The trephine drill (TD) technique. (A) The trephine drill is selected to match the diameter of the failing implant. (B) Before using the trephine drill for the removal of a Straumann Standard or Standard Plus implant, the polished neck is trimmed with a diamond bur to the size of the implant body diameter. 

Contexts in source publication

Context 1

... neo bur-elevator-forceps technique (hBEF) This technique commences with the re- moval of bone mesially and distally from the implant, aiming towards the apex. Round and/or fissure burs (No. 1) are used, with copious running saline, trying to maintain a close distance to the implant surfaces ( Fig. 2A). The implant head is grasped with the corresponding tooth/Lyer forceps and turned clockwise and anti- clockwise. When resistant to such attempted movements, a thin straight ele- vator (Couplands elevator No. 3) is placed into the mesial and distal crevices, inter- mittently applying small gentle rotating movements similar to those used for the extraction of buried roots, until the im- plant is noted to be slightly tilted to one side (Fig. 2B). Then, the elevator is placed into the crevice on the contralateral side and similar movements performed. The implant head is then grasped with dental extraction forceps and gentle rocking movements applied, pushing it mesially and distally only, thus preserving both the facial and the lingual cortical plates (Fig. 2B). When little resistance is felt, the implant is removed with a final anti- clockwise rotation leaving an ovoid defect (Fig. 2C). An appropriate trephine drill with a diam- eter and length corresponding to the size of the implant to be removed is selected (Fig. 3A). The healing abutment or abut- ment/crown is unscrewed and a mucoper- iosteal flap raised if necessary. The trephine drill is sunk over the implant into the bone using low speed 50-80 rpm dril- ling and light pressure with running saline cooling. A hole is drilled taking care that the trephine has been sunk to the exact depth by controlling the outside rings on the drill. For implant systems that do not provide a guiding cylinder/pin, a healing abutment of smallest emergence profile diameter is mounted before using the tre- phine. For Straumann Standard and Stan- dard Plus implants, the polished neck is reduced with a high-speed diamond drill to correspond to the diameter of the guided cylinder (Fig. 3B). In the event that the implant is still firm after the trephine has been lifted (in cases of insufficient drilling depth), a Couplands elevator is placed into the empty space and lightly twisted to break the bony connections, enabling easy removal of the implant using the finger- ...

Context 2

... neo bur-elevator-forceps technique (hBEF) This technique commences with the re- moval of bone mesially and distally from the implant, aiming towards the apex. Round and/or fissure burs (No. 1) are used, with copious running saline, trying to maintain a close distance to the implant surfaces ( Fig. 2A). The implant head is grasped with the corresponding tooth/Lyer forceps and turned clockwise and anti- clockwise. When resistant to such attempted movements, a thin straight ele- vator (Couplands elevator No. 3) is placed into the mesial and distal crevices, inter- mittently applying small gentle rotating movements similar to those used for the extraction of buried roots, until the im- plant is noted to be slightly tilted to one side (Fig. 2B). Then, the elevator is placed into the crevice on the contralateral side and similar movements performed. The implant head is then grasped with dental extraction forceps and gentle rocking movements applied, pushing it mesially and distally only, thus preserving both the facial and the lingual cortical plates (Fig. 2B). When little resistance is felt, the implant is removed with a final anti- clockwise rotation leaving an ovoid defect (Fig. 2C). An appropriate trephine drill with a diam- eter and length corresponding to the size of the implant to be removed is selected (Fig. 3A). The healing abutment or abut- ment/crown is unscrewed and a mucoper- iosteal flap raised if necessary. The trephine drill is sunk over the implant into the bone using low speed 50-80 rpm dril- ling and light pressure with running saline cooling. A hole is drilled taking care that the trephine has been sunk to the exact depth by controlling the outside rings on the drill. For implant systems that do not provide a guiding cylinder/pin, a healing abutment of smallest emergence profile diameter is mounted before using the tre- phine. For Straumann Standard and Stan- dard Plus implants, the polished neck is reduced with a high-speed diamond drill to correspond to the diameter of the guided cylinder (Fig. 3B). In the event that the implant is still firm after the trephine has been lifted (in cases of insufficient drilling depth), a Couplands elevator is placed into the empty space and lightly twisted to break the bony connections, enabling easy removal of the implant using the finger- ...