Implant Puncher Usage for Dental Implants
The implant puncher is used to gently remove mucous membrane prior to an implantation.
In the image you see an implant puncher; during an operation, it’s mounted to a handpiece. Here you see an illustration showing you the function of the puncher. The puncher only removes enough mucous membrane to cover the width of the implant.
In the video "Punch" you see the puncher in action. The patient has no teeth in the upper jaw and doesn’t feel comfortable with the palate of this full prosthesis. In order to spare him the palate part, two implants are placed; as you can see, this is done with the punching method; cutting and stitching are not always necessary during an implantation.
After punching, the bone is processed with special drills. Finally, the implant is placed – more on that in the video "Implantation". In this case, ball anchors are screwed onto the implants to hold the prosthesis in place. Thus, a plastic palate is not required, because the suction effect of the prosthesis is no longer necessary for holding it in place. Such minimally invasive operations greatly increase the wearing comfort of full prostheses. In addition, thanks to the punching method, the operation is possible for almost any patient due to its low impact.
Punching is not always useful. Our gums consist of a movable layer – known as Gingiva libra – and a solidly attached layer (Gingiva fixa). After the loss of a tooth, the Gingiva fixa often recedes and sometimes, only a thin strip is left. There is some evidence that in cases where the Gingva fixa is missing, more plaque develops on the implant tooth on the side facing the tongue. Thus, a good bond between the Gingiva fixa and the implant is of great significance for the durability of the implant. In general, there is more Gingiva fixa present in the upper jaw than in the lower jaw, so in most cases, punching can be performed in the upper jaw. It’s different in the lower jaw. So if there is not enough Gingiva fixa prior to an implantation, punching should not be performed because the puncher removes it completely – in that case, it’s better to make a small cut to push the mucous membrane to the side. Thus, a strip of solid gingiva remains on each side of the implant. It’s important that these instruments, as well as all surgical instruments, are used in a sterile manner.
Here you see a surgical container – the surgical instruments are neatly arranged side by side and are thus ideally placed for the sterilization process. Prior to surgery, the container is opened and the surgical instruments can be taken out with sterile gloves – the sterility chain is maintained. The use of surgical containers is standard in hospitals, but not in medical practices.
If you are to undergo an implantation, bone augmentation surgery or an intervention of a different kind, pay special attention to hygiene – sterile instruments are not the rule! Complicated wound infections and bone infections could be the result – more on that in the videos