Academy of Modern Dentistry

in association with
Dr Sachdeva's Trident Dental Clinic


Basic Surgical Principles - Implant Placement

Posted on 21 March, 2016 at 13:05

The basic surgical principles related to the placement of dental implants in partially

edentulous patients. Surgeons must take important measures preoperatively to prevent postsurgical infection, handle surgical instruments expertly to preserve soft tissues, and carefully accomplish adequate implant site preparation without overheating the bone. Precise surgical protocol includes the following precautions:

• Preoperative mouthwash with 0.1% chlorhexidine

• Perioral skin disinfection with alcohol solution

• Antibiotic prophylaxis 2 hours prior to surgery (eg, 2 g amoxicillin intraorally)

• Low-speed drilling (between 800 and 1200 rpm)

• Cooling spray during drilling with chilled sterile saline

• Intermittent drilling technique

• Use of sharp drills

It is important to perform a surgical procedure systematically, always applying the same surgical principles.


Once the implant surgical site has been exposed, a large round bur is used to smooth and level the crest of the alveolar ridge


Round bur is used to mark the position of the implant site



Initial implant site preparation is made with a 2.0-mm-diameter pilot drill


2.0-mm-diameter guide pin is inserted into the initial preparation to check its position and axis and a digital X ray is taken to confirm the same



Preparation of the implant site continues with the 2.8, 3.5-mm-diameter spiral drill (in increasing order)


A standard implant of 4.2 mm diameter is placed in the site, with the rough surface positioned at the level of the alveolar ridge crest. This allows the implant shoulder to be located at the gingival level


If the implant site is prepared with the 12-mm mark slightly below the crest, the rough border of the inserted implant will be positioned approximately 0.5 mm below the crest. This approach is most often used in posterior implant sites for a non-submerged implant healing


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