implants international No. 3, 2024
Cover
/ Editorial
/ Content
/ Redefining dental care standards with advanced proven PEMF technology
/ Peri-implantitis prevention starts with the choice of a clean implant
/ Late implant placement following bilateral sinus floor elevation
/ Long-term success of implantsupported rehabilitation in the aesthetic zone: A nine-year followup case report
/ Full maxillary rehabilitation with immediate implant placement of NEVO RC INICELL® implants in Type 3 bone
/ Immediate two-piece ceramic implants with immediate provisionalisation in the posterior region
/ Passion for customers, innovation and growth
/ DDS.Berlin concludes its premiere with positive feedback
/ Events
/ Manufacturer news
/ Imprint
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[1] =>
issn 1868-3207 • Vol. 25 • Issue 3/2024
implants
3/24
© gfx_nazim – stock.adobe.com
international magazine of oral implantology
research
Peri-implantitis prevention
starts with the choice of
a clean implant
case report
Full maxillary rehabilitation
with immediate implant
placement
interview
Passion for customers,
innovation and growth
[2] =>
®
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• Fast regeneration/healing
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[3] =>
editorial
|
Dr Georg Bach
President of the DGZI
Pioneering insights
and innovations in
implantology
Dear colleagues!
In today’s rapidly evolving dental landscape, implantology
is a dynamic field where innovation and precision converge. This issue not only highlights the latest technological advancements but also celebrates the passion driving
these breakthroughs.
A key focus is the revolutionary application of Pulsed
Electromagnetic Fields (PEMF) technology. This innovation opens new possibilities for accelerating healing after
implant procedures and enhancing long-term stability. By
improving bone quality and increasing implant stability in
the early stages, PEMF represents a significant advancement that enhances patient outcomes while offering economic benefits for practices and laboratories.
In addition to these technological strides, we are excited
to spotlight the upcoming DGZI congress, a key event for
professionals in our field. This congress is a unique opportunity to engage with the latest research, connect with
industry leaders, and explore innovative approaches that
are shaping the future of implantology. The event promises a rich programme of lectures, workshops, and discussions that will provide invaluable insights and practical knowledge, helping us all to elevate our practice
standards.
As we prepare for this important event, we also pause to
recognise the individuals driving these innovations. An
exclusive interview with a leading expert offers insights
into the passion for customer care, innovation, and growth
that propels our industry. These stories remind us that
every technical achievement is the result of dedication,
hard work, and a commitment to excellence.
In closing, we extend our deepest gratitude to you, our
devoted readers. Your unwavering support and dedication to advancing implantology are the forces that propel
us forward. Together, let’s embrace this exciting era, elevate the standards of dentistry, and provide our patients
with the highest quality care.
Sincerely,
Dr Georg Bach
President of the German Association of
Dental Implantology
Dr Georg Bach
3 2024
03
[4] =>
| content
editorial
Pioneering insights and innovations in implantology
03
Dr Georg Bach
research
page 16
Redefining dental care standards with advanced proven
PEMF technology
06
Prof. Shlomo Barak DMD
Peri-implantitis prevention starts with the choice of a clean implant
12
Drs Dirk U. Duddeck & Dana Adyani-Fard
case report
Late implant placement following bilateral sinus floor elevation
16
Prof. Paolo Maturo & Dr Edoardo Magnanelli
page 22
Long-term success of implant-supported rehabilitation in the
aesthetic zone: A nine-year follow-up case report
22
Drs Léon Pariente & Karim Dada
Full maxillary rehabilitation with immediate implant placement
of NEVO RC INICELL® implants in Type 3 bone
28
Dr Mathieu Rousset
Immediate two-piece ceramic implants with immediate
provisionalisation in the posterior region
32
Drs Alexandre Marques Paes da Silva, Alice Maria de Oliveira Silva, Lissya
Tomaz da Costa Gonçalves, Rodrigo Franco Motta, Daniel Moraes Telles,
Mayla Kezy Silva Teixeira & Eduardo Veras Lourenço
page 28
interview
Passion for customers, innovation and growth
36
events
Cover image courtesy of Thommen
Medical AG, www.thommenmedical.com
issn 1868-3207 • Vol. 25 • Issue 3/2024
implants
3/24
© gfx_nazim – stock.adobe.com
international magazine of oral implantology
DDS.Berlin concludes its premiere with positive feedback
38
Engaging clinical education and meaningful networking at Implant
Solutions World Summit 2024
40
EuroPerio11 kicks off with virtual event and ambassador meet-up
44
The beauty of regeneration
45
Details make perfection: EAO congress 2024
46
Patient-customised concepts: “Implantology 4.0” in Düsseldorf
this November
48
30 years OEMUS MEDIA
47
news
manufacturer news
49
about the publisher
imprint
research
Peri-implantitis prevention
starts with the choice of
a clean implant
case report
Full maxillary rehabilitation
with immediate implant
placement
interview
Passion for customers,
innovation and growth
04
3 2024
50
[5] =>
Visit us at
Booth F55
24 – 26 October
EAO Milan 2024
CONELOG®
PROGRESSIVE-LINE
conical performance [1, 2]
at bone level
Precise conical connection
Long conus for reduced micromovements
Superior positional stability in comparison to o
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Integrated platform switching supporting the p
of crestal bone
www.biohorizonscamlog.com/con
[1] Semper-Hogg, W, Kraft, S, Stiller, S et al. Analytical and experimental position stability of the abutment in different dental
implant systems with a conical implant–abutment connection Clin Oral Invest (2013) 17: 1017.
[2] Semper Hogg W, Zulauf K, Mehrhof J, Nelson K. The influence of torque tightening on the position stability of the
abutment in conical implant-abutment connections. Int J Prosthodont 2015;28:538-41.
CONELOG® is a registered trademark of CAMLOG Biotechnologies GmbH. It may however not be registered in all markets.
[6] =>
| research*
Redefining dental care
standards with advanced proven
PEMF technology
Prof. Shlomo Barak DMD, Israel
PEMFs therapy has found applications in various medical
and dental treatments, offering relief from postoperative
pain, managing inflammation, and aiding in bone and
wound healing. This review explores the historical development of PEMFs technology, detailing its in vitro and in
vivo studies, and highlighting its diverse therapeutic applications in medical and dental fields. From its origins in
the 19th century to modern-day applications, PEMFs have
evolved into a promising therapy with significant potential
in clinical settings.
Magdent with its exclusive proprietary patents has developed a Miniaturised Electromagnetic Device (MED) for
PEMFs therapy in dental implants. This device, resembling
traditional healing abutments, significantly improved implant stability, bone quality, and reduced pro-inflammatory
cytokine levels compared to conventional healing abutments. It was found to enhance implant stability, particularly in the early healing phases, and contribute to improved
bone development surrounding the implant.
This innovation is not just a breakthrough in patient care; it
represents a substantial growth opportunity in the dental
tech market. Implementing Magdent’s device in clinics has
shown to increase income by offering efficient, premium
treatments and helps implant companies to save millions on
their R&D pipeline, offering its technology with their products.
In vitro studies demonstrate PEMFs’ ability to influence
cellular activities, such as apoptosis, proliferation, and
differentiation, through modulation of ion channels and
signal transduction pathways. In vivo studies further support these findings, showing effects on tissue hypoxia,
capillary blood flow, and wound healing.
1
PEMFs in implantology
Pulsed Electromagnetic Fields (PEMFs) have made significant strides in dental applications, particularly in dental
implantology. Dental implants, which rely on primary stability for successful osseointegration, often face challenges
with poor bone quality. Studies have shown that PEMFs
stimulate bone formation, induce osteoid formation, and
promote neo-vascularisation, ultimately improving bone
quality around dental implants.
06
3 2024
2
3
Figs. 1–3: A cross-sectional view of the Miniaturised Electromagnetic Device
(MED) healing abutment (1); an activator device which triggers the battery
in the MED (2 & 3).
* The articles in this category are provided by the manufacturers or distributors and do not reflect the opinion of the editorial team.
Pulsed Electromagnetic Fields (PEMFs) technology,
known for its therapeutic benefits, has gained recognition
for its non-invasive nature and ability to fully penetrate tissues. It has been extensively studied for its impact on biological processes, including DNA synthesis, gene expression, and cell migration.
[7] =>
OmniTaper EV ™ Implant
Intu tive.
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ƫɥƇǾƤƲ٪ɦǛɅǕ٪ƤȉǾ˚ƫƲǾƤƲ٪ɦǛɅǕ٪ɅǕƲ٪ǼǾǛ½ƇȬƲȯ٪-Ü ™ Implant
ƇǾƫ٪ȉɍȯ٪njɍdzdz٪-Ü٪UǼȬdzƇǾɅ٪FƇǼǛdzɬ٪ƇɅ٪ɦɦɦؘƫƲǾɅȷȬdzɬȷǛȯȉǾƇؘƤȉǼؘ
¤ƇȯɅ٪ȉnj٪ɅǕƲ٪UǼȬdzƇǾɅȷ٪¯ǛǍǾƇɅɍȯƲ٪Ýȉȯǯ˛ȉɦȷ٪ȬȉɦƲȯƲƫ٪ƣɬ٪%¯٪ ȉȯƲ™ؘ
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Implant®٪-Ü
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Implant
OmniTaper EV™
Implant
[8] =>
| research*
affecting prognosis. Additional stimulants for enhanced
osteogenesis are needed to overcome failures, especially
in poor bone quality, and shorten loading times.
Fig. 4: Bone-to-implant contact higher in test implants after two weeks and
stable after four weeks.
Furthermore, PEMFs therapy has shown promise in treating peri-implantitis, a common complication that can lead
to implant loss if untreated. Studies have investigated the
use of MED in implants affected by peri-implantitis,
demonstrating significantly less crestal bone loss, lower
levels of pro-inflammatory cytokines, and overall improvement in clinical parameters compared to conventional
treatments.
The introduction of the Miniaturised Electromagnetic
Device (MED) marks a significant advancement, particularly in dental implantology, by promoting implant stability, osseointegration, and antimicrobial effects, improve bone
quality and address complications as peri-implantitis
(Figs. 1–3).
Magdent has been working for the past few years with
world-recognised researchers such as Prof. Jamil Shibli,
Dr Yaniv Mayer and Dr Alberto Monje, supported by its
founders, Prof. Shlomo Barak and Dr Moshe Neuman.
This marks a significant milestone for millions of chronic
patients with poor bone quality, including those suffering
from conditions like diabetes, osteoporosis, and heavy
smokers, all of whom are at a high risk of failure.
Effect of PEMF on Dental Implants Stability—Accelerating Osseointegration: “Effect of the Pulsed Electromagnetic Field (PEMF) on Dental Implants Stability:
A Randomized Controlled Clinical Trial”. Bhukya P. Nayak
et al. Materials. 2020 Apr 3;13(7):1667.
The waiting period for functional loading after osseointegration can be lengthy in dental implants procedures. Recent advancements allow for earlier loading, addressing
patient discomfort and improving quality of life. Primary
Based on Magdent’s disrupting results, the company has
been working with leading dental implant companies to
distribute its products through their distribution channels,
currently available in Europe, and targeting its launch in
the US towards the end of 2025.
Increasing bone-to-implant contact & trabecular bone
volume density: “A new device for improving dental implants anchorage: a histological and micro-computed tomography study in the rabbit”. Barak et al. Clinical Oral
Implants Research. 2016 Aug;27(8):935–42.
Dental implants typically require a two- to six-month healing period before loading, but shortening this time increases failure rates, particularly for unsplinted implants.
Immediate loading necessitates primary stability and adequate bone tissue quantity and quality at the interface,
08
3 2024
5
Fig. 5: Implant stability change from baseline in ISQ (Implant Stability Quotient).
* The articles in this category are provided by the manufacturers or distributors and do not reflect the opinion of the editorial team.
4
The study conducted on rabbits involved the insertion of
implants in the proximal tibial metaphysis, with half receiving a healing cap containing an active PEMF and the
other half receiving a traditional cap. At two and four
weeks, samples underwent micro-computed tomography and histology. Results showed significant increases
in trabecular bone fraction, trabecular number, and connectivity density in the coronal region of test implants
compared to controls at both time points. Additionally,
bone-to-implant contact was higher in test implants after
two weeks and remained stable at four weeks (Fig. 4).
The study concludes that the PEMF device accelerated
early bone formation around dental implants resulting in
higher peri-implant BIC and bone mass already after two
weeks which suggests an acceleration of the osseointegration process by more than three times.
[9] =>
[10] =>
| research*
6
7
implant stability is crucial for successful osseointegration,
influenced by tissue quantity and quality.
In this randomised clinical study, implants treated with the
Miniaturised Electromagnetic Device (MED) showed a
significant increase in stability by 13% compared to a 2%
decrease in the control group. The MED-treated group
also demonstrated a notable decrease in marginal bone
loss at six and 12 weeks. Primary stability, crucial for longterm implant survival, remained consistently higher in the
MED group throughout the study period, indicating superior total stability. This enhanced stability is attributed to
PEMF’s ability to promote osteoblast activity and proliferation, shifting the balance between bone resorption
and formation in favour of the latter. Lower levels of proinflammatory cytokines (TNF-α and IL-1β) in the MED group
further support the positive impact of PEMF treatment
on implant stability by modulating the inflammatory response.
8a
These results indicate that PEMF treatment may enhance
implant stability and establish a new benchmark for care,
shortening the healing period and achieving full osseointegration within four to eight weeks instead of the conventional three to six months (Fig. 5).
Impact of PEMF on bacterial biofilm colonisation
around implants: “Antimicrobial effects of a pulsed electromagnetic field: an in vitro polymicrobial periodontal
subgingival biofilm model”. M. Faveri et al. Biofouling.
2020:1–8.
PEMF have been explored for their antimicrobial properties
and potential in orthopaedics and wound healing showing that could affect bacterial membranes, altering cell metabolism and growth. The aim of this in vitro study was to
assess the antimicrobial effects of PEMF on a polymicrobial
subgingival periodontal biofilm model, potentially offering
a novel approach to managing peri-implant diseases.
8b
Fig. 8a: The distance from the implant shoulder to bone crest was measured on X-rays using the ImageJ software at baseline (T0), one month (T2) and three
months (T3). *p < 0.05, **p < 0.01 Fig. 8b: Mean of pocket depth measurements at baseline, one and three months in control and test groups. *p < 0.05, **p < 0.01
10
3 2024
* The articles in this category are provided by the manufacturers or distributors and do not reflect the opinion of the editorial team.
Fig. 6: Changes in bacterial biofilm around implant. Fig. 7: The Magdent MED generated PEMF may have an antimicrobial effect on bacterial species.
[11] =>
research*
Baseline
9a
1 month
9b
3 months
9c
Baseline
1 month
10a
10b
|
3 months
10c
* The articles in this category are provided by the manufacturers or distributors and do not reflect the opinion of the editorial team.
Figs. 9a–c: The distance from the implant shoulder to bone crest in a patient from the test group: Measurements taken at baseline (a); after one month (b);
and after three months (c). Figs. 10a–c: The distance from the implant shoulder to bone crest in a patient from the test group: Measurements taken at baseline
(a); after one month (b); and after three months (c).
The results indicate significant differences in bacterial
counts between the test and control groups. Total bacterial counts were lower in the test group compared to the
control group, with a statistically significant difference
(p = 0.0492). Analysis of specific bacterial species revealed that seven species were significantly elevated in
the control group, including E. nodatum, F. nucleatum
ssp. nucleatum, S. intermedius, S. anginosus, S. mutans,
F. nucleatum ssp. vicentii, and C. ochracea (p < 0.05).
The mean percentage of DNA probe counts revealed significantly higher proportions of two bacterial species in
the test group (G. morbillorum and A. gerencseriae) compared to three bacterial species in the control group
(E. nodatum, F. nucleatum ssp. nucleatum, and S. mutans; Fig. 6).
The Magdent MED generated PEMF may have an antimicrobial effect on bacterial species and can be considered as a new treatment modality to control bacterial colonisation around dental implants.
Recently, the company has undertaken a comparable
clinical study, confirming identical results and presenting
a significant new approach to managing peri-implant diseases (Fig. 7).
ical, radiographic, and immunological—were conducted
at baseline, one month, and three months (Figs. 8–10).
Among the 23 patients with 34 implants studied, the test
group exhibited significantly lower mean crestal bone loss
compared to the control group. Additionally, IL-1β levels
were notably reduced in the test group at two weeks.
Noteworthy improvements were observed in peri-implant
pocket depth, plaque index, and bleeding on probing
across both groups throughout the study duration.
The study findings underscore the potential of PEMF
therapy as a complementary approach to non-surgical
treatments for peri-implantitis, showcasing its ability to
reduce inflammation and bone loss. Notably, PEMF therapy exhibits promise in fostering tissue repair and diminishing proinflammatory cytokines. Mayer et al. emphasise
a new paradigm in dental implantology by using PEMF
therapy receiving favourable outcomes with the test group
displaying enhanced clinical parameters and decreased
bone loss relative to the control group over a brief observation period.
about the author
Influence of PEMFs on peri-implantitis: “A novel nonsurgical therapy for peri‐implantitis using focused pulsed
electromagnetic field: A pilot randomized double‐blind
controlled clinical trial”. Mayer et al. Bioelectromagnetics.
2023;44:144–55.
Prof. Shlomo Barak DMD is an internationally recognised oral and maxillofacial surgeon who has published over
45 articles on oral surgery and dentistry. He is former director of Dental &
Maxillofacial department—“Hillel Yafe”
medical center. Prof. Barak founded and
managed the “Maccabi-Dent” dental
clinics chain for 18 years.
Peri-implantitis, characterised by inflammation and bone
loss around dental implants, is a significant concern in
dentistry. While various treatments exist, their effectiveness can be limited. This study aimed to evaluate the effectiveness of PEMF therapy as an adjunct to non-surgical
treatment for peri-implantitis.
The study encompassed patients diagnosed with periimplantitis, categorised into two groups: a test group undergoing PEMF therapy via an innovative healing abutment embedding active PEMF, and a control group receiving inactive PEMF. Following non-surgical mechanical
debridement of the implant surface, assessments—clin-
contact
Prof. Shlomo Barak
Taga Innovations, 16 Beit Hillel St.
Tel Aviv, 670017 Israel
shlomo@tagapro.com
3 2024
11
[12] =>
| research*
Peri-implantitis prevention starts
with the choice of a clean implant
Drs Dirk U. Duddeck & Dana Adyani-Fard, Germany
© CleanImplant Foundation
Peri-implantitis is a pathological condition affecting the
bone surrounding dental implants, characterised by inflammation of the adjacent soft and hard tissues, leading
to progressive bone loss.1, 2 If not diagnosed and treated
promptly, this condition can result in the loss of the implant. Unfortunately, the clinical and histological factors
1a
Sterile yet contaminated implants
A vastly underestimated risk factor that needs to be better understood has recently gained attention: the manufacturing and packaging processes of dental implants.
These largely overlooked factors can significantly impact
the short- and long-term success of implants placed
intra-orally. The cleanliness of the implant surface is crucial, particularly because it directly affects the surrounding bone during placement and the early phases of osseointegration.4
It is imperative that every stage of the manufacturing process is meticulously controlled to ensure that the final
product is not only sterile but also free from any surface
contaminants that could provoke an immunological
response. While the implant may be sterile when it is
removed from its packaging, there is a possibility of thin
film contaminants, as well as plastic or metallic particles,
remaining on the surface—residuals of the complex and
intricate manufacturing process.5
1b
Figs. 1a & b: SEM 500x (a) and SEM 380x (b). Significant impurities located at the shoulders of two sterile packaged titanium implants.
12
3 2024
* The articles in this category are provided by the manufacturers or distributors and do not reflect the opinion of the editorial team.
For decades, dental implants have been the gold standard
for replacing missing teeth, whether it’s a single tooth or
an entire dental arch. However, alongside this success,
experts have noted a rise in cases of peri-implantitis and
the associated peri-implant bone loss.
that contribute to the progression from peri-implant mucositis to peri-implantitis are still not completely understood.3 Clinically, sites affected by peri-implantitis often
exhibit more extensive inflammatory lesions compared to
periodontal sites around natural teeth.
© CleanImplant Foundation
Two years ago, in implants 4/2022, we raised an important question: how clean must sterile-packaged implants
be to meet the high expectations of dental professionals
who entrust these medical devices to their patients? At
that time, extensive quality assessments conducted by
the CleanImplant Foundation revealed troubling impurities on the surfaces of new, sterile-packaged implants,
identified through independent laboratory testing. It was
reasonable to expect that the manufacturers involved
would address these issues promptly and ensure that
their medical devices meet the highest standards of
cleanliness. Regrettably, even after two years, we cannot
give the “all-clear”. Here’s an update to where things
stand now.
[13] =>
2b
|
© CleanImplant Foundation
2a
© CleanImplant Foundation
research*
Figs. 2a & b: Major carbon-based contamination of titanium implant threads straight after unpacking, shown at SEM 500x.
Contaminants, whether in the form of particles or thin layers on the implant surface, can be accurately identified
through a combination of advanced analysis techniques.
In a particle-free clean room environment, the precise
location of these impurities is determined using material
contrast imaging in a scanning electron microscope (SEM).
To further characterise the impurities, energy-dispersive
X-ray spectroscopy (EDS) provides initial insights into
their elemental composition. The exact chemical nature
of these contaminants is then identified through timeof-flight secondary ion mass spectrometry (ToF-SIMS).
The CleanImplant Foundation ensures that all these
analyses are conducted exclusively in accredited testing laboratories, adhering to the stringent standards of
DIN EN ISO/IEC 17025:2018, guaranteeing precision and
objectivity in every analysis.
Results
In quality assessment studies conducted by the
CleanImplant Foundation in collaboration with Charité–
Universitätsmedizin Berlin and the Sahlgrenska Academy in Gothenburg, Sweden, significant impurities were
discovered on new, sterile-packaged dental implants.
These impurities affected both titanium and zirconia implants.5, 6 On average, one in three analysed implant systems exhibited notable factory-related contamination on
the implant surface immediately after removal from the
packaging. The contaminants identified included organic
particles from the manufacturing process, metallic particles—such as iron-chromium compounds, nickel, or tungsten—resulting from milling or surface treatments, and
plastic residues from handling and packaging. The areas
most frequently contaminated were the shoulder region
of the implant platform (Figs. 1a & b) and the implant threads
(Figs. 2a & b). In some instances, analyses revealed not
only isolated impurities but also larger areas of the im-
plant surface that had either been inadequately cleaned
during production or contaminated during packaging.
At high magnification, SEM images showed carbonaceous
particles as black spots, alongside thermoplastic materials, synthetic polymers, and polysiloxanes on sterile implant surfaces. Both titanium implants (Figs. 1a–2b) and
zirconia (ceramic) implants from various manufacturers
were found to be affected by these contaminants.
Certain ceramic implants were found to have significant
deposits of polysiloxane, which could be traced back to
the packaging material (Fig. 3). Another potential threat
to successful healing (osseointegration) after implantation comes from thin-layer residues of highly aggressive, cytotoxic cleaning agents, such as dodecylbenzene
sulphonic acid (DBSA)7 or the pesticide didecyldimethylammonium chloride (DDAC-C10)8. This quaternary
ammonium compound was identified using ToF-SIMS
3
© CleanImplant Foundation
* The articles in this category are provided by the manufacturers or distributors and do not reflect the opinion of the editorial team.
Methods of analysis
Fig. 3: SEM image at 1,000× revealing significant plastic material and thinfilm contamination on a sterile-packaged ceramic implant.
3 2024
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[14] =>
| research*
4
Fig. 4: ToF-SIMS visualisation of polysiloxane (red) and the quaternary ammonium compound DDAC (C22H48N+; green) on the surface of the ceramic
implant shown in Figure 3 (with permission of Tascon GmbH, Münster, Germany).
on the surface of a sterile-packaged ceramic implant
(Figs. 3 & 4).
Alarmingly, all implants analysed and found to contain
contaminants carried the CE mark or had received clearance from the US Food and Drug Administration. This
highlights a critical concern: even sterile-packaged medical devices can pose risks to patients if contaminated.
Such contamination can lead to implant failure, often associated with peri-implantitis, as a result of inflammatory
reactions triggered by these impurities.
However, it is important to note that many implants examined under SEM revealed flawless surfaces, completely free of inorganic, organic, and plastic particles
(Fig. 5). This demonstrates that contamination is not only
a significant concern but also one that is technically preventable.
Even at low concentrations, thin-film contaminants—
such as those containing DBSA or quaternary ammonium compounds—are cytotoxic to cells and impede
rather than facilitate implant healing. DBSA, an aggressive surfactant, is categorised as a “hazardous substance” by the EPA. Similarly, the biocide/pesticide
DDAC-C10 disrupts intermolecular interactions and
destroys cell membranes.9
Carbon-containing organic particles that persist on the
implant’s surface during manufacturing or plastics from
packaging can provoke an immune response in the form
of a foreign body reaction (Fig. 6). During implant insertion, particles that detach from the surface are engulfed
by macrophages through phagocytosis. This process
triggers a cascade of proinflammatory cytokines, including TNF-α, interleukin(IL)-1β, and IL-6. These cytokines
promote the differentiation of osteoclast precursors into
mature osteoclasts, which can enhance osteoclastic
activity and result in peri-implant bone resorption.10
Particularly, foreign particles ranging from 0.2 to 7.2 µm
in size are known to be highly proinflammatory.11–13 The
increased expression of Matrix Metalloproteinase-8 (MMP-8)
exacerbates soft-tissue damage and inflammation, which
can progressively affect the adjacent bone.10 Consequently,
the rough implant threads become exposed to the oral
environment, leading to bacterial colonisation, often described as the “beginning of a bad ending” and accelerating peri-implant disease. This progression often culminates
in further crestal bone loss and, potentially, implant failure.
Discussion
© CleanImplant Foundation
The immunological response to contaminants varies
among patients. While some may exhibit minimal or no
reactions, others may experience severe responses.
The growing recognition of peri-implant disease, facilitated by advances in clinical understanding, indicates
that contaminants can provoke immunological reactions
in a significant number of patients.
5
Fig. 5: SEM mapping image of the whole implant after removal from the
manufacturer’s packaging (top); SEM magnification 500x (left) and 2,500x
(right), demonstrating a clean surface free of any organic or metallic particles
or other debris.
14
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Contaminants on an implant’s surface signify a compromised implant. Addressing this issue is not complex: manufacturers have the capability to prevent such contamination, and it is their responsibility to do so. There is no
justification for failing in this regard; the well-being of patients and the integrity of scientific standards demand the
highest quality control. As dental implants become more
widely used, it is imperative to monitor patients closely
throughout the lifespan of their restorations. Early detection and intervention for peri-implant mucositis are crucial
for preserving the surrounding bone, halting the progression of peri-implantitis, and enhancing long-term clinical
outcomes.
* The articles in this category are provided by the manufacturers or distributors and do not reflect the opinion of the editorial team.
© CleanImplant Foundation
Clinical effects
[15] =>
research*
© IMD Berlin, Dr. Volker v. Baehr
However, preventing undesirable foreign body reactions
and early-stage peri-implantitis begins with selecting an
implant system that is rigorously proven to be clean.
Sterility alone does not ensure safety, as contaminants—
regardless of being labelled as “sterile dirt”—can still
trigger immunological responses.
Conclusion
The quality of the implant surface and the cleanliness of
the implant are crucial factors in peri-implant diseases,
though they remain significantly underestimated. Whether
the implants are made of titanium or ceramic, it is essential that the implant’s surface is free from foreign particles
after removal from sterile packaging. Particulate and thinfilm contaminants are often invisible to the naked eye, even
under magnification with magnifying glasses or microscopes.
* The articles in this category are provided by the manufacturers or distributors and do not reflect the opinion of the editorial team.
In most cases of peri-implantitis or implant failure, clinicians may attribute the issue solely to patient factors.
However, the results from quality assessments of sterilepackaged implants suggest that the medical device itself
should also be considered a potential source of inflammatory reactions and a possible trigger for peri-implantitis
during the placement process.5
6
Fig. 6: Impurities detach during implant insertion from the surface and induce a storm of pro-inflammatory cytokines leading to bone resorption and
soft-tissue degradation.
The decision to award this quality mark is made by the
renowned scientists on the Foundation’s Scientific Advisory Board through a rigorous peer review process. To
uphold the Trusted Quality seal, a random sample of five
implants from each system undergoes comprehensive,
independent analysis every two years.
For the past eight years, the CleanImplant Foundation
has collaborated with an expanding network of industry
partners to ensure particle-free implant production. It has
established the “Trusted Quality” seal as a mark of assurance for implants that have been rigorously tested and
deemed clean.
The foundation acts as an intermediary, bridging the legitimate expectations of patients and providers with the quality assurance processes of medical device manufacturers. Through its initiatives, the foundation has frequently
identified previously unrecognised deficiencies in manufacturing and packaging, leading to significant and lasting improvements in production protocols. The shared
commitment to the fundamental medical ethics principle
of primum non nocere (first do no harm) highlights the
collaborative nature of the Foundation’s work with its
partners and manufacturers. Moreover, understanding the
implications of residual biocides, such as DDAC, and
cytotoxic, surface-active agents like DBSA on sterilepackaged implants intended for patient use is critical to
ensuring product safety and efficacy.
Dentists interested in supporting the CleanImplant Foundation can become members through the website. This
non-profit organisation provides details on the benefits of
membership and showcases numerous implants that
have received the prestigious seal of quality, the “Trusted
Quality” mark, after thorough testing. The criteria for ensuring that implants are largely free of particles were established in a consensus paper published in 2017.14
|
Literature
Read the previous article
contacts
Dr Dirk U. Duddeck
CleanImplant Foundation
Berlin, Germany
info@cleanimplant.org
www.cleanimplant.org
Dr Dana Adyani-Fard
Düsseldorf, Germany
info@cleanimplant.org
www.cleanimplant.org
Dr Dirk U. Duddeck
Dr Dana Adyani-Fard
3 2024
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| case report
Late implant placement following
bilateral sinus floor elevation
Prof. Dr Paolo Maturo & Dr Edoardo Magnanelli, Italy
Partial tooth loss in the posterior region can lead to significant functional deficits and, particularly in young patients, may also result in aesthetic concerns. If left untreated, the loss of vertical dimension and subsequent
tooth migration can lead to temporomandibular joint (TMJ)
disorders. Additionally, untreated partial malocclusion in
the posterior region is a primary cause of maxillary sinus
pneumatisation and vertical bone loss.
geometry, non-tapered implant neck, and conical prosthetic internal configuration with integrated platform switching are particularly advantageous.1, 2
Diagnostics
When the residual crestal bone volume is minimal, preserving the surrounding native bone is crucial for the longterm stability of implants after bone regeneration. Several
factors, including implant geometry and prosthetic connection, play a role in crestal bone resorption. In this context, iSy implants offer features that support the longterm preservation of marginal bone. Notably, their macro-
A 28-year-old woman sought further treatment in our
practice following the extraction of her posterior teeth #16,
#26, and #27 alio loco over five years ago. She requested
reconstruction of the edentulous regions with dental implants. Upon initial oral examination, it was noted that the
absence of tooth #16 had caused a mesial inclination of
tooth #17, resulting in a reduced interproximal space. The
orthopantomograph (OPG) revealed a mesioangulation
of tooth #28 and several minor fillings (Figs. 1a & b). Additionally, significant bone height reduction was observed
1a
1b
2
Figs. 1a & b: Clinical situation pre-op in the first and second quadrants. Fig. 2: The OPG reveals pneumatisation of the maxillary sinus and tooth inclination.
16
3 2024
[17] =>
© MIS Implants Technologies Ltd. All rights reserved.
ONE-TIME
SOLUTION
TISSUE-LEVEL SCREW-RETAINED SYSTEM
MAKE IT SIMPLE
CO
ECT
The MIS CONNECT is a stay-in abutment system which enables avoiding interference
with the peri-implant gingival seal. It offers doctors the ability to maximize the
tissue-level restoration concept, enabling the entire prosthetic procedure and
restoration to occur far from the bone, and at any level of the connective tissue.
Learn more about MIS at: www.mis-implants.com
[18] =>
3
Fig. 3: A CBCT scan was deemed necessary to determine the appropriate therapeutic approach.
4a
4b
4c
Figs. 4a–c: Following mucoperiosteal flap elevation, a lateral window was prepared using the piezo technique.
5a
5b
5c
Figs. 5a–c: The caudal osteotomy line was positioned approximately 3 mm above the estimated sinus floor. The membrane was carefully detached using a
specialised sinus instrument. A particulate xenograft was employed to augment the maxillary sinus, and the bone window was covered with a collagen membrane, which was stabilised by soft-tissue closure.
6a
6b
Figs. 6a & b: Successful augmentation of the maxillary sinus using a particulate xenograft, followed by secure wound closure.
18
3 2024
[19] =>
case report
|
7
Fig. 7: Post-augmentation X-ray imaging to verify the efficacy of the procedure.
in the areas where teeth #16 and #26 had been extracted,
due to vertical crestal bone resorption and sinus pneumatisation (Fig. 2).
To ensure the stable placement of implants, bone augmentation in the maxillary sinus was necessary. The CBCT
scan showed a residual bone height of less than four millimetres, leading us to opt for an external approach to the
maxillary sinus (Fig. 3). The sinus floor needed to be elevated by more than three millimetres to counteract the
pneumatisation and restore the bone height. Given the
circumstances, we chose a two-stage approach,3, 4 as
8a
8b
primary stability of the implants is significantly influenced
by preoperative bone height and quality.
Surgery
Following comprehensive radiological diagnostics and a
detailed consultation, the treatment was executed on the
same day under local anaesthesia. A trapezoidal incision
was made with a 15-c bistoury blade to prepare the mucoperiosteal flap. The lateral window was created on both
sides using a piezoelectric device, which employs ultrasonic technology to ablate only hard tissues and bone
8c
Figs. 8a–c: At the time of implantation, the augmented area exhibited sufficient height and stability to support implant anchorage. The implantation site was
exposed using a modified mucosal flap technique and an iSy implant was placed according to the drilling protocol. The pre-assembled base remained in the
implant, a gingiva former was attached, and the soft tissue was closed with a non-absorbable monofilament suture.
9a
9b
9c
Figs. 9a–c: The implant was similarly inserted in the left quadrant, with incisions made 1.5 mm from the mesial and distal papilla.
3 2024
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[20] =>
| case report
10
Fig. 10: The two implants (Ø 3.8 mm, L 11 mm) were inserted with primary stability in the augmented region.
while preserving surrounding soft tissue. Care was taken
to position the caudal osteotomy line approximately three
millimetres above the estimated maxillary sinus floor.
After fenestrating the vestibular bone wall, the bone flap
was delicately separated from the membrane and immersed in saline. Schneider’s membrane was carefully
detached from the palatal side using specialised hand
curettes, with constant bone contact maintained to minimise the risk of perforation (Figs. 4a–c). The cavity between the alveolar bone and the sinus membrane was
filled with particulate xenograft. A collagen membrane
was then placed over the window to prevent washout.
The mucoperiosteal flaps were repositioned to secure
the collagen membrane in place without the need for
pins. The flaps were precisely adapted to the wound margins and closed with individual button sutures, ensuring
a saliva-proof seal (Figs. 5–7).
Implant insertion
After an eight-month healing period, an intra-oral X-ray and
CBCT scan were performed, revealing sufficient bone regeneration at the grafted site. Nine months post-sinus
floor augmentation, an iSy implant was placed in each
edentulous area, following the open treatment protocol
designed for the system.
The alveolar bone was exposed at the predetermined implant sites using a minimally invasive, modified mucosal
flap technique. Incisions were made 1.5 mm away from
the mesial and distal papillae to prevent their collapse or
regression. The implant bed was prepared according to
the efficient drilling protocol provided by the manufacturer. A round bur was used to punch-mark the implant
position, and subsequent pilot drilling determined the
depth and axis of the implant site. Final drilling was carried out using the single-patient form drill included in the
package.
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3 2024
One iSy implant (Ø 3.8 mm, L 11 mm) was placed on each
side, achieving the necessary primary stability for open
healing (Figs. 8a–9c). Despite the parallel shape of the
implant, which is not ideal for achieving high primary
torque stability, the design of the implant base—with an
abutment diameter slightly larger than the implant diameter—prevents sinus migration during the healing phase.
In cases like this, where primary stability of 20 Ncm torque
or greater is achieved, transgingival healing can be selected as the treatment option (Fig. 10). PEEK healing
caps were mounted on the implant base, and the flaps
were sutured tightly around the healing caps with surgical
knots, using 5/0 non absorbable monofilament. An intraoral X-ray was taken as a baseline to verify the first bone–
implant contact (BIC) at the implant shoulder (Fig. 11).
The prosthetic restoration
The prosthetic restoration began 16 weeks after the implant placement and regular follow-up appointments. The
PEEK healing caps were removed, and multifunctional
caps were clicked into place. An analogue impression of
the two implant positions was taken intra-orally using an
11
Fig. 11: The implant bases were fitted with healing caps for an open healing
approach.
[21] =>
case report
12a
12b
12c
12d
|
Figs. 12a–d: The final metal-ceramic crowns in situ, featuring aesthetically pleasing crowns #16 and #26. The Platform Switching concept of the system
facilitates the stable attachment of peri-implant tissue.
impression key. In the laboratory, a model was fabricated
to replicate the implant positions precisely. Custommade iSy Universal abutments were then screwed onto
the implant analogues and modified to accommodate
the peri-implant soft tissues, implant angulation, and the
insertion direction of the crowns. Metal-veneered porcelain crowns (PFM) were fabricated and subsequently
cemented.
Given the clinical diagnosis and the patient’s parafunctional habits, PFM crowns were selected over zirconia to
minimise the risk of chipping or wear due to the reduced
height of the TiBase and limited retention. For the final
restoration, the pre-assembled iSy implant bases were
removed from the implants for the first time using the
abutment disconnector. A stable peri-implant mucosal
tissue was observed, and the titanium abutments were
inserted and screw-retained to the implants with an abutment screw (20 Ncm). After functional and shade verification, the two metal-ceramic crowns were cemented
onto the roughened abutments (Figs. 12a–d).
about the authors
Prof. Dr Paolo Maturo is employed in
the Department of Surgical Sciences at
the Faculty of Medicine and Surgery at
the University of Rome Tor Vergata. He
holds a PhD in Biochemistry and Molecular Biology and is engaged in clinical
research in the fields of preventive and
pediatric dentistry, the application of
lasers in dentistry, and the simplification of protocols in oral implantology and bone regeneration. He
completed his implant prosthetic training at Boston University in
2005 and at the Kirsch-Ackermann Clinic in Filderstadt in 2013.
In recognition of his outstanding work, he was awarded the Axel
Kirsch Prize by the former Italian Camlog Academy in 2012.
Dr Edoardo Magnanelli earned his
DDS degree in Dentistry at the Universitat Internacional de Catalunya (UIC) in
Barcelona and obtained a certificate in
implant-based therapy from the EAO in
2019. In the same year, he also completed his International Master’s degree
in Oral Surgery at UIC in Barcelona.
Conclusion
After six months of functional loading, the hard and soft
tissues remained stable. A significant advantage of the iSy
treatment concept is the minimal unscrewing and screwing required for prosthetic restoration,
Literature
reducing the risk of bone remodeling
at the implant shoulder caused by inflammatory connective tissue (ICT). The
treatment successfully achieved aesthetics, patient satisfaction, and functional rehabilitation.
contact
Prof. Dr Paolo Maturo, PhD
Department of Surgical Sciences
University of Rome Tor Vergata, Studio Maturo
Viale Parioli 180, 00197 Rome, Italy
paolo.maturo@uniroma2.it
3 2024
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[22] =>
| case report
Long-term success of implantsupported rehabilitation in the
aesthetic zone: A nine-year followup case report
Drs Léon Pariente & Karim Dada, France
Dental implants have revolutionised the field of restorative
dentistry, offering reliable solutions for replacing missing
teeth. The success of dental implant treatment relies on
meticulous treatment planning, precise surgical techniques, and appropriate follow-up care. In the aesthetic
zone, where patient satisfaction is closely tied to the appearance of the restoration, achieving optimal outcomes
becomes even more critical.
bility.1,2 These implants mimic a dental root shape, as they
have a smaller diameter at the apical part than at the neck
of the implant. The claimed benefits of this design include
enhancement of the primary stability by the pressure of
the cortical bone on regions with poor bone quality, as
well as the reduced risk of bone perforation due to its
macrotopography.3
This case report presents the nine-year follow-up of two
Straumann® BLT implants placed in the aesthetic zone,
focusing on their clinical performance, peri-implant tissue
health, and patient satisfaction. By examining the longevity and aesthetic outcomes, this report highlights the
importance of careful treatment planning and execution
in achieving predictable outcomes.
A determinant of long-term implant success also lies in
the selection of an appropriate implant system. Straumann®
BLT implants, characterised by their proprietary Roxolid®
material and SLActive® surface, have garnered considerable attention for their osseointegration potential and sta-
Initial situation
A 56-year-old female patient, non-smoker, classified as
healthy (ASA I), with no current medications or known allergies, visited our clinic with a chief complaint centered
around her persistent dissatisfaction with her smile. She
2
Fig. 1: The patient’s extra-oral examination revealed a medium smile line. Fig. 2:
Misalignment observed in the maxillary front teeth.
1
22
3 2024
[23] =>
case report
|
3
Fig. 3: Intra-oral examination shows periodontal attachment loss and mobility in the upper left central incisor and lateral
4
incisors. Fig. 4: CBCT scan reveals the absence of buccal bone.
reported the development of a chronic infection in her front
teeth over recent years, leading to noticeable mobility.
This dental concern has significantly affected her ability
to eat and speak with confidence. The patient was actively seeking a long-term solution but expressed concerns about potential pain during the treatment process.
The patient’s extra-oral examination revealed a medium
smile line and misalignment of the front teeth (Figs. 1 & 2).
During the intra-oral examination, advanced periodontal
attachment loss and mobility were noted in teeth #12, #21,
and #22 (Fig. 3). Cone-beam computed tomography
(CBCT) imaging indicated the absence of buccal bone
on tooth #21 (Fig. 4).
According to the SAC classification, the patient was classified surgically as complex and prosthetically as straightforward (Fig. 5).
Treatment planning
Taking into consideration the patient’s needs and desires,
the following treatment plan was chosen:
1. Atraumatic extractions of teeth #12, #21 and #22 with
alveolar curettage.
2. Dental preparations on teeth #13, #11 and #23.
3. Temporary resin-based bridge on teeth #13-23.
4. Placement of Straumann® Roxolid BLT ∅ 3.3 mm implant on position #12 and Straumann® Roxolid®
SLActive® BLT ∅ 4.1 mm on position #21.
5. Simultaneous minor bone augmentation with Straumann® XenoGraft and a collagen membrane.
6. Immediate loading of implant #12 and delayed loading
of implant #21.
7. Papilla conformation with a temporary ovate pontic on
ridge position #22.
8. Final screw-retained crown delivery on implants #12
and #21-22.
Surgical procedure
Local anaesthesia with lidocaine 2% with epinephrine
1:100,000, was administered. This was followed by atraumatic extractions of teeth #12, #21, and #22, with alveolar
curettage. Additionally, dental preparations on teeth #13,
#11, and #23 were carried out (Fig. 6).
A temporary resin-based bridge was placed in the second
sextant (Fig. 7). Following wound healing, horizontal and
vertical deficiencies were observed at ridge position #21
(Fig. 8).
At the six-week follow-up post dental extractions, the patient presented with uneventful wound healing (Fig. 9).
A mucoperiosteal flap, with a crestal incision, was raised
to facilitate implant placement. The Straumann® Surgical
Cassette was employed to prepare the implant bed.
Subsequently, a Straumann® Roxolid ® SLActive ® BLT
∅ 3.3 mm implant was positioned at site #12, and a
Straumann® Roxolid® SLActive® BLT ∅ 4.1 mm implant
was placed at position #21 (Fig. 10). The implants were
5
Fig. 5: Based on SAC classification, the patient was classified as surgically
complex and prosthetically straightforward.
3 2024
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[24] =>
| case report
positioned using the handpiece in a clockwise direction
with a speed of 15 rpm and torqued to 35 Ncm. Simultaneously, bone augmentation was carried out at position #21 to enhance the structural integrity of the implant
site.
A radiographic control was conducted on implant #21,
five months post implant surgery, to assess the progress
and ensure the integrity of the implant in its position (Fig. 11).
6
Prosthetic procedure
Soft-tissue conformation was evaluated seven months
after the delayed loading of implant #21, with the aim to
assess the maturation and adaptation of the surrounding
soft tissues to the implant site (Fig. 12).
7
After the successful healing and osseointegration of both
implants, the final restorations were placed on the implants, and the screws were tightened within the range
of 15 to 35 Ncm revealing a natural and aesthetically
pleasing appearance of the final crowns (Figs. 13 & 14).
Oral hygiene instructions were provided, and occlusion
was checked. Recall appointments were efficiently scheduled to ensure ongoing monitoring and maintenance of
the achieved oral health.
8
Treatment outcomes
Radiographic control was conducted at the time of the
final impression to ensure an accurate assessment of the
implant placement and surrounding structures (Fig. 15).
Additionally, a follow-up radiographic evaluation was performed six years after the completion of the treatment to
monitor the long-term stability and health of the treated
area (Fig. 16).
9
At the six-year (Figs. 17 & 18) and nine-year (Fig. 19) followups, comprehensive clinical and radiographic assessments underscored favourable outcomes, including osseointegration, the maintenance of bone density around the
implants, and pleasing aesthetics. These findings collectively indicated the success of the long-term treatment.
10
Fig. 6: Extraction of the upper left central incisor and
lateral incisors, followed by the preparation of upper
right central incisor and canines. Fig. 7: Placement of a temporary resin-based bridge. Fig. 8:
Post-healing, horizontal and vertical ridge deficiencies observed at the site of #21. Fig. 9: Six weeks
after dental extractions, the patient exhibited uneventful wound healing. Fig. 10: Placement of
Straumann® Roxolid® SLActive ® BLT ∅ 3.3 mm
implant at site #12, and a BLT ∅ 4.1 mm implant
at site #21. Fig. 11: At five months post-surgery,
the radiographic control of implant #21 confirmed
proper positioning and implant integrity.
11
24
3 2024
The treatment journey has resulted in exceptional health
outcomes for both hard and soft tissues. The patient expressed her gratitude to the team, who meticulously
managed each phase of the treatment.
The effectiveness of the maintenance programme has
been fundamental in preserving the achieved results over
time. The patient reported enhanced functionality, enabling proper eating and confident speech. Furthermore,
the realisation of the “dream smile” stands as a testimony
to the comprehensive and successful nature of the provided care.
[25] =>
case report
12
|
13
14
15
16
17
about the authors
18
19
Fig. 12: Successful soft-tissue healing observed at the seven-month follow-up.
Fig. 13: Placement of the final restorations. Fig. 14: The aesthetically pleasing appearance of the final crowns. Fig. 15: Radiographic assessment at the
time of final impression confirmed precise implant placement and verified bone
structure integrity. Fig. 16: A follow-up radiographic evaluation assessed the
long-term stability and health of the implant sites. Fig. 17: Six-year follow-up
showing favourable aesthetic results. Fig. 18: Six-year follow-up demonstrating
a satisfactory clinical outcome. Fig. 19: Nine-year follow-up revealing successful results, with healthy soft and hard tissues maintained.
Authors’ testimonial
In our daily practice, Straumann® BLT implants have consistently delivered predictable results, particularly in the
aesthetic zone. We ensure seamless integration and longterm patient satisfaction through meticulous treatment
planning and interdisciplinary collaboration.
Dr Léon Pariente, DDS has a private
practice specialised in Implantology and
Periodontology in Paris. He graduated of
the Paris Descartes University and absolved in 2012 an advanced programme
in implant dentistry at the New York University College of Dentistry. He has several research projects at the Prosthetic
and Implant Department of the Paris Descartes University.
Dr Karim Dada, DDS, MS graduated
with a degree in dental surgery and postgraduate certificates in implant prosthodontics and implant surgery from
the Paris Descartes University. He was
recognised in 2005 by the Académie
Nationale de Chirurgie Dentaire for his
work in providing implant treatment to
patients with head and neck cancer who are undergoing radiotherapy. Dr Dada maintains a private practice in Paris focusing
on perio-plastic surgery and implant dentistry.
contact
Cabinet dentaire Paris-Invalides
62 Boulevard de la Tour Maubourg 62 LTM
75007 Paris, France
+33 1 42884081
62LTM@orange.fr
www.dr-dada-karim.chirurgiens-dentistes.fr
Literature
3 2024
25
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[28] =>
| case report
Full maxillary rehabilitation with
immediate implant placement of
®
NEVO RC INICELL implants in
Type 3 bone
Dr Mathieu Rousset, France
The emergence of fully digital workflows in implant
dentistry has revolutionised the way clinicians approach
complex rehabilitative cases. Achieving high primary
stability in low-quality bone, such as Type 3 or 4 bone
(Lekholm & Zarb 1985), has traditionally posed significant
challenges. However, advancements in implant design,
surgical techniques, and digital imaging have enabled the
successful placement and immediate loading of implants
even in these challenging scenarios. The following case
report presents a comprehensive approach to full maxillary rehabilitation using immediate implant placement in
Type 3 bone, leveraging modern digital tools and the
innovative and gentle NEVO implant design to achieve
healthy and satisfying clinical outcomes.
Case presentation
A 64-year-old male patient with good general health presented with a long history of wearing a removable prosthesis, seeking a fixed solution to enhance both function
and aesthetics. Upon clinical and radiological examination, it was clear that the patient had four remaining teeth
in the maxilla not worth keeping that needed extraction
(Figs. 1 & 2). Additionally, the bone quality was classified
2
Fig. 1: Preoperative condition of the maxilla.
as Type 3, indicating low bone density and presenting
challenges for implant placement, particularly in achieving primary stability. After thorough discussion of all the
available options, the patient opted for an all-on-six approach with immediate implant loading.
Preoperative planning
Detailed preoperative planning was critical for the success of this case. Using advanced 3D imaging technology and planning software (PDIP, Carestream Dental),
3
Fig. 2: Full-mouth image taken preoperatively. Fig. 3: 3D surgical planning.*
28
1
3 2024
[29] =>
case report
4
|
5
Fig. 4: Stackable surgical guide (designed using RealGUIDE TM by Genesis Dental Lab).* Fig. 5: Flap elevation following guide fixation.
6
7
Fig. 6: NEVO RC INICELL® implant placement using the surgical guide. Fig. 7: Placement of VARIOmulti abutments.
a comprehensive virtual treatment plan was developed
and showed to the patient (Fig. 3)*. The planning procedure included the design of a stackable surgical guide
system comprising the position guide, base guide, and
drilling guide (Fig. 4).* This guide would ensure precise implant placement, crucial for achieving optimal outcomes
in a case with compromised bone quality.
Surgical procedure
8
9
The surgical procedure commenced with the stabilisation
of the base guide using four anchor pins (MIS), providing
a secure and accurate reference for subsequent steps. A
flap was raised to expose the underlying bone, followed
by the extraction of the four remaining teeth (Fig. 5).
Fig. 8: Optical impression with scanbodies and sutured flap. Fig. 9: Additional photogrammetry to ensure maximum accuracy.
3 2024
29
[30] =>
| case report
10
11
Fig. 10: Chairside fabrication of the temporary prosthesis. Fig. 11: Temporary prosthesis placement six hours postsurgery.
Following tooth extraction, six implant beds were prepared according to the manufacturer’s guidelines. The implant beds in the four extraction sockets were only partially drilled to allow for high primary stability in the poorquality bone. Six NEVO RC INICELL® implants (Thommen
Medical) were then placed into the prepared implant beds
through the drilling guide (Fig. 6). Despite the poor bone
quality, the immediately placed implants in extraction sockets achieved an Implant Stability Quotient (ISQ) of 73, indicating sufficient initial stability for immediate loading.
Prosthetic procedure
VARIOmulti abutments (Thommen Medical) were placed
on all implants, with two posterior abutments angled at
12
Fig. 12: Post-placement radiograph of the temporary prosthesis.
30
3 2024
17 degrees to accommodate the anatomical structure and
prosthetic requirements (Fig. 7).
To address the bone defects and enhance stability, grafting was performed using “sticky bone” (Porcin hydroxyapatite, REGEDENT).
With the implants and abutments in place, attention
turned to the prosthetic phase (with kind support of
Genesis dental lab, Bordeaux, France). Scanbodies were
inserted, the flap was sutured, and an optical impression
was taken (Fig. 8). The base guide remained in situ during
the impression to ensure precise repositioning, facilitating accurate model creation by the dental technician.
Given the size and complexity of the implant-supported
[31] =>
case report
13
|
14
Fig. 13: Clinical image three months postsurgery, showing healthy soft tissue. Fig. 14: Radiograph three months postsurgery, demonstrating stable bone levels.
bridge, additional photogrammetry was employed to
achieve the highest possible accuracy (Fig. 9). This technique provided a precision of less than 15 microns, essential for the passive adaptation of the prosthetic framework.
A temporary full arch bridge was designed and printed
chairside within one hour (3D printer, SprintRay), leveraging modern digital dentistry technologies (Fig. 10). The
temporary prosthesis was installed six hours after surgery, providing immediate functional and aesthetic benefits to the patient (Fig. 11). The radiograph image showed
good bone levels after placement (Fig. 12).
Postoperative results
The postoperative period was uneventful, with the patient
exhibiting excellent healing and adaptation to the temporary prosthesis. After three months, clinical and radiographic evaluations showed healthy soft tissues and
stable bone levels around the implants (Figs. 13 & 14). The
success of the immediate implant placement and the use
of advanced surgical guides and photogrammetry underscored the effectiveness of the treatment protocol.
Conclusion
This case highlights the successful full maxillary rehabilitation achieved through immediate implant placement in
Type 3 bone. The use of NEVO RC INICELL® implants,
with their unique and gentle cylindrical-tapered shape,
was pivotal in achieving high primary stability without
compromising the bone, even in a compromised bone
environment. This immediate loading protocol was further supported by the integration of 3D planning, precise
surgical guides, advanced grafting techniques, and digital prosthetic workflows. Together, these modern techniques enabled the delivery of a high-quality, fixed solution in a single surgical session. The patient’s satisfaction
and the clinical outcomes underline the potential of modern implant dentistry to effectively address complex cases
with compromised bone conditions.
* Planning was performed with ELEMENT implants (Thommen Medical) due
to limited availability of NEVO in the planning software ahead of its full
market release. ELEMENT and NEVO implants share the exact same outer
implant body contour.
about the author
Dr Mathieu Rousset operates in his
private practice in Brive la Gaillarde,
France. With additional qualifications in
biomaterials, oral surgery, and computerassisted dentistry, he has refined his practice to specialise exclusively in implantology. Dr Rousset has established the
training center Association Malemortoise de Parodontologie et Implantologie
Orale (AMPIO) within his practice, in which he teaches implantology with a focus on guided surgery and digital dentistry. In
addition, he holds a teaching position in digital dentistry at the
Diplome Universitaire Européeen (DIUE) d’Implantologie in Corsica,
emphasising his passion for sharing knowledge and shaping the
future of dental professionals.
contact
Dr Mathieu Rousset
Association Malemortoise de Parodontologie et
Implantologie Orale
2 rue de la Paix
19360 Malemort, France
AMPIO.formation@icloud.com
www.ampioformation.com
3 2024
31
[32] =>
| case report
Immediate two-piece ceramic
implants with immediate provisionalisation in the posterior region
Drs Alexandre Marques Paes da Silva, Alice Maria de Oliveira Silva, Lissya Tomaz da Costa Gonçalves,
Rodrigo Franco Motta, Daniel Moraes Telles, Mayla Kezy Silva Teixeira & Eduardo Veras Lourenço, Brazil
The present case report aims to describe the clinical and
radiographic performance of ceramic implants placed
in the posterior regions of two patients who visited the
private SobreImplantes clinical study centre in Rio de
Janeiro in Brazil. CBCT was used to carry out surgical
planning, and periapical radiographs were used in the immediate postoperative period and in the follow-up consultations. The implants were placed into fresh sockets
(immediate) and immediately provisionalised. After receiving the implants, the patients remained under follow-up
for three months after surgery. The temporary prostheses
were then removed and replaced with definitive crowns.
The patients remained under follow-up for 18 months,
over which time it was possible to observe clinical and
radiographic success in relation to osseointegration,
stability of the marginal bone level and peri-implant health
of both implants. The patients were asked at the end of
treatment and in follow-up consultations about their degree of satisfaction with the aesthetic result of the treatment using a visual analogue scale, and both patients
were very satisfied. No mechanical or biological complications were observed during this period.
2a
2b
1
Fig. 1: Neodent Zi Ceramic Implant System.
Introduction
The possibility of having a more aesthetic alternative capable of withstanding masticatory forces has expanded
the use of zirconia implants in recent years.1 Among its
advantages, we highlight its aesthetics (colour similar to
that of teeth), resistance (high flexural strength of 900–
1,200 MPa, hardness of 1,200 Vickers, and Weibull
modulus of 10–12), and biocompatibility (low affinity for
bacterial plaque).2
3a
Figs. 2a & 3a: Initial clinical situation. Figs. 2b & 3b: Initial tomographic imaging examination.
32
3 2024
3b
[33] =>
case report
4a
4b
5a
|
5b
Fig. 4a: Minimally invasive extraction. Fig. 4b: Neodent Zi 4.3 × 11.5 mm. Fig. 5a: Fresh socket oclusal view. Fig. 5b: Neodent Zi 4.3 × 10.0 mm.
The first ceramic implants to be designed and manufactured were of the one-piece type;3,4 however, this implant
design presents surgical and prosthetic limitations: there
may be wound healing complications and unintentional
loading during the healing period, especially in cases
where primary stability has not been achieved, and poor
positioning of the implant may result in the need to refine
the most coronal portion of the implant, thus reducing its
mechanics.5 With the aim of overcoming these limitations, several two-piece ceramic implant systems have
emerged more recently, minimising these problems and
providing prosthetic versatility, such as the possibility of
angulation of the abutment and better positioning of the
implant.6, 7
The objective of this case report is to demonstrate the
clinical and radiographic performance of a two-piece
ceramic implant system (Neodent Zi, Straumann; Fig. 1)
employed in two patients who visited the SobreImplantes
private clinic located in the city of Rio de Janeiro in Brazil
in order to undergo oral rehabilitation of posterior teeth
with single implants and to report the degree of satisfaction of these patients in relation to the aesthetics of the
treatment. Both patients were non-smokers and had good
general health or controlled systemic conditions. For planning and diagnosis, the patients were asked to undergo
CBCT (Figs. 2 & 3).
brided in order to ensure removal of any type of inflammatory lesion of endodontic and/or periodontal origin,
and abundant irrigation with saline solution was employed. Once the instrumentation had been performed,
the ceramic implant was inserted into the socket using
a contra-angle handpiece previously adjusted to 24 rpm
and 30 Ncm (Figs. 4 & 5), and the socket was subsequently filled with bone substitute material (0.5 cm3 maxresorb, 0.5–1.0 mm, Straumann; Fig. 6). The dimensions
of the implants were 4.3 × 11.5 mm and 4.3 × 10.0 mm,
respectively. To receive the immediate temporary crowns,
abutments were selected for prostheses cemented to
zirconia: an abutment angled at 17° in one case and a
straight component in the other (Figs. 7 & 8). Finally, the
temporary crown was seated, and a periapical radiograph was performed in the immediate postoperative
period (Figs. 9 & 10).
After three months, the patients were re-evaluated, and
there had been no complications during the healing
period. Following a conventional workflow, the definitive
crowns were manufactured. It is important to highlight
that the gingival emergence profile was carefully copied,
using a light-polymerised flowable resin (Master Flow,
Biodinamica; Fig. 11). One patient received a milled crown
(IPS e.max, Ivoclar Vivadent; Fig. 12) and the other a
milled monolithic zirconia crown (Fig. 13), and the pros-
Surgical procedure
The same surgical protocol described by da Silva et al.
was applied to both patients.8 Antibiotic prophylaxis (four
tablets of 500 mg amoxicillin) was performed one hour
before, and the patients rinsed their mouths with 0.12%
chlorhexidine for 30 seconds before receiving local anaesthesia with 4% articaine and 1:100,000 adrenaline.
Tooth extraction was performed according to a minimally
invasive surgical approach, using delicate periotome to
rupture the periodontal ligament and elevate the tooth.
After extraction, the tooth socket was thoroughly de-
6
Fig. 6: Occlusal view annulled abutment and bone substitute (maxresorb).
3 2024
33
[34] =>
| case report
7a
7b
8a
8b
Figs. 7a & b: Angled CR abutment. Fig. 8a: CR Straight Abutment. Fig. 8b: Oclusal view of CR Straight Abutment.
9a
9b
10a
10b
Figs. 9a & 10a: Provisional crown—immediate postoperative. Figs. 9b & 10b: Immediate postoperative radiograph.
thetic abutments were cemented to the implants with
adhesive cement (Relyx U200, 3M).
Radiographic analysis
At the end of the prosthetic treatment, once the definitive
crowns had been cemented to their respective implants,
a periapical radiograph was taken to observe the stability
of the marginal bone level (Fig. 14) in comparison with the
immediate postoperative radiograph. To analyse changes
in the marginal bone level, ImageJ software (National
Institutes of Health) was used. The diameter of the implant was used as a reference point for calibrating the radiographic images, as it is a precise measurement and
known by the operators. Bone changes after 18 months
of follow-up were measured on radiographs using the
11
implant–abutment interface (easily identified) as a reference up to the point of the first bone–implant contact in
the mesial and distal regions of each implant, comparing
them with the radiograph taken postoperatively. These
measurements were carried out by two experts, who
were first subjected to the inter-examiner kappa test
(0.86—almost perfect agreement).
Level of patient satisfaction
The patients were followed up periodically for 18 months,
and at the time of writing, there had been no complications. At the end of the treatment, both patients said they
were very satisfied when asked about their level of satisfaction with the aesthetic result of the treatment according to a visual analogue scale (Fig. 15).
12
Fig. 11: Analog flow—emergency profile molding. Fig. 12: Cemented definitive crown (e.max).
34
3 2024
[35] =>
case report
13a
13b
14a
|
14b
Figs. 13a & b: Milled monolithic zirconia crown. Fig. 14a: X-ray of the last follow-up appointment (18 months)—milled monolithic zirconia crown.
Fig. 14b: X-ray of the last follow-up appointment (18 months)—milled e.max crown.
Discussion
Conclusion
The objective of the present case report was to evaluate
the clinical and radiographic performance of the Neodent
Zi two-piece ceramic implant system in the posterior
regions of two patients. After 18 months of follow-up, no
technical or biological complications were observed, demonstrating clinical and radiographic success of the implants
and satisfactory preservation of the shape of the soft and
hard tissue. Other studies using this ceramic implant system have shown results like ours after 12 months.7–10 Both
patients presented with properly osseointegrated implants
during the first three months, in agreement with animal
studies that reported that the osseointegration of zirconia
implants is similar to that of titanium implants under different loading conditions, and osseointegrated zirconia
implants have increased removal torque values.11, 12
Despite the limitations of the present case report, after
18 months of follow-up, the two-piece zirconia implant
system used appears to be a safe and reliable alternative
in oral rehabilitation involving posterior teeth. Further studies must be carried out to confirm our findings, and the
cases presented here will continue to be monitored.
Another very important point observed in the present
study was the health of the peri-implant tissue around
the ceramic implants after 18 months. According to current literature, zirconia surfaces have a lower affinity for
bacterial plaque compared with titanium surfaces.13
Literature
about the author
Dr Alexandre Marques Paes da Silva
is a lecturer in the department of prosthodontics of the faculty of dentistry at
the Universidade do Estado do Rio de
Janeiro in Brazil.
It is worth mentioning that, although an 18-month followup period is short, during this entire period, there were no
clinical or biological complications in these cases, and
the bone level around the implants was maintained. The
implants showed no marginal bone loss, a result similar
to that of other studies that evaluated the same implant
system.8–10
Dr Alexandre Marques
Paes da Silva
contact
15
Fig. 15: Visual analogue scale (VAS).
Dr Alexandre Marques Paes da Silva
+55 21 997905289
xandemps@gmail.com
3 2024
35
[36] =>
| interview
Passion for customers,
innovation and growth
During the 2024 Implant Solutions World Summit,
held in June in Miami in the US, Dental Tribune International had an opportunity to talk to Tony Susino, group
vice president of global implant and prosthetic solutions
at Dentsply Sirona. In this interview, he discusses this
year’s summit theme, “Passion delivered”, which reflects
Dentsply Sirona’s commitment to customer success, innovation and growth. He also shares insights into the
summit’s focus on scientific innovations in implant dentistry, which enhance patient care through advanced
technologies.
© Dentsply Sirona
Mr Susino, could you elaborate on the primary goals
you aim to achieve with the 2024 Implant Solutions
World Summit, and could you explain how they align
with Dentsply Sirona’s long-term vision for implant
dentistry?
Fig. 1: Since taking the reins of Dentsply Sirona’s global implant and prosthetic business two years ago, Tony Susino has focused on customer acquisition and success, product development and digitally connected implant
solutions.
36
3 2024
The theme of our event, “Passion delivered”, isn’t just the
slogan of the meeting; it’s a summary of our implant and
prosthetics solutions group strategy. Let me put it differently: our strategy is to have a passion for customers, a
passion for innovation and a passion for growth. These
pillars have been evident in our commitment to peer-topeer education and community building, in our investment in our sales teams and in the harmonisation of our
implant portfolio. Since I joined this business two years
ago, our team has become laser-focused on three things:
customer success and acquisition; new product development and the enhancement of our ability to be a digitally connected implant company; and growth through
new market opportunities and the introduction of new
therapies.
The goal of the meeting is to inspire clinicians, to have
them learn from some of the best speakers in the world
and for them to share their passion for implant dentistry
with one another. We are committed to investing in our
community and to sharing our solutions in order to build
dental professionals’ confidence so that they are able to
provide the best care possible to their patients.
What are some of the latest scientific innovations
and advancements in implant dentistry being showcased at the summit, and in what way do you expect
these to transform patient care?
For more than four decades, Dentsply Sirona has collaborated with clinicians and scientists at the forefront of implant dentistry. Together, we have worked to pioneer innovations that deliver excellent outcomes across an array
of fields. We instil clinician confidence through predictable and reliable results, natural aesthetics and lasting
bone care. The technology breakthroughs that drive
these solutions—including the EV Implant Family—are
recognised worldwide and supported by more than
1,400 scientific publications. Our passion for discovery,
[37] =>
interview
|
data and innovation is relentless, and our work always
well documented. The EV Implant Family consists of
three implant systems with different body shapes that
share a common DNA. Each design is based on clinical
preference and/or patient situation, but they are unified
by key features such as OsseoSpeed and the EV connection. These features are supported by solid, documented preclinical and clinical evidence. Each implant
system is designed to stimulate the healing process and
help deliver long-term function and natural-looking aesthetics. The scientific evidence we have collected on the
EV Implant Family is the topic of our new “A passion for
progress” campaign and a science focus at the summit.
The advancements in implant dentistry in the scientific
programme include the developments in digital dentistry
involving our digital solutions—Simplant guided surgery,
Atlantis, Primescan, CEREC and Primeprint—and what
DS Core brings to the table, as well as our regenerative
portfolio. We are also giving the most recent updates on
newly published data on implant procedures, intra-oral
health and peri-implantitis, as well as updates on practice
building. The developments bring benefits to the patient
through treatment outcomes that are more efficient and
predictable and through reduced treatment time owing to
more convenient and efficient procedures, including intra-oral scanning, information sharing by means of DS
Core and guided surgery.
© Dentsply Sirona
Education and collaboration are key themes for this
summit. How is Dentsply Sirona fostering these elements through the event, and what unique opportunities can attendees expect in terms of learning and
networking?
At Dentsply Sirona, we recognise that education and collaboration are foundational pillars for driving innovation
and progress in implant solutions. Events such as the Implant Solutions World Summit play a crucial role in driving
innovation, education and community development within
the realm of implant dentistry.
Fig. 3: The meeting aimed to inspire clinicians by featuring top speakers and
encouraging the exchange of passion for implant dentistry.
© Dentsply Sirona
Fig. 2: Participants had the opportunity to attend masterclasses focusing on
various aspects of implant dentistry.
At the summit, we have created a vibrant ecosystem
through which ideas are exchanged and partnerships—
and, indeed, friendships—are formed. Through interactive workshops, panel discussions and keynote presentations, participants can engage with experts in the field,
exchange insights and explore cutting-edge advancements in technology.
As part of the congress, attendees could register for a
series of masterclasses focusing on various aspects of
implant dentistry. These hands-on workshops and lectures covered surgical techniques, digital workflows for
single-tooth and full-arch treatment, and the integration
of advanced dental technologies into everyday practice.
Our dedication to encouraging continuous learning and
collaboration extends beyond the summit. We strive to
cultivate a supportive community where the sharing of
knowledge will persist long after the event concludes.
We offer the technology, the service and, through our DS
Academy, the clinical education to help our customers
add implant treatment to their practice offering. We have
57 education centres in 35 countries, and it is clear that
dental professionals are taking advantage of these clinical education opportunities: there have been 1.95 million
course registrations since 2019, and 9,200 courses took
place in 84 countries in 2023. Through the DS Academy,
dental professionals can also access several clinical education course series, including a 23-course implant series that will assist in building and expanding clinicians’
digital implant knowledge and skills.
Dentsply Sirona
contact
Dentsply Sirona
contact@dentsplysirona.com
www.dentsplysirona.com
3 2024
37
[38] =>
| events*
DDS.Berlin concludes its
premiere with positive feedback
During the event, a total of 32 presentations were given
by more than 50 speakers, including many experts from
the Digital Dentistry Society itself. They presented a wide
range of topics related to digital dentistry and its application in daily practice. Highlights included the presentations
by Prof. Christos Angelopoulos, Dr Luis Bessa, Dr Leon
Emdin, Dr Raquel Zita Gomes, Dr Anne Heinz, Dr Miloš Ljubičić and Dr Paul Schuh, who presented a broad range
of clinical cases and demonstrated applications of digital
technologies.
In addition to the presentations, more than 20 workshops
were held, offering the 300 attendees hands-on learning
experiences on topics such as intra-oral scanning, digital
implant placement, chairside workflows, dynamic data acquisition, 3D printing and Al-supported treatment planning.
Holger Emmert, Head of Marketing at SprintRay Europe,
commented: “We are pleasantly surprised by the audience
and the highly specific questions that were asked. The
overall level of expertise of the attendees is higher than what
we normally encounter at trade fairs or conferences.”
“DDS.Berlin is an important meeting of scientific and industrial groups [...]. Unlike larger conferences with a general focus, this event provides a unique opportunity to
focus exclusively on the digital aspects”, said Connie
Peterse-van der Koppel, Principal Scientific Adviser at
NextDent by 3D Systems.
Dr Henriette Lerner, Past President of the Digital Dentistry
Society, who has been involved in planning the scientific
programme, added: “Digital dentistry is the present and
the future of our clinical practice. The value of this event
lies in the convergence of the latest technological developments and the exchange on clinical applications
through workshops and lectures.”
DDS.Berlin also offered a live stream of the presentations,
which will be available online shortly. The next DDS.Berlin
event is scheduled for 26 and 27 June 2026.
More information about the event can be found on the
DDS.Berlin website.
contact
DDS.Berlin
Digital Dentistry Show
DDS Berlin
info@dds.berlin
www.dds.berlin
The first edition of DDS.Berlin offered a considerable number of educational opportunities. In his workshop, Dr Miloš Ljubičić demonstrated the transformative
effect of 3D printing in dentistry (left). As part of the lecture programme, Dr Elisabeth Prause from Charité—Universitätsmedizin Berlin spoke about the use of
advanced digital technologies in prosthetic rehabilitation (right).
38
3 2024
* The articles in this category are provided by the manufacturers or distributors and do not reflect the opinion of the editorial team.
DDS.Berlin, the first edition of the Digital Dentistry Show,
took place at Arena Berlin on 28 and 29 June 2024.
Nearly 80 exhibitors and more than 1,000 attendees did
not want to miss the premiere. About half of the attendees came from Germany. The event also attracted many
dentists from other European countries and the rest of
the world.
[39] =>
ANZEIGE
WE
LOVE
WHAT
WE
DO.
rn
Wir feie
re er.
h
a
J
0
3 arkt-Pow
Dentalm
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WE
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LOVE
WHAT
WE
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ORG
OEMUS MEDIA AG
Holbeinstraße 29 · 04229 Leipzig · Deutschland · Tel.: +49 341 48474-0 · info@oemus-media.de
[40] =>
| events
Fig. 1: The Implant Solutions
World Summit 2024 brought
together more than 600 implant
professionals from 25 countries.
© Dentsply Sirona
Engaging clinical education and
meaningful networking at Implant
Solutions World Summit 2024
Dentsply Sirona’s commitment to advancing implant
dentistry through high-quality clinical education and by
delivering state-of-the-art science and innovative technologies was on full display at the Implant Solutions World
Summit 2024 in Miami.
More than 600 implant professionals from 25 countries
attended the strong scientific programme, giving them
the opportunity to gain knowledge through a series of
master classes and lectures led by a renowned group of
international speakers and moderators. The programme
allowed for multiple opportunities for building networks,
engaging in lively discussions, and finding inspiration and
confidence for the dental team.
One of the standout sessions at the Implant Solutions
World Summit was “The Monday morning patient” moderated by Malene Hallund and Dean Lyndon Cooper, the
two scientific chairs of the Implant Solution World Summit. This session featured an expert panel that discussed
various cases from initial assessment through planning
and treatment, encouraging collaborative problem solving and peer-to-peer learning. Attendees, both on stage
and in the audience, actively participated by voting on
their preferred approaches to these challenging Monday
morning cases.
© Dentsply Sirona
Fig. 2: Prof. Jan Eirik Ellingsen from the University of Oslo, Norway received
the first Stig Hansson Award for Innovation.
40
3 2024
In addition, a highly relevant selection of masterclasses
offered participants in-depth knowledge and hands-on
experience. These gave them the opportunity to engage
with experts in smaller, interactive settings, enhancing
their skills and understanding of advanced implant techniques.
[41] =>
AD
Stig Hansson Award for Innovation
Dentsply Sirona also presented the first Stig Hansson
Award, recognising pioneering innovation and research
within implant dentistry. It honors the legacy of Stig Hansson († 2023), a former employee of Dentsply Sirona and
a pioneer in the development of modern dental implants.
He not only invented the Astra Tech Implant System but
also brought the principles of biomechanics to implant
design, resulting in TiOblast, the first moderately rough
implant surface, and MicroThread, retention elements on
the implant neck. His work created a new gold standard
that holds to this day.
This year’s award went to Prof. Jan Eirik Ellingsen from
the University of Oslo for his creation of the OsseoSpeed
implant surface, the first chemically modified implant surface. The award aims to inspire and recognise individuals
who embody the spirit of innovation and drive positive
change in the field of dental implantology.
Are you
a writer?
Do you have clinical cases and a profound knowledge about a special treatment method? Then become part of implants—international magazine
of oral implantology. Share your experience and
knowledge and benefit from a global reach and
high level of awareness.
We are always on the lookout for new faces to increase our clinical and scientific network.
Submission checklist
Send us a text with length of 10,000
to 15,000 characters. We do not want
to limit you in terms of article length,
so please use the word count as a
general guideline!
Numbered images in TIF or JPEG format, in a printable quality of at least
300 dpi.
© Dentsply Sirona
Fig. 3: Experts guided the audience through implant dentistry topics in the
scientific programme.
In celebration of the spirit of innovation and clinical excellence through the Stig Hansson Award, Dentsply Sirona
proudly announced a $10,000 donation to its partner
Smile Train, the world’s largest cleft-focused organisation, in the name of Prof. Jan Eirik Ellingsen. This contribution, part of an ongoing partnership that began in
2021, underscores the company’s commitment to advancing the future of left care and improving oral health
globally.
Most important: we would like to introduce you/the mind behind the article.
So please send us also your portrait
photo with a short biography about
your professional career and your
contact information.
Dr Alina Ion
Editorial Manager
a.ion@oemus-media.de
+49 341 48474-141
contact
Dentsply Sirona
www.dentsplysirona.com
OEMUS MEDIA AG
Holbeinstraße 29 · 04229 Leipzig · Germany
Phone: +49 341 48474-0 · info@oemus-media.de
[42] =>
IMPLANTOLOGY 4.0
ON THE WAY TO PATIENT
SPECIFIC CONCEPTS
8—9 NOVEMBER 2024
DUESSELDORF/GERMANY
53RD INTERNATIONAL
ANNUAL CONGRESS OF DGZI
REGISTRA
TION
www.d
gzi-jahresko
ngress.de/
e
n
Programme for dentists and dental technicians
FRIDAY, 8 NOVEMBER 2024
SATURDAY, 9 NOVEMBER 2024
SCIENTIFIC PRESENTATIONS
09:30 – 09:45 Opening ceremony
Dr Georg Bach/GER—DGZI President
SCIENTIFIC PRESENTATIONS
09:00 – 09:10 Welcome and introduction of the speakers and
scientific programme
Dr Georg Bach—DGZI President
09:45 – 10:15 Dental sedation techniques: Nitrous oxide, oral sedatives
and intravenous sedation—Quo vadis?
Dr Joel Nettey-Marbell/GER
10:15 – 11:15
11:15 – 11:30
11:30 – 12:15
Bone augmentation measures—possibilities and limitations
Priv.-Doz. Dr Dr Achim von Bomhard/GER
Priv.-Doz. Dr Dr Andreas Fichter/GER
Speaker and podium discussion
The speakers and the scientific leader/host discuss the
relevance of the presented developments for the daily
clinical practice of implantologists.
Participants have the opportunity to actively take part
in the discussion.
09:10 – 09:40 Vitamin D: Clinical relevance from implant prognosis
to cancer prevention
Prof. Dr Dr Knut A. Grötz/GER
09:40 – 10:10 Lifetime augmentation concepts—Which factors are decisive?
Prof. Dr Dr Andres Stricker/GER
10:10 – 10:40 Enhanced osseointegration by osteoimmunology &
Sticky bone protocols: clinical benefits
Dr Joseph Choukroun/FR
10:40 – 11:00
Speaker and podium discussion
11:00 – 11:45
Break/Dental exhibition
Break/Dental exhibition
11:45 – 12:15
TUTORIALS
12:15 – 13:15
Implant-prosthetic concepts for the treatment of older patients
Prof. Dr Samir Abou-Ayash/CH
Tutorial n
Update on digital impressions
in implantology
Prof. Dr Benedikt Spies/GER
12:15 – 12:45
Use of PRP, PRGF, PRF, hyaluronic acid in oral surgery/
implantology/dentistry—What makes sense?
What should you „use“ in daily practice?
Prof. Dr Dr Ralf Smeets/GER
12:45 – 13:15
30 years of laser and implantology:
Where do we stand—has it made a difference?
Dr Georg Bach/GER
13:15 – 13:30
Speaker and podium discussion
13:30 – 14:15
Break/Dental exhibition
14:15 – 14:45
Soft-tissue management on implants—aesthetics
or long-term functional success
Dr Jochen Tunkel/GER
14:45 – 15:15
From the universal solution to personalised dentistry—
How individual is augmentation surgery today?
Dr Dr Diana Heimes/GER
Information: Selected table clinics are held in English.
More information: www.dgzi-jahreskongress.de/en
15:15 – 15:45
Dynamic navigated implant placement—The new standard?
Priv.-Doz. Dr Dr Stefan Röhling/GER
18:00 – 20:00 Get-together at the congress/exhibition area
15:45 – 16:00 Speaker and final discussion
13:15 – 14:15
14:15 – 15:15
Tutorial o
Immediate implant placement and
immediate restoration
Prof. Dr Dr Peer Kämmerer, MA/GER
Prof. Dr Dr Eik Schiegnitz/GER
Break/Dental exhibition
TABLE CLINICS (TC)
15:15 – 16:00 Session 1
16:00 – 16:15 Change of table
16:15 – 17:00 Session 2
17:00 – 17:15 Change of table
17:15 – 18:00 Session 3
[43] =>
CREDIT
P
16
U
VERIFIABL
D
16
CP
UP
TO
HO
RS
TS
IN
O
Organisational matters
E
CONGRESS FEES
Friday, 8 November and Saturday, 9 November 2024
Dentist/dental technician DGZI member
Dentist/dental technician non-member
Medical assistant (with proof) DGZI member
Medical assistant (with proof) non-member
Student (with proof)
Conference fee**
€295*
€345*
€120*
€135*
only conference fee
€128 excl. VAT
TEAM FEES
Friday, 8 November and Saturday, 9 November 2024
Dentist + dental technician DGZI member
Dentist + dental technician non-member
Dentist + assistant DGZI member
Dentist + assistant non-member
Conference fee** per person
€395*
€475*
€375*
€400*
€128 excl. VAT
* The reservation is made on behalf of and on the account of DGZI e.V. incl. 7% VAT.
** Incl. coffee breaks, drinks and lunch. The conference flat rate has to be paid by every participant.
ORGANISER
DGZI e.V.
Paulusstraße 1 | 40237 Düsseldorf | Germany
Phone: +49 211 16970-77
Fax: +49 211 16970-66
sekretariat@dgzi-info.de
www.dgzi.de
ORGANISATION | REGISTRATION
OEMUS MEDIA AG
Holbeinstraße 29 | 04229 Leipzig | Germany
Phone: +49 341 48474-308
Fax: +49 341 48474-290
event@oemus-media.de
www.oemus.com
VENUE
HILTON DUESSELDORF
Georg-Glock-Strasse 20 | 40474 Düsseldorf | Germany
Phone: +49 211 43770
www.hilton.com
Your partner for hotel booking
PRIMECON GmbH
reservierung@primecon.eu
Phone: +49 211 49767-20
Fax: +49 211 49767-29
Online registration: www.dgzi-jahreskongress.de/en
53RD INTERNATIONAL ANNUAL
CONGRESS OF DGZI
Registration form via fax to
+49 341 48474-290
or by e-mail to
event@oemus-media.de
I would like to register the following persons bindingly for the 53rd International Annual Congress of DGZI on 8 and 9 November 2024
in Duesseldorf, Germany (Please mark accordingly):
Academic title, last name, first name, profession
Academic title, last name, first name, profession
yes
no
Friday
Saturday
DGZI member
Participation
yes
no
Friday
Saturday
DGZI member
Participation
n___ o ___ p ___
(of chosen table clinics)
n___ o ___ p ___
(of chosen table clinics)
Evening event on Friday, 8 November 2024 ____ (# of persons)
Stamp
I am hereby agreeing to the general terms and conditions of the
53rd International Annual Congress of DGZI.
Date, Signature
E-mail address (Please declare, you will receive the invoice and certificate via e-mail.)
[44] =>
| events*
EuroPerio11 kicks off with virtual
event and ambassador meet-up
The virtual event featured three clinical masters of periodontal and implant surgery who dissected the outcomes
of the live surgeries performed at EuroPerio10 in Copenhagen, Denmark, 2022. Attendees were thrilled to experience the excitement of the operating room from the
front row as the masters unveiled the results of their firstclass clinical procedures.
Kick-off event of the EuroPerio11.
With over 2,000 registrations, the event drew significant
attention. 1,050 people tuned in to watch it live, reflecting
the high interest and anticipation for EuroPerio11. The kickoff also emphasised the importance of the upcoming
congress, which will take place from 14 to 17 May 2025
in Vienna, Austria.
Anton Sculean, EuroPerio11 chair, encourages dental health
professionals to attend EuroPerio11: “EuroPerio is the world’s
leading congress in periodontology and implant dentistry.
The congress features a rich and varied scientific programme, including live surgeries, interactive sessions,
and much more. With more than 150 top speakers from
all over the world who are the most respected masters in
their fields, it’s the ideal place to meet friends and colleagues and exchange the latest information. The exhibition showcases the latest products and technologies, while
the poster exhibition will present over 1,000 new publications in the field. To sum up, EuroPerio11 is the place to be.”
EuroPerio11 ambassadors also met in Vienna to discuss
their roles and strategies for promoting the congress within
their respective member societies. The total number of
ambassadors participating in this initiative is 30, including
full and associate members. A group of eight international
ambassadors will also help to promote the event in their
regions. Ambassadors play a crucial role in ensuring widespread engagement and participation in EuroPerio11.
The chair of the ambassador group, Mia Rakić, highlighted their significance saying: “EuroPerio ambassadors are vital in promoting the event across Europe. Their
dedication and efforts in each member society are key to
the success of the congress. We are grateful for their
commitment and enthusiasm.”
1,050 participants followed the event live.
EuroPerio11 promises to be a pivotal event in the field of
periodontology, offering unparalleled opportunities for
learning and networking. Registration and abstract submission for EuroPerio11 will open on 2 September 2024.
Be sure to mark your calendars and prepare for an exceptional event that will shape the future of periodontology and implant dentistry.
contact
The results of EuroPerio10 in Copenhagen 2022 were analysed.
44
3 2024
European Federation of Periodontology (EFP)
www.efp.org
* The articles in this category are provided by the manufacturers or distributors and do not reflect the opinion of the editorial team.
The virtual kick-off for EuroPerio11 took place on 3 June
2024, marking the beginning of the countdown to the
world’s leading congress in periodontology and implant
dentistry.
[45] =>
events*
National
Osteology
Symposium
The beauty
of regeneration
26–28 Septembre 2024
Paris
osteology-paris.org
#osteologyparis
* The articles in this category are provided by the manufacturers or distributors and do not reflect the opinion of the editorial team.
|
Maison de la Chimie
The Beauty of Regeneration
La Beauté de la Régénération
The National Osteology Symposium is set to convene
in the vibrant city of Paris from 26 to 28 September 2024,
offering three days of unrivaled learning and networking
opportunities. Hosted at the historic Maison de la Chimie,
the event will bring together world leaders and experts in
oral tissue regeneration, led by scientific chairs Emmanuelle Ettedgui, Hélène Arnal, and Anton Sculean. All sessions will be in English or with English translation.
The symposium will begin on Thursday morning with
hands-on workshops designed to enhance surgical skills
and introduce participants to innovative materials. In the
afternoon, attendees will have the unique opportunity to
engage with renowned speakers Franck Renouard,
Giovanni Salvi and Brenda Mertens as they explore strategies for preventing errors and complications in periodontal and implant surgery, with a focus on predictable
procedures and reliability.
Friday’s agenda is dedicated to exploring the latest advances in hard- and soft-tissue regeneration. Attendees
will be treated to a phenomenal session on guided bone
regeneration, featuring the pioneer Christer Dahlin as well
as Istvan Urban and Georges Khoury who will share their
expertise in vertical and horizontal bone regeneration.
The afternoon will continue with presentations from masters of soft-tissue regeneration, including Mario Roccuzzo,
Stavros Pelekanos, and Oscar González Martín.
Saturday’s sessions promise to maintain the high standard set by previous days, with discussions led by ex-
perts Giulio Rasperini, Nikos Donos, Martina Stefanini,
and Sofia Aroca. Topics will include intrabony and furcation lesions, severe recession cases, and connective tissue substitutes.
Don’t miss this unparalleled opportunity to meet the
cream of the crop in oral tissue regeneration in the heart
of Europe.
For more information and registration details, visit osteology.org.
contact
Osteology Foundation
Osteology Foundation
+41 41 3684444
info@osteology.org
www.osteology.org
3 2024
45
[46] =>
Details make perfection:
EAO congress 2024
The European Association for Osseointegration is delighted to announce that its 2024 annual congress will be
held in Milan, Italy from 24 to 26 October 2024.
The scientific committee has put together an inspiring
programme structured around three daily themes. These
will focus on “The fundamentals”, “State of the art—certainties” and “Beyond the limits”.
As always, the congress will bring together experts to debate the latest evidence-based practice, with a strong focus on take-home techniques for daily use in your clinic.
46
There are so many reasons to attend this meeting. It will
combine a unique mixture of cutting-edge presentations
and opportunities to network with distinguished colleagues, while spending time in a beautiful European city.
Most importantly, the programme is top-notch, and the
speaker line-up represents the best professionals in the
field of implant dentistry and related specialities.
On behalf of the EAO, the IAO and the SIdP, we look forward to seeing you in Milan!
The meeting will continue the EAO’s tradition of partnering with respected local associations, and will share the
stage with the Italian Academy for Osseointegration (IAO)
and the Italian Society of Periodontology (SIdP). Their
well-respected scientific and professional perspectives
will form an important additional element of the meeting.
contact
This will be the EAO’s second visit to Italy in a decade following its 2014 congress in Rome. We are looking forward to welcoming you to modern and lively Milan, which
offers unique opportunities both socially and culturally.
EAO European Association for Osseointegration
+33 1 42366220
info@eao.org
eao.org
3 2024
* The articles in this category are provided by the manufacturers or distributors and do not reflect the opinion of the editorial team.
| events*
[47] =>
30 years OEMUS MEDIA
oemus
YE
A
|
RS
lebrates three
OEMUS MEDIA AG ce
in the dental market.
decades of influence
e, the upcoming
To mark this mileston
24 will feature
issues of implants 20
ories on our team.
shor t background st
WE
LOVE
WHAT
WE
DO.
ORG
WE PUBLISH DENTAL
Introducing the implants team
Timo Krause
Sales & Product Manager
For nearly 12 years, Timo has been a great force in
the dental world. From the very beginning, he immersed himself in international business, seizing every
opportunity to learn directly from the source. His presence is a familiar sight at numerous dental congresses
and exhibitions. Over time, Timo developed a deep affection for oral implantology, eagerly staying abreast of
the latest developments and treatment procedures. Although Timo is not a dentist, his growing understanding
of the field speaks volumes.
In the dental community, Timo is well-known for
always having his camera at the ready. It’s not
just a tool for him—it’s a passion. What else
is there to know about Timo? He enjoys
restoring vintage bicycles and is a
dedicated gardener.
implants
ceramic
implants
EDI Journal
3 2024
47
[48] =>
| events*
Patient-customised concepts:
“Implantology 4.0” in Düsseldorf
this November
On 8 and 9 November 2024, the 53rd International Annual Congress of the German Association of Dental Implantology (DGZI) will be held in Düsseldorf, centered on the theme
“Implantology 4.0—on the way to patient-specific concepts.” This congress promises to
be an enlightening event, guiding the future of dental implantology, fostering insightful discussions, and unveiling innovative approaches through the dynamic interaction between
participants, speakers, and the industry.
* The articles in this category are provided by the manufacturers or distributors and do not reflect the opinion of the editorial team.
For decades, dental practitioners have relied on standardised, evidence-based implantological treatments applicable to all patients. However, recent studies indicate a pressing
need to reassess this one-size-fits-all methodology. What ensures success in one patient
might not yield the same result in another. Hence, the focus is shifting towards patientindividualised concepts.
48
At the forefront of this transformation, the congress will showcase the latest scientific and
practical findings. Renowned speakers will engage with participants to explore the full
spectrum of dental implantology, fostering a collaborative environment where future advancements can take root. Traditionally, the congress kicks off with a forward-looking
perspective, featuring presentations from the emerging generation of DGZI professionals who will share their current research and projects in a dedicated forum.
This year’s DGZI Annual Congress will also include two in-depth tutorials: one on digital impressions in implantology and the other on immediate implantation and immediate loading. These sessions are designed to provide practical insights and hands-on
experience. Additionally, the ever-popular table clinics return, offering participants the
chance to discuss specialised topics with distinguished experts, thereby expanding
their knowledge beyond their usual practice.
Complementing the scientific sessions, a separate congress for implantological assistants will take place, ensuring that the entire practice team benefits from comprehensive training and education.
Set against the backdrop of Düsseldorf, a city renowned for its vibrant culture and
dynamic atmosphere, the congress offers more than just professional development.
It promises an enriching and holistic experience that combines cutting-edge knowledge with the charm of one of Germany’s most fascinating cities. The DGZI Annual
Congress is a must-attend event for anyone involved in dental implantology, offering unparalleled opportunities for learning, networking, and professional growth.
contact
DGZI e.V.
DGZI e.V.
Paulusstraße 1, 40237 Düsseldorf, Germany
+49 211 1697077
sekretariat@dgzi-info.de
www.dgzi.de
3 2024
[49] =>
manufacturer news*
|
Geistlich Pharma
* The articles in this category are provided by the manufacturers or distributors and do not reflect the opinion of the editorial team.
Geistlich collagen portfolio receives EU MDR certification
Geistlich is one of the first companies in the field of regenerative
dentistry to receive MDR certification for its collagen product
range. This includes the entire product lines of Geistlich Bio-Gide®,
Geistlich Fibro-Gide® and Geistlich Mucograft®. The Swiss company is taking a pioneering role in their field with the approval of
these products for bone- and soft-tissue regeneration.
Geistlich has received MDR (Medical Device Regulation) certification from TÜV SÜD Product Service GmbH for its established product lines of Geistlich Bio-Gide®, Geistlich Fibro-Gide® and Geistlich
Mucograft®, fulfilling the new EU regulations.
Despite the increased and more demanding quality and evidence
requirements of the MDR, all indications for these products, which
include a variety of regenerative procedures, have been confirmed.
Doctors can therefore rely on a complete range of collagen products
that meet their high standards of quality and therapeutic safety.
Pioneer in medical regeneration, extended range of indications
Geistlich Fibro-Gide® is the first non-active class III medical device
of animal origin to be certified according to MDR by TÜV SÜD Product Service GmbH. The MDR certification for Geistlich Mucograft®,
which is now also approved for indications outside the mouth in
the facial area, is particularly pleasing.
we share together with doctors.” With its four subsidiaries and
numerous sales partners in Europe, Geistlich has been committed
to the well-being of patients on the continent for decades and is
driving medical regeneration forward.
Commitment to the highest quality standards and patient safety
Diego Gabathuler, CEO, says: “With the MDR certification, long
before the official transition period ends, we underline our commitment to the highest quality standards and patient safety, which
Geistlich Pharma AG
+41 41 4925555
info@geistlich.com
www.geistlich-pharma.com
Straumann
Revolutionise your full-arch solutions with
LOCATOR FIXED® for Straumann® implants
If you’re
re seeking an affordable, reliable fixed full-arch solution, it’s
time to consider LOCATOR FIXED®.
The LOCATOR FIXED® system leverages the same abutment and
workflow as the renowned LOCATOR® Removable Attachment
System, making the transition seamless. This revolutionary fullarch treatment ensures a truly fixed prosthesis, enhancing both
function and aesthetics for your patients. With its high-retention
housing, the system provides a strong bond and reduces chair
time, offering efficiency and flexibility in your practice.
Dental professionals praise LOCATOR FIXED® for its simplicity and
effectiveness, which translates to lower costs and improved patient satisfaction. Additionally, comprehensive
online training is available for free to ensure
you and your team can
fully capitalise on the
system’s benefits.
Upgrade your practice with LOCATOR FIXED®
and experience the next level of dental restoration.
More information
Straumann Holding AG
info@straumann.com
www.straumann.com
3 2024
49
[50] =>
| about the publisher
Congresses, courses
and symposia
FDI World
Dental Congress
12–15 September 2024
Istanbul, Turkey
www.fdiworlddental.org
implants
Imprint
Publisher
Torsten R. Oemus
oemus@oemus-media.de
Designer
Aniko Holzer
a.holzer@oemus-media.de
Board
Ingolf Döbbecke
doebbecke@oemus-media.de
Customer Service
Lysann Reichardt
l.reichardt@oemus-media.de
Lutz V. Hiller
hiller@oemus-media.de
Published by
OEMUS MEDIA AG
Holbeinstraße 29
04229 Leipzig, Germany
Phone: +49 341 48474-0
Fax: +49 341 48474-290
kontakt@oemus-media.de
Torsten R. Oemus
oemus@oemus-media.de
National Osteology
Symposium
Chief Editorial Manager
Dr Torsten Hartmann (V. i. S. d. P.)
hartmann@dentalnet.de
26–28 September 2024
Paris, France
osteology.org
Editorial Council
Dr Rolf Vollmer
info.vollmer@t-online.de
Dr Georg Bach
doc.bach@t-online.de
Dr Suheil Boutros
SMBoutros@aol.com
IAO-EAO-SIdP
Joint Meeting
24–26 October 2024
Milan, Italy
congress.eao.org/milan/en/
Editorial Management
Dr Alina Ion
a.ion@oemus-media.de
Executive Producer
Gernot Meyer
meyer@oemus-media.de
Printed by
Silber Druck GmbH & Co. KG
Otto-Hahn-Straße 25
34253 Lohfelden, Germany
implants—
international magazine of oral
implantology is published in cooperation
with the German Association of Dental
Implantology (DGZI).
DGZI
DGZI Central Office
Paulusstraße 1
40237 Düsseldorf, Germany
Phone: +49 211 16970-77
Fax: +49 211 16970-66
office@dgzi-info.de
Product Manager
Timo Krause
t.krause@oemus-media.de
Art Director
Alexander Jahn
a.jahn@oemus-media.de
www.dgzi.de
www.oemus.com
www.implants.de
53rd International Annual
Congress of DGZI
8–9 November 2024
Düsseldorf, Germany
www.dgzi.de
Copyright Regulations
implants—international magazine of oral implantology is published by OEMUS MEDIA AG
French Dental Association
Annual Meeting
26–30 November 2024
Paris, France
adfcongres.com/en/homepage/
50
3 2024
and will appear with one issue every quarter in 2024. The magazine and all articles and illustrations
therein are protected by copyright. Any utilisation without the prior consent of editor and publisher
is inadmissible and liable to prosecution. This applies in particular to duplicate copies, translations,
microfilms, and storage and processing in electronic systems.
Reproductions, including extracts, may only be made with the permission of the publisher. Given
no statement to the contrary, any submissions to the editorial department are understood to be in
agreement with a full or partial publishing of said submission. The editorial department reserves the
right to check all submitted articles for formal errors and factual authority, and to make amendments
if necessary. No responsibility shall be taken for unsolicited books and manuscripts. Articles bearing
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OEMUS MEDIA AG. Responsibility for such articles shall be borne by the author. Responsibility for
advertisements and other specially labeled items shall not be borne by the editorial department. Likewise, no responsibility shall be assumed for information published about associations, companies and
commercial markets. All cases of consequential liability arising from inaccurate or faulty representation
are excluded. General terms and conditions apply, legal venue is Leipzig, Germany.
[51] =>
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/ Late implant placement following bilateral sinus floor elevation
/ Long-term success of implantsupported rehabilitation in the aesthetic zone: A nine-year followup case report
/ Full maxillary rehabilitation with immediate implant placement of NEVO RC INICELL® implants in Type 3 bone
/ Immediate two-piece ceramic implants with immediate provisionalisation in the posterior region
/ Passion for customers, innovation and growth
/ DDS.Berlin concludes its premiere with positive feedback
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/ Manufacturer news
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