (4.6) 4. 4.6

6.0mmD 1. Tri-Step* 1. Tri-Step* 1. Tri-Step*

2. 3.6 2. 3.6 2. 3.6
3. 4.2 3. 4.2 3. 4.2
4. 4.6 4. 4.6 4. 4.6
5. (5.2) 5. 5.2 5. 5.2
6. (5.6) 6. 5.6

Note: (x.x) drill to the depth of the cortex only. All measurements are in mm.
CAUTION: The drill preparation is up to 1mm longer than the implants.
* For initial drilling, you may use 2, 2.8 and 3.2 drills in sequence instead of the Tri-Step drill.

3.6 Drills Cautions and Warnings: • Do not exceed the maximum speeds indicated in this
user manual.
• ADIN dental drills should only be used by a licensed
practicing dentist who has the specialization, skills and • Avoid any excessive drilling speed and/or drilling duration,
appropriate training in implantation and restoration of in order to avoid overheating and any complications
dental implants, in order to assure a successful treatment associated with overheating.
and outcome.
• Make sure to continuously move the drill when in use in
• Inspect drills for any kind of damage and/or any wear and order to avoid localized heating.
tear that might have occurred, before each use. Discard
defective drills. • Clean and sterilize the drills with accordance to the
sterility directions given in the instructions for use, prior to
• Ensure that the drill is completely in place and gripped initial use and before each reuse.
within the handpiece collet before use.
Note: Before using ADIN drills, it is recommended
• Maintain the handpiece in excellent working condition and to carefully review all indications, contraindications,
properly lubricated. recommendations, warnings and instructions, and fully
comply with them.

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 MB015-01 11.15

Industrial Zone Alon Tavor POB 1128 T. +972-4-6426-732 [email protected]

Afula 1811101, Israel F. +972-4-6426-733 www.adin-implants.com