Prep work

1. Wipe down entire area with Lysol 2. 2. Wash hands and use CHX scrub and then place non-sterile gloves. Entire room except light covers can be done with non-sterile gloves. Maybe suction sleeves?? 3. Set up room according to protocol. 4. Xray is up for patient and on screen in front of patient. 5. Patient is seated and is handed medical history form to review and sign and date. 6. Assistant dry mucosa with air/water syringe and place topical. 7. Confirm AB (if needed) and have patient take 600mg ibuprofen - ASK patient if they can take ibuprofen and say that it is to decrease post surgical inflammation and pain. 8. Implant consent form is reviewed with doctor and patient signs. 9. First step anesthetic by doctor 10. Give them CHX .12% rinse for 1 minute 11. Del. rest of 1 carp B and L 4% art. w/ 1:100k epi then1 carp 2% lido. w/ 1:50k epi 12. Place the patient drape and offer them light blocking glasses 13. Betadine or CHX facial scrub 14. Mouth prop (bite block) and sterile gauze Surgery 1. Sterile gloves 2. Midcrestal incision with #15, 15c, or 12 blade with two beveled vertical releasing incisions and reflection of tissue just like we do for surgical extractions. Scalpel from this day forward will be called #15, #15c, or #12. Never use word scalpel or blade again a. 12 used for lower first molars, sulcus b. 15 for lower anteriors c. 15c for lower first molars, midcrestal incisons, upper premolars 3. Remove all tissue from area, scrape area with curette and spoons 4. Careful lingual flap blunt dissection (watch genoid area) 5. Assistant holds flap closest to them and surgical suction 6. Seat guide if have 7. Osteotomy through hard cortical bone with locator drill first 8. First drill is the 2.3/2.0 and when it is 1/3 to 2/3 we stop 9. Place paralleling pin and check for angle and take PA 10. Finish drilling with 2.3 to length and then go to next size up 11. Continue increasing until big enough a. Undersize in maxilla b. Bone contourer in hard mand 11. Once osteotomy (bone hole) is right size then drive in implant at 35 NCm 12. With hand wrench (end with a flat side to buccal) 13. With motor start at 35 Ncm then increase 14. Measure and record final torque
15.Place healing cap or cover screw 16.Suture (cover perio patch or crazy glue?)

17. Anesthetic for the road (.5% bupivicaine) 18. Post op instructions and bottle CHX 19. ASK any questions

Implant surgical

Post op instructions
Soft food Peridex Continue AB if complicated 3x3x3 rule and pain meds if needed Post op instruction sheet day of surgery 2 follow-ups 4-7 days ensure no pain and suture is still sealed 4 months to uncover 2-6 weeks to take impression (OD 2 non-esthetic 4 esthetic 6)