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Anesthetize the implant site. Infiltration anesthesia under mucogingival junction with 1/2 ample (1:100,000 2% lidocane) is enough.
Scrub the implant site with H₂O₂and dry with air.Drying the implant site will make the next step easier.
Mark the expected root form on keratinized gingiva with explorer. The root form is imagined in the panoramic X-ray.
Drill to the appropriate depth using a low-speed handpiece under copious irrigation with an isotonic saline solution. A drill speed of 1,000~1,500rpm and pressure of 10~15Ncm produce the best results. The 1.5mm-diameter guide drill is especially helpful when drilling through cortical bone( Leibinger Co. 1.5mm-diameter REF 01-08195 ). We feel the penetration sensation of drill when the drill perforates the cortical bone and we can see the bleeding as a result of penetration of drill to the cancellous bone. Drill to cortical bone depth only, not to cancellous bone . Drilling to cancellous bone can damage the root.
Remove the colored-coded cap from the sterile Cimplant package and then place the Cimplant body into the screw holder.
Assemble the Cimplant body to the screw driver. Axis of screw driver and axis of Cimplant body form a straight line.
Screw the body of the Cimplant clockwise into the prepared site. Screw until the top of Cimplant body is equal to gingival surface. You feel tightness in the final stage of screwing. This is normal.
Assemble the head into the Cimplant body using the appropriate instrument either immediately after implantation or 1-2 weeks later.
The method to assemble the head is as follows : Hold the head with hemostat and then insert the head into the Cimplant body inner hole. Insert the tip of explorer into the tube of the head and then rotate it with explorer to be parallel to the occlusal plane. Assemble the head part of Cimplant into the Cimplant body by lightly tapping with a small mallet 1 to 2 times. It helps to usea mirror holder to translate the mallet force to the head. Immediate loading is possible in areas of dense bone where stability is assured. However, the stability of the Cimplant should be confirmed four weeks after placement.
 
 
Instruments which need to be sterilized
① screw driver tip
② drill
③ Cimplant holder
Types of drill
① Long drill for low speed straight hand piece
② Short drill for low speed contra-angle hand piece
If we use a smaller-diameter drill, it makes a smaller hole in the alveolar bone. This may cause the Cimplant body to slip and the insertion of Cimplant body into the drilled hole more difficult. It is recommended to use the drill with correct size of diameter (1.5mm)
The main implantation site for Cimplant is the interdental space between the second premolar and first molar. If the interdental space of this area is too narrow or the alveolar bone is not enough due to extension of maxillary sinus, it should not be implanted. The next choice for the interdental space would be between the first molar and second molar.
 
Fig.1 The interdental space between the second premolar and first molar is sufficient. But too much apically positioned implantation may invade maxillary sinus and it is the cause of exfoliation.

Fig.2 The interdental space between the second premolar and first molar is not enough but the interdental space between the first molar and second molar is enough. In this case, the interdental space between the first molar and second molar is the implantation site.

 
Fig.3 The interdental space between the second premolar and first molar is enough and Cimplant is implanted horizontally.

Fig.4 The interdental space between the second premolar and first molar is not enough. Therefore theCimplant was vertically inclined. This doesn’t damage the periodontal ligament directly, but too close of an implantation to the periodontal ligament may be the cause of early exfoliation

Removal of Cimplant
Anesthetize the implant site topically. Then disassemble the head from the Cimplant body using a How plier (counter-clockwise rotates the Cimplant body using a screw drive). If it is hard to remove the Cimplant body using a screw driver, an orthodontic heavy wire plier can be used. Soft tissue is healed within a few days.
When early exfoliation occurs, re-implant Cimplant.
Mobility of Cimplant in 1 to 3 weeks after implantation means failure of implantation. In this situation, Cimplant should be removed and removal of Cimplant is usually done with head in Cimplant body. Removed Cimplant can be reused in the same patient.
The method to reuse is as follows : Separate the head from the Cimplant body and clean the removed Cimplant surface with water-spray. Sandblast(s) the Cimplant surface. Autoclave(s) the Cimplant and reuse it. If assembling the screw driver to Cimplant body in Cimplant holder is difficult due to loosening of binding, slightly squeeze the notch of Cimplant neck and try to assemble again. However, strongly squeezing the Cimplant may crush the neck structure.