INFO SURGEON  
Instructions for use  
 

Read the whole instruction guide carefully, because it contains valuable information in relation to the use of the bollard

  • Location of insertion
    • In upper or lower jaw at a safe distance away from the root apices of the teeth
    • most commenly on the infra-zygomatic crest of the maxillary buttress or in the lower canine region between lateral incisor and canine
    • the device may also be inserted on the paranasal crest or in the premolar or molar region of the mandible
  • Surgical technique

The devices are placed under local anesthesia. However, if problems of compliance are expected, especially in young children, it is recommended to place the devices under general anesthesia, or under local anesthesia combined with NO2 or IV sedation.
To reduce the risk for infections, placement of the medical devices should not be combined with extractions of teeth in the proximity of implant insertion.

When the package is not sealed or damaged, the medical device should be desterilized.

  • Orthodontist instructions

Refer to orthodontist for initial loading 2-3 weeks after surgery.
Initial loading should not exceed 100-150 grams and may be progressively increased if indicated for the ortodontic application

  • Patient instructions
    • Post surgical ice application and antiseptic mouth rinsing
    • Avoid any repetitive contacts by tongue, cheek or finger pressure
    • 1 week after surgery brushing with a soft tooth brush of the soft tissues around the medical devices

 

 

On the infra-zygomatic crest

 

An L-shaped incision is made with anterior convexity. The vertical part of the incision (1) is made ± 1cm mesial from and parallel to the infra-zygomatic crest and up to 2mm below the muco-gingival boarder. The incision is extended distally (2) with a horizontal incision 2mm below and parallel to the muco-gingival boarder.


A posterior based mucoperiosteal flap is made for bone exposure.

 

The miniplate is slightly bended to obtain good contact to the cortical bone. The bending should be limited to the region between the holes (1) in the mini plate. The connection between the miniplate and the neck should be slightly bended in the opposite direction (2) to ensure good contact between the lower part of the neck and the alveolar bone (3).

 

The device is positioned so that the round connecting bar of the neck penetrates the soft tissues exactly at the angle of the L-shaped incision 2mm below the muco-gingival boarder. The centre of the holes in the miniplate should be on top of the infra-zygomatic crest. A first hole with a diameter of 1.65mm is drilled through the middle hole of the miniplate.

 

The first screw is not completely fixed in order to allow some rotation of the miniplate. The lower hole is drilled and the screw is inserted, followed by the upper one and all are fixed for a strong stable retention.

After rinsing with saline solution, closure is obtained in one plane with 4/0 resorbable sutures. The mucoperiosteal flap is positioned by the first suture just anterior from the neck of the bone anchor. Additional sutures are placed until good closure is obtained. The fixation unit should be oriented parallel to the alveolar bone with the blocking screw facing to the front.

 

In the lower canine region

 

An inverted L-shaped incision is made with an angle slightly superior to 90°.  The horizontal part of the incision is located 2 mm above de muco-gingival boarder.

 

A posterior based mucoperiosteal flap is made for bone exposure.

 

The device is positioned so that the round connecting bar of the neck penetrates the soft tissues at the angle of the L-shaped incision 2mm above the muco-gingival boarder. The centre of the holes in the miniplate should be in the middle of the axis of the 2 neighbouring teeth. A first hole is drilled through the upper hole of the miniplate at the level of the root apices.

 

The first screw is inserted but not completely fixed in order to allow some rotation of the miniplate. The second hole is drilled and the screw is inserted in the mandibular body and both are fixed for a strong stable retention.

After rinsing with saline solution, closure is obtained in one plane with 4/0 resorbable sutures. The mucoperiosteal flap is positioned by the first suture just anterior from the neck of the bone anchor. Additional sutures are placed until good closure is obtained. The fixation unit should be oriented parallel to the alveolar bone with the blocking screw facing to the distal.

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copyright Michaël De Baets