Retrieval instrumentation Procedures manual Note: In order to improve readability, Nobel Biocare does not use ™ or ® in the running text. By doing so, however, Nobel Biocare does not waive any right to the trademark or registered mark and nothing herein shall be construed to the contrary. Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. 3 Contents Introduction Product overview Implant retrieval Instrument selection guide Basic procedure Advanced procedure Rescue kit 5 6 8 10 Abutment / clinical screw retrieval Instrument selection guide Basic procedure Advanced procedure Rescue kit 12 13 14 18 Abutment retrieval Instrument selection guide Abutment Release Pin Zirconia abutments Titanium abutments Rescue kit 20 21 22 24 25 Appendices Article list / reorder information Cleaning and sterilization Customer service worldwide 27 29 31 4 4 Rescue manual / introduction Product overview The retrieval instrumentation assortment consists of implant retrieval, abutment screw retrieval and abutment retrieval instruments for performing safe, efficient rescue procedures for all Nobel Biocare implants and implantbased restorations. Implant retrieval The assortment consists of the Implant Retrieval Instrument for basic implant retrieval procedures and trephine drills for more advanced procedures. Abutment / clinical screw retrieval The assortment consists of the Abutment Screw Remover for basic abutment / clinical screw retrieval procedures and reverse drills and abutment retrieval instruments for more advanced procedures. Abutment retrieval The assortment consists of a general Abutment Release Pin and dedicated abutment retrieval instruments for conical connection abutments in zirconia and titanium. Rescue manual / implant retrieval 5 Implant retrieval instrument selection guide Implant retrieval The instrument selection guide below can be used to match the correct Implant Retrieval Instrument, Implant Rescue Collar and Trephine Drill to the implant type. Implant type should be determined via patient records or standard imaging techniques prior to attempting implant retrieval. Implant Rescue Collar Trephine Drill ∅ 3.0 mm CC 3.0 – 3.2/4.0 ∅ 3.5 mm CC NP – 3.8/4.6 ∅ 4.3 mm ∅ 5.0 mm CC RP – 4.4/5.2 5.2/6.2 ∅ 5.5 mm CC WP – 5.6/6.6 ∅ 3.5 mm ∅ 4.3 mm* Tri-Ch NP Tri-Ch ∅ 3.5 3.8/4.6 4.4/5.2* ∅ 4.0 mm ∅ 4.3 mm ∅ 5.0 mm* Tri-Ch RP Tri-Ch ∅ 4.3 4.4/5.2 ∅ 5.0 mm ∅ 6.0 mm* Tri-Ch WP – 5.2/6.2 6.2/7.0* ∅ 6.0 mm Tri-Ch 6.0 – 6.2/7.0 ∅ 3.3 mm Ext Hex NP – 3.8/4.6 ∅ 3.75 mm ∅ 4.0 mm Ext Hex RP – 3.8/4.6** 4.4/5.2 ∅ 5.0 mm ∅ 6.0 mm Ext Hex WP – 5.2/6.2 6.2/7.0 Abutment screw retrieval Implant Retrieval Instrument Conical connection Abutment retrieval 5.2/6.2* Tri-channel connection External hex connection Note: Refer to page 11 for instrument article numbers. Appendices *NobelReplace Platform Shift ** For a diameter 3.75 implant that has lost the flange collar the 3.8/4.6 Trephine Drill may be used, followed by a 5 mm diameter implant if sufficient bone width is available. 6 Rescue manual / implant retrieval Basic procedure The Implant Retrieval Instrument may be used to remove an implant where the implant connection has been damaged and the ordinary implant driver cannot be used to remove it. In situations where the implant cannot be removed with the Implant Retrieval Instrument alone, due to strong osseointegration or other factors, refer to the advanced procedure on page 8. Note: The Implant Retrieval Instrument is a single-use instrument for one patient and one surgical treatment only. General precautions / warnings: – Do not use the Implant Retrieval Instrument for any purpose other than the removal of Nobel Biocare implants with internal conical connection, tri-channel connection or external hex connection. – It is strongly recommended that the implant retrieval instruments only be used with Nobel Biocare related implant and surgical instruments as combining components with different dimensions can lead to mechanical and/or instrument failure or damage the tissue. Decision tree for implant retrieval No Is the implant fractured or the implant connection is damaged? Yes Does the implant driver engage? No Can the implant screw channel be engaged? Can the osseointegration be broken? Yes Implant driver reverse mode Yes Implant Retrieval Instrument (see basic procurede p. 6) No Trephine Drill (see advanced procedure p.8) 1 Select Implant Retrieval Instrument Select the appropriate Implant Retrieval Instrument based on the implant connection, type and size from the instrument selection guide on page 5. Rescue manual / implant retrieval 7 Implant retrieval 2 Connect Implant Retrieval Instrument Connect the Implant Retrieval Instrument to the Manual Torque Wrench Adapter and Manual Torque Wrench Surgical. Abutment screw retrieval 3 Secure reverse mode Make sure that the Manual Torque Wrench Surgical is in reverse mode by ensuring the arrow is pointing in a counterclockwise direction. 4 Insert the Implant Retrieval Instrument into the implant. Place the Implant Retrieval Instrument into the implant. Abutment retrieval Note: For removal of NobelReplace NP ∅ 3.5 or RP ∅ 4.3 implants with internal tri-channel connection, where the connection has collapsed, an Implant Rescue Collar and Handle may be used for implant removal. Implant Rescue Collar and Handle 5 Unscrew implant Unscrew the implant in a counterclockwise direction using the Manual Torque Wrench Surgical. Warning: Excessive torque on the Implant Retrieval Instrument may damage or fracture bone structures. Note: If the implant cannot be removed without applying excessive torque, please consider using a Trephine Drill. Appendices 8 Rescue manual / implant retrieval Advanced procedure In situations where an implant cannot be removed with the Implant Retrieval Instrument, due to strong bone integration or other factors, trephine drills may be used to remove bone around the implant in order to remove the damaged implant. It may not be possible to immediately place an implant after using a Trephine Drill due to the size of the resulting hole and/or other factors. 1 Select Trephine Drill – Select appropriate Trephine Drill based on implant diameter according to laser-marking. – The Trephine Drill selected should have an inner diameter slightly exceeding the outer diameter of the implant. – If the implant type is known, select the appropriate Trephine Drill based on the implant connection / prosthetic interface from the instrument selection guide on page 5. – If implant type is not known, the implant diameter must first be determined using standard imaging techniques. Note: Trephine drill depth markings are in true millimeters. Warning: To avoid oversized osteotomies, no oversized Trephine Drill should be used. 2 Place Trephine Drill – Place the Trephine Drill over the implant after the connected abutment / prosthetics have been removed. Optionally, a straight Multi-unit abutment may be used to guide the Trephine Drill into the proper position. Note: Trephine Drills are single-use instruments for one patient and one surgical treatment only. Do not use for any purpose other than the removal of bone outside an implant. Caution: Location of vital anatomical structures should be verified with X-ray images before implant retrieval. 16 mm 13 mm 10 mm 7 mm 0 mm 13 mm implant Rescue manual / implant retrieval 9 Implant retrieval 3 Drilling Start the drilling procedure using low speed and copious irrigation. When the Trephine Drill has gripped into the bone, the optional straight Multi-unit Abutment can be removed and the speed can be increased. Start speed 60–100 rpm 1200–1500 rpm Warnings: –D o not apply excessive pressure as breakage can occur. – Instruments can wear out over time. If the cutting function becomes reduced, replace the Trephine Drill with a new one. –D uring the drilling procedure care must be taken to prevent adjacent vital structures being damaged as a result of the increased width of the implant being removed. – It is recommended to use the depth markings on the Trephine Drills as landmarks in order to ensure that the drill does not progress deeper than planned. This could result in damage to vital structures. Abutment retrieval Cautions: –G enerous cooling is important when using Trephine Drills to avoid overheating. –S teady handling is strongly recommended as a Trephine Drill may jump sideways abruptly before fully surrounding the implant. Abutment screw retrieval Maximum speed 4 Remove implant Stop drilling before the full depth of the implant is reached. Wiggle back and forth to remove implant and Trephine Drill. Appendices 10 Rescue manual / implant retrieval Rescue kit 37470 Implant Retrieval Kit ––Includes instruments to remove implants ∅ 3.0, 3.3, 3.5, 3.75, 4.0, 4.3, 5.0, 5.5 and 6.0 mm. ––For NobelActive, NobelParallel CC, NobelReplace Conical Connection, NobelReplace Platform Shift, NobelReplace and Replace Select Tapered and Straight, Brånemark System, NobelSpeedy, and NobelDirect (Groovy, Oval and Posterior). 37514 37473 37474 37475 37927 37480 37472 37471 37476 37478 37479 37477 37928 37929 37930 37931 37932 Rescue manual / implant retrieval 11 Implant retrieval Implant Retrieval Kit 37470 (The articles below can also be purchased individually) Kit includes Implant Retrieval Instrument Ext Hex and Tri-Channel NP/RP 22 mm 37471 Implant Retrieval Instrument Ext Hex and Tri-Channel NP/RP 31mm 37472 Implant Retrieval Instrument CC 3.0 31mm 37473 Implant Retrieval Instrument CC NP and Ext Hex WP 22 mm 37474 Implant Retrieval Instrument CC RP and Tri-Channel WP 22 mm 37475 Implant Retrieval Instrument CC WP 22 mm 37927 Implant Retrieval Instrument Tri-Channel 6.0 22 mm 37476 Trephine Drill 3.2/4.0 mm 37477 Trephine Drill 3.8/4.6 mm 37928 Trephine Drill 4.4/5.2 mm 37929 Trephine Drill 5.2/6.2 mm 37930 Trephine Drill 5.6/6.6 mm 37931 Trephine Drill 6.2/7.0 mm 37932 Implant Rescue Collar Tri-Channel ∅ 3.5 37478 Implant Rescue Collar Tri-Channel ∅ 4.3 37479 Handle for Implant Rescue Collar and Drill Guides 37480 Implant Retrieval Wall Chart 37602 Abutment retrieval 37514 Abutment screw retrieval Implant Retrieval Kit Box Appendices 12 Rescue manual / abutment screw retrieval Abutment / clinical screw retrieval instrument selection guide The instrument selection guide below can be used to match the correct abutment / clinical screw retrieval instruments to the implant type. Implant type should be determined via patient records or standard imaging techniques prior to attempting to retrieve a screw. Abutment Screw Remover Rescue Drill Guide Reverse Drill Screw Retrieval Instrument Screw Tap Repair ∅ 3.0 mm 3.0 3.0 3.0 3.0 M1.4 ∅ 3.5 mm NP NP NP NP M1.6 ∅ 4.3 mm ∅ 5.0 mm RP RP RP RP M2 ∅ 5.5 mm WP WP WP WP M2 ∅ 3.5 mm ∅ 4.3 mm* NP NP NP NP M1.8 ∅ 4.0 mm ∅ 4.3 mm ∅ 5.0 mm* RP RP RP RP M2 ∅ 5.0 mm ∅ 6.0 mm* WP WP WP WP M2 ∅ 6.0 mm 6.0 6.0 6.0 6.0 M2 ∅ 3.3 mm NP NP NP NP M1.6 ∅ 3.75 mm ∅ 4.0 mm RP RP RP RP M2 ∅ 5.0 mm ∅ 6.0 mm WP WP WP WP M2.5 Conical connection Tri-channel connection External hex connection *NobelReplace Platform Shift Note: The abutment / clinical screw retrieval instruments are can be also used for the removal of broken abutment / clinical screws in NobelProcera Abutments, NobelProcera Implant Bridges and Implant Bar Overdentures, on implant level. Note: Refer to page 19 for instrument article numbers. Rescue manual / abutment screw retrieval 13 Basic procedure Implant retrieval If the head of an abutment screw breaks, the screw fragment frequently remains as a loose piece of metal within the implant. This can often be teased out of the threaded portion of the implant using hemostats or pliers. In situations where the Abutment Screw Remover alone cannot remove a broken screw, refer to the advanced procedure (reverse drilling) on page 14. It is strongly recommended that the abutment screw retrieval instruments are used only with Nobel Biocare related prosthetic components and surgical instruments. Combining components with different dimensions can lead to mechanical and/or instrument failure or damage the tissue. Caution: Because of the small size of the prosthetic components, care must be taken that they are not swallowed or aspirated by the patient. Abutment screw retrieval The Abutment Screw Remover can be used to retrieve a broken abutment / clinical screw if part of the screw is left inside the implant screw channel and the fragment can be rotated (Abutment Screw Remover works for all Nobel Biocare screw retained restorations, both pre-fabricated and NobelProcera). Warning: Do not use the Abutment Screw Remover for any purpose other than the retrieval of a broken abutment / clinical screw. Decision tree for abutment screw retrieval Yes Is the abutment fractured at the screw head? Is the stuck screw fragment rotatable? Yes Abutment screw remover (see basic procedure p. 13) 1 No Reverse drilling instruments (see advanced procedure p. 14) 1 Select Abutment Screw Remover Select the appropriate Abutment Screw Remover from the instrument selection guide on page 12. Attach to either a handpiece or a Handle for Machine Instruments. 1 mm 2 3 Abutment retrieval No Hemostat/pliers 2 Remove screw – To remove the screw shaft from the implant, place the end of the Abutment Screw Remover onto the fractured screw and rotate counterclockwise while applying light pressure. – The teeth on the end of the instrument are designed to grab the screw and back it out. Note: For handpiece operation, ensure the drill unit is in reverse mode, maximum speed 50 rpm. 50 rpm Appendices Maximum speed 14 Rescue manual / abutment screw retrieval Advanced procedure In situations where an abutment / clinical screw cannot be removed with the Abutment Screw Remover alone as per the basic procedure on page 13, the following advanced procedure with reverse drilling instruments may be used to retrieve the screw. It is strongly recommended that the abutment screw retrieval instruments are used only with Nobel Biocare related prosthetic components and surgical instruments. Combining components with different dimensions can lead to mechanical and/or instrument failure or damage the tissue. Warning: Do not use the instruments for any purpose other than the retrieval of a broken abutment / clinical screw and for implant thread cleaning. Caution: Because of the small size of the prosthetic components, care must be taken that they are not swallowed or aspirated by the patient. 1 Select Rescue Drill Guide Select appropriate Rescue Drill Guide based on the implant connection / type and size according to laser-marking. 2 Attach Rescue Drill Guide Attach the Rescue Drill Guide to the handle and then connect it to the interface of the implant. The Rescue Drill Guide helps center the Abutment Screw Retrieval Reverse Drill on the screw. It also provides secure support during drilling. Rescue manual / abutment screw retrieval 15 Implant retrieval 3 Select Reverse Drill Select the appropriate Abutment Screw Retrieval Reverse Drill from the instrument selection guide on page 12. Connect to the handpiece. Abutment screw retrieval Recommended speed 1 mm A Abutment retrieval 4 Drill a hole Drill a hole to a depth of ~1 mm into the fractured screw. Markings on the drill can be used as a support to define the depth. Image shows drill markings of 1 mm (A). If the abutment screw is not broken, but shows a damaged screw head connection, drill a hole to the depth of the screw head without using the Rescue Drill Guide and the handle (B). In situations with broken abutment/clinical screws at thread level: Drill a hole to a depth of ~1 mm into the fractured screw. Marking on the drill can be used as a support to define the depth. Image shows drill markings of 1 mm (F). 2000 rpm Notes: – Ensure the drill unit is in reverse mode. Recommended speed is 2000 rpm. – The Rescue Drill Guide can be heated by the drill. Always hold the Rescue Drill Guide with the handle. – To avoid shavings clogging the guide channel, release the Rescue Drill Guide and air-blast during the procedure. B Warning: The Abutment Screw Retrieval Reverse Drill may damage the implant's internal threads and make the implant unusable. Caution: Generous cooling is important when using the Abutment Screw Retrieval Reverse Drill to avoid overheating. Appendices 16 Rescue manual / abutment screw retrieval 5 Loose abutment screw During the drilling sequence the fractured abutment / clinical screw might come loose. 6 Connect Abutment Screw Retrieval Instrument If the fractured screw is still stuck, remove the Rescue Drill Guide and connect the Abutment Screw Retrieval Instrument to the Handle for Machine Instruments. 7 Remove abutment / clinical screw – Place the tip of the Abutment Screw Retrieval Instrument into the hole in the screw and rotate the handle in a counterclockwise direction (A). Add light pressure until the instrument grips the screw and the screw can be removed. – If the fractured screw cannot be removed with the Handle for Machine Instruments, connect the Abutment Screw Retrieval Instrument to the Manual Torque Wrench Adapter and Manual Torque Wrench Surgical in order to generate more torque (B). – If the Abutment Screw Retrieval Instrument cannot grab the screw, drill further and try again. A B Rescue manual / abutment screw retrieval 17 Implant retrieval Recommended speed 50 rpm Abutment screw retrieval 8 Clean implant threads –B efore a new screw is placed, it is recommended to evaluate the threads inside the implant for damage. This can be done with a guide pin, a screw from an impression coping, or a healing abutment. If resistance is encountered, a Screw Tap Repair may be used to re-establish the thread design. In this case, select the appropriate Screw Tap Repair from the instrument selection guide on page 12. –C onnect the Screw Tap Repair to the Handle for Machine Instruments or to the handpiece. Recommended speed is 50 rpm. –A fter successful screw removal, a new screw can be inserted. Abutment retrieval Appendices 18 Rescue manual / abutment screw retrieval Rescue kit 37481 Abutment Screw Retrieval Kit ––Includes instruments to remove abutment / clinical screws. ––For all Nobel Biocare abutment / clinical screws. 37515 37505 37506 37507 37485 29161 37501 37480 37503 37504 37487 37489 37933 37490 37502 37491 37483 37484 37497 37500 37498 37517 37499 37486 37488 37482 Rescue manual / abutment screw retrieval 19 Implant retrieval Abutment Screw Retrieval Kit 37481 (The articles below can also be purchased individually) Kit includes Rescue Drill Guide External Hex NP 37482 Rescue Drill Guide External Hex RP 37483 Rescue Drill Guide External Hex WP 37484 Rescue Drill Guide Conical Connection 3.0 37485 Rescue Drill Guide Conical Connection NP 37486 Rescue Drill Guide Conical Connection RP 37487 Rescue Drill Guide Conical Connection WP 37933 Rescue Drill Guide Tri-Channel NP 37488 Rescue Drill Guide Tri-Channel RP 37489 Rescue Drill Guide Tri-Channel WP 37490 Rescue Drill Guide Tri-Channel 6.0 37491 Screw Tap Repair M1.4 37497 Screw Tap Repair M1.6 37498 Screw Tap Repair M1.8 37499 Screw Tap Repair M2 37517 Screw Tap Repair M2.5 37500 Abutment Screw Retrieval Reverse Drill 3.0/NP 37501 Abutment Screw Retrieval Reverse Drill RP/WP/6.0 37502 Abutment Screw Retrieval Instrument 3.0/NP 37503 Abutment Screw Retrieval Instrument RP/WP/6.0 37504 Abutment Screw Remover 3.0 37505 Abutment Screw Remover NP 37506 Abutment Screw Remover RP/WP/6.0 37507 Handle for Implant Rescue Collar & Drill Guides 37480 Handle for Machine Instruments 29161 Abutment Screw Retrieval Wall Chart 37603 Abutment retrieval 37515 Abutment screw retrieval Abutment Screw Retrieval Kit Box Appendices 20 Rescue manual / abutment retrieval Abutment retrieval instrument selection guide The instrument selection guide below can be used to match the correct Abutment Release Pin, Abutment Retrieval Zirconia Instrument and Abutment Retrieval Titanium Instrument to the abutment type. Abutment Release Pin Abutment Retrieval Zirconia Abutment Retrieval Titanium ∅ 3.0 mm 3.0 – – ∅ 3.5 mm NP NP NP ∅ 4.3 mm ∅ 5.0 mm RP RP RP ∅ 5.5 mm WP WP WP Conical connection Note: Refer to page 26 for instrument article numbers. Rescue manual / abutment retrieval 21 Abutment Release Pin Implant retrieval The Abutment Release Pin may be used to remove intact abutments if the abutment is stuck in the implant due to the tight conical seal. 1 Remove abutment / clinical screw Remove the abutment / clinical screw using the Unigrip Screwdriver. Note: Prior to using the Abutment Release Pin, the abutment / clinical screw needs to be removed. Abutment screw retrieval The Abutment Release Pin CC 3.0 can be used to remove intact titanium and gold alloy abutments from NobelActive 3.0 implants. The Abutment Release Pin CC NP and RP/WP can be used to remove intact zirconia abutments (NobelProcera zirconia restorations, Procera Esthetic Abutment) from Nobel Biocare implants with conical connection NP and RP/WP, respectively. In cases where the abutment cannot be removed with the Abutment Release Pin, the Abutment Retrieval Instrument Zirconia CC and the Abutment Retrieval Instrument Titanium CC may be used to remove zirconia (including metal adapter) and titanium abutments, respectively. Note: The abutment screw must be unthreaded from both the internal threads of the implant and the abutment. If the loose abutment / clinical screw is difficult to remove, use a small amount of sticky wax on the tip of the Unigrip Screwdriver, which will aid retention of the abutment screw head. Abutment retrieval 2 Insert Abutment Release Pin – Select the appropriate Abutment Release Pin from the instrument selection guide on page 20. – Insert Abutment Release Pin into the abutment until it reaches a stop. 3 Wiggle Abutment Release Pin Loosen the abutment from the implant by gently wiggling the Abutment Release Pin. Appendices 22 Rescue manual / abutment retrieval Zirconia abutments The Abutment Retrieval Instrument Zirconia for conical connection abutments may be used to remove both prefabricated or NobelProcera “one piece” Zirconia Abutments if the abutment is stuck in the implant due to the tight conical seal, or the NobelProcera ASC Abutment, if the metal adapter is stuck in the implant due to the tight conical seal. General precautions / warnings: – It is strongly recommended that the abutment retrieval instrument is used only with Nobel Biocare (pre-fabricated and NobelProcera CAD/CAM) zirconia abutments with conical connection as combining components with different dimensions can lead to mechanical and/or instrument failure or damage the tissue. –D o not use the retrieval instrument for removal of titanium abutments. 1 Remove abutment / clinical screw ––For abutments without adapter (A), remove the abutment / clinical screw using the Unigrip Screwdriver. ––For abutments with metal adapter NobelProcera Angulated Screw Channel (ASC) (B), remove the abutment / clinical screw using the Omnigrip Screwdriver. The metal adapter stays in place. Note: The abutment screw must be unthreaded from both the internal threads of the implant and the abutment. If the loose abutment / clinical screw is difficult to remove, use a small amount of sticky wax on the tip of the Unigrip Screwdriver, which will aid retention of the abutment screw head. A B I II 2 Insert engaging pin ––The abutment retrieval instrument consists of two pieces, engaging pin (I) and activating needle (II). ––Insert the engaging pin into the abutment / metal adapter of the abutment until it reaches a stop. Note: The engaging pin has to be pushed in rather firmly to reach its end stop. There is first an intermediate stop that has to be passed before the pin is in final position. Rescue manual / abutment retrieval 23 Implant retrieval 3 Assemble instrument Assemble the instrument by inserting the activating needle. Abutment screw retrieval A B A B A B 4 Squeeze instrument Squeeze the abutment retrieval instrument parts together using e.g. a hemostat or pliers until the abutment (A) or the metal adapter (B) is released. Appendices 6 Remove instrument Remove the activating needle first and then pull the engaging pin from the abutment or the metal adapter by hand. Abutment retrieval 5 Remove abutment Remove abutment (A) or metal adapter (B) together with and the abutment retrieval instrument from the implant together. 24 Rescue manual / abutment retrieval Titanium abutments The Abutment Retrieval Instrument Titanium may be used to remove a titanium abutment if the abutment is stuck in the implant connection due to the tight conical seal. General precautions / warnings: – It is strongly recommended that the abutment retrieval instrument is only used with Nobel Biocare titanium abutments with conical connection as combining components with different dimensions can lead to mechanical and/or instrument failure or damage the tissue. 1 Remove abutment / clinical screw Remove the abutment / clinical screw using the Unigrip Screwdriver. 2 Insert Abutment Retrieval Instrument Insert the Abutment Retrieval Instrument Titanium into the abutment and screw it into place using the Unigrip Screwdriver until the tip of the screw touches the bottom of the hole inside the implant screw channel. 3 Release abutment Apply torque to the Unigrip Screwdriver to release the abutment from the implant. You need to turn the screw clockwise and, as the threads of the screw are designed counterclockwise, the abutment is lifted. Note: The abutment screw must be unthreaded from both the internal threads of the implant and the abutment. Use of a small amount of sticky wax on the tip of the Unigrip Screwdriver will aid in retention of the abutment screw head. –D o not use the abutment retrieval instrument for any purpose other than the removal of titanium abutments for implants with internal conical connection with NP, RP or WP prosthetic interface. o not use the retrieval instrument for removal of zirconia –D abutments. Rescue manual / abutment retrieval 25 Rescue kit Implant retrieval Abutment screw retrieval 37508 Abutment Retrieval Kit ––Includes instruments to remove abutments. ––For Temporary Abutment Engaging, Immediate Temporary Abutment, Procera Esthetic Abutment, Esthetic Abutment, Snappy Abutment, Narrow Profile Abutment, GoldAdapt Engaging, Multi-Unit Abutment, Brånemark System Zygoma Multi-unit Abutment, NobelProcera Zirconia Abutment, NobelProcera Titanium Abutment, NobelProcera ASC Zirconia Abutment, NobelProcera FCZ Implant Crown. 37509 37511 37882 36247 37881 Abutment retrieval 37512 37510 Appendices 26 Rescue manual / abutment retrieval Abutment Retrieval Kit 37508 (The articles below can also be purchased individually) Kit includes Abutment Retrieval Kit Box 37516 Abutment Retrieval Instrument Zirconia CC NP 37512 Abutment Retrieval Instrument Zirconia CC RP/WP 37882 Abutment Retrieval Tool Titanium CC NP 36247 Abutment Retrieval Tool Titanium CC RP/WP 37881 Abutment Release Pin CC 3.0 37509 Abutment Release Pin CC NP 37510 Abutment Release Pin CC RP/WP 37511 Abutment Retrieval Wall Chart 37604 Rescue manual // appendices 27 Article list / reorder information Implant retrieval Single-use instruments Single-use instruments are delivered sterile and are for one patient and one surgical treatment only. 37477 37928 37929 37930 37931 37932 Abutment Screw Remover Abutment Screw Remover 3.0 Abutment Screw Remover NP Abutment Screw Remover RP/WP/6.0 37505 37506 37507 Abutment Screw Retrieval Reverse Drill Abutment Screw Retrieval Reverse Drill 3.0/NP Abutment Screw Retrieval Reverse Drill RP/WP/6.0 37501 37502 Abutment Screw Retrieval Instrument Abutment Screw Retrieval Instrument 3.0/NP Abutment Screw Retrieval Instrument RP/WP/6.0 37503 37504 Screw Tap Repair Screw Tap Repair M1.4 Screw Tap Repair M1.6 Screw Tap Repair M1.8 Screw Tap Repair M2 Screw Tap Repair M2.5 37497 37498 37499 37517 37500 Appendices Trephine Drill Trephine Drill 3.2/4.0 mm Trephine Drill 3.8/4.6 mm Trephine Drill 4.4/5.2 mm Trephine Drill 5.2/6.2 mm Trephine Drill 5.6/6.6 mm Trephine Drill 6.2/7.0 mm Abutment retrieval 37471 37472 37473 37474 37475 37476 37927 Abutment screw retrieval Implant Retrieval Instrument Implant Retrieval Instrument Ext Hex and Tri-Channel NP/RP 22 mm Implant Retrieval Instrument Ext Hex and Tri-Channel NP/RP 31 mm Implant Retrieval Instrument CC 3.0 31 mm Implant Retrieval Instrument CC NP and Ext Hex WP 22 mm Implant Retrieval Instrument CC RP and Tri-Channel WP 22 mm Implant Retrieval Instrument Tri-Channel 6.0 22 mm Implant Retrieval Instrument CC WP 22 mm 28 Rescue manual // appendices Reusable instruments Reusable instruments are delivered non-sterile and must be cleaned and sterilized prior to use. Refer to cleaning and sterilization guidelines on page 29 for details. Implant Rescue Collar Implant Rescue Collar Tri-Channel ∅ 3.537478 Implant Rescue Collar Tri-Channel ∅ 4.337479 Rescue Drill Guide Rescue Drill Guide External Hex NP Rescue Drill Guide External Hex RP Rescue Drill Guide External Hex WP Rescue Drill Guide Conical Connection 3.0 Rescue Drill Guide Conical Connection NP Rescue Drill Guide Conical Connection RP Rescue Drill Guide Conical Connection WP Rescue Drill Guide Tri-Channel NP Rescue Drill Guide Tri-Channel RP Rescue Drill Guide Tri-Channel WP Rescue Drill Guide Tri-Channel 6.0 37482 37483 37484 37485 37486 37487 37933 37488 37489 37490 37491 Handle for Machine Instruments Handle for Machine Instruments Handle for Implant Rescue Collar and Drill Guides 29161 37480 Abutment Release Pin Abutment Release Pin CC 3.0 Abutment Release Pin CC NP Abutment Release Pin CC RP/WP 37509 37510 37511 Abutment Retrieval Instrument Zirconia Abutment Retrieval Instrument Zirconia Conical Connection NP Abutment Retrieval Instrument Zirconia Conical Connection RP/WP 37512 37882 Abutment Retrieval Instrument Titanium Abutment Retrieval Instrument Titanium Conical Connection NP Abutment Retrieval Instrument Titanium Conical Connection RP/WP 36247 37881 Rescue manual // appendices 29 Cleaning and sterilization Implant retrieval Sterile components The devices delivered sterile have a “Sterile” marking on the label. Sterile products intended for single use must not be used if the expiration date (see label) has passed and/or the packaging is damaged before use or is already open. Abutment screw retrieval Non-sterile components Reusable instruments should be replaced when their efficiency declines. Worn-out or damaged instruments need to be discarded and replaced with new instruments. Abutment retrieval Care and maintenance of reusable instruments and drills are crucial for successful treatment. Well-maintained instruments not only safeguard your patients and staff against infection, but are also essential for the overall treatment outcome. For additional information on cleaning and sterilization please consult the Cleaning and sterilization guidelines for Nobel Biocare products available at www.nobelbiocare.com/sterilization or request the latest printed version from a Nobel Biocare representative. Appendices 30 Rescue manual // appendices Rescue manual // appendices 31 Customer service worldwide Implant retrieval Europe, Middle East and Africa Russia Brazil Austria Nobel Biocare Russia Nobel Biocare Brazil Nobel Biocare Austria Phone: +7 495 974 77 55 Phone: 0800 16 999 6 Phone: +43 1 892 89 90 South Africa Canada Belgium Nobel Biocare South Africa Nobel Biocare Canada Nobel Biocare Belgium Phone: +27 11 802 0112 Phone: +1 800 939 9394 Phone: +32 2 467 41 70 Spain Chile Denmark Nobel Biocare Spain Dental Biocare Nobel Biocare Denmark Phone: +34 900 850 008 Phone: +56 220 19282 Phone: +45 39 40 48 46 Sweden Colombia Finland Nobel Biocare Sweden Hospimedics S.A. 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