Tapered PTG: Implant System
Tapered PTG: Implant System
implant system
Catalog & Surgical Manual
BioHorizons Tapered implants
Every implant treatment presents its own challenge.
BioHorizons broad portfolio of Tapered implants
provides solutions for all indications. Choose from
narrow-diameter 3.0mm implants to wide-diameter
immediate molar implants or short 6mm-length
implants to 18mm-length implants. Whatever
your preference, there’s a workflow to suit your
need, from fully digital to traditional workflows.
guided workflow
BioHorizons guided surgery
system uses an open architecture
design, providing compatibility
with various software providers
and guide manufacturers.*
digital restorative
workflow
Custom abutments can be
sourced through validated
milling centers or designed
and fabricated in-house.
traditional workflow
BioHorizons comprehensive
surgical kit and wide range
of prosthetics support
traditional workflows.
Table of contents
Tapered PTG product information & ordering 3-4
healing abutments 10
multi-unit abutments 11
surgical protocols 13
drill overview 16
osteotomy preparation 17
implant transfer 18
healing protocols 19
appendix 20
icon legend 21
narrow apex
progressive threads reduced apical
dynamically engages bone diameter allows for
for added stability precise placement
Laser-Lok ®
microchannels
better science, better implants
• over 25 years of in vitro, animal and human
studies at leading universities1
• reduced incidence of peri-implantitis
compared to traditional surfaces2
• only surface shown to attract a physical,
connective tissue attachment 3-11
• overdenture study showing only 0.42mm
of bone loss compared to 1.13mm
for NobelReplace™ Select12
traditional Laser-Lok
surface surface
learn more at
laser-lok.com
shop online at store.biohorizons.com 3
Tapered PTG
platform
switch
Laser-Lok
zone
prosthetic
Laser-Lok zone 1.8mm connection
body diameter
features:
• versatile, removable, hinged lid
• 40% smaller and 40% lighter than other kits
• easy to disassemble and assemble during cleaning
• implant staging area for implant vials during surgery
• use to place Tapered PTG, Tapered Pro, Tapered Internal, Plus, 3.0 and Tissue Level
• empty spare slots for other instrumentation such as stop drills or extended shank drills
Tapered HD Drills
The Tapered HD drills feature highly efficient cutting 18.0mm
flutes for crisp osteotomies in even the densest bone.
Simplified drill markings correspond to the standard 15.0mm
implant lengths. Drills should be replaced every 12-20
osteotomies for maximum cutting efficiency. 12.0mm
10.5mm
Part Number Part Description 9.0mm
7.5mm
TSD2020HD 2.0mm HD Drill
features:
• cutting flutes designed for maximum efficiency
• non-reflective surface for high visibility
• simplified drill markings standard implant lengths
• compatible with Tapered PTG, Tapered Pro, Tapered Internal, Plus, 3.0 and Tissue Level
• creates 12-20 osteotomies depending on bone density
• recommended drill speed 1,500-2,000 rpm (2.0 & 2.5mm), 1,000 rpm (all others)
Parallel Pins
* Mount-free Tapered Pro, Tapered PTG, Tapered Internal, Tapered Plus, Tapered 3.0, Tapered
Tissue Level implants. 5.2mm and 5.8mm instruments sold separately.
authentic connection
Using authentic BioHorizons parts will ensure
a precision fit connection between the
advantages:
• lifetime warranty on all implants and prosthetics
prosthetic component and implant, avoiding
costly component failures that may occur • Spiralock® technology minimizes screw loosening
from using third-party prosthetics. Authentic • precise mating geometries reduce prosthetic failures
BioHorizons parts are color-coded for easy • advanced design creates a better engineered connection
identification to match the mating implant. • color-coded prosthetic components match implant platforms
Healing Abutments
Abutment
Part Description diameter
1mm height 2mm height 3mm height 5mm height
abutment
The 3.5mm, 4.5mm and 5.7mm healing abutments
height are laser marked for easy intraoral identification of the
Laser-Lok
prosthetic platform, emergence and height:
3.0 healing abutments are not laser marked due to their small size.
TRYPYMU30 3.5mm Multi-unit Try-in 30° Angled Abutment Straight 17°Angled 30°Angled
Laser marking Laser marking Laser marking
This surgical manual serves as a reference for using the Tapered PTG implants and surgical instruments. It is intended
solely to provide instructions on the use of BioHorizons products. It is not intended to describe the methods or
procedures for diagnosis, treatment planning, or placement of implants, nor does it replace clinical training or a
clinician’s best judgment regarding the needs of each patient. BioHorizons strongly recommends appropriate training
as a prerequisite for the placement of implants and associated treatment.
The procedures illustrated and described within this manual reflect idealized patient presentations with adequate
bone and soft tissue to accommodate implant placement. No attempt has been made to cover the wide range of actual
patient conditions that may adversely affect surgical and prosthetic outcomes. Clinician judgment as related to any
specific case must always supersede any recommendations made in this or any BioHorizons literature.
Small diameter implants are intended for the anterior region of the mouth and are not intended
for the posterior region of the mouth due to possible failure of the implant.
Indications
Tapered PTG, Tapered Pro, Tapered Internal, Tapered Plus and Tapered Tissue Level Implants are intended for use in the
mandible or maxilla as an artificial root structure for single tooth replacement or for fixed bridgework and dental retention.
The implants may be restored immediately:
1) with a temporary prosthesis that is not in functional occlusion or
2) when splinted together for multiple tooth replacement or when stabilized with an overdenture supported by
multiple implants.
Because of their length and diameter, BioHorizons Tapered PTG implants are well-suited for implant placement through
the maxillary tuberosity in the pterygoid plate, supporting full-arch treatment in extremely atrophic maxillae and
providing an alternative to grafting, which may expedite treatment.13,14
Tapered Internal 3.0 and Tapered Tissue Level 3.0 Implants may be used as an artificial root structure for single tooth
replacement of mandibular central and lateral incisors and maxillary lateral incisors. The implants may be restored
immediately:
(1) with a temporary prosthesis that is not in functional occlusion,
(2) when splinted together as an artificial root structure for multiple tooth replacement of mandibular incisors,
(3) for denture stabilization using multiple implants in the anterior mandible and maxilla.
The implants may be placed in immediate function when good primary stability has been achieved and with appropriate
occlusal loading.
Important Considerations
• Peri-operative oral rinses with a 0.12% Chlorhexidine Digluconate solution have been shown to significantly lower the
incidence of post-implantation infectious complications.15 A pre-operative 30-second rinse is recommended, followed by
twice daily rinses for two weeks following surgery.
• Drilling must be done under a constant stream of sterile irrigation. A pumping motion should be employed to prevent
over-heating the bone. Surgical drills and taps should be replaced when they are worn, dull, corroded or in any way
compromised. BioHorizons recommends replacing drills after 12 to 20 osteotomies.16 A Drill-usage Tracking Chart is
available at biohorizons.com to record this important information.
• There is a risk of injury to the mandibular nerve associated with surgical drilling in posterior mandibular regions. To
minimize the risk of nerve injury, it is imperative that the clinician understands the drill depth markings as they relate to
the implant length to produce the desired vertical placement of the implant.
Two-Stage Protocol
In a two-stage surgery, the implant is placed below the soft tissue and protected
from occlusal function and other forces during osseointegration. A low-profile
cover cap is placed on the implant to protect it from the ingress of soft tissue.
Single-stage Protocol
Single-stage surgery may be accomplished by placing a healing abutment at
the time of implant surgery. This eliminates the need for a second procedure.
Although the implant is not in occlusal function, some forces can be
transmitted to it through the exposed transmucosal element.
Implant-to-Tooth Spacing
The osteotomy centerpoint required to maintain a specific
implant-to-tooth spacing is calculated according to this formula:
1/2 (implant body diameter) + the desired spacing. osteotomy
centerpoint
osteotomy
centerpoint
Implant-to-Implant Spacing
The osteotomy center-to-center measurement required to
maintain a specific edge-to-edge spacing between two implants
is calculated according to this formula: 1/2 (sum of 2 implant
body diameters) + the desired spacing.
edge-
to-edge
During implant placement, clinicians must spacing
apply their best judgment as to the appropriate
spacing for individual patient conditions.
Drill Markings
All surgical drills included with this system are externally 18.0mm
irrigated and designed to be used with steady sterile irrigation.
Reduced drill speed may be indicated in softer bone or as drill
diameter increases. 15.0mm
length
indicator
0mm
2.0mm HD Drill
The 2.0mm depth drills are designed to increase and/or set the
depth of the osteotomy.
Paralleling Pins
Purpose: Evaluate osteotomy position and angle.
• Provided straight or with a 20° angle
• Use after 2.0mm Starter Drill
• 9mm shank for radiographic evaluation of proximity to adjacent anatomy
• Hub diameter is 4.0mm
HD Drills
Purpose: Incrementally widen the osteotomy to reduce heat generation.
• Depth-marked for reference
• Efficient cutting drill design collects bone for autografting
• The drill tip has limited end cutting. However, the osteotomy
depth can be increased with these drills as needed
• Matte finish for increased visibility under operatory lights
•1,000 RPM
driver
Implant Pick-up hex
To pick-up the implant, align the driver hex with the implant
hex and press firmly to engage the PEEK snap ring.
PEEK
snap
ring
Implant Placement
Place the apex of the implant into the osteotomy and begin rotating slowly.
The cover cap for the mount-free implant is mounted in the vial cap.
cover cap
Bone Profilers
Purpose: In cases where excess crestal bone has been created, use
a bone profiler at implant uncovery to contour the bone. This will
provide the necessary clearance for proper abutment seating.
• Profiler guide protects implant platform
• Color-coded by prosthetic platform
(gray=3.0mm, yellow=3.5mm, green=4.5mm, blue=5.7mm)
• 800 rpm drill speed with steady sterile irrigation
Using an .050” hex driver, remove the surgical cover cap from the
implant and place the profiler guide that matches the color of the
prosthetic platform. Use the profiler with copious amounts of sterile
irrigation. Once the excess bone and soft tissue are removed,
unscrew the guide and seat the appropriate prosthetic component.
Post-operative Instructions
A period of unloaded healing time is often recommended to allow for integration between
the bone and implant surface. This is dependent on individual patient healing rates and
bone quality of the implant site. Each case must be independently evaluated.
The patient should be instructed to follow a post-surgical regimen including cold packs for 24 hours
post-implantation. The patient’s diet should consist of soft foods and possibly dietary supplements.
Pharmacological therapy should be considered as the patient’s condition dictates.
If a removable prosthesis is used during the initial healing phase, a soft liner material should be used to prevent
pressure on the surgical site. Relieve the prosthesis over the implant site prior to the soft liner application.
Periodically check the patient’s soft tissue and bone healing using clinical and radiographic evaluations.
Ongoing hygiene for the implant patient is vital. Hygiene recall appointments at three month intervals are suggested.
Instruments designed for implant abutment scaling, such as Implacare® instruments from Hu-Friedy® should
be utilized. The stainless steel handles may be fitted with assorted tip designs for hygiene on natural teeth.
The Implacare® scalers contain no glass or graphite fillers that can scratch titanium implant abutments.
BioHorizons
Manufacture date -DD
products carry the
(YYYY-MM-DD) CE mark and fulfill
-DD the requirements of
2797 the Medical Devices
Sterile by Directive 93/42/EEC
STERILE R gamma
irradiation (01)
(17)
00847236010119
YYMMDD
(11) YYMMDD
NON-STERILE Non-sterile (10) YYXXXXX
EU Authorised Representative
ES IMPLANTE
LPTG4215B REV B Quality First International OÜ
Laki 30
12915 Tallinn
Estonia
Label number
Tel +372-610-4196
Tapered PTG
Product body diameter prosthetic platform
Labeling
4.2mm 3.5mm (yellow internal hex & cover cap)
Additional Warranties: BioHorizons warranties surgical drills, taps and other surgical and restorative instruments.
(1) Surgical Drills and Taps: Surgical drills and taps include a warranty period of ninety (90) days from the date of initial invoice. Surgical instruments should
be replaced when they become worn, dull, corroded or in any way compromised. Surgical drills should be replaced after 12 to 20 osteotomies.16
(2) Instruments: The BioHorizons manufactured instrument warranty extends for a period of one (1) year from the date of initial invoice. Instruments include
drivers, implant site dilators and BioHorizons tools used in the placement or restoration of BioHorizons implants.
Return Policy: Product returns require a Return Authorization Form, which may be acquired by contacting Customer Care. The completed Return
Authorization Form must be included with the returned product. For more information, please see the reverse side of the invoice that was shipped with the
product.
Disclaimer of Liability: BioHorizons products may only be used in conjunction with the associated original components and instruments according to the
Instructions for Use (IFU). Use of any non-BioHorizons products in conjunction with BioHorizons products will void any warranty or any other obligation,
expressed or implied.
Treatment planning and clinical application of BioHorizons products are the responsibility of each individual clinician. BioHorizons strongly recommends
completion of postgraduate dental implant education and adherence to the IFU that accompany each product. BioHorizons is not responsible for incidental
or consequential damages or liability relating to use of our products alone or in combination with other products other than replacement or repair under
our warranties.
Distributed Products: For information on the manufacturer’s warranty of distributed products, please refer to their product packaging. Distributed products
are subject to price change without notice.
Validity: Upon its release, this literature supersedes all previously published versions.
Availability: Not all products shown or described in this literature are available in all countries. BioHorizons continually strives to improve its products and
therefore reserves the right to improve, modify, change specifications or discontinue products at any time.
Any images depicted in this literature are not to scale, nor are all products depicted. Product descriptions have been modified for presentation purposes. For
complete product descriptions and additional information, visit store.biohorizons.com.
References
1. Incidence of Peri-Implant Diseases on Implants with and without Laser-Microgrooved Collar: A 5-Year Retrospective Study Carried Out in Private Practice Patients.
Guarnieri R, Grande M, Zuffetti F, Testori T. Int J Oral Maxillofac Implants. 2018 Mar/Apr;33(2):457-465.
2. For a complete research summary, please see Laser-Lok Clinical Overview (BioHorizons document ML0606).
3. Human histologic evidence of a connective tissue attachment to a dental implant.
M Nevins, ML Nevins, M Camelo, JL Boyesen, DM Kim. International Journal of Periodontics & Restorative Dentistry. Vol. 28, No. 2, 2008.
4. The effects of laser microtextured collars upon crestal bone levels of dental implants.
S Weiner, J Simon, DS Ehrenberg, B Zweig, JL Ricci. Implant Dentistry. Volume 17, Number 2, 2008. p. 217-228.
5. Influence of a microgrooved collar design on soft and hard tissue healing of immediate implantation in fresh extraction sites in dogs.
SY Shin, DH Han. Clin. Oral Impl. Res. 21, 2010; 804–814.
6. Maintaining inter-implant crestal bone height via a combined platform-switched, Laser-Lok® implant/abutment system: A proof-of-principle canine study.
M Nevins, ML Nevins, L Gobbato,HJ Lee, CW Wang, DM Kim. Int J Periodontics Restorative Dent. Volume 33, Number 3, 2013.
7. Histologic evidence of a connective tissue attachment to laser microgrooved abutments: A canine study.
M Nevins, DM Kim, SH Jun, K Guze, P Schupbach, ML Nevins. International Journal of Periodontics & Restorative Dentistry. Vol. 30, No. 3, 2010.
8. Histologic evidence of connective tissue integration on laser microgrooved abutments in humans.
NC Geurs, PJ Vassilopoulos, MS Reddy. Clinical Advances in Periodontics. Vol. 1, No. 1, May 2011.
9. Connective tissue attachment to laser microgrooved abutments: A human histologic case report.
M Nevins, M Camelo, ML Nevins, P Schupbach, DM Kim. Int J Periodontics Restorative Dent. Volume 32, Number 4, 2012. p. 384-392.
10. Reattachment of the connective tissue fibers to the laser microgrooved abutment surface.
M Nevins, M Camelo, ML Nevins, P Schupbach, DM Kim. Int J Periodontics Restorative Dent. Volume 32, Number 4, 2012. e131-134.
11. The impact of dis-/reconnection of laser microgrooved and machined implant abutments on soft- and hard-tissue healing.
Iglhaut G, Becker K, Golubovic V, Schliephake H, Mihatovic I. Clin Oral Implants Res. 2013 Apr;24(4):391-7.
12. The effects of laser microtexturing of the dental implant collar on crestal bone levels and peri-implant health.
S Botos, H Yousef, B Zweig, R Flinton and S Weiner. Int J Oral Maxillofac Implants. 2011;26:492-498.
13. Glossary of Oral and Maxillofacial Implants. WR Laney. Int J Oral Maxillofac Imp. Jul/Aug 2017;32(4):Gi-G200.
14. Pterygoid implant: option for the rehabilitation of the atrophic posterior maxilla. PVR Nag, P Sarika, T Bhagwatkar, V Dhara. Int J Contemp Dent Med Rev. 2019;1-5
15. The influence of 0.12 percent chlorhexidine digluconate rinses on the incidence of infectious com-plications and implant success.
Lambert PM, Morris HF, Ochi S. J Oral Maxillofac Surg. 1997;55(12 supplement 5):25-30.
16. Heat production by 3 implant drill systems after repeated drilling and sterilization.
Chacon GE, Bower DL, Larsen PE, McGlumphy EA, Beck FM. J Oral Maxillofac Surg. 2006 Feb;64(2):265-9.
17. Root Form Surgery in the Edentulous Mandible: Stage I Implant Insertion.
CE Misch. Contemporary Implant Dentistry Second Edition. Mosby: St. Louis, 1999. 347-369.
Distributors
For contact information in our 90 countries, visit biohorizons.com
shop online at
store.biohorizons.com
BioHorizons®, Laser-Lok®, MinerOss®, AutoTac®, Mem-Lok® and TeethXpress® are registered trademarks of BioHorizons. Unigrip™ is a trademark of Nobel
Biocare AB. Zimmer® Dental ScrewVent® and Tapered ScrewVent® are registered trademarks of Zimmer, Inc. AlloDermTM, AlloDerm GBRTM and NovoMatrixTM
are trademarks of LifeCell Corporation, an Allergan affiliate. Grafton® DBM is a registered trademark of Medtronic, Inc. Cytoplast® is a registered trademark of
Osteogenics Biomedical, Inc. Puros Dermis is a registered trademark of Zimmer Biomet. Mucograft is a registered trademark of Ed. Geistlich Sogne Ag Fur Chemische
Industrie. Symbios PerioDerm is a registered trademark of Dentsply Sirona. Hu-Friedy® is a registered trademark of Hu-Friedy Mfg. Co., LLC. Spiralock® is a
registered trademark of Spiralock Corporation. Pomalux® is a registered trademark of Westlake Plastics Co. Locator® is a registered trademark of Zest Anchors,
Inc. Delrin® is a registered trademark of E.I. du Pont de Nemours and Company. Bio-Gide® is a registered trademark of Edward Geistlich Sohne AG Fur Chemische
Industrie. BioMend® is a registered trademark of Zimmer Biomet Dental. IntraSpin®, L-PRF® and Xpression® are trademarks of Intra-Lock® International Inc. Not
all products shown or described in this literature are available in all countries. As applicable, BioHorizons products are cleared for sale in the European Union under
the EU Medical Device Directive 93/42/EEC and the tissues and cells Directive 2004/23/EC. We are proud to be registered to ISO 13485:2016, the international
quality management system standard for medical devices, which supports and maintains our product licences with Health Canada and in other markets around
the globe. Original language is English. ©BioHorizons. All Rights Reserved.