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SPI ® VARIOmulti MULTIUNIT, OCCLUSAL SCREW-RETAINED BRIDGE RESTORATIONS. Prosthetic procedure
SPI®VARIOmultiMULTIUNIT, OCCLUSAL SCREW-RETAINED BRIDGE RESTORATIONS.Prosthetic procedure
2 © Thommen Medical
1. At a glance
These instructions apply to all VARIOmulti Abutments, including associated VARIOmulti auxiliary parts, as listed in the product catalogue (www.ifu-tm.com/THM31111). There, you will also find directions on the identifying characteristics (geometries, dimensions) of the individual components.
Component Material
VARIOmulti abutment/VARIOmulti abutment angled Pure titanium grade 4
Abutment screw Titanium alloy
VARIOmulti protective cap, incl. occlusal screw Titanium, titanium alloy
VARIOmulti temporary cap, incl. fabrication screw Stainless steel
VARIOmulti impression coping Aluminum
VARIOmulti gold cap, incl. burn-out cylinder OA/burn-out plastic
VARIOmulti burn-out cap Plastic
LOCATOR® abutment and collar for VARIOmulti Titanium alloy with TiN coating/ titanium alloy
VARIOmulti analog Stainless steel
Occlusal screw Titanium alloy
Bone contouring instrument Stainless Steel
INDICATION
Thommen Medical VARIOmulti Abutments are to be used in conjunction with Thommen System dental implants in the maxillary and/or mandibular arch to provide support for bridges and overdentures.
RESTRICTIONS FOR USE
VARIOmulti abutments must not be used for single tooth restorations.See general restrictions of use (Page 11).
STORAGE
VARIOmulti burn-out plastic caps and the VARIOmulti gold cap incl. burn-out cylinder must be stored at room temperature and protected from exposure to strong light or high heat.
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CLINICAL USE
The Thommen Medical VARIOmulti abutment is designed for multi-unit, screw-retained bridge restorations and must not be used for individual imp-lant restorations.
Angled abutments on small diameter implants (PF B 3.5 mm) are not recom-mended for use in the molar region, unless they are splinted to larger diameter implants to distribute occlusal forces.
Depending on the number and position of implants, implant divergences of up to approximately 40° are bridgeable with VARIOmulti abutments.
Before insertion and attachment of the prosthetic components, the implant shoulder and inner configuration must be free of contaminants and overhan-ging soft tissue.
For permanent insertion, it is essential to use new abutment and occlusal screws. Torque value for the attachment of the titanium base:
VARIOmulti abutment straight/angled (abutment screw) · 15 Ncm for PF B 3.5 mm· 25 Ncm for PF B 4.0–6.0 mm
Occlusal screw · 15 Ncm (or 10 Ncm if using the VARIOmulti protective cap)
You can find an overview of all torque values for the attachment of Thommen abutments online at: www.ifu-tm.com/THM61122.
The LOCATOR abutment and collar is a Zest product – more product i nformation is available online at: www.ifu-tm.com/THM61126. LOCATOR® is a registered trademark of Zest Anchors LLC.
2. Application and handling
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Bone contouring instrument
Bone contouring instrument
ATTACHING THE ABUTMENT
Remove the gingiva former or temporary bridge from the implant. Clean and dry the inner configuration of the implant thoroughly. If bone prevents the complete seating of the abutment, use the bone contouring instrument to remove excess bone. The bone contouring instrument can be used manually with the short MONO insertion device or under power. If you use the contra-angle handpiece, we recommend cooling with physiological, sterile, cooled saline solution (approx. 5° C/41º F) at a maximum rotational speed of 200 rpm. Use the bone contouring instrument exclusively for VARIOmulti abut-ment angled. For more information please see the “Surgical Procedure”.
VARIOmulti straightUse the enclosed plastic handle to place and hand-tighten the straight VARIO multi abutment. Remove the handle and tighten the VARIOmulti abut-ment to the recommended torque value using the MONO insertion device and MONO torque ratchet.
Fix the VARIOmulti abutment directly on the implant with a tightening torque of: · 15 Ncm for PF B 3.5 mm· 25 Ncm for PF B 4.0–6.0 mm
VARIOmulti angledUse the positioning handle (art. no. 3.03.521) to place the angled VARIOmulti abutments. Screw the handle gently onto the abutment without force. Align-ment of the angled VARIOmulti abutments can only be optimal if the Implant‘s inner hex was also correctly aligned during implantation.
Remove the handle and tighten the VARIOmulti abutment to the recommen-ded torque value using the MONO insertion device and MONO torque ratchet to a torque value of:· 15 Ncm for PF B 3.5 mm· 25 Ncm for PF B 4.0–6.0 mm
ABUTMENT LEVEL IMPRESSION
The impression must be carried out using the open tray technique and an elastomer impression material (no hydrocolloids). Position the VARIOmulti impression coping on the abutment and secure using the yellow screw for impression coping PF B 3.5 mm. Ensure that the impression coping is po-sitioned properly before tightening. The impression coping may be shorte-ned by one retention ring, if needed. A short screw for impression coping PF B 3.5 mm is recommended in this case. After shortening the impression co-ping, smooth the resulting rough or sharp edges with a suitable instrument to prevent the screw from binding. Allow the impression material to set, and then loosen and remove the impression screws. Remove the impression and send it together with the impression screws to the laboratory for fabrication of the model.
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IMPLANT LEVEL IMPRESSION
Different impression copings with corresponding impression screws are availa-ble for the open- or closed-tray technique on the implant level. See Product Catalogue (www.ifu-tm.com/THM31111) for all impression components. If impression is taken on implant level, temporary restorations are fabricated using customizable gingiva formers or temporary abutments.
For more information about impression techniques please refer to www.ifu-tm.com/THM61127
MASTER CAST FABRICATION
VARIOmulti abutment analogs should be used for fabricating the model after taking the impression at the abutment level. Place the analogs on the VARIO-multi impression copings and tighten onto the impression copings using the yellow screws PF B 3.5 mm. The model analogs must only be used once (single use).
MODIFICATION OF THE ABUTMENT
Modification of VARIOmulti abutments is not permitted.
VARIOmulti protective capClean the VARIOmulti abutment thoroughly in the mouth. The VARIOmulti protective cap has an integrated occlusal screw. Tighten the protective caps using a tightening torque of 10 Ncm. The protective cap must not be sub-jected to any stress loading.
FABRICATING THE TEMPORARY RESTORATION CHAIRSIDE
VARIOmulti temporary capVARIOmulti temporary caps must be veneered and blocked with temporary plastic. It is recommended that the surface of the temporary cap is sandbla-sted for better adhesion to the plastic. The screw channel must be protected during the veneering process. Ideally, this should be done using the modeling screw, included in the package. The following applies:· Single use· Do not use for permanent insertion· Isolate with Vaseline before modeling· Tighten by hand only (max. 5 Ncm)
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It is mandatory to use new occlusal screws to insert the temporary supra-structure, with a final tightening torque of 15 Ncm. Seal the occlusal screw openings after fixation of the temporary restoration. Use a removable mate-rial (e.g. cotton, gutta-percha) to cover and protect the screw head, followed by composite which seals the screw channel.
CONSTRUCTING THE FINAL PROSTHETIC RESTORATION
The final reconstruction must be carried out in accordance with the most up-to-date dental technology in compliance with the manufacturer’s in-structions for the materials used.
Gold capsVARIOmulti gold caps for occlusal screw-retained bridges consist of a non-oxidizing, precious metal alloy and a plastic cylindrical structure for frame-work modeling.
Special instruments from Thommen are available for reworking the perime-ter of the base and the screw seat after casting (see from page 8 for options and instruction).
Material specification: VARIOmulti gold capMelting interval 1400–1460 °C (2552–2660°F)Coefficient of thermal expansion 25–600 °C/77–1112 °F 12.8 μm/mkPrecious metal content 0.3 grGold 60 %Platinum 24 %Palladium 15 %Iridium 1 %
Burn-out plastic capsThe outer ring reinforces the screw seat and serves as retention for the mo-deling material. The cylindrical structure of the screw channel is marked with a minimum height indication (A). The screw channel must not be shor-tened below this indication to remain above the height of the final abutment screw.
The occlusal screw used for modeling must be hand-tightened only using minimal force.
Excessive tightening will deform the plastic cap and result in a distorted Pattern.
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Do not wax below this margin
Wachs nichtüber den Rand auftragen
Wachs nichtüber den Rand auftragen
Wachs nichtüber den Rand auftragen
Place the VARIOmulti caps (plastic or gold) on the Analog and secure them with occlusal screws. Shorten the plastic cylinders so that they are slightly out of occlusion. Begin with framework fabrication (wax-up).
The gold base must not be modified in any manner. The plastic screw chan-nel can be shortened if necessary (to the indicator) as described above.
WAX-UP AND FRAMEWORK CONSTRUCTION WITH GOLD CAP
During the wax-up of the frame it is important that the VARIOmulti gold caps are completely covered by wax in the areas which will receive porcelain veneer.
To prevent casting alloy from overflowing onto the machined surface of the VARIOmulti Gold Caps, do not cover the fine-structured marginal edge with wax. Clean the margin of wax and debris before the investing procedure.
A final thickness of 0.3 mm must be maintained by the cast alloy layer. Since VARIOmulti gold caps are made of a non-oxidizing alloy and do not form a bonding oxide, ceramic material cannot be directly fused to this alloy. If the casting alloy layer is too thin or perforated through to the gold base, cera-mic bonding issues will result. Please comply with the recommendations of the alloy manufacturer.
WAX-UP AND FRAMEWORK CONSTRUCTION WITH PLASTIC CAP
The outside of the burn-out plastic cap must be covered by a minimum wax layer of 0.3 mm in thickness. The fine-structured marginal edge must not be covered by wax.
The investment mold material needs to be matched with the alloy used (preferably with a high gold content).
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PROCESSING THE FRAMEWORK
The internal screw seat must not be sandblasted under any circumstance. Ultrasound, water jet, pickling acid or glass fiber brush are suitable for the careful removal of the investment mold.
If casting flash or defects are detected on the perimeter of the machined surface, these defects can be carefully removed (preferably under magnifi-cation) with the VARIO/VARIOmulti reamer for base (art. no. 3.03.420) and with the replaceable guide pin for VARIOmulti reamer (art. no. 3.03.424).
The internal screw seat must not be modified with a handpiece under any circumstances. Reducing the screw seat would allow the occlusal screw to penetrate more deeply into the internal configuration. This would result in a loss of mechanical strength, and proper retention would no longer be gua-ranteed.
The screw seat can be refined manually and is done only after smoothing the perimeter of the base. In order to refine the screw seat properly, use the VARIOmulti reamer for the screw channel (A) and the associated guide (B). Position the bridge abutment to be reworked on the contact area of the guide (C). Operate the reamer manually using the MONO insertion device (D).
Introduce the VARIOmulti screw channel reamer into the screw channel and rotate it clockwise. During the finishing process, the perimeter of the abutment’s base must completely cover the contact area of the guide (C).
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Rotate the VARIOmulti reamer (art. nr. 3.03.437) into the screw chan-nel as far as it will go (E). Perform the finishing process likewise for each bridge abutment.
Smooth the surface of the screw seat (F) with the reamer. The reamer is not suitable for removing coarse casting beads or overflows in the screw channel or screw seat.
If casting flash or defects are detected in the screw seat or connec-tion geometry, the framework must be remade.
Finish the framework using conventional methods in preparation for ceramic veneer.
When polishing the outer crown margin, first attach it to the analog to protect the connection geometry, thereby preventing the danger of marginal damage.
FABRICATING THE DEFINITIVE PROSTHETICRESTORATION USING CAD/CAM
The VARIOmulti system can be used to fabricate multiunit, occlusal screw-retained framework(s) on implants in fully or partially edentu-lous upper and lower jaws using CAD/CAM.
The Thommen Medical Implant System is a comprehensive concept. Apart from the exceptions described below, it must be used only in conjunction with the original components and instruments of Thom-men Medical and in full compliance with the instructions provided by Thommen Medical.
The use of parts from non-partner manufacturers may compromise the function of the Thommen Medical implants and prosthetic com-ponents and can lead to failure. Please note that not all of the products or processes mentioned in these instructions for use are available in all countries. Please consult with your country’s sales representative.
Exception: Application of the Procera® System (Nobel Biocare) on abutment level All VARIOmulti abutments and the VARIOmulti analog have the same abutment head geometry (diameter, cone height and angle, internal thread, etc.) as the Multiunit abutments of Nobel Biocare. Therefore, a framework made by Procera can be placed on VARIOmulti abut-ments.
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To use Procera® technology, the frame is fabricated with Nobel Biocare tem-porary multiunit titanium caps (incl. prosthetic screw, art. no. 29046), which are placed on the VARIOmulti analog. For all NobelProceraTM suprastructures on VARIOmulti abutments use only the Nobel Biocare prosthetic screw and screwdriver provided by Nobel Biocare, also if the prosthetic screw has to be replaced at a later stage. Prosthetic screws (order number: 29285) and scre-wdrivers are thus available only from Nobel Biocare.
Please comply with the user instructions of both manufacturers.
DEFINITIVE ATTACHMENT OF THE PERMANENT RESTORATION
Remove the temporary restoration from the abutment and clean the abut-ment. Always use new occlusal screws for permanent fixation of the supra-structure. Take the permanent restoration from the master model, clean it, and place it in the mouth of the patient. Tighten the occlusal screws using a tightening torque of 15 Ncm.
Using CAD/CAM (Nobel Procera)The permanent restoration is inserted and secured using Nobel Biocare pros-thetic screws (art. no. 29285) and the corresponding set of instruments. Use a tightening torque of 15 Ncm, as recommended by Nobel Biocare, to tighten the prosthetic screws.
Seal the occlusal screw openings after fixation of the final restoration. Use a removable material (e.g. gutta-percha) to cover and protect the screw head, followed by composite to seal the screw channel.
CLEANING, DISINFECTION, STERILIZATION
Thommen abutments and components are not supplied in a sterile state. Unless directed otherwise, a steam sterilization of the abutment and plastic handle (straight abutments) is recommended:· Fractionated vacuum procedure with at least 3 vacuum steps,
(with adequate product drying)· A steam sterilizer compliant with DIN EN 13060/DIN EN 285 and/or
ANSI AAMI ST 79 (for USA: FDA clearance)· Maximum sterilization temperature of 138 °C (280 °F; plus tolerance in
compliance with DIN EN ISO 17665)
Sterilization time (exposure time at sterilization temperature) of at least 4 minutes (or 18 minutes, prion inactivation – not relevant for USA) at 132 °C (270 °F)/134 °C (273 °F). Steam sterilize straight VARIOmulti abutments and plastic handles.
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3. General notes
THOMMEN IMPLANT SYSTEM
Manufacturer: Thommen Medical AG Neckarsulmstrasse 28 2540 Grenchen, Switzerland www.thommenmedical.com
Batch code
Use by date
Date of manufacture
Sterilized using irradiation
Sterilized using steam or dry heat
Temperature limitation
Do not re-use
Non-sterile
Caution
Article number
Conformity symbol as specified by EU Directive MDD 93/42/EEC
Consult instructions for use
Do not resterilize
Do not use if package is damaged
Atmospheric pressure limitation
Manufacturer
Keep away from sunlight
May only be sold to and prescribed by physicians (USA)
COLOURED WARNING STICKERApplication has changed - follow the corresponding instruc-tions for use.
New design – the application has not been changed.
PRODUCT INFORMATION The information in this document describes the application of the Thommen Medical implant system. This information is available in electronic form online at: www.ifu-tm.com. For technical advice, the responsible country representative or distributor of Thommen Medical AG is present to answer questions.
COLOR CODE Each implant platform diameter has a color code, which can be found on all implant and abutment packagings, on the impression items and on most diameter-specific instruments.
brown = PF 3.0
Yellow = PF B 3.5 mm
Green = PF B 4.0 mm
Blue = PF B 4.5 mm
Grey = PF B 5.0 mm
Purple = PF B 6.0 mm
AVAILABILITY Not all of the Thommen Medical products mentioned in these instructions for use are available in all countries. The responsible country representative or distri-butor of Thommen Medical AG informs about availability for the country in question.
GENERAL RESTRICTIONS OF USE Restorations with cantilevers to individual implants are not recommended. In-dividual restorations with angled abutments should not be used in regions with high mechanical stress. For implants with a small diameter (PF 3.0 and 3.5), the prosthetic restoration should be constructed in such a way that large bending moment does not occur. The Thommen Medical products may not be used on patients who are known to have allergies to the corresponding materials.
POSSIBLE COMPLICATIONS A stressed loading of the implant or abutment over and above its functional capacity can lead to excessive bone loss or fracture of the implant or restoration. The clinician must supervise the occlusion and functional loading of the prosthetic supraconstruction very carefully.
WARNINGS/PRECAUTIONS All Thommen Medical products that come into effect inside the oral cavity must be protected against aspiration. Thommen Medical products have not been evaluated for safety and compatibility in the MR envi-ronment. Thommen Medical products have not been tested for heating, migration, or image artifact in the MR environ-ment. The safety of Thommen Medical products in the MR environment is unknown. Scanning a patient who has this product may result in patient injury.
RESPONSIBILITY/LIABILITY As a part of an overall scheme, Thommen Medical products may be used only with the ori-ginal components and instruments in accordance with the instructions for use provided by Thommen Medical. The use of non-system parts may compromise the performance of Thommen Medical products and lead to failures. Users must have appropriate knowledge and information about the handling of Thommen Medical products in order to use the products safely and professionally in accordance with the in-structions for use. Thommen Medical products should only be used in accordance with the instructions for use provided by Thommen Medical. The user is obliged to use the Thommen Medical products according to the instructions for use and to check whether the product is suitable for the individual patient situation. The use of Thommen Medical products is the responsibility of the user, as such, beyond the control of Thommen Medical AG. We refuse to accept any responsibi-lity or liability for any damage due to incorrect utilization of the product. Products labeled “Do not re-use” may not be refurbished and/or reused. The refurbishment and/or reuse of these products can affect their function (e.g. fitting and/or cutting properties) as well as their safe use (e.g. risk of infection, disease transmission, fading of the laseror color marks, corrosion). Detailed information about the possible consequences, which may result from negligence to follow this information, can be obtained from the responsible country representative or distributor of Thommen Medical AG. Caution: Federal law (USA) restricts this device to sale by or on the order of a dentist or physician.
GUARANTEE The comprehensive guarantees can be found in the country-specific guarantee leaflets.
TRANSPORT AND STORAGE Please note the specifications on all labels and package leaflets regarding transportation, storage and instructions for use. Products whose packaging is damaged must not be used. Under no circumstances may Thommen Medical products be used beyond the expiry date, as proper functioning or sterility of sterile packaged pro-ducts cannot be guaranteed by the manufacturer anymore.
INSTRUCTIONS FOR USE The following information is not intended as comprehensive for the Thommen Implant Sys-tem. New customers are advised to undergo training by a specialist experienced in the use of this system.
GUARANTEE OF STERILITY Products of the Thommen Implant System supplied in sterile packaging must not be re-steri-lized. If the sterile packaging is damaged during transport or storage, the product may under no circumstances be used. Products that have been opened and have not been immediately used for the intended operation must not be used thereafter. After resterilization, the safety, function and efficacy of the product cannot be guaranteed by the manufacturer. The products intended for single use must never be reprocessed, sterilized or reused and must be dis-posed of safely and properly after use in compliance with all applicable legal and regulatory requirements. Reusable products must be reprocessed according to the instructions for use and, if used on patients, sterilized. They must be checked for their integrity before each use. Any damage (such as scratches, cracks, nicks, notches), as well as bent parts mean that they must not be used any more. The number of reprocessing cycles is limited and must be moni-tored. If the number of cycles is exceeded, proper function and sterility of the product are not guaranteed by the manuf-acturer anymore.
DISPOSAL In the case of cutting products, there is always a risk of injury, therefore the products must be disposed of safely and properly after use, observing all applicable legal and regulatory requirements. Products that have been used on a patient are at risk of infection. After application, they must be disposed of safely and properly in compliance with all applicable legal and regulatory requirements.
COPYRIGHT©/REGISTERED® SPI®, INICELL® and APLIQUIQ® are registered trademarks of Thommen Medical AG. Publi-cation or reproduction is permitted only with the written consent of Thommen Medical AG. LOCATOR® is a registered trademark of Zest Anchors Inc., CA, USA. Novaloc® is a re-gistered trademark of Valoc AG, Möhlin, CH.
VALIDITY © Thommen Medical AG. All rights reserved. This instruction for use replaces all previous editions.
HEADQUARTERS
Thommen Medical AG Neckarsulmstrasse 282540 Grenchen | SwitzerlandTel. +41 61 965 90 20Fax +41 61 965 90 [email protected]
SUBSIDIARIES/NATIONAL DISTRIBUTORS
AUSTRALIA/NEW ZEALANDOsteon Medical23/1866 Princess HighwayClayton Victoria 3168 | AustraliaTel. (inside Australia): 1300 411 473Tel. (outside Australia): +61 3 9264 [email protected]
AUSTRIAThommen Medical Austria GmbHMühlgasse 32322 Zwölfaxing | AustriaTel. +43 660 [email protected]
BENELUXThommen Medical Benelux B.V. Dierenriem 13738 TP Maartensdijk | NetherlandsTel. +31 30 68 68 [email protected]
CHINA Shanghai Yujing Trading Co., Ltd.Room G | Floor 15th | Plaza JiaFa | No.1Lane 129 | DaTian Road | JingAn DistrictShanghai | ChinaTel. +86 21 62723077Fax +86 21 62175264
FINLAND Vector Laboratories OyEngelinaukio 8 B00150 Helsinki | FinlandTel. +358 400 940 [email protected]
FRANCEThommen Medical France10 avenue Gabriel Pierné 77680 Roissy-en-Brie | FranceTel. +33 1 83 64 06 35Fax +33 3 89 33 52 [email protected]
GERMANYThommen Medical Deutschland GmbHAm Rathaus 279576 Weil am Rhein | GermanyTel. +49 7621 422 58 30 Fax +49 7621 422 58 [email protected]
HONG KONGShengyuan (Hong Kong) Int. Trade Co. Ltd.Level 13, 68 Yee Wo StreetCauseway Bay | Hong KongTel. +852 530 876 41
ITALYDental Trey S.r.l.Via Partisani, 347016 Fiumana | Predappio (FC) | ItalyTel. +39 0543 929111Fax +39 0543 [email protected]
JAPANJ. Morita Corporation3-33-18, Tarumi-choSuita | Osaka 564-8650 | JapanTel. +81 6 6384 6921Fax +81 6 6384 6746www.morita.com
LITHUANIA/LATVIACERNIKIS MEDICAL PROJECTS, UABSiaures prospektas 5B, KaunasLithuania LT-49191Tel. +370 37 201072Mobile +370 65 [email protected]
MIDDLE EASTStar Science International GmbHJupiterstrasse 573015 Bern | SwitzerlandTel. +41 31 941 07 31Fax +41 31 941 07 [email protected]
NORWAYNovus Dental ASJohannes Bruns gate 50452 Oslo | NorwayTel. +47 951 07 [email protected]
POLANDC.WITT DENTAL Sp. z o. o.Ul. Granitowa 1087-100 Toruń | NIP 951-15-08-371 | PolandTel. +48 56 623 61 [email protected]
REPUBLIC OF CROATIA Futura Dental d.o.o.Kralja Zvonimira 10810 000 Zagreb | Republic of CroatiaTel. +385 91 6814 [email protected]
RUSSIAN FEDERATIONCIS – JSC GeosoftBuild. 14, Ap. 16, 3-ya Mytishchinskaya ul.Moscow, 129626 | Russian FederationTel. +7 495 663 22 [email protected]
SINGAPOREFONDACO Pte Ltd7 Kaki Bukit Road 1, #03-06Eunos Techno LinkSingapore 415937 | SingaporeTel. +65 6392 2806Fax +65 6392 [email protected]
SOUTH KOREAAPS Advanced Prosthetic Solution201, Kolon Aston505-14 Gasan-dong Geumchoen-guSeoul | South KoreaTel. +82 2 3141 2875Fax +82 2 3141 2877www.apsdd.com
SPAIN/PORTUGALThommen Medical IbéricaC/Los quintos n 103350 Cox (Alicante) | SpainTel. +34 96 536 1020Mobile +34 606 99 78 [email protected]
SWITZERLANDThommen Medical AGNeckarsulmstrasse 282540 Grenchen | SwitzerlandTel. +41 32 644 30 20Fax +41 32 644 30 [email protected]
TAIWANEn-Jye International Co., Ltd.No. 18 | Lane 177 | Sec 3 | Chengde Rd.Taipei, 103 TaiwanTel. +886 2 2585 1669Fax +886 2 2585 [email protected]
TURKEY Bioport Biyolojik Maddeler A.S.Büyükdere cd. Subay evleri 9. Blok D1 EsentepeSisli 34394 Istanbul | TurkeyTel. +90 212 2727577Fax +90 212 [email protected]
USA/CANADAThommen Medical USA L.L.C.1375 Euclid Avenue | Suite 450Cleveland OH 44115 | USATel. +1 866 319 9800 (toll free)Fax +1 216 583 [email protected] [email protected]
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