Preparation of Implant Site
After the bone is exposed the surgrcal guide template is positioned, and a periodontal probe is used to make a
preliminary assessment of potential implant sites (Fig. 14,47). The residual ridge may have areas of unevennessor sharp ridges that are best reduced with a rongeur before implant placement. . Placement procedures for all implant systems require . atraumatic preparation of the recipient site. A low-speed (1500 to 2000 revolutio s per minute [rpm]), high-torque
handpiece and copious irrigation are-necessary to prevent excess thermal injury to the pone. Irrigation may be externally applied or internally directed through the drills. Recommendations of the specific implant manufacturer should be followed, because they relate to the type of irrigation and the allowable speed of the drilling equipment. The implant recipient site is prepared by a series of gradually larger burs. All implant systems have an initial small-diameter dill that is used to mark the implant site (Fig. 14-48). The implant site is located using the surgical guide template, which may also assist in directing the angulation of the implant. With the initial drill the center of the implant recipient site is marked and the initial pilot hole is prepared. A paralleling pin is placed in the initial preparation to check alignment and angulation,(Fig. 14-49). Once the initial preparation for the implant is determined to be appropriate, it is sequentially enlarged to a . dimension that precisely conforms to the. dimensions of the implant. Cylindrical implant systems accomplish this with a series of progressively larger-diameter drills of the desired length. Each drill follows the path created by the previous drill.