Implant Tribune U.S. No. 8, 2012
Events / News / Industry / Products
Table of contents
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IMPLANT TRIBUNE
The World’s Dental Implant Newspaper · U.S. Edition
AUGUST 2012 — Vol. 7, No. 8
www.dental-tribune.com
Titanium implants may
carry risk of corrosion
By Dental Tribune International
B
IRMINGHAM, U.K.: Titanium
medical implants used in
dental prostheses and boneanchored hearing aids may be
less robust than commonly believed.
Researchers have found evidence to suggest that in environments where there is
no significant wear process, microscopic
particles of titanium can be found in the
surrounding tissue, which may have a
negative impact on the devices, as this
can potentially be pro-inflammatory.
Globally, more than 1,000 tons of titanium are implanted into patients in
the form of biomedical devices every
year. Metallic prostheses, fixation and
anchoring devices are used extensively
for dental, orthopedic and craniofacial
rehabilitation and their effects on the
body are widely perceived to be predictable following initial implantation.
Titanium was first discovered in England in 1791.
Today, it occurs mainly in Australia, North
America, Malaysia, Russia and Scandinavia.
(Photos/Provided by concept w and Sergey
” See TITANIUM, page C7
Shcherbakoff, Shutterstock)
ICOI celebrates its 40th anniversary
at World Congress XXIX in Orlando
T
he ICOI will commemorate 40
years of implant education and
camaraderie when it holds its
World Congress XXIX in Orlando from Sept. 20 –22. The venue for this
World Congress will be the World Center
Marriott Hotel.
Since its inception in 1972 at its first
World Congress in Paris, the ICOI has
grown from a fledgling “study club” to
more than 13,000 dues-paying members
in 2012. Its membership spans to all continents save for Antarctica. Initially, the
ICOI office was run out of ICOI co-chair,
Dr. Kenneth Judy’s office, then from an
office in his home. The ICOI now occupies an entire floor of an office building
in Upper Montclair, N.J.
To help the ICOI acknowledge its 40th
anniversary, leaders from its component
and affiliate societies around the world,
as well as members of its International
Ambassadors’ Circle, will be present in
Orlando.
Dr. John Russo created and prepared
the scientific program for the Orlando
World Congress. A diversified and international faculty will honor this World
Congress, he said.
The complete scientific program is as
follows:
Thursday, September 20
Afternoon session host: Dr. John Russo
12:45 to 1 p.m. — Opening
comments, Drs. Kenneth Judy, Jon Suzuki and John Russo
1 to 2 p.m. — Dr. Michael Pikos: “Alveolar Ridge Regenerative Strategies — Autogenous Bone vs. Tissue Engineering”
2 to 3 p.m. — Dr. Richard Kraut: “Predictable Horizontal and Vertical Bone
Augmentation of the Alveolar Ridges”
3 to 3:30 p.m. — Break with exhibitors
3:30 p.m. to 4:30 p.m. — Dr. Jon Suzuki:
“Clinical Advances in Implant Regeneration Surgery”
4:30 to 5:30 p.m. — Ulrich Hauschild:
“The Standardization of ComputerAided Implantology Process Visualized
on Complex Cases”
5:30 to 6:30 p.m. — Dr. Kenneth Hebel:
“The Revolutionary Digital Denture: A
Game Changer for Implant Dentistry”
6:30 to 8 p.m. — Tabletop and Poster
Presentations/Welcome Reception
“The Edentulous Maxilla: Questions
and Answers to Current Implant Controversies”
10 to 10:30 a.m. — Break with exhibitors
10:30 to 11:30 a.m. — Dr. Robert Marx:
“The Effective Use of (rhBMP-2) in Ridge
Augmentation Prior to Implant Placement”
11:30 a.m. to 12:30 p.m. — Dr. Bradley
McAllister: “Bone Augmentation with
Cellular Allograft”
12:30 to 1:30 p.m. — Lunch with exhibitors
Friday, Sept. 21
Friday, Sept. 21
Morning session host: Dr. Thomas Ford
8 to 9 a.m. — Dr. Craig Misch: “Emerging Trends in Methods and Materials for
Bone Augmentation”
9 to 10 a.m. — Dr. Edwin McGlumphy:
Afternoon session host: Dr. Thomas
Ford
1:30 to 2:30 p.m. — Dr. Carl Misch:
” See ICOI, page C2
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“ ICOI, Page C1
IMPLANT TRIBUNE
“Prosthetic-Related Complications”
2:30 to 3:30 p.m. — Dr. Rick Ferguson:
“Bone Grafting — Misconceptions and
Strategies for Predictable Success”
3:30 to 4:15 p.m. — Break with exhibitors
4:15 to 5 p.m. — Dr. Shohei Kasugai:
“New Approach to Bone Augmentation:
Respecting Endogenous Key Players and
Providing Space for Regeneration”
5 to 6 p.m. — Dr. John Russo: “Reduce
Complications, Increase Confidence,
Achieve Excellence”
7 to 8 p.m. — Awards ceremony
Publisher & Chairman
Torsten Oemus t.oemus@dental-tribune.com
Chief Operating Officer
Eric Seid e.seid@dental-tribune.com
Group Editor
Robin Goodman r.goodman@dental-tribune.com
Editor in Chief IMPLANT Tribune
Sascha A. Jovanovic, DDS, MS
sascha@jovanoviconline.com
Managing Editor Implant Tribune
Sierra Rendon s.rendon@dental-tribune.com
Managing Editor Show Dailies
Kristine Colker k.colker@dental-tribune.com
Saturday, Sept. 22
Morning session host: Dr. Rick Ferguson
8 to 9 a.m. — Dr. Bach Le: “Management of the Ailing Implant”
9 to 10 a.m. — Dr. Pablo Galindo
Moreno: “Bone Level Stability Around
Implants Placed in Pristine and Grafted
Areas”
10 to 10:30 a.m. — Break with exhibitors
10:30 to 11:30 a.m. — Dr. Maurice
Salama: “Contemporary Reconstructive
Hard- and Soft-Tissue Surgery: Myths,
Realities and Future Trend in Dentistry”
11:30 a.m. to 12:30 p.m. — Dr. Jeremy
Mao: “Regenerative Dental Products:
Science Fiction or Reality”
12:30 to 1:30 p.m. — Lunch with exhibitors
Managing Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.com
Managing Editor
Robert Selleck, r.selleck@dental-tribune.com
Dr. Maurice Salama. (Photos/Provided by ICOI)
Dr. Michael Pikos
A large number of sponsored precongress courses will be offered on
Thursday morning, Sept. 20.
The event’s Gold Sponsors, DENTSPLY IMPLANTS and MIS, will provide
hands-on courses.
Dr. Jin Kim, and his sponsor,
DENTSPLY, will wow attendees with his
course on “Mastering Clinical Digital
Photography,” organizers said. Among
other things, this course will instruct
attendees on mastering the techniques
for surgical and cosmetic operative documentation purposes.
MIS’s representative, Dr. Amos Yahav,
Account Manager
Humberto Estrada h.estrada@dental-tribune.com
Marketing Manager
Anna Wlodarczyk-Kataoka
a.wlodarczyk@dental-tribune.com
Project and Events manager
Lorrie Young l.young@dental-tribune.com
C.E. DIRECTOR
Christiane Ferret c.ferret@dtstudyclub.com
Dental Tribune America, LLC
116 West 23rd Street, Suite 500
New York, NY 10011
Phone (212) 244-7181
Fax (212) 244-7185
Published by Dental Tribune America
© 2012 Dental Tribune America, LLC
All rights reserved.
Saturday, Sept. 22, 2012
Afternoon session host: Dr. Scott Ganz
1:30 to 2:30 p.m. — Dr. Alan Fetner:
“Subcrestal Implant Placement to Optimize Soft-Tissue Esthetics — Controversy and Practicality”
2:30 to 3:30 p.m. — Dr. Fred Bergmann:
“Current Protocol of Bone and SoftTissue Management in the Atrophic Alveolar Ridge for the Long-Term Esthetic
and Functional Outcome”
3:30 to 4 p.m. — Break with exhibitors
4 to 4:45 p.m. — Dr. Scott Ganz: “A
Comparison of Interactive Software
Applications in Assessing the Reality
of Anatomy: Diagnostics and Implant
Planning Accuracy”
4:45 to 5:30 p.m. — Dr. Ady Palti: “SoftTissue Management for Esthetic Results
with Modified Abutments. A New Concept for the Daily Practice”
5:30 to 6 p.m. — Dr. Mariano Herrero
Climent: “Surgical Decision Making in
Esthetic Implant Dentistry”
6 to 6:30 p.m. — Dr. Konstantinos
Valavanis: “Perimplant Tissue Design:
Parameters and Key Factors for Optimum Esthetics”
6:30 p.m. — Closing comments, Drs.
Jon Suzuki and John Russo
Implant Tribune U.S. Edition | August 2012
Dental Tribune strives to maintain the utmost accuracy in its news and clinical reports. If you find a
factual error or content that requires clarification,
please contact Managing Editor Sierra Rendon at
s.rendon@dental-tribune.com.
Dr. Carl Misch
Dr. Bob Marx
will cover “Bone Augmentation and
Ridge Preservation for Implant Placement,” utilizing bone-grafting materials and hard-tissue models for hands-on
experience.
Silver Sponsors will also conduct precongress courses, starting with Osteogenics and Dr. Michael Pikos, whose topic will be “Extraction Site Management
for Implant Reconstruction: Hands-on
Workshop.” The hands-on segment will
include models for socket grafting, connective tissue grafting and free gingival
grafting.
Dr. Dennis Smiler and NUBONE
will provide a hands-on workshop on
“Solving the Challenges of Bone Graft
Success: Successful Grafts with Stem
Cells, Stemvie Matrix, Growth Factors.”
Attendees at this course will receive anatomic take-home models, DVD movies
of bone morrow aspiration technique
and a sterile sample of StemVie Graft
Matrix.
Dr. Carl Misch will discuss “Controversies in Implant Number” for
BioHorizons. Attendees at this course
will learn the guidelines that determine
implant number and the treatment
planning for multiple missing teeth. Dr.
Louie Al-Faraje will focus on the minidental implant phenomenon in his lecture for 3M ESPE on “Small-Diameter
Implants for the Modern Implant Practice: Treatment Options and Indication
for Fixed and Removable Prostheses.”
Dr. Leonard “Lenny” Linkow will provide a historical examination of and a
prognosis for the future of the implant
field in his course on “Implant Dentistry: What Was, What Is and What Probably Will Be,” organizers said. Linkow’s
course will evaluate where we are today
with all materials and techniques, educations processes and programs worldwide.
Drs. Michael Toffler and Barry Zweig
and Hiossen will hold a course on “Sinus Augmentation; Crestal and Lateral
Approaches; Challenges and Solutions.”
Objectives of this course include an understanding of new and safer approaches to sinus lifting.
Rounding out this World Congress
will be a 2½-day ADIA program for the
auxiliary staff members. On Thursday
and Friday, the event’s main podium
will feature Drs. Jon Suzuki, Rick Ferguson, Kathy Ferguson, Carl Misch, Kostas
Valavanis and Scott Ganz and Joy Millis, Emily Duross, Seon Jaromillo, Laura
Jamison and Lynn Mortilla.
As is customary, the event’s last day,
Saturday, will be devoted to four simultaneous certification programs for dental hygienists, dental assisting, practice
management and implant coordinator
training. These courses are always lively and always filled, organizers said, so
plan to enroll soon.
For more information on this meeting, visit ICOI’s web site at www.icoi.org.
Dental Tribune cannot assume responsibility for the
validity of product claims or for typographical errors. The publisher also does not assume responsibility for product names or statements made by advertisers. Opinions expressed by authors are their own
and may not reflect those of Dental Tribune America.
Editorial Board
Dr. Sascha Jovanovic, Editor in Chief
Dr. Bernard Touati
Dr. Jack T. Krauser
Dr. Andre Saadoun
Dr. Gary Henkel
Dr. Doug Deporter
Dr. Michael Norton
Dr. Ken Serota
Dr. Axel Zoellner
Dr. Glen Liddelow
Dr. Marius Steigmann
Dr. Pankaj Singh
Corrections
Implant Tribune strives to maintain the
utmost accuracy in its news and clinical
reports. If you find a factual error or
content that requires clarification, please
report the details to Managing Editor
Sierra Rendon at s.rendon@dental-tribune
.com.
Tell us what you think!
Do you have general comments or criticism
you would like to share? Is there a particular
topic you would like to see articles about in
Implant Tribune? Let us know by e-mailing
feedback@dentaltribune. com. We look
forward to hearing from you! If you would
like to make any change to your subscription
(name, address or to opt out) please send us
an e-mail at database@dental-tribune.com
and be sure to include which publication
you are referring to. Also, please note that
subscription changes can take up to 6 weeks
to process.
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Implant Tribune U.S. Edition | August 2012
AAOMS to host 94th annual meeting
at San Diego Convention Center
Rousing topics, a scenic
locale and a visit to the
ballfield are on tap for
this September event
The American Association of
Oral and Maxillofacial
Surgeons will head to the San
Diego Convention Center, left,
for its 94th annual meeting
from Sept. 10-15.
Photo/Provided by
Timothy Hursley
By Sierra Rendon, Managing Editor
Dr. Peter Moy will speak at the AAOMS annual
meeting in September.
AD
The American Association of Oral and
Maxillofacial Surgeons will host its 94th
annual meeting, scientific sessions and
exhibition from Sept. 10-15 at the San Diego Convention Center.
The AAOMS annual meeting attracts
more than 3,200 members and more than
5,500 registrants.
Speakers and sessions include Dr. Lyndon F. Cooper speaking on “Graft Solutions for Fixed Prosthetics;” Dr. Edwin A.
McGlumphy speaking on “Graftless Solutions With Angled Implants With Hybrid
Prostheses;” Dr. Peter Moy on “Graftless
Solutions With Angled Implants With Hybrid Prostheses;” and many more.
Educational sessions and the exhibition
will take place at the San Diego Convention
Center, unless otherwise noted. Business
sessions, opening ceremony, welcome reception, some educational sessions and
other social functions will take place at the
headquarters hotel, the Hilton San Diego
Bayfront, unless otherwise specified.
Exhibition hall hours
The AAOMS exhibition hall will be filled
with hundreds of exhibitors providing the
latest and greatest in implants and related
technology.
The schedule for the exhibition hall:
• Thursday, Sept. 13:
9 a.m. – 5 p.m.
• Friday, Sept. 14:
9 a.m. - 5 p.m.
• Saturday, Sept. 15:
9 a.m. - 1 p.m.
President’s event
For one memorable night, Petco Park,
home of the San Diego Padres, will be
transformed in celebration of the 2012
AAOMS Annual Meeting President’s Event
honoring President Arthur C. Jee, DMD,
and his wife, Martha. During this event,
from 7-10 p.m. Thursday, Sept. 13, at what
has been called “the world’s best ballpark
in America’s finest city,” you and your
guests will party where the players play.
You’ll be able to roam the outfield, take
batting practice — even sit in the dugout.
Try your hand at inflatable speed pitch,
inflatable basketball, or fantasy baseball,
which includes batting cage, pitchers, ball
shaggers, batting helmets, bats and balls.
After working up an appetite, attendees can visit the lavish buffet for which
AAOMS President’s Events are justifiably
renowned.
Information and registration
For more information on the AAOMS annual session and events, visit www.aaoms.
org/annual_meeting/2012/.
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Implant Tribune U.S. Edition | August 2012
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news
Implant Tribune U.S. Edition | August 2012
Report: Selective
use of CBCT
offers advanced
imaging
modality
In the August issue of The Journal
of the American Dental Association,
the American Dental Association’s
(ADA) Council on Scientific Affairs
(CSA) presents an ADA report with
recommendations for the safe use
of cone-beam computed tomography (CBCT) in dental practice. This
imaging method provides threedimensional detail of oral and maxillofacial structures, which can help clinicians, provide improved treatment
and lead to better patient outcomes.
The published recommendations
provide essential principles for consideration in the selection of CBCT imaging for individual patient care. Importantly, clinicians should perform
radiographic imaging, including CBCT,
only after professional justification
that the potential clinical benefits will
outweigh the risks associated with exposure to ionizing radiation. However,
CBCT may supplement or replace conventional dental X-rays when the conventional images will not adequately
capture the needed information.
The statement emphasizes the application of professional judgment
in clinical decision-making that is
informed by the latest scientific evidence and professional guidance. A
guiding principle for use of all X-rays,
including CBCT, is to keep radiation
exposure as low as reasonably achievable (“ALARA”). The new statement incorporates the ALARA principle while
also recognizing the need to expand
pre-doctoral and continuing dental
education on CBCT use and image interpretation. Actions recommended
to help achieve this principle include:
consulting with a medical physicist
or other qualified expert to perform
equipment evaluations at installation; confirming compliance with
local, state and federal requirements
at least annually; and establishing a
facility quality control program.
CBCT technologies offer an advanced point-of-care imaging modality that has developed into an
important adjunct to conventional
radiography. As a science-based organization, the ADA supports ongoing
research on CBCT and all aspects of
dentistry that will help to ensure patient safety, enhance preventive care
and facilitate the management and
treatment of oral diseases. The ADA
encourages patients to talk with their
dentists about the use of CBCT imaging and all aspects of their dental care.
About the ADA
The not-for-profit ADA is the nation’s
largest dental association, representing more than 156,000 dentist members. For more information about the
ADA, visit the association’s website at
www.ada.org.
“ TITANIUM, Page C1
For this study, Dr Owen Addison in the
biomaterials unit of the University of
Birmingham’s School of Dentistry and
his team obtained tissue from patients
undergoing scheduled revision surgery
associated with bone-anchored hearing
aids (BAHA) at University Hospitals Birmingham NHS Foundation Trust. Soft
tissue surrounding commercially pure
titanium anchorage devices was examined using micro-focus synchrotron Xray spectroscopy at the Diamond Light
Source, Oxford, U.K.
“The results showed, for the first
time, a scattered and heterogeneous
distribution of titanium in inflamed
tissue taken from around failing skinpenetrating titanium implants,” the
authors reported. “Wear processes and
implant debris were unlikely to be ma-
jor contributors to the problem. In the
absence of obvious macroscopic wear
or loading processes, we propose that
the titanium in the tissue results from
micro-motion and localized corrosion
in surface crevices.”
The development of peri-implant
inflammation may result in the premature loss of the implanted device
or the requirement for revision/rescue
surgery, which are scenarios that can
“impact on patients’ well-being and
economically on the health service
provider,” the authors concluded in the
study.
“Our results emphasise the need to
understand further both the physical
and chemical mechanisms leading to
the dispersal of titanium species in tissue around implants and their potential
to exacerbate inflammation. Similar
processes are likely to contribute to the
c7
failure of other metal implants in soft
tissues, where macroscopic wear is not
considered to be a risk.”
Addison commented: “Titanium is
still the most appropriate material to
put into bone and to be used in these
devices. It is the gold standard. However,
these interesting findings demonstrate
that improvements in these materials
can be sought.
“Research at Birmingham is currently
being conducted to look at the biological
consequences of these findings and to
understand the mechanisms by which
the debris is produced. This should in no
way alarm those with BAHA implants or
similar devices.”
The study “Do ‘passive’ medical titanium surfaces deteriorate in service in the
absence of wear?” was published online
during July in the Journal of the Royal
Society Interface.
AD
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Implant Tribune U.S. Edition | August 2012
industry
C9
3Shape TRIOS digital impression
solution now with implant scanning
TRIOS captures
implant positions
and soft-tissue
emergence profile
in unique
dual-step workflow
3Shape, a technology leader in 3-D
scanning and CAD/CAM software for
dental applications, announces its latest
breakthrough innovations for implant
work. With 3Shape TRIOS®, dentists can
now capture single implant positions using autoclavable scan bodies supporting
a wide range of implant systems.
Implant cases made easy for
dentists
For dentists, digital impression-taking
with 3Shape TRIOS represents many advantages. The straightforward workflow
replaces conventional implant impression-taking which traditionally can be
time-consuming, error-prone and cumbersome. Furthermore, with TRIOS digital impressions, dentists can save time
and money by skipping the extra steps
involving custom tray production, shipping and handling by the lab.
“Scanning with 3Shape TRIOS makes
implant cases easy. It allows me to capture not only the implant positions, but
also the soft tissue,” said Dr. Simon Kold
of Herning Implant Center. “By adding
scans of the soft-tissue emergence profile, I can give my lab detailed information that allows it to optimize the fit
and esthetic qualities of the customized
abutment and final restoration. This is
great for clinical and esthetic results
while boosting patient satisfaction.”
New implant service opportunities
for labs
With TRIOS, labs can receive the digital
impression minutes after scanning and
can immediately start designing the
digital implant model, the customized
abutment and the crown. The TRIOS digital implant impression, 3Shape’s Model
Builder™ and its Abutment Designer™
software come together in a fully integrated workflow.
3Shape’s Model Builder CAD/CAM software allows labs to design digital models
for implant cases. Based on the software’s
implant position detection, users can virtually add interfaces for implant analogs,
including glue-in analogs, directly in the
model design.
3Shape TRIOS is currently available in
Europe and is expected to be launched in
North America and other selected markets in Q3 2012. TRIOS implant scanning
is available with TRIOS software version
1.1.2.0.
About 3Shape A/S
3Shape A/S is a Danish company specializing in the development and marketing
of 3-D scanners and CAD/CAM software
solutions designed for the creation, processing, analysis and management of
high-quality 3-D data for application
in complex manufacturing processes.
3Shape envisions the age of the “full
digital dental lab,” and its more than 130
developers provide innovation power toward reaching this goal.
3Shape’s flexible solutions empower
dental professionals through automation
of real workflows, and its systems are applied in thousands of labs in more than
85 countries worldwide, putting 3Shape
technologies at the peak of the market
in relation to units produced per day by
dental technicians. 3Shape boosts its
first-line distributor support network
with a second-line support force of more
than 30 in-house experts placed in five
support and service centers strategically placed around the globe. 3Shape is
a privately-held company headquartered
in Copenhagen, with the market’s largest
team dedicated to scanner and software
development for the dental segment
based in Denmark and Ukraine, production facilities in Poland, and business
development and support offices in New
Jersey and Asia.
For further information regarding
3Shape, please refer to www.3shapedental.
com.
3Shape TRIOS. (Photos/Provided by 3Shape)
AD
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Industry
Implant Tribune U.S. Edition | August 2012
From intraoral scan to final
custom implant restoration
By Perry E. Jones, DDS, FAGD
Introduction
This case demonstrates the optical
scanning of Inclusive® Scanning Abutments (Glidewell Laboratories; Newport Beach, Calif.) utilizing the iTero™
digital scanning system (Align Technology; San Jose, Calif.) with software version 4.0. Digital data was used with laboratory CAD/CAM planning to fabricate
custom all-ceramic implant abutments
and a four-unit fixed prosthesis. The
abutments and fixed prosthesis were
fabricated using advanced computeraided milling technology.
Dental history
The patient was a 52-year-old healthy
Hispanic male who sustained a traumatic avulsion and lost his maxillary
incisors in an automobile accident. Following healing, a four-tooth transitional
removable partial denture was constructed. He was seen by the oral and
maxillofacial surgery service of Virginia
Commonwealth University for dental
implant therapy.
Fig. 1: Inclusive scanning abutments attached to implants.
Photos/Provided by Glidewell Laboratories
Fig. 2: Abutment planning (labial view) with 3Shape’s DentalDesigner software and Prismatik CZ add-on module (Glidewell Laboratories).
Fig. 3: Inclusive all-zirconia custom abutments #7 and #10.
Fig. 4: Four-unit BruxZir Solid Zirconia fixed bridge cemented in place.
Treatment plan
The patient was informed of the alternatives, benefits and potential complications of various treatment options
before deciding to pursue implant restoration of his missing teeth. The treatment plan included placement of two
Replace® Select Straight RP 4.3 x 13 mm
implants (Nobel Biocare; Yorba Linda,
Calif.) with 5 mm healing abutments,
followed by a six-month healing period
and restoration with all-ceramic custom
abutments and a four-unit all-ceramic
fixed prosthesis to restore the anterior
incisors to form and function.
Surgical procedure
Using local anesthesia, two Replace Select Straight RP implant fixtures were
placed in the area of tooth #7 and #10
using standard Nobel implant placement protocol. Placement angulation
and depth were verified and deemed
satisfactory. Standard RP 5 mm healing
abutments were placed, and the fully reflected tissue flap was closed with interrupted sutures.
Restorative procedure
Following six months of healing postimplant placement, intraoral photos
were taken to record and confirm the
healthy remaining dentition. Osseous
integration was confirmed with a panoramic X-ray, followed by resonance
frequency analysis (RFA) using an Osstell® ISQ implant stability meter with
SmartPeg™ attachment (Osstell Inc.;
Linthicum, Md.), which displayed an implant stability quotient (ISQ) of 78 on a
minimum-to-maximum scale of 1–100.
Counter rotation with a torque wrench
confirmed no rotation to 35 Ncm.
The implant fixtures were considered
acceptable for restoration.
The 5 mm healing abutments were removed, Inclusive Scanning Abutments
were placed on the implants and the
accompanying titanium screws were
tightened (Fig. 1).
Using the iTero scanner with updated
software (version 4.0), a full maxillary
arch scan, full mandibular arch scan and
centric bite in maximum intercuspation
were completed.
A three-dimensional digital record of
the patient’s anatomy was created from
these scans and electronically submitted to Glidewell Laboratories to be used
in the CAD/CAM restoration process.
At Glidewell Laboratories, the virtual
scan was registered to the scanning
abutments, providing the dental technicians with the implant system, size, axis,
position relative to the adjacent anatomy and locking feature orientation.
A virtual zirconia abutment was designed using 3Shape’s DentalDesigner™ software (3Shape Inc.; New Providence, N.J.) and the Glidewell Digital
Abutment Library (Fig. 2).
From this, the corresponding physical Inclusive All-Zirconia Custom Abutments (Glidewell Laboratories) were
milled. Similarly, a BruxZir® Solid Zirconia four-unit fixed bridge (Glidewell Laboratories) was designed and milled using
state-of-the-art CAD/CAM technology.
The custom zirconia abutments were
trial-fitted in the patient’s mouth with
some slight tissue blanching noted (Fig.
3).
In the same visit, the final four-unit
all-ceramic milled BruxZir Solid Zirconia bridge was tried-in and examined for
proper occlusion. There was “tight” anterior coupling for this case as evidenced
by the history of provisional denture
fracture. The occlusion was checked and
presented as so precise that no adjustment was required.
The anterior view of the final prosthesis demonstrates optimal mesial-distal
width proportion, incisal edge proportion, pontic-tissue contact and excellent shade/esthetics (Fig. 4). Further, the
occlusal view demonstrates an optimal
incisal edge arch form. The soft-tissue lip
position and speech phonetics appeared
to be optimal.
Following the trial seating, the fixed
bridge was removed, the zirconia abutment retention screws torqued to 35
Ncm, the abutment screws covered with
cotton/Cavit™ Temporary Filling Material (3M™ ESPE™; St. Paul, Minn.), and
the prosthesis cemented with GC Fuji
PLUSTM (GC America; Alsip, Ill.).
NOTE: Cadent Inc. (Carlstadt, N.J.) was
acquired by Align Technology (San Jose,
Calif.) in May 2011.
References available upon request from
the publisher.
About the author
Dr. Perry Jones received his DDS from Virginia
Commonwealth University School of Dentistry,
where he has held adjunct faculty positions
since 1976. He maintains a private practice in
Richmond, Va.
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Implant Tribune U.S. Edition | August 2012
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industry
Implant Tribune U.S. Edition | August 2012
Anew implants meet the
‘most precise’ standards
F
irst used in 2000 and granted
FDA approval in 2004 for longterm use as determined by
health-care providers, the 1.8, 2.2
and 2.4 mm diameter ANEW implants
from Dentatus have met the most precise implantology standards having undergone rigorous testing, research and
clinical use by the profession.
ANEW Implants are widely recognized
AD
by clinicians and universities worldwide.
These narrow-body implants provide effective remedy for many because they
are ideal for patients who have limited
inter-dental spaces, insufficient bone or
require provisionalization during augmentation procedures.
Nearly 25 percent of patients who come
in for implant treatment will not have
enough bone to place a conventional diameter implant, Dentatus said. ANEW
Implants should also be considered when
financial constraints might delay or prevent treatment. Every practitioner placing implants should consider including
ANEW in his or her armamentarium so
that all patients might take advantage of
the benefits that implants afford.
ANEW Implants are the only one-piece
narrow-body implants that have restorative options for screw-retained prosthesis, Dentatus said. ANEW boasts a number
of features that set it apart from other
implants, including a short-threaded external connector that tolerates substantial
abutment angulation without stress.
ANEW’s prosthetic components provide patients with a cosmetic, fixed chairside restoration at the time of placement
so they never have to go without teeth.
There are a variety of platforms available
for restorative ease, presenting flexibility
for optimal esthetic solutions.
For instances of single-tooth replacement in narrow spaces, the availability
of ANEW Implants provides patients who
might have to proceed with a fixed or
resin-bonded bridge the luxury of dental
implants without preparation and/or reduction of the adjacent natural dentition.
Another advantage to this modality is
the maintenance of aveolar bone, which
is documented to undergo resorption
with other restorative options.
In 2012, Dr. Francois Fisslier and Dr.
Carlos Munoz from the New York University Department of Implant Dentistry
presented the following findings about
papilla regeneration at the Academy of
Osseointegration’s 27th annual meeting:
“In this case series, nine patients received 10 [ANEW Narrow Diameter Implants (NDIs)], which were loaded for
periods of six months to 10 years postinsertion. No implants or prosthesis had
to be removed or replaced during the
follow-up period. Neither a surgical or
prosthetic complication was seen on any
of the 10 NDIs.
“The average mesial [Papilla Index
Score (PIS)] was 2.4 and the average distal PIS was 2.7, indicating that the NDIs
regenerated at least 50 percent of the papilla in all cases (20/20 papilla).”
The non-hygroscopic screwcap allows
for retrievability, so that during the healing period the restoration contours can
be easily modified to the tissue architecture, thereby eliminating a final “black
triangle” result, Dentatus said.
” See ANEW, page 16
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C16
“ ANEW, Page 14
ANEW Implants by Dentatus USA.
Photo/Provided by Dentatus
AD
Their effective adaptation and integration in bone has been shown to be on par
with conventional implant fixtures and
provide excellent support and retention.
In 2007, Dr. Stuart Froum and his colleagues published a study in the International Journal of Perio and Restorative
Dentistry stating “40 Anew Implants
in patients for one to five years postloading. No implant failures were reported, yielding a 100 percent survival rating.”
In 2005, the Journal of Oral and Maxillofacial Implants published Dr. Michael
Rohrer’s histology study on Dentatus
implants. Rohrer determined that the
percentage of bone in contact with the
body of Dentatus implants is in “the same
range and sometimes higher than what is
usually seen with conventional implants.”
The recommended surgical techniques
allow for minimally invasive flapless
placement and immediate loading. This
eliminates most postoperative challenges
and dramatically reduces the total time in
treatment.
These implants solve the problems
of time, money and perceived pain
for most patients who otherwise do
not proceed with care, Dentatus said.
Other indications for use:
Atrophic and thin ridges
For patients with atrophic and thin ridges
who cannot or do not want to undergo
lengthy augmentation procedures based
on age, systemic disease or inadequate
volume of bone, Anew Implants are an
economical and viable long-term solution.
Emergency repairs
One of the most difficult situations for
the practitioner is the emergency intraoral repair of a broken bridge. With ANEW
Implants on hand, those difficulties are
Implant Tribune U.S. Edition | August 2012
a thing of the past, Dentatus said. Once
the bridge is removed, the implant can be
placed in the interceptal bone, stabilizing
the bridge, returning the patient to a dentate state while a long-term treatment plan
is determined.
Bone augmentation
Many implant treatment plans include
some type of bone augmentation procedure. It may involve a sinus lift, replacement of the buccal plate and/or widening
or heightening a ridge. Selling an implant
case involves overcoming a patient’s concerns; one of the major roadblocks is the
patient’s perception of a long, drawn out
treatment period. Anew implants will give
patients teeth during the entire treatment
and avoids transmucosal loading of the
graft while the patient is able to function
with a fixed restoration.
For more information and to see other
areas of use, visit www.DentatusUSA.com.
For daily use:
The new
Implantmed
by W&H
Attractive and powerful are two
words that describe the new W&H Implantmed, the company says. The new
drive unit excels by virtue of its ease
of operation, a powerful motor and a
motorised thread cutter function. It
offers safety and maximum precision
for oral surgery in the fields of implantology and also maxillo-facial surgery.
The advantages in detail:
• Easy to use: The new Implantmed
has an intuitive operating concept.
All programs can be easily set up in
just one user level, either with the foot
control or by pressing the buttons on
the unit. The settings are clearly visible
on the large display. The clinician can
concentrate on the essential factor: the
patient.
• Powerful motor: Even difficult
procedures no longer demand great
strength when using Implantmed. Implantmed is powerful enough for all
operations with a motor torque of 5.5
Ncm and a motor speed range of 300
to 40,000 rpm. The automatic torque
control for rotary instruments, which
can be set between 5 and 70 Ncm, ensures that the instrument is safe.
• Fatigue-free operation: The lightweight motor and the ergonomically
shaped W&H contra-angle handpieces
are perfectly balanced in the user’s
hand. The advantage for the implantologist: ability to work for long periods
without fatigue or the hand cramping.
• Automatic thread-cutting function: The integrated automatic threadcutting function supports the implantologist in placing implants in hard
bone. Cutting a thread before screwing
in the implant prevents excessive compression of the bone and promotes
stress-free healing of the implant.
For more information, visit www.
wh.com.
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products
Implant Tribune U.S. Edition | August 2012
80 Ncm: the new
Elcomed by W&H
The new Elcomed.
Photo/Provided by W&H
AD
Top quality and power — the new
Elcomed SA-310 from W&H has some impressive features, the company says.
The most crucial advantages, according
to the company, at a glance, include:
• Just one operating stage for setting all
necessary parameters
• Six program spaces, which can be set
individually
• Shortest and lightest 50,000 rpm motor on the market
• Up to 80 Ncm on the rotary instrument
• Complete documentation using USB
stick
• Automatic thread-cutter function
Operation made easy
With just one operating stage and a total
of four buttons, the user is able to adjust
all the important parameters. In addition
to torque, motor speed and quantity of
liquid, six different programs can also be
accessed from the clearly laid out display.
The user is thus able to individually save
the most important recurring operational
procedures. In addition, the attached instruments are also preset on the display in
order to guarantee optimum power transmission.
Full power
The Elcomed motor not only achieves
speeds of 50,000 rpm but is also the lightest and shortest motor in its class, the
company said. It can be used with all surgical instruments that have an ISO connection.
Together with the surgical handpieces/
contra-angles from W&H, it can achieve
a torque of 80 Ncm on the rotary instrument. This high torque guarantees an extremely high motor power. The user is able
to cut through the bone without exerting
large amounts of force.
Complete documentation
The new Elcomed also features the advantage of simple and complete documentation. Data is stored directly on the
USB stick that is included in the delivery.
Using the USB interface, the user is therefore able to transfer the saved treatment
stages to the PC very easily.
The data is displayed as a csv file, ready
to be imported into standard analysis
programs, and as a bitmap file. The documented information contains the torque
curve and the screenshot of the Elcomed
display, on which all the set parameters
can be viewed. Complete documentation
is therefore guaranteed at no additional
cost.
Thread-cutter function
To enable the implant to heal as quickly as
possible and with the least possible stress,
the new Elcomed SA-310 has an automatic
thread-cutter function. The thread cuts
into the bone when the foot control is activated.
Upon reaching the pre-set torque, the
thread cutter immediately switches to
reverse operation, in order to remove any
bone chips. This process can be stopped
by releasing the foot control. If the foot
control is activated again, the threadcutter function will restart in forward operation. In this way, compression on the
bones is minimized and potential bone
damage avoided.
The motor, cable and handpiece holder
are naturally thermo washer disinfectable and sterilizable.
For more information, visit www.
wh.com.
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c20
Implant Tribune U.S. Edition | August 2012
SimPlant GO: new solution in guided implant surgery
M
SimPlant GO by Materialise Dental.
(Photo/Provided by Materialise Dental)
aterialise Dental just
launched a new userfriendly implant planning solution. With
SimPlant GO, there are no surprises
during surgery because you have optimally planned the implants in the
bone — and with SurgiGuide, this
planning is then transferred into a
fully predictable surgery.
SimPlant GO’s intuitive navigation,
3-D images and simple four-step process is so straightforward that you
can learn it over lunchtime, during
a break or in-between appointments,
the company said.
This software is made for dentists
who have only a few minutes to become familiar with this easy 3-D
implant-planning software.
SimPlant has been hugely successful
during the past 20 years in addressing the needs of the implant specialists, the company said. However, some
dentists who were placing implants less
frequently felt overwhelmed by the
amount of flexibility that SimPlant has
offered. SimPlant GO has been designed
to specifically address their needs.
The solution has been specifically designed for dentists without a cone-beam
scanner in their office.
“Although cone beam is the way of
the future, not everybody is willing to
invest in it yet. And now dentists have
a great, low-threshold solution to start
with computer-guided implantology,”
said Bert Van Roie, SimPlant product
The latest from OSADA:
Enac Model OE-F15
manager for Materialise Dental.
“We strongly believe there is a place for
our earlier products, so we will continue
to invest in their future, and new versions of SimPlant Planner, Pro and Master will be released this fall,” said Bart
Swaelens, CEO at Materialise Dental.
“Expanding our portfolio is our way of
ensuring that the best implant planning
software and surgical guides on the market reach the widest audience possible.”
Part of the scan-plan-guide process,
SimPlant GO is more than just a fancy
new computer software program; it’s
part of a full solution for your cases.
“On top of this, the process is a cool and
smooth user experience,” he added.
Find out more by visiting www.
simplantgo.com.
ZEST
ANCHORS’
NEW
WEBSITE
Company launches its enhanced bone-cutting
specialist with extended boosting power
OSADA developed and introduced Enac
in the United States in 1984, a piezoelectric ultrasonic system, multi-purpose
instrument that can be used in various
applications in the dental field.
Utilizing the dynamic nature of piezoelectric ultrasonic system, Enac has been
used extensively in endodontic and periodontic treatments, OSADA says. Because
it is automatically tuned, the Enac system is user-friendly. It provides continually stable oscillation at any level of power with any of the chosen tips. Its ease of
operation enhances the users’ technique
in achieving excellent results, the company says.
The clinical application of the ultrasonic device in the oral surgery field has
been seen in a variety of different contexts, including ultrasonic scalpels, apicoectomy and bone surgery in the maxillofacial area, to name a few.
In particular, bone surgery, which uses
the piezoelectric element (the dynamic
energy in the ultrasonic wave) ensures
minimal invasion to biological tissues including blood vessels and nerves, which
in turn leads to faster healing after surgery.
Upon introducing the OSADA Enac
OE-W10, featuring extended power setting No. 10 through No. 12 and sterile irrigation by the peristaltic pump, many
extended applications in oral surgery
became easily attainable, including
atraumatic tooth extractions, osteotomy,
osteoplasty, sinus lift, split ridge, crown
extension, implant preparation, corticotomy and more.
With OSADA’S latest model, Enac OEF15, the focus is on the powerful but safe
bone cutting (power No. 10 through No.
Zest Anchors, a leading
manufacturer of innovative products for overdentures, including the world
renowned LOCATOR® Attachment, recently launched
its
new
website
www.
zestanchors.com.
The new, intuitive and easyto-navigate website features
information on all of Zest’s
products. A key section to the
website is the improved ecommerce portion featuring
Shop Assistant.
Shop Assistant helps clinicians, staff members and technicians quickly and accurately
select the items needed to restore overdenture patients on
a variety of different implant
systems.
You are invited to set up
your online account now and
be automatically entered into
a prize drawing.
The Enac Model OE-F15 by OSADA.
(Photos/Provided by OSADA)
15). The surgical tips (also known as ultrasonic scalpels) enable the surgeons to
present fine and precise cutting results.
Combined with newly introduced
stronger tips, the OE-F15 makes the minimally invasive surgical procedures easier
to attain by cutting the bone faster but
leaving the adjacent soft tissue, blood
vessels, nerves, etc., with minimal injury,
the company said.
The ergonomically designed SE15 handpiece stays cool and its LED illuminates
the surgical area. The built-in peristaltic pump with simultaneous irrigation
minimizes temperature increases on the
handpiece, tips and the surgical area.
Log on to www.zestanchors.
com/promo today to learn
about Shop Assistant, and enter
your information to be eligible
to win your choice of one of
three prizes.
For more information, visit www.
osadausa.com.
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