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Benefits of Barrier Plugger and Barrier Excavator in the Management of Dental Implant Screw Channels


35Newtons Dedicated Instruments for FirstPlug

FirstPlug® is a medical grade dental implant screw channel barrier material. Unlike off-the-shelf solutions, the advantages of the FirstPlug® material lie in its unique composition and form. To fully harness the benefits of FirstPlug®, 35Newtons® has introduced two specialized instruments- Barrier Plugger and Barrier Excavator. In this blog post we will highlight the special features of these instruments and present the clinical workflow for managing dental implant screw access channels.


Barrier Plugger and Barrier Excavator by 35Newtons
Design and Advantages of Barrier Plugger and Barrier Excavator

35Newtons® Barrier Plugger

The Barrier Plugger is a specialized dental instrument designed to efficiently compact and condense barrier material. 35Newtons® has optimized its ergonomics, shank diameter, and shank length to accommodate for majority of screw channels. An important feature of the plugger is the incorporation of 5mm and 10mm markings. With these markings, the clinician or dental personnel can easily measure the depth of the screw channel on the bench or intraorally, ensuring the right amount of FirstPlug® is dispensed. This not only minimizes material waste but also reduces the time needed to close the screw channel.


35Newtons® Barrier Excavator

The Barrier Excavator is a versatile instrument designed for the removal of dental materials. 35Newtons® has optimized the ergonomics, shank length and spoon diameter of this instrument to work seamlessly with dental implant screw channels. Another critical design feature is the incorporation of notches and serrations into the spoon portion, facilitating the efficient grabbing and removal of FirstPlug®. This makes the Barrier Excavator highly versatile and useful in removing legacy materials such as cotton, plumber's tape, or silicone.


Clinical Case Presentation

In this clinical case, we will demonstrate the effective use of FirstPlug® and the dedicated placement and removal instruments. The patient required replacement of the upper right posterior teeth with a 3-unit implant-supported bridge.


During the interim phase of treatment, a milled one-piece acrylic screw-retained provisional prosthesis was used. For this provisional prosthesis, the screw channel was closed using FirstPlug® barrier material and composite filling. Check the photo below to see the Barrier Excavator in action while removing the barrier material.


35Newtons Excavator
Excavator Design Allows for Efficient Removal of the Barrier

For the definitive design, we decided to use custom-milled titanium abutments and a 3-unit cemented zirconia bridge with access channels (screwmentable design). The depth of the screw channels was measured using the Barrier Plugger, and the appropriate amount of FirstPlug® material was selected for each channel based on the guidelines provided by 35Newtons®. Before the seating appointment, FirstPlug® and restorations were soaked in a chlorhexidine solution.


Preparation of FirstPlug
Preparation of FirstPlug for the Seat Appointment

During the seating appointment, we verified and confirmed the esthetics, fit, and passivity of the abutments and zirconia bridge. Any necessary adjustments were made. The abutments were torqued following the manufacturer's recommended values, and the 3-unit bridge was cemented using definitive cement. After removing excess cement, the screw channels were thoroughly cleaned and blow-dried. We then used the Barrier Plugger to precisely condense the FirstPlug® material into the screw channel. Finally, we ensured about 2mm of space for the restorative material and closed the access channel with light-cured restorative composite.


Sequence of FirstPlug placement using Barrier Plugger
Sequence of FirstPlug placement using Barrier Plugger

Conclusion

The 35Newtons® Barrier Excavator and Barrier Plugger offer enhanced control, efficiency, precision, and patient comfort. The combination of FirstPlug® Screw channel barrier and these dedicated instruments empowers dental professionals to deliver exceptional care and improve patient outcomes. Embrace the advantages offered by these new instruments and experience the positive impact they can have on your practice of implant dentistry.

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