What's special about KAT System?
What's the ideal last drill size for my implant?
What is the difference between KAT system and other dental implant systems?
KAT system is different because:
1) All implants of KAT System have a single platform. This allows clinicians to use any abutment on any implant of KAT System. Also, the implant delivery system is simplified - there is only one implant driver for all implants, including One-piece implants.
2) All KAT implants have a solid body design which allows a significant increase in implant strength (440 N for two-piece 3.1 mm implants), surface area (due to deep threads) and insertion torques (over 100 Ncm) without compromising the integrity of the implant. Fatigue testing of 3.1 mm implants and 3.5 mm implants was done by an independent lab as part of FDA clearance process.
3) There is no microgap between abutments and implants of KAT System, as proved by an independent laboratory SEM Gap Analysis Test.
Where are KAT implants made?
KAT implants is a USA-based company, all KAT implants are made in USA.
How long have KAT implants been used?
KAT implants have been in clinical use since February of 2009.
Do you have problems with abutments coming loose?
KAT Implants has not received any reports of the implant abutments coming loose since the introduction of the system in 2009.
Are KAT implants One-piece or Two-piece implants?
KAT Implants are provided in both designs. Two-piece implants are available in 2.5, 3.1, 3.5, 4.3 and 5.0 mm diameters while One-piece implants are available in 2.5 and 3.0 mm diameters only. The difference is in the post length. One-piece implants are not designed to be used with abutments.
What is the shortest implant length that you sell?
6.0 mm length is available in 4.3 and 5.0 mm diameters.
How deep should I place the implants?
- Buccal bone margin the same level as the junction of the blasted and machined surfaces
Single extraction sites:
- Buccal bone margin the same level as the middle of the implant post
Multiple adjacent extraction sites or molar sites:
- Buccal bone margin about the same level as the top of the implant post
The other option is to use buccal gingival margin of the adjacent teeth as a reference point. Top of the implant post has to be at the same level as the buccal gingival margins of the adjacent teeth.
Where can 2.5 and 3.1 mm diameter tom-KAT implants be placed and which abutments can I use with these implants?
2.5 and 3.1 mm diameter implants are indicated for transitional and long-term applications in any area of the mouth. Any abutment of KAT system can be used with 3.1 mm diameter implants. 2.5 mm implants should not be used with angled abutments.
Can two-stage surgery be done with KAT implants?
Yes, just like with other type of implants.
Is it necessary to cover the threaded bore on top of the implant during two-stage surgery?
No. If soft tissue fills the threaded bore, it comes out attached to the flap during implant uncovering. If the threaded bore is exposed to the oral environment, the debris can be easily rinsed with air/water jet.
Is it necessary to close the healing abutment threaded bore?
No. Debris can be easily rinsed with air/water jet prior to healing abutment removal. Alternatively, cotton pellet and cavit, or other block-out material can be used.
What is the most common mistake made when placing KAT implants?
Placing the implant not deep enough, which will result in poor aesthetic outcome.
Do I have to use the reamer?
Yes. Reamer must be used prior to placement of any abutment, healing or final. If the reamer is not used, the abutment will bind on bone and torquing the abutment will move the implant out of the osteotomy. You may not notice it, but the extraction force may cause implant failure or abutment loosening.
Do I have to use the reamer during immediate placement?
Yes. It is impossible to see if the abutment is binding on one of the walls of the extraction socket. Reaming takes 1 minute, is done with a handpiece and will guarantee proper placement of the abutment.
Do I have to use the reamer if I want to place abutment that is bigger in diameter than the healing abutment?
Yes. Reamer will shape the hard and soft tissue to the size of the abutment. No need to retract the flap in this situation.
Do I have to flap prior to reaming during the second stage?
Yes, most of the time. Flap retraction allows for keratinized tissue preservation. If you have plenty of it, then reaming can be done without flap retraction.
How do I know if I completed reaming?
Reamer will stop against the implant post and will not advance any further. You may go up and down to verify this.
Do I have to irrigate during reaming?
No, use 100 RPM speed without irrigation. Same protocol when using the drills.
I have unexplained implant failures. What am I doing wrong?
There are several possible implant failure modes:
1) Bone overheating.
That's the most common one. You may use pilot drills at 1000 rpm with copious irrigation, but must replace them every 10-12 cycles and more often in the bone is dense. You also must go up and down pretty often while drilling at that speed. You have to remove the drill completely to allow cooling of the drill tip before plunging it down.
Or you can do what I do - run all drills at 100 rpm without irrigation. This way you can extend the life of pilot drills to maybe 30 cycles. I still "peck" in increments of about 2mm depth while drilling hard bone. If you see bone coming out white - that's a warning to take it very slow. I use all my drills at 100 rpm speed.
2) Bone overcompression.
If the implant is placed at torque exceeding 60 Ncm. I personally don't like to go over 45 Ncm. You can apply higher torques during the implant placement but don't leave it like that, rotate implant counter-clock, set the torque at 45 Ncm and finish placement with that torque.
3) Not reaming the bone prior to placement of the healing or other abutments.
Placement of the abutment without reaming will result in "pull-out" forces on the implant.
4) Implant placed with insufficient amount of torque.
"Spinners" are the implants you can rotate with fingers. Some of them will be fine, some will fail. Never ream bone or attach a healing abutment unless reverse torque exceeds 20 Ncm.
5) Implant contamination during placement.
If you brush the implant against the tooth, saliva gets on it, touch with gloves - discard the implant. Your gloves are not sterile at the point you are ready for implant placement. You touch pt's skin multiple times during procedure. If you need to place the implant somewhere during osteotomy adjustment, place it inside the pouch it came in, don't place it on a drape or gauze.
6) Implant is provided non-sterile.
Every batch of our implants gets checked for bioburden and sterility. Sterility test is done on 10 samples after the radiation (about 10 times less than the final dosage) is administered. We never had a positive result on any of the 10 samples from any of the batches since introduction of the system in 2009. The chance of the implant not being sterile is less than one in a million.
Driver does not disengage from implant/ implant falls from the driver
KAT implant drivers, both manual and handpiece, are designed to securely carry the implant to osteotomy. Clinician has full control over how strong the connection between the driver and implant should be. This connection is activated by pressing the driver and implant together while the implant is still located in a protective PE pouch. Retention amount can be easily verified by simply pulling on a driver while holding PE pouch with implant in the other hand. If connection is deemed too weak, push the driver and implant more.
In order to disengage the driver from implant the driver has to be tilted back and forth lightly a few times (up to 15 times if parts are pressed very hard). Even if the driver and implant are pressed together extremely hard, this rocking motion will break the seal and allow predictable disengagement.
- Press the driver and implant tight enough to carry implant to osteotomy, don't over-press;
- Verify secure fit by pulling on a driver while the implant is still located in a PE pouch;
- Rock the driver side to side to disengage with light pressure multiple times. Don't pull on it or apply excessive pressure.
What's the ideal last drill size for my implant?
It is impossible to predict every clinical situation, such as bone density and other factors. The best we can do is to make suggestions based on our experience.