Guided surgery with NobelActive®

NobelGuide® procedures manual

Note: In order to improve readability, Nobel Biocare does
not use ™ or ® in the running text. By doing so, however,
Nobel Biocare does not waive any right to the trademark
or registered mark and nothing herein shall be construed
to the contrary.

Disclaimer: Some products may not be regulatory

cleared/released for sale in all markets. Please contact
the local Nobel Biocare sales office for current product
assortment and availability.
 Guided surgery with NobelActive® Manual 3

Contents

Introduction NobelGuide treatment workflows 4

Surgical procedure quick guide 6
Checklist before surgery 8
Extended treatment options 9
Important drilling considerations 10

Pilot drilling + freehand Guided pilot drilling and freehand drill sequence 12
Required instruments 14
Surgical access 15
Detailed drilling sequence 16
Implant insertion 19
NobelActive 3.0 23

Fully guided Fully guided surgery 24

Required instruments 26
Special consideration 27
Surgical access 29
Detailed guided drilling sequence 32
Guided implant placement procedure 34
Guided implant placement – partially edentulous 36
Guided implant placement – edentulous 38

Product information Product overview 40

Surgical components for guided pilot drilling 41
Surgical components for fully guided surgery 42
Laboratory and prosthetic components 43
Cleaning and sterilization 44

Contact us Customer service worldwide 47

4 Guided surgery with NobelActive® Manual // Introduction

NobelGuide® treatment workflows

Single-tooth / partially edentulous workflow Edentulous workflow

The NobelGuide treatment workflow for the partially eden­tulous The NobelGuide treatment workflow for the edentulous patient
patient allows the clinician to combine a surface scan of the uses the so-called (CB)CT double scan protocol. A radio­graphic
mastercast and prosthetic tooth setup information with a guide is fabricated in the dental laboratory prior to the patient
(CB)CT scan of the patient. This (CB)CT scan can be taken scan. This is done either as a PMMA duplicate of a new diag-
at any time in the diagnostic process, and there is no need nostic tooth setup/wax-up or a metal-free optimized denture
for markers or a radiographic guide to be in place during the in which radiopaque markers are placed. The patient needs
patient scan. With this combined data in NobelClinician, impor- to be scanned wearing this radiographic guide in the correct
tant intra-oral information such as the soft tissue contour and ­position. A second scan is taken of the same radiographic
thickness can be visualized, and preliminary treatment plans guide alone. These two sets of data are imported into the
can be refined and finalized according to the desired prosthetic ­NobelClinician Software allowing for a prosthetic-­driven treat-
outcome. The user can go straight to surgery or choose, at ment planning. Once the treatment plan is finalized, the user
any point in the process, to order a surgical template for can go straight to surgery or choose, at any point in the pro-
­either guided pilot drilling or fully guided surgery. The surgi- cess, to order a surgical template for either guided pilot drilling
cal template is designed automatically with one click using or fully guided surgery. The surgical template is automatically
the digitized surface scan of the mastercast and is no longer created in NobelClinician, based on the shape information
a replica of a radiographic guide. provided by the radiographic guide. The radiographic guide
therefore has to be designed in the laboratory as a prosthetic
reference but the shape will also be used for the surgical tem-
plate. For optimal results it is advised to use the NobelGuide
Calibration Object as reference for automatic segmentation of
the scanned radiographic guide. This ­workflow can also be
used for partially edentulous patients.

Note: Current manual shows the surgical procedure

for guided pilot drilling and fully guided surgery with
NobelActive implants. Please refer to the NobelGuide
Concept Manual for instructions on the procedure for
preparing and ordering the surgical template.

Download it on: nobelbiocare.com/resources

 Guided surgery with NobelActive® Manual // Introduction 5

Introduction
Partially edentulous – Edentulous patients –
SmartFusion Radiographic guide

Pilot drilling + Freehand

Clinical examination

Dental cast / prosthetic Radiographic guide

(CB)CT scan
setup scan

(CB)CT double scan

Fully guided
Planning with NobelClinician

Ordering and production

of surgical templates

Guided surgery:

Product information
pilot drill or fully guided

Contact us
6 Guided surgery with NobelActive® Manual // Introduction

Surgical procedure quick guide

The protocols illustrate the use of NobelActive® RP 4.3 x 13 mm implants

Guided pilot drilling

+ freehand

OR

Depth reference Depth reference

Depth Probe Twist Drill ∅ 2.0

Mark drill position Guided drilling

Fully guided (if indicated) Guided Twist Drill ∅ 2.0
Guided Start Drill

Guided drilling
Guided Twist Step
Drill 2.4/2.8
 Guided surgery with NobelActive® Manual // Introduction 7

Introduction
Pilot drilling + Freehand
Drilling Drilling Implant placement
Twist Step Drill Twist Step Drill Implant Driver CC RP
2.4/2.8 3.2/3.6

Fully guided
Product information

Guided drilling Screw tapping Implant placement

Contact us

Guided Twist (Mandatory) Guided Implant

Step Drill 3.2/3.6 Guided Screw Tap Mount NobelActive
RP 4.3 RP 4.3
8 Guided surgery with NobelActive® Manual // Introduction

Checklist before surgery

Confirm ID tag on surgical template corresponds with treatment ID in the

NobelClinician Software (order manager)

Confirm the surgical template corresponds with the virtual treatment plan
in NobelClinician

Confirm NobelGuide Surgical Guidelines document (shipped with surgical

template)

Print treatment plan report from the NobelClinician Software

Verify optimal fit of the surgical template on stone model and/or clinically
in the patient before treatment

If adjustment is required, carefully modify the surgical template as required

with a lab bur

If adjusted, strengthen/reinforce the outer surface of the surgical template

with a compatible resin

Confirm that surgical index, if applicable, fits the surgical template and
patient’s opposing jaw when occluding

Confirm that all required implants, surgical components and instruments

have been ordered and received

Confirm prosthetic components, if applicable

Follow the treatment protocol from the correct patient treatment plan
report from NobelClinician (implants, length / diameter, drill depths),
according to the Nobel Biocare Instructions for Use (nobelbiocare.com)
 Guided surgery with NobelActive® Manual // Introduction 9

Extended treatment options

Introduction
Indications for use Considerations based on bone quality and quantity
NobelActive implants are endosseous implants intended to be Proceed with examination and treatment planning according
surgically placed in the upper or lower jaw bone for anchoring to established protocols.
or supporting tooth replacements to restore patient esthetics
and chewing function. Confirm available bone and significant anatomical landmarks

Pilot drilling + Freehand

such as blood vessels, nerves and concavities. Use conven-
NobelActive implants are indicated for single- or multiple-unit tional diagnostic tools, such as radiographic imaging, probing
restorations in splinted or non-splinted applications. This can and palpation, and 3D imaging if indicated.
be achieved with two-stage or one-stage surgical technique in
combination with immediate, early or delayed loading proto- Traditionally, the density of compact bone provides good
cols, recognizing sufficient primary stability and appropriate primary stability for the installed implant. To improve stability
occlusal loading for the selected technique. NobelActive 3.0 in softer bone qualities, the body of NobelActive is tapered. It
implants are intended to replace a lateral incisor in the maxilla is further enhanced by threads that increase in vertical thick-
and/or a central or lateral incisor in the mandible. NobelActive ness as insertion proceeds to condense bone. These features,
3.0 implants are indicated for single-unit restorations only. combined with the possibility for under-preparation of site
diameter in soft bone, allow for achievement of substantial
Contraindications stability also in predominantly cancellous bone sites (see drill
It is contraindicated to place NobelActive implants in patients: protocol based on bone quality page 13).
– who are medically unfit for an oral surgical procedure.
– with inadequate bone volume unless an augmentation pro- The amount of bone available for implant retention differs from

Fully guided
cedure can be considered. site to site. The implant is “active” enabling an angle change
– in whom adequate sizes, numbers or desirable positions of during insertion. This ability for redirection allows the implant
implants are not reachable to achieve safe support of func- to be inserted into available bone, for example within the pala-
tional or eventually parafunctional loads. tal wall of an anterior extraction socket, and then be redirected
– allergic or hypersensitive to commercially pure titanium for stabilization while establishing proper restorative alignment
grade 4, titanium alloy Ti-6Al-4V (titanium, aluminum, vana- (see page 24).
dium), stainless steel or DLC (diamond-like carbon) coating.
NobelActive 3.0 implants are not indicated to be used to re- To maintain vertical tissue dimension, be sure to allow at least
place a central incisor, a canine, a premolar or a molar in the 1.5  mm of bone both lingual to and buccal to the implant collar.
maxilla, nor to replace a canine, a premolar or a molar in the The special narrowing of the implant collar diameter allows for
mandible. NobelActive 3.0 implants are not indicated to be favorable ridge adaptation when crestal ridge width is limited.
used for multiple-tooth replacements.

Product information
Contact us
10 Guided surgery with NobelActive® Manual // Introduction

Important drilling considerations

Drills

––Drills are made of stainless steel with a diamond-like carbon (DLC)

coating, which gives them their black color. They are used with
external irrigation.
––Use an in-and-out motion during the drilling procedure to ensure cooling.
––Ensure the drills move freely and easily through all template sleeves
and/or drill guides before any drilling (prior to surgery).
––Check that irrigation is switched on and flowing.
––Start drilling with the drill in the template sleeve and/or drill guide.
––Avoid lateral pressure on drills when drilling. Lateral pressure may
damage the drill.

Maximum speed 800 rpm

Caution: Drills are for single use only and must not be reprocessed.
Reprocessing could cause loss of mechanical, chemical and / or bio-
logical characteristics. Re-use could cause cross contamination.

Note: Guided drills extend an additional 10 mm, indicated

as (10+).

Guided pilot drill

In certain clinical indications the default distance (10 mm) between

planned implant (implant shoulder) and pilot sleeve is not sufficient
(e.g., the implant needs to be placed deeper). In these indications the
pilot sleeve collides with the surface of the bone and/or soft tissue.
In order to create the surgical template, the pilot sleeve height can
be adjusted in the NobelClinician Software to avoid contact with the
bone and/soft tissue.

Note: Confirm the correct guided pilot drill depth by consulting the
printed treatment plan report from NobelClinician and/or the NobelGuide
­surgical guidelines included in the surgical template package.

Fully guided

The default distance between the planned implant (implant shoulder)

and the fully guided sleeve is 9 mm and the height of the Guided Drill
Guides is 1 mm. The NobelGuide s­ urgical instrumentation is designed
with these measurements in mind.

1 mm

9 mm
 Guided surgery with NobelActive® Manual // Introduction 11

Introduction
Drill Stops

––Mount a drill stop on Twist Drills for a safe and accurate

drilling procedure.
––Insert the Guided Twist Drill with the corresponding drill
stop in a mounting hole with a depth corresponding to the

Pilot drilling + Freehand

planned depth of the osteotomy.
––Use the larger holes for drills ∅ 3.4 and above.
––Tighten the screw using a Screwdriver Unigrip.
––The Drill Stop is now mounted at a height where it serves
as a hard stop when drilling the desired depth through
a drill guide embedded in the surgical template.

Fully guided
Drill Guide Handle

The drill guides are attached to the Handle for Guided Drill
Guides by inserting the ball of the drill guide into the tip of
the handle (see picture). The drill guide is locked into place
by firmly tightening the upper part of the handle. Note that
the drill guide is free to rotate in the socket of the handle
before it is locked into place. This is to ensure that the drill
guide and handle can be positioned so as not to interfere
with other surgical instruments.

Note: Be sure to lock the drill guide into the handle outside

Product information
of the patient's mouth. Because of the small sizes of the
­devices, care must be taken that they are not swallowed or
­aspirated by the patient.

Contact us
12 Guided surgery with NobelActive® Manual // Pilot drilling + Freehand

Guided pilot drilling and freehand drill sequence

Drill protocols / product reference lines

Example of guided pilot drilling followed by the freehand drill protocol for
a ∅ 4.3 × 13 mm implant in soft and medium / dense bone.

Soft bone

13 mm

OR

0 mm

1. Guided 2. Depth 3. Non-guided 4. Implant

pilot drilling* identification site preparation insertion

Medium / dense bone

Optional for
medium bone

13 mm

OR

0 mm

1. Guided 2. Depth 3. Non-guided 4. Screw 5. Implant

pilot drilling* identification site preparation tapping insertion

* Confirm correct guided pilot drill depth by consulting the printed treatment plan report from
NobelClinician and/or the NobelGuide surgical guidelines included in the surgical template package.
 Guided surgery with NobelActive® Manual // Pilot drilling + Freehand 13

Introduction
Drill protocols according to bone quality*
Recommended to ensure optimal primary implant
stability when planning for Immediate Function.

Pilot drilling + Freehand

Platform ∅ Implant Soft Bone Medium Bone Dense Bone
Type IV Type II-III Type I

3.0 ∅ 3.0 1.5 2.0 2.0

2.4/2.8
NP ∅ 3.5 2.0 2.0 2.0
(2.4/2.8) 2.4/2.8 2.4/2.8
(2.8/3.2) 2.8/3.2
RP ∅ 4.3 2.0 2.0 2.0
2.4/2.8 2.4/2.8 2.4/2.8
(2.8/3.2) 3.2/3.6 3.2/3.6
(3.8/4.2)
RP ∅ 5.0 2.0 2.0 2.0
2.4/2.8 2.4/2.8 2.4/2.8

Fully guided
3.2/3.6 3.2/3.6 3.2/3.6
3.8/4.2 3.8/4.2
(4.2/4.6)
WP ∅ 5.5 2.0 2.0 2.0
2.4/2.8 2.4/2.8 2.4/2.8
3.2/3.6 3.2/3.6 3.2/3.6
(3.8/4.2) 3.8/4.2 3.8/4.2
4.2/4.6 4.2/5.0
(4.2/5.0) Screw Tap
Note: All data is stated in mm.
Drills within brackets (- -) denote widening of the cortex only, not drilling to the full drilling depth.

Product information
Soft bone considerations Dense bone considerations
The self-drilling capability of NobelActive allows it to be inserted – Self-drilling should not be attempted in dense bone.
into sites that have been prepared to a reduced depth. This – Screw Taps should be used if the standard dense bone
ability becomes very useful in situations that are in close prox- protocol is not sufficient to fully seat the implant without
imity to vital anatomical structures, or in softer bone when exceeding the recommended maximum insertion torque
maximum condensation is desirable. Drill to 2–4 mm less than (max. 70 Ncm for NP, RP and WP and 45 Ncm for 3.0
the total implant length, insert implant to drilled depth and ­implants).
continue to insert. The implant will drill its way to final depth.
Contact us

* According to classification by Lekholm U, Zarb GA. Patient selection and preparation.

In: Brånemark PI, Zarb GA, Albrektsson T, editors: Tissue-integrated prostheses:
Osseointegration in clinical dentistry. Quintessence, Chicago, 1985, pp 199-209.
14 Guided surgery with NobelActive® Manual // Pilot drilling + Freehand

Required instruments

1. Guided pilot drilling

Guided Twist Drill ∅ 1.5 mm*

Guided Twist Drill ∅ 2.0 mm

Guided Twist Drill ∅ 1.5 mm For anchoring template

Guided Anchor Pin

2. Freehand surgery kit

NobelActive Surgery Kit

3. Disposable drills and optional Screw Taps for selected implant

dimensions and bone density**

Twist Drill ∅ 2.0 mm Screw Tap

(7–10 mm, 7–15 mm and 7–18 mm)

Twist Step Drills

(7–10 mm, 7–15 mm and 7–18 mm)

* NobelActive 3.0 only.

** Please refer to page 41 for full list of available Twist (Step) Drills, Cortical Drills and Screw Taps.
 Guided surgery with NobelActive® Manual // Pilot drilling + Freehand 15

Surgical access

Introduction
Pilot drilling + Freehand
Fully guided
Option 1 Option 2
Perform flap elevation prior to guided drilling using the Perform guided drilling using the surgical template before
surgical template. ­performing flap elevation.

––Carefully position the surgical template. ––Carefully position the surgical template

Product information
––Using the first drill in the indicated drilling protocol, ––Perform guided drilling using the selected guided pilot drills
carefully mark the soft tissue. based on the treatment plan report from NobelClincian.
––Remove the surgical template. ––Remove the surgical template.
––Perform the incision. ––Perform the incision.
––Elevate the flap by performing sub-periosteal preparation ––Elevate the flap by performing sub-periosteal preparation
and mobilization using a raspatory or elevator. and mobilization using a raspatory or elevator.
––Carefully reposition the surgical template.* ––Continue site preparation and/or implant insertion.
––Perform guided drilling using the selected guided pilot drills
based on the treatment plan report from NobelClinician.
––Remove the surgical template.
––Continue site preparation and/or implant insertion.
Contact us

* Ensure the exact same fit and position is achieved as before soft tissue manipulation.
16 Guided surgery with NobelActive® Manual // Pilot drilling + Freehand

Detailed drilling sequence

The illustrated drilling sequence shows the use of

NobelActive RP 4.3 × 13 mm implants.

1 Position surgical template

––Carefully and correctly position the surgical template.
Secure using anchor pins, if applicable (for details see
page 27).
––Keep the surgical template stabilized at all times during
the surgery.

2 Drill with Pilot Twist Drill

Drill with the Guided Twist Drill ∅ 2.0 × (10+)7–18 mm
to the desired depth with an in-and-out motion under
profuse irrigation.

Maximum speed 800 rpm

Note: Correct guided drill depth information must be con-

firmed by referencing the printed treatment plan r­ eport from
NobelClinician and/or the NobelGuide surgical g­ uidelines
­included in the surgical template package.

Caution: The guided twist drills are identified by the (10+) on

the shaft. This indicates that the drills extend an additional
10 mm.

3 Remove surgical template

Carefully remove the surgical template.
 Guided surgery with NobelActive® Manual // Pilot drilling + Freehand 17

Introduction
4 Confirm orientation
Use the direction indicator to confirm orientation and
inclination of the preparation.

Pilot drilling + Freehand

5 Identify osteotomy depth
––Identify reference for osteotomy depth for freehand surgery.
––Use a depth probe with depth markings or the non-guided
Twist Drill ∅ 2.0 (not while it is rotating) to identify the depth
for f­ reehand surgery with reference to the patient’s anatomy.

Fully guided
6 Drill with Twist Step Drills
––Continue site preparation using Twist Step Drill ∅ 2.4/2.8 mm.

Product information
––Check orientation using Direction Indicator ∅ 2.0/2.4–2.8 mm.
––Finalize site preparation using Twist Step Drill ∅ 3.2/3.6 mm.

Maximum speed 2000 rpm Contact us

18 Guided surgery with NobelActive® Manual // Pilot drilling + Freehand

7 Widen cortex (dense bone)

Widen cortex to full cortex depth using Twist Step Drill
∅ 3.8/4.2 mm. Do not drill to full drilling depth.

Maximum speed 2000 rpm

8 Use Screw Tap (dense bone)

– Place Screw Tap RP 4.3 into prepared implant site using low
speed (25 rpm).
– Apply firm pressure and begin rotating the Screw Tap slowly.
When the threads engage, allow Screw Tap to feed without
pressure to defined depth (until all threads on the Screw Tap
have engaged bone).
– Switch the handpiece to reverse mode and back the Screw
Tap out.

Low speed 25rpm

Note: The Screw Tap WP 5.5 11.5–15 mm has a special

depth marking indicating the defined depth for the 15 mm Special depth marking for the Screw Tap
WP 5.5 11.5–15mm
length implant.
 Guided surgery with NobelActive® Manual // Pilot drilling + Freehand 19

Implant insertion

Introduction
1 Unpack implant
Each implant is packaged in a double aseptic vial system. The
outer package has a printed label with product data including
diameter and length. Its cap is color-coded to identify the im-

Pilot drilling + Freehand

plant diameter. The inner titanium casing is also marked with
implant platform and size.

– Pull the red tab to disengage the plastic shrink-rap film and
unscrew the color-coded lid.
– Take out the sterile inner titanium casing and lift off the
plastic cap to gain access to implant.
– Record the implant size and LOT number on the patient’s
chart with the two peel-off labels from the outer vial.

2 Choose insertion instrument

Depending on the clinical situation and accessibility, there are

Fully guided
three different options for inserting the implant:

A With a NobelActive Manual Torque Wrench Surgical

B With a Surgical Driver A NobelActive Manual Torque Wrench Surgical
C With a drilling unit and contra-angle

Notes:
– In the anterior region it is recommended to use the manual
surgical driver to facilitate good control during insertion and
angulation changes.
– The surgical driver is intended to be used while grasped
with finger tips only to avoid excessive insertion torque.
B Surgical Driver
– It is possible to start the implant insertion manually,

Product information
using the NobelActive Implant Driver and Surgical Wrench
Adapter.
– For NobelActive 3.0, the NobelReplace Manual Torque
Wrench Surgical or the Manual Torque Wrench Prosthetic
with Surgical Wrench Adapter can also be used, as they
both have a 45 Ncm marking.

Caution: Overtightening an implant may lead to damage of

the implant, fracture or necrosis of the bone site. If a Surgical
C Drilling unit with contra-angle
Driver is used to insert the implant, special care needs to be
taken to avoid overtightening.
Contact us
20 Guided surgery with NobelActive® Manual // Pilot drilling + Freehand

3 Pick up implant
– Connect the appropriate implant driver to the insertion
instrument.
– Pick up the implant from the inner casing by applying light
pressure on the implant driver and carefully turning the casing
counterclockwise until implant driver is fully seated.

Tip: The implant drivers have markings to facilitate the insertion

of the driver into the implant.

A B

Caution: Make sure that the implant driver is fully seated.

4 Insert implant
– Begin inserting the implant into the osteotomy.
– When using a drilling unit, start inserting the implant using
low speed.

Low speed 25 rpm  ax. torque 70 Ncm (NP, RP, WP),

M
Max. torque 45 Ncm (3.0)
A B C
Caution:
– The maximum insertion torque for NP, RP and WP implants
is 70 Ncm and may be measured with the NobelActive
Manual Torque Wrench Surgical. For NobelActive 3.0
never exceed an insertion torque of 45 Ncm.
– The surgical driver is designed to be used while grasped
with finger pressure only. Use of full palm grip can yield
over 200 Ncm insertion torque.
– Overtightening an implant may lead to damage of the
­implant, fracture or necrosis of the bone site. If a Surgical
Driver is used to insert the implant, special care needs to
be taken to avoid overtightening.
 Guided surgery with NobelActive® Manual // Pilot drilling + Freehand 21

Introduction
5 Tighten manually
– Connect the NobelActive Manual Torque Wrench Surgical
to the Manual Torque Wrench Adapter and place the implant
to final depth.

Pilot drilling + Freehand

– For Immediate Function, the implant should withstand a
final insertion torque of at least 35 Ncm. Do not exceed
70 Ncm for NP, RP and WP implants and 45 Ncm for
NobelActive 3.0.
– Remove the Implant Driver with an easy upward motion.

Experiencing strong resistance

Excessive torque while inserting the implant must be avoided.
It can cause deformation of the implant or connection and
may result in excessive compression of the bone.
– If strong resistance (max. 70 Ncm for NP, RP and WP and
45 Ncm for 3.0 implants) is encountered at any point during
insertion, rotate the implant counterclockwise approximately
a 1/2 turn to enable the self-tapping capacity of the implant,
then continue to insert the implant.
– If there is still strong resistance, remove the implant and

Fully guided
Markings for 35, 45 and 70 Ncm.
place it back into the titanium casing. Widen the implant
site according to the drill protocol or use Screw Tap matching
the diameter of the implant.

Product information
Contact us
22 Guided surgery with NobelActive® Manual // Pilot drilling + Freehand

6 Final implant placement A

– Available abutment margin height needs to be considered
during the planning of implant placement to assure appropri-
ate seating depth of the implant relative to the available soft
tissue thickness and the planned emergence of the restoration.
– For maximum esthetic results place the implant between
0 – 1 mm below buccal bone (A).
– When placing the implant, align one of the black hex
indicators on the implant driver parallel to the buccal wall.
This ensures that one of the flat sides of the hexagon is
parallel to the buccal side (B), ensuring preferred
prosthetic abutment orientation.

Notes:
–T  he implant driver has a 3 mm height indicator to facilitate
vertical implant positioning and six black lines correlating B
to the flat sides of the implant hexagon (C).
– If the implant driver is difficult to remove, slightly rotate it
counterclockwise before lifting it up.

Hex indicators
{
3 mm
{

Hex and height indicators on implant driver

 Guided surgery with NobelActive® Manual // Pilot drilling + Freehand 23

NobelActive® 3.0

Introduction
Indications
– Lateral incisors in the maxilla
– Lateral and central incisors in the mandible
– Single-unit applications in the above-mentioned positions

Pilot drilling + Freehand

1 Prepare implant site
Prepare the implant site according to drill protocol (see page 13).

2 Pick up implant
Open the implant package and pick up the implant from the inner
casing with the implant driver for NobelActive 3.0.

3 Place and tighten implant

– Insert the implant with low speed, maximum 15 rpm, using drilling
machine or by hand using Manual Torque Wrench Surgical.
– Tighten the implant with an insertion torque of maximum 45 Ncm
(see marking on torque wrench). For Immediate Function a mini-
mum installation torque of 35 Ncm is required.

Fully guided
If experiencing strong resistance
Excessive torque while inserting the implant must be avoided. It
can cause deformation of the implant or connection and may result
in e­ xcessive compression of the bone.
– If strong resistance (max. 45 Ncm) is encountered at any point
during insertion, rotate the implant counterclockwise approxi-
mately 1/2 a turn to enable the self-tapping capacity of the im-
plant, then continue to insert the implant.
– If there is still strong resistance, remove the implant and place it
back into the titanium casing. Widen the implant site according to
the drill protocol or use Screw Tap matching the diameter of the
implant.

Product information
Note: For NobelActive 3.0, the NobelReplace Manual Torque
Wrench Surgical or the Manual Torque Wrench Prosthetic with
Surgical Wrench Adapter can also be used, as they both have a
45 Ncm marking.

4 Temporary restoration
Depending on the surgical protocol of choice, place a cover screw
or abutment and suture.

Caution: All prosthetic components for NobelActive 3.0 must be

tightened to 15 Ncm only using a Screwdriver Machine Unigrip and
Contact us

Manual Torque Wrench Prosthetic. Overtightening may lead to

screw fracture.
24 Guided surgery with NobelActive® Manual // Fully guided

Fully guided surgery

Guided drill protocol

Example of the guided drill protocol for a ∅ 4.3 × 13 mm implant
in soft / medium and dense bone.

Soft / medium bone

Optional for
soft bone

A B C

1. Surgical access options 2. Guided drilling 3. Screw 4. Implant

tapping insertion
(manda­tory)
Dense bone

A B C

1. Surgical access options 2. Guided drilling 3. Screw 4. Implant

tapping insertion
(manda­tory)
 Guided surgery with NobelActive® Manual // Fully guided 25

Introduction
Drill protocols according to bone quality Optional Drills
During drilling procedures bone quality should be considered. If bone density is inconsistent (varying between medium and
Recommended drill sequences are based on bone quality to soft or medium and dense bone), optional drills can be added
ensure optimal primary stability when applying Immediate to the drill protocol to ensure the torque level does not exceed
Function. Drills are used to the full drilling depth (top of 45 Ncm. It is recommended that the Guided Counterbore

Pilot drilling + Freehand

guided drill guide as reference). Drill data are stated in mm. ­NobelActive (single use) is used in medium and dense bone
(maximum 800 rpm) to create adequate access for the Guided
Screw Tap and/or Guided Implant Mount. The dense bone pro-
tocol is to be used when the implant cannot be fully seated.

Caution: Never exceed an insertion torque of 45 Ncm for the

implants. Overtightening may damage or fracture the implant
and could cause necrosis of the bone site.

NobelActive guided drill sequence

Fully guided
Implant Soft bone Medium bone Dense bone
diameter Type IV Type II–III Type I

∅ 3.75 2.0 2.0 2.0

(2.4/2.8) 2.4/2.8 2.4/2.8
Guided Counterbore 3.75 2.8/3.2
(Guided Screw Tap 3.75) Guided Counterbore 3.75
Guided Screw Tap 3.75

∅ 4.3 2.0 2.0 2.0

2.4/2.8 2.4/2.8 2.4/2.8
(2.8/3.2) 3.2/3.6 3.2/3.6
Guided Counterbore 4.3 Guided Counterbore 4.3

Product information
(Guided Screw Tap 4.3) Guided Screw Tap 4.3

∅ 5.0 2.0 2.0 2.0

2.4/2.8 2.4/2.8 2.4/2.8
3.2/3.6 3.2/3.6 3.2/3.6
(3.8/4.2) 3.8/4.2 3.8/4.2
Guided Counterbore 5.0 Guided Counterbore 5.0
(Guided Screw Tap 5.0) Guided Screw Tap 5.0

∅ 5.5 2.0 2.0 2.0

2.4/2.8 2.4/2.8 2.4/2.8
3.2/3.6 3.2/3.6 3.2/3.6
4.2/4.6 4.2/5.0 4.2/5.0
(4.2/5.0) Guided Counterbore 5.5 Guided Counterbore 5.5
(Guided Screw Tap 5.5) Guided Screw Tap 5.5
Contact us

Note: All data are in mm and the drills within brackets denoted as optional.
26 Guided surgery with NobelActive® Manual // Fully guided

Required instruments

1. NobelActive Guided Surgery Kit

NobelActive Guided Surgery Kit

2. Guided Drill Stop Kit

3. Disposable drills and optional Screw Taps for selected implant

dimensions and bone density*

Guided Twist Drill ∅ 2.0 mm Guided Screw Tap

(7–13 mm and 7–18 mm) (mandatory soft/medium bone)

Guided Twist Step Drills Guided Dense Bonce Screw Tap

(7–13 mm and 7–18 mm) (mandatory dense bone)

* Please refer to page 42 for full list of available Guided Twist (Step) Drills, Guided Counterbores and Guided Screw Taps.
 Guided surgery with NobelActive® Manual // Fully guided 27

Special considerations

Introduction
The unique thread design of NobelActive implants allows for
redirection of the implant during insertion. This feature has
been taken into consideration in the drilling protocol for
placing NobelActive implants in conjunction with the
NobelGuide surgical template.

Pilot drilling + Freehand

Mandatory guided Screw Taps
Guided screw tapping is mandatory and has the following aims:

Securing insertion precision

Fully guided
For guided insertion of the NobelActive implant, the correct
starting point is crucial. The separate dedicated Screw Taps
for soft/medium and dense bone are mandatory for all indica-
tions. They define the correct insertion point for precise im-
plant placement. Early steering means the Guided Screw Tap
engages with the Guided Sleeve before encountering bone.
Tapping of just two or three threads (height of cortical bone)
may be enough in soft bone.

Product information
Avoid early bone contact
Before using the Screw Tap, the shape of the crest should be
checked to avoid early collision between the upper half of the
Screw Tap and the bone. Remove the bone to allow insertion
of the Screw Tap.
Contact us
28 Guided surgery with NobelActive® Manual // Fully guided

Accurate implant placement following the pre-

tapped path
First, rotate the implant counterclockwise using the surgical
adaptor until the implant falls into the pre-tapped tread. Then
rotate the implant clockwise into the pre-tapped path. This
technique ensures that the implant is placed accurately with
zero friction between sleeve and implant, which enables pre-
cise torque measurements.

Place implant subcrestally without removing

additional bone
Designed to complement the unique characteristics of
NobelActive, the diameter of the Guided Implant Mount
is identical to the implant shoulder, allowing for subcrestal
placement without removing additional bone on the neigh-
boring crest. The Guided Implant Mount includes a precise
vertical stop. Visual control of implant installation through
the sleeve is required during the full insertion procedure.

NP RP 4.3 RP 5.0 WP 5.5

Guided sleeve (A) ∅ 4.11 ∅ 5.02 ∅ 6.22 ∅ 6.22

Implant mount (B) ∅ 3.52 ∅  3.90 ∅ 3.90 ∅ 5.08

Diameter difference 0.59 1.12 2.32 1.14

Diameter and diameter difference in mm

 Guided surgery with NobelActive® Manual // Fully guided 29

Surgical access

Introduction
The NobelGuide concept supports flap, mini-flap and flapless
procedures. Flapless procedures are aided by a guided soft
tissue punch. Based on the actual case, the clinician is advised
to choose the preferred option at the planning stage. Thorough
clinical diagnostics and inspection are needed prior to planning

Pilot drilling + Freehand

– for instance to diagnose availability of keratinized mucosa
around the prospective implant sites.

Notes:
––The combination of tissue grafting and Immediate Function
is not recommended.
––If simultaneous bone augmentation is performed, submerged
healing is indicated

Flapless
The flapless procedure is the most straightforward procedure.
The surgical template can remain at its initially installed position
without the need to detach and re-position it again. This
­procedure is indicated for surgeons starting with the system,

Fully guided
however punching of soft tissue must be clinically indicated
(i.e. esthetics).

1 Position surgical template

Carefully and correctly position and secure the surgical template
using the surgical index and anchor pins.

Maximum speed 800 rpm

Product information

2 Access surgical tissue

––Punch the soft tissue without removing the surgical
­template.
––The surgical template can be temporarily detached after
punching to carefully remove the punched soft tissue. The
surgical template is carefully repositioned and the anchor
pins replaced into the existing anchorage holes in the bone.
Contact us
30 Guided surgery with NobelActive® Manual // Fully guided

Non-flapless (flap, mini-flap)

Keratinized tissue may be saved. Submerged placement of
the implant is also possible (allowing for simultaneous bone
augmentation procedures, etc.) by using a mini-flap or flap.

1 Position surgical template

––Prior to any manipulation of the soft tissue, securely
position the surgical template using the surgical index
to confirm position.
––Check for the correct initial positioning of the surgical
template.
––Drill and place anchor pins. Use an in-and-out drilling
motion with copious irrigation.

Maximum speed 800 rpm

2 Mark implant positions

––Mark the intended implant positions through the installed
template by gently stamping the contour of the entry
point of the implant using the Soft Tissue Punch.
––Use gentle force on the soft tissue using the Soft
Tissue Punch.

3 Perform incision with scalpel

––Remove the anchor pins and the surgical template.
––Perform the incision, respecting the position of the
implants (the shown flap design is for illustration only).
 Guided surgery with NobelActive® Manual // Fully guided 31

Introduction
4 Elevate flap
––Perform sub-periosteal preparation and mobilization
using a raspatory.

Pilot drilling + Freehand

5 Modify surgical template
––In order to ensure that the surgical template can be
repositioned in the correct location, or to prevent damage
to the soft tissue flap, adjustment of the surgical template
may be required.

Fully guided
––Slightly modify the fitting surface of the surgical template
by relieving as much material as needed.
––After grinding, rinse with sterile physiologic liquid (saline)
to remove any small particles.

Note: Ensure adequate thickness of the surgical template

is maintained at these sites.

Product information
6 Reposition surgical template
Reposition the surgical template using the surgical index
and at the exact same site prepared for the anchor pins.

Note: Anchor pins may also be planned in order to assist

with retracting a flap. The flanges of the surgical template
­itself may also be used to retain a flap.
Contact us
32 Guided surgery with NobelActive® Manual // Fully guided

Detailed guided drilling sequence

The illustrated drilling sequence shows the use of NobelActive RP

4.3 × 13 mm implants.

1 Drill with Guided Start Drill

––Start drilling one implant first, from start to finish, including
guided implant insertion.
––Place the Guided Drill Guide RP to ∅ 2 mm in the selected
template sleeve.
––Drill with the Guided Start Drill to the built-in drill stop.

Maximum speed 800 rpm

2 Drill with Guided Twist Drill

––Mount a Drill Stop Ø 2 mm on the Guided Twist Drill ∅ 2 ×
(10+) 7–18 mm for a safe and accurate drilling procedure.
––Place the Guided Drill Guide RP to ∅ 2 mm in the selected
template sleeve.
––Drill with the Guided Twist Drill ∅ 2 × (10+) 7–18 mm to
the desired depth with an in-and-out motion under profuse
irrigation using the Guided Drill Guide for guidance.

Maximum speed 800 rpm

Notes:
––The depth markings on the Twist Drill correspond to 7, 10,
13, 15 and 18 mm implants and should be measured while
level with the Guided Drill Guide.
––When using the Twist Drills, use copious irrigation and an
“in-and-out” drilling motion with emphasis on bringing the
tip of the drill out of the template when preparing the site
to avoid overheating.
––A (10+) indicates that the drills extend an additional 10 mm. 7 mm
–D uring surgery maximum attention must be paid to ensure 10 mm
that the surgical template does not move in any direction 13 mm
15 mm
from the correct position when being manipulated with
18 mm
instruments, e.g., lateral shift through inadequate handling of
(pilot) drill in “knife – edge” situations or shift / deformation
of surgical template due to excess vertical force application
during implant installation.
 Guided surgery with NobelActive® Manual // Fully guided 33

Introduction
3 Continue drilling
––Mount the Drill Stop Ø 2.8 mm on the Guided Twist Step Drill
2.4/2.8 × (10+) 7–18 mm.
––Place the Guided Drill Guide RP to ∅ 2.8 mm and drill to the stop

Pilot drilling + Freehand

with the Guided Twist Step Drill 2.4/2.8 × (10+) 7–18 mm.
––Drill with an in-and-out motion under profuse irrigation.
––Finalise site preparation using the Guided Twist Step Drill
3.2/3.6 × (10+) 7–18 mm and Guided Drill Guide RP to ∅ 3.6 mm.

Maximum speed 800 rpm

Fully guided
4 Mandatory screw tapping
––Place the Guided Screw Tap NobelActive RP 8.5–10mm directly into
the sleeve and prepare the site to the desired depth at low speed
(20–45 Ncm) and with copious irrigation.
––Carefully remove the Screw Tap to avoid damaging the prepared site.

Low speed 25 rpm Max. torque 45 Ncm

Product information
Note: If less bone condensing is required, use the Guided Screw Tap to
a reduced depth. Decide how deep to tap based on the quality of the
bone. In soft bone, just two or three threads (the height of the cortical
bone) may be enough.

Guided Screw Tap

(mandatory soft/medium bone)

Guided Dense Bonce Screw Tap

Contact us

(mandatory dense bone)

34 Guided surgery with NobelActive® Manual // Fully guided

Guided implant placement procedure

1 Unpack implant
Each implant is packaged in a double sterile vial system. The outer
package has a printed label with product data including diameter
and length. Its cap is color-coded to identify the implant diameter.
The inner casing is also marked with implant diameter and length.

––Pull the red tab to disengage the plastic shrink-rap film and unscrew
the color-coded lid.
––Take out the sterile inner casing and lift off the plastic cap to gain
­access to implant.
––Record the implant size and LOT number on the patient’s chart with
the two peel-off labels from the outer vial.

Note: The Cover Screw is co-packed with the implant.

2 Pick up mounted implant

––Connect the Guided Implant Mount NobelActive RP 4.3 to the
implant using a Screwdriver Unigrip and the surgical adapter from
the Manual Torque Wrench.
––Make sure that the Guided Implant Mount is fully seated on the
shoulder of the implant platform.

3 Pick up mounted implant

Pick up the mounted implant with the Surgical Adapter by holding
it with two fingers.
 Guided surgery with NobelActive® Manual // Fully guided 35

Introduction
4 Manual implant insertion
––Perform the first turns of the insertion by hand. Start with a
gentle left turn until you can feel the implant falling into the
pre-tapped thread.

Pilot drilling + Freehand

––Then turn to the right into the pre-tapped path. This tech-
nique makes it easier to find the correct pre-tapped path
and optimizes the accuracy of implant placement.

Notes:
Visually check that the Guided Implant Mount is kept in the
center of the guided sleeve during the entire insertion process.

Alternative: Use the Connection to Handpiece for installa-

tion by machine, starting at 30 Ncm. As the insertion of the
NobelActive implant goes quickly, a very slow rotational speed
is recommended. Using the machine compromises the tactile
feedback for initial placement. The use of the machine for initial
placement is only indicated if the mouth opening or access (in
posterior region) does not allow for manual initial placement.

Fully guided
Product information
Contact us
36 Guided surgery with NobelActive® Manual // Fully guided

Guided implant placement – partially edentulous

Go to page 38 to continue with guided implant placement for
edentulous cases.

5 Insert implant with machine

––Remove the surgical adapter and continue the implant in-
sertion with the Connection to Handpiece using the low set-
ting on the drilling unit or use the Manual Torque Wrench.
––Insert the implant until the flange of the Guided Implant
Mount NobelActive touches the outer surface of the guided
sleeve in the surgical template.
––Final implant insertion can be done manually. The maximum
torque for the implant is 70 Ncm and may be measured
with the NobelActive Manual Torque Wrench Surgical.
––Use a Screwdriver Unigrip to remove the Guide Implant
Mount.

Low speed 25 rpm Max. torque 70 Ncm

6 Anchor the surgical template

––Use the Guided Template Abutment NobelActive RP 4.3.
––Tighten manually using a Screwdriver Unigrip.
––Ensure that the surgical template stays in its initial correct
position for the next implant site preparation.
 Guided surgery with NobelActive® Manual // Fully guided 37

Introduction
7 Place remaining implants
––Proceed with preparation of the remaining implant sites.
––Install the remaining implants according to the previously
described procedure.

Pilot drilling + Freehand

Notes:
––Place Guided Template Abutments on the first two implants.
After placement, leave the Guided Implant Mounts seated
in their final position until all implants are placed.
––If only two implants are to be placed, there is no need for
a Guided Template Abutment on the second implant.

Fully guided
8 Remove surgical template
––Once all implants are installed, remove Guided Implant
Mounts and Guided Template Abutments using the
­Screwdriver Unigrip.
––Remove the anchor pins and the surgical template.

Product information
Contact us
38 Guided surgery with NobelActive® Manual // Fully guided

Guided implant placement – edentulous

Go to page 36 for the procedure on guided implant
placement for partially edentulous cases.

5 Insert the first mounted implant

––Insert the first implant (for example in the canine position)
until the flange of the Guided Implant Mount is 1 mm short
of the outer surface of the surgical template sleeve.
––Leave the Guided Implant Mount in place.

Low speed 25 rpm Max. torque 70 Ncm

6 Insert the second mounted implant

––Choose the implant site strategically placed in the middle of
the opposite half of the arch to obtain proper distribution.
––Prepare and insert the second implant until the flange of the
Guided Implant Mount is 1 mm short of the outer surface of
the surgical template sleeve.

Low speed 25 rpm Max. torque 70 Ncm

7 Finalize implant insertion

––Using the NobelActive Manual Torque Wrench Surgical,
carefully seat the first and second implant until the flange of
the Guided Implant Mounts slightly touch the surgical tem-
plate sleeve.

Note: Follow the described protocol to minimize the risk

of over-torquing and to minimize movement of the surgical
template.

Max. torque 70 Ncm

 Guided surgery with NobelActive® Manual // Fully guided 39

Introduction
8 Anchor the surgical template
––Use the Screwdriver Unigrip to remove the Guided Implant
Mounts.
––Place a Guided Template Abutment NobelActive RP 4.3

Pilot drilling + Freehand

onto each of the seated implants.
––Tighten manually using the Screwdriver Unigrip.
––Ensure that the surgical template maintains its initial correct
position for the following implant site preparation.

9 Install remaining implants

Fully guided
––Proceed with preparation of the remaining implant sites
(step 1–5, page 33–36).
––Install the remaining implants until the flange of the Guided
Implant Mount touches the top of the guided sleeve in the
surgical template.

Notes:
––Place the Guided Template Abutments on the first two
implants. After placement, leave the seated Guided Implant
Mounts in their final position until all implants are placed.

Product information
10 Remove surgical template
––Once all implants are installed, remove Guided Implant
Mounts and Guided Template Abutments using the
­Screwdriver Unigrip.
––Remove the anchor pins and the surgical template.
Contact us
40 Guided surgery with NobelActive® Manual // Product information

Product overview

NobelActive
Platform Implant ∅ Length
7 mm 8.5 mm 10 mm 11.5 mm 13 mm 15 mm 18 mm
* 3.0 mm – – 36769 36770 36771 36772 –
** 3.5 mm – 35221 34125 34126 34127 34128 35215
4.3 mm – 35223 34131 34132 34133 34134 35219
5.0 mm – 35225 34137 34138 34139 34140 35220
3.0 NP 3.5 RP 4.3 RP 5.0 WP 5.5
*** 5.5 mm 37806 37807 37808 37809 37810 37811 –

Cover Screw Conical Connection

3.0 NP RP WP
36775 36649 36650 37812

* NobelActive 3.0 is only indicated for the replacement of single-unit maxillary lateral incisors and single-unit mandibular
lateral and central incisors. Multiple-unit restorations are neither indicated nor accommodated by restorative components. On all Nobel Biocare implants including
** NobelActive NP is not recommended to be used in the posterior region. prefabricated prosthetic components.
*** Color coded and cover screw included For further information visit
nobelbiocare.com/warranty
 Guided surgery with NobelActive® Manual // Product information 41

Surgical components for guided pilot drilling

Introduction
For guided pilot drilling
Guided Pilot Twist Drill for NobelActive 3.0 Guided Twist Drills 7–13 mm 7–18 mm
∅ 1.5 (10+) 10–15 mm 37397 ∅ 2.0 (10+) 33107 32746

Pilot drilling + Freehand

Guided Anchor Pins Guided Twist Drill1
∅ 1.5 mm 30909 ∅ 1.5 mm × 20 mm 33066
∅ 1.5 mm Short Shaft 34761

For freehand surgery

Twist Drills 7–10 mm 7–15 mm 10–18 mm Twist Step Drills 7–10 mm 7–15 mm 10–18 mm
∅ 1.5 – 31278 – ∅ 2.4/2.8 32260 32261 32262
∅ 2.0 32296 32297 32299 ∅ 2.8/3.2 37873 34638 34639
∅ 3.2/3.6 32263 32264 32265
∅ 3.8/4.2 32275 32276 32277
Drill Extension Shaft ∅ 4.2/4.6 37874 34582 34583
29164 ∅ 4.2/5.0 37875 37876 –

Fully guided
37883 NobelActive Surgery Kit
Includes instruments to perform implant surgery
Screw Taps 3.0 NP RP 4.3 RP 5.0 WP with NobelActive implants. Drills and screw taps
must be ordered separately
36816 36236 36237 36238 378712 / 378723

Implant Drivers 3.0 NP RP WP

28 mm 36773 36718 36720 37859
37 mm 36774 36719 36721 37860

Product information
Contact us
42 Guided surgery with NobelActive® Manual // Product information

Surgical components for fully guided surgery

Guided Anchor Pins Guided Twist Drill1

∅ 1.5 mm 30909 ∅ 1.5 mm × 20 mm 33066
∅ 1.5 mm Short Shaft 34761

Tissue Punches NP RP 4.3 RP 5.0 WP

Guided Soft Tissue 32Z2006 32Z2007 32Z2008 32Z2008
Punch 5/pkg (manual)

Guided Tissue Punch 37153 37154 37155 380605

(for machine)

Guided Drill Guides NP RP 4.3 RP 5.0 WP

∅ 2 mm 32814 32815 32816 32816
∅ 2.8 mm 32817 32818 38046 38046
∅ 3.2 mm 35882 – – –
∅ 3.6 mm – 35883 35885 35885
∅ 4.2 mm – 35884 32825 32825
∅ 4.6 mm – – 35886 35886
∅ 5.0 mm – – – 32826

Guided Start Drill Handle for Guided Drill Guide 37952 NobelActive Guided Surgery Kit
Kit consists of three kit boxes for guided surgical
∅ 2.0 (10+) 37152 32813
access, guided drilling and guided implant
insertion. It includes instruments for NP and
RP 4.3 implants. Drills and screw taps must be
ordered separately.
Guided Twist Drills 7–13 mm 7–18 mm Drill Extension Shaft
∅ 2.0 (10+) 33107 32746 29164

Guided Twist Step Drills 7–13 mm 7–18 mm

∅ 2.4/2.8 (10+) 35839 35844
∅ 2.8/3.2 (10+) 35840 35875
∅ 3.2/3.6 (10+) 35841 35876
∅ 3.8/4.2 (10+) 35842 35877 33085 Guided Drill Stop Kit
Guided drill stops provide a stop 10 mm deeper
∅ 4.2/4.6 (10+) 35843 38045
than regular drill stops, as the corresponding
∅ 4.2/5.0 (10+) 37934 37945 guided drills are 10 mm longer than regular drills.

Guided Screw Taps NP RP 4.3 RP 5.0 WP

35878 35879 35880 379466 / 379477

Guided Dense Bone Screw Taps NP RP 4.3 RP 5.0 WP

38179 38180 38181 381826 / 381837

Guided Implant Mounts NP RP 4.3 RP 5.0 WP

35887 35888 35889 37948

Guided Template Abutments with Screw NP RP 4.3 RP 5.0 WP

35890 35891 35892 37949

NobelActive Kit upgrade components

–3  7954 NobelActive Guided Surgical Access Kit Box
5 The Guided Tissue Punch for WP/6.0-sleeve (5.5) is for NobelActive WP 5.5. Do not use Guided Tissue Punch Plate: insert into NobelActive Guided Surgery Kit Box
for WP/6.0-sleeve (5.0) (art.no. 37155) or Guided Tissue Punch for WP/6.0-sleeve (6.0) (art.no. 37156). –3  7956 NobelActive Guided Drilling Kit Box Plate:
6 For 7–8.5 mm implants. insert into NobelActive Guided Drill Guide Kit Box
7 For 10–15 mm implants. – 37958 NobelActive Guided Implant Insertion Kit Box
 Guided surgery with NobelActive® Manual // Product information 43

Laboratory and prosthetic components

Introduction
Laboratory components for fully guided procedure
NP RP 4.3 RP 5.0 WP
Guided Cylinder with Pin 37172 37173 37174 37950
Unigrip™ Conical Connection

Pilot drilling + Freehand

NP RP WP
Implant Replica
36697 36698 37879
Conical Connection

Healing abutments
3.0 NP RP WP NP RP WP
Healing 3 mm 5 mm 7 mm 3 mm 5 mm 7 mm 3 mm 5 mm 7 mm 3 mm 5 mm Healing 3 mm 5 mm 7 mm 3 mm 5 mm 7 mm 3 mm 5 mm
Abutment Abutment
∅ 3.2 36794 36795 36796 – – – – – – – – Bridge
∅ 3.6 – – – 36639 36640 36867 36643 36644 36872 – – ∅ 4.0 36864 36865 36866 – – – – –
∅ 3.8 36797 36798 36799 – – – – – – – – ∅ 5.0 – – – 36869 36870 36871 – –
∅ 5.0 – – – 36641 36642 36868 36645 36646 36873 37813 37814 ∅ 6.0 – – – – – – 37817 37818
∅ 6.0 – – – – – – 36647 36648 36874 – –
∅ 6.5 – – – – – – – – – 37815 37816
WP

Fully guided
Slim – 37669 37670 – 37666 37665 – 37667 37668 – – Healing Abutment 6×7 mm 7×8 mm
Healing Anatomical PEEK 37819 37820
Abutment

Temporary abutments*
3.0 NP RP WP NP RP WP
Immediate 1.5 mm 3 mm 1.5 mm 3 mm 1.5 mm 3 mm 1.5 mm 3 mm QuickTemp™ 1.5 mm 3 mm 1.5 mm 3 mm 1.5 mm 3 mm
Temporary 36777 36778 36653 36655 36654 36656 – – Abutment 36659 36657 36660 36658 – –
Abutment

Temporary 36779 – 36663 – 36664 – 37823 37824 Temporary 36661 – 36662 – 37825 37826
Abutment Abutment
Engaging Non-Engaging

Product information
Slim 6.5 mm 7.5 mm 6.5 mm 7.5 mm 6.5 mm 7.5 mm – Temporary – – 6×7 mm 7×8 mm
Temporary 37675 37676 37671 37672 37673 37674 Abutment 37821 37822
Abutment Anatomical
PEEK
* Abutment screw included.

Know exactly when your surgical template will arrive

Check the production status of your surgical templates
within the NobelClinician Software, and the delivery status
with our easy-to-use tracking tool. Register for MyNobel on
­nobelbiocare.com/mynobel to benefit from this and many
other services and offerings.
Contact us
44 Guided surgery with NobelActive® Manual // Product information

Cleaning and sterilization

Sterile components
The devices delivered sterile have a “Sterile” marking on
the label. See current cleaning and sterilization guidelines for
details: nobelbiocare.com/sterilization.

Note: Implants must never be re-sterilized.

Implants
Implants are delivered sterile, are for single-use only.
Do not use implants if the packaging has been damaged
or previ­ously opened.

Twist and Twist Step Drills, Counterbores and Screw Taps

Twist Drills, Twist Step Drills, Counterbores and Screw Taps
are delivered sterile and for single use only.

Abutments and plastic copings

Multi-unit Abutments, Snappy Abutments, QuickTemp
Abutments, Immediate Temporary Abutments and their
respective plastic copings are delivered sterile and are for
single-use only.
 Guided surgery with NobelActive® Manual // Product information 45

Introduction
Non-sterile components
Care and maintenance of reusable instruments are crucial
for successful treatment. Well-maintained instruments not
only safeguard your patients and staff against infection, but

Pilot drilling + Freehand

are also essential for the outcome of the total treatment.
See current cleaning and sterilization guidelines for details:
nobelbiocare.com/sterilization.

NobelGuide surgical templates

The NobelGuide Surgical Template is delivered non-sterile.
This is because pre-processing in the dental laboratory is
needed to optionally prefabricate master casts that contain
implant replicas at the planned implant locations in order to
prepare provisional restorations prior to surgery.
Use disinfecting agents described below.

In the laboratory:

Fully guided
Use ultrasonic cleaning with water and mild detergents.
Rinse thoroughly with water, dry well and return to the
protection bag in which it was delivered.

In the clinic:
Immediately prior to surgery: disinfect the surgical template
in a high level disinfectant, according to the manufacturer’s
instructions (e.g. Chlorhexidine solution). Rinse thoroughly
with sterile water and dry well, but not longer than 40 minutes.

Do not use heat or autoclave the surgical template.

Product information
Abutments and plastic copings
Some abutments made of titanium, gold alloy, and plastic
(PEEK) are delivered non-sterile. For more information refer
to the label on the specific abutment. It is recommended to
sterilize the abutment prior to placing it in the oral cavity. For
sterilization, see current cleaning and sterilization guidelines:
nobelbiocare.com/sterilization

Notes:
––If modifications have been made to the abutment, clean the
abutment prior to sterilization.
––Non-sterile plastic copings should not be resterilized, as
they are for single use only.
Contact us
46 Guided surgery with NobelActive® Manual // Contact us
 Guided surgery with NobelActive® Manual // Contact us 47

Customer service worldwide

Introduction
Americas Europe, Middle East and Africa Russia

Brazil Austria Nobel Biocare Russia

Nobel Biocare Brazil Nobel Biocare Austria Phone: +7 495 974 77 55

Phone: 0800 16 999 6 Phone: +43 1 892 89 90 South Africa

Canada Belgium Nobel Biocare South Africa

Nobel Biocare Canada Nobel Biocare Belgium Phone: +27 11 802 0112

Phone: +1 800 939 9394 Phone: +32 2 467 41 70 Spain

Chile Denmark Nobel Biocare Spain

Phone: +34 900 850 008

Pilot drilling + Freehand

Dental Biocare Nobel Biocare Denmark
Phone: +56 220 19282 Phone: +45 39 40 48 46 Sweden

Colombia Finland Nobel Biocare Sweden

Hospimedics S.A. Nobel Biocare Finland Phone: +46 31 335 49 00

Phone: +57 1 640 0608 Phone: +358 20 740 61 00 Switzerland

Mexico France Nobel Biocare Switzerland

Nobel Biocare Mexico Nobel Biocare France Phone: 0800 211 424

Phone: +52 55 524 974 60 Phone: +33 1 49 20 00 30 United Kingdom

USA Germany Nobel Biocare UK

Nobel Biocare USA Nobel Biocare Germany Phone: +44 208 756 3300

Phone: +1 800 322 5001 Phone: +49 221 500 850

Hungary
Distributor markets
Nobel Biocare Hungary
Asia Pacific Phone: +36 1 279 33 79 Algeria, Bulgaria, Croatia, Cyprus,

Australia Czech Republic, Greece, Jordan, Kuwait,

Ireland
Nobel Biocare Australia Lebanon, Malta, Romania, Saudi Arabia,
Nobel Biocare Ireland
Serbia, Slovenia, Tunisia, Turkey,

Fully guided
Phone: 1800 804 597 Phone: 1800 677 306
United Arab Emirates
China Italy Phone: +34 933 560 562
Nobel Biocare China Nobel Biocare Italy
Phone: +86 21 5206 6655 Phone: +39 800 53 93 28
Hong Kong Lithuania
Nobel Biocare Hong Kong Nobel Biocare Lithuania
Phone: +852 2845 1266 Phone: +370 5 268 3448
India Netherlands
Nobel Biocare India Nobel Biocare Netherlands
Phone: 1800 266 9998 Phone: +31 30 635 49 49
Japan Norway
Nobel Biocare Japan Nobel Biocare Norway
Phone: +81 3 6717 6191 Phone: +47 64 95 75 55
New Zealand

Product information
Poland
Nobel Biocare New Zealand Nobel Biocare Poland
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