[Prosthetics]  Angled driver

I just delivered two screw retained implant crowns 25 and 26. I struggled with the angulation of the 26 due to very difficult access as the patient had limited opening. As a result the 26 was leaning to the buccal. Nick from SkyCad indicated that I would need to use the angled driver which Id rather do then cement retained.

I didnt realized until delivery appointment that the angled driver does not fit into the hiossen torque wrench so I have hand tightened 26 for the time being.

2 questions:

1. Is there a special torque wrench for the angled driver tool that has a green ring on it and is from Surgical Smart (Purhchased from them at a bites course).

2. Is there an extension on the market that is maybe 1/2 or 2/3 the size of the extension that comes with the Hiossen kit for cases where access is an issue but you need some length for visibility and access to the edentulous area?

Dr. Storey

by Stefano Storey at Mon, Aug 8, 2016 12:36 AM

1261 Views | 3 Replies | Avg Rating : 5.00


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Stefano Storey Replied at Thu, Aug 11, 2016 12:06 AM

Thanks guys i was unaware that they also carried the wrench. If i could clarify my second question a bit more. I find alot of times with the hiossen kit and nobel as well when i was using it that the surgical drills alone are sometimes short. For example placing a 36 when 37 and 35 still exist i find the head of the drill gets close to the teeth and it can also be difficult to create and assess the initial osteotomy on the right angle Obviously by human nature you add on the extension and it can be extremely tight which can push your drill buccal to accomodate the tight space. Because nobel and hiossen overall drill lengths and extensions are similar is there a smaller extension I feel like sometimes i need 5-6mm more rather then the full amount the extension provides. Ironically a nobel rep told me today the biggest knock to their drill system is they are too short and hiossen are comparatively similar Dr kwon can you make hiossen enginneer a mid range extension lol Thoughts? Ideas?

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Mark Kwon Replied at Tue, Aug 9, 2016 9:19 PM

Hi Stefano, I use short ASC driver for posterior cases. Yes. You do need both length. Surg smart carries both and also carry the wrench as well. Drivers are dedigned to break deliberately at very high torque. As long as angle correction is not severe, you should be good. - mark

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Ho-Young Chung Replied at Mon, Aug 8, 2016 1:09 AM

Hey stefano. The angled driver comes in short and long. You need both as in certain situations you need short and in others you need long. The torque wrench is sold by surgical smart. Do not over torque using these drivers. The screw tends to strip on the side more often depending on the angle correction. For np Hiossen fixtures I torque abutment screw to 20ncm three times over 5 minute increments. For rp I do it to 30ncm. What's also important is that the crown is in implant protected occlusion in CO and no excursive contacts. With scrc screw will tend to loosen over time due to hyper occlusion. I prefer screw retained as well but sometimes cement retained is a better option depending on the situation. Ho-Young