IMPLANT DRIVER WITH SIMULTANEOUS CONTROL OF DEPTH AND ROTATION OF THE IMPLANT ACCORDING TO A DIGITAL PLANNING

Abstract

An implant driver assembly for placing an implant according to a digital virtually planned implant and implant position in the jaw of a patient, wherein said implant driver assembly comprises at least an implant driver and at least a surgical template, wherein the implant driver having one or more first markers, and being adapted to be aligned with the surgical template, the surgical template having a guiding element and having one or more second markers, so that alignment of one or more first markers on the implant driver when connected to the implant and one or more second markers on the surgical template defines a spiral motion of the implant when it is being inserted in a jaw bone, the implant driver and surgical template also including at least one of the one or more first and at least one of the one or more second markers for indicating the implant driver's rotational or rotationally symmetric position as defined by the digital virtually planned implant position, whereby the guiding element is a bushing with a smooth bore; wherein the one or more first markers comprises a thread in or on an outer surface of the implant driver; wherein the one or more second markers comprises a thread follower for following the thread which is in or on the outer surface of the implant driver; wherein the thread follower comprises one or more pins that is/are removable or retractable from the guiding element of the surgical template.

Claims

1. An implant driver assembly for placing an implant according to a digital virtually planned implant and implant position in the jaw of a patient, wherein said implant driver assembly comprises at least an implant driver and at least a surgical template, wherein the implant driver having one or more first markers, and being adapted to be aligned with the surgical template, the surgical template having a guiding element and having one or more second markers, so that alignment of one or more first markers on the implant driver when connected to the implant and one or more second markers on the surgical template defines a spiral motion of the implant when it is being inserted in a jaw bone, the implant driver and surgical template also including at least one of the one or more first and at least one of the one or more second markers for indicating the implant driver's rotational or rotationally symmetric position as defined by the digital virtually planned implant position, whereby the guiding element is a bushing with a smooth bore; wherein the one or more first markers comprises a thread in or on an outer surface of the implant driver; wherein the one or more second markers comprises a thread follower for following the thread which is in or on the outer surface of the implant driver; wherein the thread follower comprises one or more pins that is/are removable or retractable from the guiding element of the surgical template.

2. The implant driver assembly according to claim 1, wherein at least one of the one or more first and at least one of the one or more second markers are for indicating the implant driver's final vertical position.

3. The implant driver assembly according to claim 1, wherein the digital virtually planned implant and/or implant position in the jaw of a patient are stored on a signal storage device.

4. The implant driver assembly according to claim 2, wherein one of the one or more first markers is a distributed marker.

5. The implant driver assembly according to claim 4, wherein the thread has a thread start and a thread entrance.

6. The implant driver assembly according to claim 1, wherein the implant driver narrows at one end so that the thread follower disengages from the thread.

7. The implant driver according to claim 1, wherein the implant driver is adapted to pass through the smooth bored bushing.

8. A method for determining the allowed position of a first marking on an implant driver and a second marking on a guiding element of a surgical template, comprising the steps: planning a rotational position of an implant virtually with respect to digital clinical data of a patient prior to manufacturing of the surgical template, locating the second marking on the guiding element of the surgical template in such a way that the cooperation of the second marking on the guiding element and the first marking on an implant driver allows placing of an implant in the jaw of a patient using the implant driver, so that the implant driver is moved into the rotational position, wherein the guiding element has a smooth bore adapted for receiving the implant driver.

9. A method for programming, in a setup of a dental hand piece, a rotation required to place an implant into a digitally predetermined position in a patient's jaw, comprising the steps: manufacture an implant driver that includes one or more first markers that defines a spiral wherein: the longitudinal axis of the spiral coincides with the longitudinal axis of the implant driver, a pitch of the spiral coincides with the pitch of a thread of an implant with which the implant driver is compatible, the one or more first markers on the implant driver facilitate alignment with one or more second markers on a surgical template to allow establishing a predefined initial position of the implant driver and the surgical template has a smooth bored bushing through which the implant driver passes.

10. The method according to claim 9, wherein a thread entrance and a thread start allow establishing a predefined initial position of the implant driver.

11. A method of setting up a surgical template to place an implant into a digitally predetermined position in the jaw of a patient, comprising the steps: manufacturing the surgical template such that a predetermined set of surgical instruments can be guided by a guiding element that is part of the surgical template, the surgical template being adapted for use in creating an osteotomy that is positioned according to a preoperatively planned virtual position of an implant, whereby the virtual implant position is planned with respect to digital clinical data obtained from the patient, wherein the guiding element of the surgical template is a bushing, the bushing being smooth bored, the bushing including a retractable or embedded thread follower such that the thread follower follows a spiral groove on an implant driver.

12. A kit of parts comprising a digital virtually planned implant stored on a signal storage device, an implant driver with one or more first markers, an implant to be placed and a guiding element of a surgical template including one or more second markers, so that alignment of the one or more first markers on the implant driver when it is connected to the implant and one or more second markers on the surgical template define a spiral motion of the implant when it is being inserted in a jaw bone using the implant driver, the implant driver and surgical template also including at least one of the one or more first and at least one of the one or more second markers for indicating the implant driver's final vertical position so that the implant driver's final vertical position is such that the implant, when placed, is in the same vertical and rotational or rotationally symmetric position as defined in the digital virtually planned implant

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0082] FIG. 1A shows schematically a combination of an implant driver, a virtually planned implant, a surgical template with a guiding element in the form of a smooth bored bushing and a thread follower, according to an embodiment of the present invention.

[0083] FIG. 1B shows a detail of FIG. 1A.

[0084] FIG. 2A shows a combination of an implant driver and placed implant in final position and a guiding element in the form of a smooth bored bushing of a surgical template, according to an embodiment of the present invention.

[0085] FIG. 2B shows a detail of FIG. 2A.

[0086] FIG. 3 shows a part of an implant driver with a thread, thread entrance and thread start, a part of an implant, and a guiding element in the form of a smooth bored bushing with a thread follower in the form of a guiding pin according to an embodiment of the present invention.

[0087] FIG. 4 shows an implant driver with a thread, thread entrance and thread start, an implant, and a guiding element with a thread follower in the form of a guiding pin according to an embodiment of the present invention.

[0088] FIG. 5 shows an implant driver with a thread, thread entrance and thread start, a part of an implant, and a guiding element with different thread followers in the form of guiding pins, according to an embodiment of the present invention.

[0089] FIG. 6 shows an implant driver narrowed near the top with a thread, thread entrance and thread start, a part of an implant, and a guiding element with an embedded thread follower, according to an embodiment of the present invention.

[0090] FIG. 7 shows a part of an implant driver that is in virtual final position, i.e. connected to the virtually planned implant, according to an embodiment of the present invention.

[0091] FIG. 8 shows a part of an implant driver with spiral defining markers such as a spiral line and a set of dots spaced by the pitch of the spiral and a final position marker, a guiding element with a marker to be aligned with the spiral marker on the implant driver and a final position marker to be aligned with the final position marker of the implant driver, according to an embodiment of the present invention.

DEFINITIONS

[0092] “Spiral insertion path”: when a tooth implant is inserted into a jaw bone an implant driver is rotated which screws the implant into the jaw bone. A point on the implant driver will therefore rotate and move linearly along a direction parallel to the axis of rotation whereby the combined movements generate a spiral path for the point.

[0093] “Smooth bored” means all embodiments of the present invention not having a thread or other surface irregularities on the inside of a guide element on a surgical template such as a bushing. The bore of a guide element on the surgical template such as a bushing in embodiments of the invention can have one, two three four or up to five pins or screws which enter into the bore and are used as a second marking on a guide element. The pins or screws can be tractable or can be embedded in the guide element such as a bushing. The pins or screws can be thread followers.

[0094] “Distributed marker” means a marker that is spread over the surface e.g. of the implant driver so that a part of the marker can be seen by a dentist or dental surgeon independent of the rotational position of the implant driver. Such a marker can be present at any position around the surface e.g. of the implant driver, e.g. a thread traverses 360° of the surface e.g. of the implant driver.

[0095] “Localized marker” means a marker whose are is small so that the marker is at a particular location rather than being spread over a surface. A typical localized marker would be a point or a line.

Description of Illustrative Embodiments

[0096] Embodiments of the present invention can make use of virtual planning software for planning the in silico position of an implant, i.e. to make a preoperative plan. An input to the preoperative plan is preferably one or more images obtained from one or more volumetric scans such as an MRI scan, a conventional or cone beam (CB) computer tomography (CT) scan of the patient's anatomy, e.g. the jawbone and dentition. Optionally other types of scans such as an optical scan of an in vitro model or an intraoral optical scan of a patient's mouth can be used alone or in combination with other scans. From the one or more scans, a digitization of the patient's anatomy, e.g. dentition, is obtained, e.g. by using software and conventional techniques known to the skilled person. In the preoperative plan, the digitizations of the patient's anatomy, e.g. bone and dentition, are combined and the dental surgeon or practitioner can plan virtually the implant positions and orientations in their optimal or best possible clinical and esthetical position.

[0097] Embodiments of the present invention can comprise generation and use of a digital preoperative plan, the design of a surgical template or a set of instruments as well as a method to create and use this surgical template or these instruments to place a dental implant into a predetermined virtually planned digitally defined position.

[0098] The predetermined virtually planned digitally defined position of an implant may be stored digitally in a random access memory or on a signal storage medium such as an optical disk, a magnetic tape, a hard drive, a semiconductor solid state memory such as a flash drive, etc.

[0099] By having predetermined positions of markers for example on both of an implant driver and on a surgical template, or on one of these, embodiments of the present invention can define a spiral insertion path of the implant driver that can bring an implant into a position which corresponds in rotational or rotationally symmetric position to a pre-determined virtually planned implant position. Optionally, the position can correspond in both vertical and rotational or rotationally symmetric position to a pre-determined virtually planned implant position. The latter position is called the final position and may be indicated by an additional (set of) marker(s) on either, each or both of the implant driver and a guiding element that are aligned upon reaching the final position.

[0100] FIGS. 1A and 1B show an implant driver 2 with a shank 18 and an implant driver's connection shown schematically to a virtual implant position 16 in accordance with an embodiment of the present invention. FIGS. 2A and 2B show an implant driver 2 with a shank 18 and an implant driver's connection to an actual implant 24 in accordance with this embodiment of the present invention. When an implant driver 2 is used to install an implant 24 in accordance with this embodiment it is done using a first marking such as a thread 4 for example as at least one distributed rotational marker which allows the positioning of an implant 24 into the jaw when using the thread 4 to determine the final position. Thus, as the driver 2 is rotated the implant 24 enters further into the jaw. Any point on the implant driver 2 will follow a spiral path as the driver 2 is rotated and moves downwards towards the jaw or into the jaw. The correctly terminated spiral path of the implant driver's connection to achieve an implant position that coincides in rotation and optionally both in depth and rotation to a predetermined virtual implant position, can be indicated by aligning a combination of markers on both the implant driver (e.g. first marking such as a thread 4 (see FIG. 1A), or a drawn line 26 (see FIG. 1B) or 55 (see FIG. 8)) or a set of dots in a line 56A to N (see FIG. 8), a thread start 6 or a thread entrance 8 (see FIG. 1B). . .) and localized markers (e.g. second marking such as thread follower 10, or a drawn line 27 or 28 (see FIG. 1B) or 57, 58, 59 (see FIG. 8, . . .) that have a patient-specific position on a guiding element (e.g. on a smooth bored bushing 14 (see FIG. 1A)) of a surgical template 12. The first and second markings can be aligned with each other, or can co-operate with each other, interact with each other, be coordinated with each other, interoperate with each other to bring the implant 24 into the correct final position. Thereby, the markers, such as a thread 4 (see FIG. 1A), or a drawn line 26 (see FIG. 1B), a spiral line 55 (see FIG. 8) or a set of dots in a line 56 (see FIG. 8) or a thread start 6 or a thread entrance 8 etc. on the implant driver 2 define the pitch 29 of a spiral path of the implant driver 2 (see FIG. 3). The spiral path's pitch 29 (see FIG. 3) can be optionally identical to the pitch 30 (see FIG. 3) of the implant's lead screw thread to avoid damaging of the implant 2 or the jawbone upon placing the implant 24. The alignment of these distributed spiral defining markers on an implant driver 2 and localised markers on a surgical template 12 such as on a smooth bored bushing optionally with an inserted sleeve define the spiral movement of the implant driver 2 and its final position, and, thus, the implant 24 connected to it. This places the implant 24 according to a predetermined and virtually planned digitally defined implant position, including its predetermined virtually planned final rotation position around its longitudinal axis and/or its depth within the jaw.

[0101] A surgical template 12 fits onto the oral anatomy of a patient such as teeth 13. Methods to achieve this are known to the skilled person. The surgical template 12 has a guiding element (e.g. a smooth bored bushing 14). The guiding element such as the smooth bored bushing 14, will locate over the position of a missing tooth of the patient and, hence, at a virtual implant position 16 where an implant 24 is to be placed. In an embodiment of the invention, the spiral defining first marker on the implant driver 2 is a thread 4, with a thread start 6 and a thread entrance 8 (seen best in FIG. 1B). The function of the thread entrance 8 and the thread start 6 is to facilitate the alignment of such a marker on the implant driver 2, e.g. the thread 4, with a localized second marker on the guiding element (such as on a preferably smooth bored bushing 14). This can be a thread follower defined by the apex 11 of a guiding pin/screw 10 or 15 (see FIG. 4 or FIG. 6) that is assembled to a smooth bored bushing 14 by means of a (e.g. threaded in case of a screw) hole in the smooth bored bushing 14. The position of the pin/screw's apex 11 is patient-specific and depends on the position of the virtually planned implant 16, the design specification of the implant driver 2 including its markers, 4, 6, 8, 26, 27, 28, 55, 56, 57, 58, 59 and the design specification (e.g. vertical position) of the guiding element (such as smooth bored bushing 14) of the surgical template 12. The depth with which the thread follower 10 penetrates into the guiding element such as the smooth bored bushing 14 is preferably adjustable so that the apex 11 of the thread follower 10 enters and glides in the thread 4 while still allowing the implant driver 2 to be rotated and to drive the implant 24 into the jaw bone 22 of the patient through the gingiva 20 (see FIG. 2A). When the first and second markings on both the implant driver 2 and the smooth bored bushing 14 are aligned, e.g. when the apex 11 of the thread follower follows the thread 4, the spiral path of the implant driver is such that it will drive the implant 24 into the bone in such a way that the implant 24 can be placed according to a virtually planned position, at a rotational position around its longitudinal axis or optionally both in depth and rotational position. This is called the final position.

[0102] More than one apex 11 or guiding pin/screw 10 can be used as shown in FIG. 5-10A, 10B, 10. However, in order for these guiding pin/screws 10A and B to avoid blocking the rotation at the start they can be made retractable such that they are generally in a withdrawn position and are only moved into position engaging with the groove 4 after the guiding pin/screw 10 has entered into the spiral groove 4.

[0103] The bore of a guide element on the surgical template such as a bushing in embodiments of the invention can have one, two three four or up to five pins or screws which enter into the bore and are used as a second marking on a guide element. The pins or screws can be tractable or can be embedded in the guide element such as a bushing. The pins or screws can be thread followers.

[0104] The final implant position is achieved, for example as indicated by aligning a final position marker 4, 6, 8, 26 and/or a rotational marker 27 on the implant driver 2 with final position markers 28, (top surface) 60 on the surgical template 12. For example, a localized vertical position indicating line 26 on the implant driver 2 (see FIG. 1B) can be aligned with the top 60 of the smooth bored bushing 14, or a localized rotational final position indicating line 27, 58 (see FIG. 8) on the implant driver 2 can be aligned with the localized rotational final position indicating line 28, 59 (see FIG. 8) on the smooth bored bushing 14 of the surgical template 12. Final position markers on the implant driver 2 and surgical template 12 can exist in many forms such as lines, dots, ridges, valleys, colored bands, physical stops, physical shape changes, etc. that can be created in different ways. They can be drawn, engraved, milled, painted, printed etched, laser ablated or added onto marker elements in any other way, etc.

[0105] An alternative embodiment includes an implant driver 2 that is narrowed near the top such that the thread follower 10 loses contact with the implant driver 2 before the final position is reached. This final position can be indicated by a final position marker 26. When this happens, the spiral movement is no longer dictated by the cooperation of the implant driver 2 and thread 4 with the thread follower 10, but by the (thread of the) implant 24 with the bone. This latter embodiment allows to easily detach the implant driver 2 from the implant 24 after the final position is reached, e.g. in cases where an embedded (i.e. non-retractable) thread follower 10 is used.

[0106] Alternative embodiments of the present invention can include an implant driver 2 where the thread 4 can be replaced by a different kind of distributed marker that also defines a spiral, the spiral path's pitch 29 being optionally identical to the implant's lead screw thread pitch 30 (see FIG. 3) to avoid damaging of the implant 24 or jaw bone upon placing the implant 24. These implant driver markers 4, 6, 8, 26, 27, 55, 56 can take many forms such as spirals, dots, lines which can be drawn, engraved, etched, painted, printed, laser ablated, milled, or added onto elements or by any other means, . . . Examples are a physical screw thread 4 (e.g. an engraved spiral), a laser marked spiral, a line of dots 56A . . . 56N (see FIG. 8) spaced vertically and all defining a pitch 29, etc. Preferably the thread marker 4 cooperates with a thread follower 10 which is located on the surgical template 20 and passing through the guide such as the smooth bored bushing 14. The patient-specific markers 28, 57, 59, 60 on the guiding element of the surgical template, such as the smooth bored bushing 14, can also take many forms, such as any of line(s), dot(s), groove(s), hole(s), etc. that is drawn, engraved, painted, printed, laser ablated, milled, added by any other means, etc. on the guiding element such as the smooth bored bushing 14 of the surgical template 12. Such type of markers 28, 57, 59, 60, when aligned with the markers 4, 6, 8, 26, 27, 55, 56 on the implant driver 2, allow for visual enforcement and feedback of the position of the implant driver 2 and, thus, the implant 24 connected to it, along an insertion path that places the implant 24 exactly according to a predetermined virtually planned implant position. The final position can be indicated by alignment of final position markers 4, 6, 8, 26, 27 on both the implant driver 2, such as a line 27, 58, and the guiding element, such as a line 28, 60.

Embodiments Of The Present Invention Including a Method

[0107] Embodiments of the present invention provide a method for designing, and/or manufacturing and/or utilizing a surgical template 12 and a smooth bored guide 14 with patient specific localized markers 28, 57, 59, or 60 and/or an implant driver 2 with markers 4, 6, 8, 26, 27, some of which can be distributed markers. Distributed markers can be present around all of the circumference of the implant driver. The markers are used such that an implant 24 can be placed according to a predetermined virtually planned position. This predetermined virtually planned position can be achieved through digitally planning an implant position with respect to digital clinical data which can be obtained by any suitable scanning techniques such CAT-scan, X-ray, MRI, CBCT, optical or intra-oral scan, or any combination thereof.

[0108] A method for determining the allowed positions of the surgical template guiding element's markings, such as the apex 11 of a pin - shaped thread follower 10, is provided with the following steps. [0109] Step 1: Manufacture an implant driver 2 that has one, some or all of markers 4, 6, 8, 26, 27, 55, 56, 58 in the design specification of the implant driver 2. One or more of these markers can be distributed markers, e.g. that define a spiral including following specifications: [0110] The longitudinal axis of the spiral coincides with the longitudinal axis of the implant driver 2. [0111] The pitch 27 of the spiral optionally coincides with the pitch 30 of the thread of the implant(s) with which the implant driver 2 is compatible. [0112] Optionally, the markers 4, 6, 8, 26, 27, 55, 56, 58 on the implant driver 2 facilitate alignment with the marker(s) 28, 57, 59, 60 on the surgical template 12 e.g. on smooth bored bushing 14. For example, the thread entrance 8 and thread start 6 facilitate alignment with the thread follower 10 on the surgical template 12, e.g. on bushing 14 to establish a predefined initial position of the thread start 6 and, thus, the implant driver/implant assembly. [0113] Step 2 (before or after step 1): Virtually plan an implant position for a patient's jaw with respect to digital clinical data obtained from the patient. [0114] Step 3: Based on the virtual implant position and the design specification of the implant driver 2, define the virtual spiral defined by the position of the implant driver's markers 4, 6, 8, 26, 27, 55, 56 on the implant driver 2 in its virtual final position, i.e. connected to the virtually planned implant. [0115] Step 4: Define the position of the marker(s) 28, 57, 59, 60 in the design of the surgical template's guiding element (e.g. smooth bored bushing 14) such that it can be aligned with the spiral path as defined in step 3. [0116] Step 5: Manufacture the surgical template 12 including the marker(s). [0117] Step 6: Install the surgical template 12 on the patient's anatomy, create the osteotomy, connect the implant driver 2 to the implant, insert the implant driver/implant combination in the guiding element 14 of the surgical template 12, align the markers 28, 57, 59, 60 on the guiding element 14 of the surgical template 12 with the markers 4, 6, 8, 26, 27, 55, 56 of the implant driver 2, drive the implant 24 into the bone while keeping the markers 4, 6, 8, 26, 27, 28 on both the implant driver and guiding element aligned. Stop the placement of the implant 24 when the final position is reached, indicated by final position markers on both the implant driver and the guiding element 4, 6, 8, 26, 27, 28.

[0118] An embodiment of the present invention provides a method for programming, in a dental hand piece setup, the rotation required to place an implant into a digitally predetermined position: [0119] Step 1: Manufacture an implant driver 2 that includes one, some or all of markers 4, 6, 8, 26, 27, 55, 56 in the design specification of the implant driver 2 that define a spiral including following specifications: [0120] The longitudinal axis of the spiral coincides with the longitudinal axis of the implant driver 2. [0121] The pitch 29 of the spiral optionally coincides with the pitch 30 of the thread of the implant(s) with which the implant driver is compatible. [0122] the markers 4, 6, 8, 26, 27, 57, 56, 58 on the implant driver 2 facilitate alignment with the marker(s) 28, 57, 59, 60 on the surgical template 12, such as a thread entrance 8 and thread start 6, to allow establishing a predefined initial position of the thread start 6 and, thus, the implant driver/implant assembly. [0123] Step 2: (before or after step 1) Virtually plan an implant position for a patient's jaw with respect to digital clinical data obtained from the patient. [0124] Step 3: Based on the virtual implant position and the design specification of the implant driver, define the virtual spiral defined by the position the implant driver's markers 4, 6, 8, 26, 27, 55, 56 of the implant driver 2 in its virtual final position, i.e. connected to the virtually planned implant 24. Furthermore, identify the position of a thread start 6 of the implant driver 2 that is virtually connected to the virtually planned implant position. This is the thread start's final position (see FIG. 7). [0125] Step 4: Choose the position of the thread follower/guiding pin 10 in the design of the surgical template 12,e.g. the position of guiding pin's apex 11, as a point located on the spiral path as defined in Step 3. By definition, upon implant placement, the thread start's initial position will coincide with the position of the thread follower 10. See section “Operating principle” below for more details. [0126] Step 5: Calculate the polar rotation required to move the thread start's initial position to the thread start's final position (determined in step 3) following the spiral defined by the markers 4, 6, 8, 26, 27, 55, 56 of the implant driver 2. This can be done using the following formula where α is the polar rotation, h is the vertical height (measured along the longitudinal axis of the virtually planned implant) between thread start's initial position and the thread start's final position:

[00002]$\alpha =2\pi .Math.\frac{h}{\mathrm{pitch}}$ [0127] Step 6: Program this polar rotation into a dental hand piece system such that this rotation can applied to the implant driver 2 after the thread start 6 was moved into its initial position, i.e. thread start 6 coincides with the position of the thread follower 10, e.g. a guide pin's apex position 11.

Operating Principle

[0128] For the sake of clarity, an embodiment of a surgical template 12 with a guiding element in the form of a bushing 14 (preferably smooth bored) with a single guiding thread follower such as a pin 10 is disclosed. [0129] First a surgical template 12 is designed and manufactured such that a predetermined set of surgical instruments can be guided by a guiding element such as a bushing 14 (preferably smooth bored) that is part of the template 12. This surgical template 12 is used to create an osteotomy that is positioned according to a preoperatively planned virtual position of an implant 24. That virtual implant position is planned with respect to digital clinical data obtained from the patient. [0130] The guide element or bushing 14 (preferably smooth bored) of the surgical template 12 is designed and manufactured such that it includes a retractable or embedded thread follower 10 such as the apex 11 of retractable pin/screw 10 or embedded pin 15 (see FIG. 6), such that the pin/screw's apex 11 will be positioned on the spiral defined by the method. [0131] After the osteotomy has been created, the implant driver 2 is or can be connected to the implant 24, this assembly being suitable for being moved into, or is then moved into the guiding element such as a bushing 14 (preferably smooth bored) of the surgical template 12. The driver thread entrance 8 is aligned with the apex 11 of the pin/screw 10, 15, the driver 2 is then moved down into the bushing 14 (preferably smooth bored) until the thread start 6 coincides with the pin/screw's apex 11. This is the thread start's initial position. [0132] Then, the implant driver/implant assembly is moved down in a spiral motion that is forced by the implant driver's thread 4 and the bushing's thread follower 10 since the pin's/screw's apex 11 is following the thread 4 of the implant driver 2. This movement is continued until the thread start 6 and thus the implant diver/implant assembly, is moved into its final position. This final position can be further indicated by aligning final position markers 4, 6, 8, 26, 27, 58 on the implant driver 2, with final position markers on the surgical template, such as line 28, the top 60 of the surgical template 12 and a line 59 on the bushing 14 (preferably smooth bored), respectively.