The Omni-Tight™ Implant System is supplied non-sterilized in a clean sealed sterilizable pouch and must be sterilized prior to use. The full placement kit, implant, healing cap, and emergence profiler as well as the transfer device, must be sterilized in the steam auto clave at 121° C (250° F) for 15 minutes. I also place all of the secondary instruments, hand piece, powder free gloves, towels, 2 X 2's etc., in the autoclave at this time. All the other surgical articles that can't endure the heat and pressure may be cold sterilized in the correct solutions for the time stated and then rinsed off with sterile water.

Omni-Tight™ implants come individually packaged in a convenient strip that should be sterilized and not opened until the time of implant placement and then the appropriate parts only handled by their respective sterilized carriers, thereby precluding handling contamination . Never place a contaminated implant!

Care and maintenance of the implant placement kit

Because all of the placement kit instruments are stainless steel, sharp and small, extreme care must be taken to assure their complete cleanliness and sterilization after each procedure. The use of small, disinfected brushes and port wires are useful before the instruments are placed into the heated Ultrasonic cleaner prior to steam sterilization. At the time of sterilization, the instruments may be placed in their respective spots in the blue kit box and sterilized with the top in place and taped shut with sterilization tape that shows dark marks after sterilization is complete. This procedure maintains cleanliness, correct order of instruments, sterilization and freedom from contamination. Be sure the kit box is kept upright after loading and maintained upright when moved from the auto- clave to the sterile drape on the mayo stand tray. It is important to keep a sterile field about the tray and its set up. Be sure the first set of sterile exam gloves are used to set the tray up:

1. Sterile drape the top of the disinfected stainless Mayo stand tray.
2. Place the unopened placement kit and hand piece on the covered tray.
3. De-bag the secondary instruments and place them around the covered tray in convenient locations.
4. Fill the SS cup with cold sterile water or normal saline for irrigation from its clear bag via the Baxter irrigation set (Decanter Set).
5. Be sure the implant strip and sterile scissors are close at hand on the tray.
6. When the draped tray is completely set up, then cover the tray and all instruments with the second sterile drape.

At the time of implant placement (after local anesthetic, and any patient instructions concerning the mouth prop if utilized), the sterile drape is now placed on the patient's chest, sterile side up (that side that was against the instruments) to be utilized as a secondary work surface if necessary during placement. The patient is instructed to refrain from touching the drape surface.

After the entire procedure is completed, all instruments are thoroughly cleaned of all debris and washed before being placed in the heated Ultrasonic bath for a cleaning cycle. Don't forget to be sure all ports are cleaned with appropriate wire port cleaners. Be certain the internal irrigation channel in the osteotomy burs is cleaned thoroughly before sterilization. The blue placement kit is refilled with instruments; secondary instruments are placed in individual see-through sterilizing pouches to be ready for the next round of sterilization just prior to the next placement procedure.

It is strongly recommended that internal irrigation with very cold irrigation be utilized for the osteotomy portion of the placement procedure. Some placement surgical units have integrated pumps to provide irrigant flow to the placement site. Some units don't. For those units that don't have a built in pump, an internal irrigation squeeze pump set is very satisfactory. Either way, the cannula clip set and surgical tubing must be cleaned and sterilized for each procedure. Be sure the cannula clip set is removed carefully from the hand piece and sterilized separately (the clips become brittle and break if in contact with the metal of the hand piece during sterilization). Safe spray lubricants should be used on the hand piece internals before sterilization. The tubing should be drained of sterile irrigant before sterilization, but not dry.

Remember: All cold sterilized articles, i.e., mirrors, guide stents, mouth props, etc., must be rinsed with sterile water prior to use in the placement procedure.