Implant Tribune UK No. 1, 2017
Ceramic dental implants: What benefi ts do they offer? / Shifting consumer preferences and positive uptake of CAD/CAM technology / One week diary with our X-Mind Trium 3D CBCT in practice
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IMPLANT TRIBUNE
The World’s Implantology Newspaper · United Kingdom Edition
Ceramic dental implants:
What benefits do they offer?
By Brendan Day, DTI
implants that allow for more lexible placement options and better
healing.
Although the search for metal-free
implant materials began in the late
1960s, recent improvements in ceramic materials have made their
development process considerably
easier. As an alternative to titanium-based implants, ceramic implants offer greater aesthetic appeal and possess antiallergenic and
tissue-friendly properties. This article highlights some of the companies that currently offer ceramic
implants and explore why they are
still much less commonly used than
their titanium counterparts.
For the better part of four decades, titanium and titanium-alloy
dental implants have been successfully used as tooth replacements. However, recent research
indings have raised fears regarding these implants’ tendency to
corrode and decay. During the corrosion process, titanium implants
release particles or ions into their
surrounding tissue, which could
lead to implant failure and bone
disintegration. A 2014 paper published in the Open Journal of
Stomatology, titled “Corrosion aspect of dental implants—An overview and literature review”, detailed this process by explaining
that the compatibility of titanium
implants is largely the result of a
thin layer of oxide that forms on
their surface. This layer can erode
due to movements between bone
tissue and the implant during
loading conditions, which could
lead to corrosion, leaking and an
overall weakening of the implant.
Given their non-metallic nature,
ceramic implants are not susceptible to this form of decay.
However, the lack of concrete
evidence concerning the mechanical properties and osseointegration of ceramic implants has impeded their uptake, although this
is partially due to their relative
newness. The FDA only approved
ceramic implants in 2007. Additionally, there have also been relatively few clinical studies conducted on their long-term use.
However, in the Clinical Implant
Dentistry and Related Research
journal, a 2015 study of zirconia
implant abutments that supported entirely ceramic crowns
found that after 11 years of use,
these abutments had a cumulative success rate of 96.3 per cent. In
addition, a 2010 study in the journal for Clinical Oral Implants Research found that the osseointegration of zirconia implants is
similar to that of titanium implants. Despite these positive indings, the sheer lack of depth in research has deterred the majority
of dental professionals from using
ceramic implants.
The one-piece design of ceramic implants is another element that has both positive attributes and drawbacks. A one-piece
implant eliminates the connective point between the abutment
and the i xture, ideally reducing
bacterial growth and improving
overall oral health. However, a
high level of attention to detail
with regards to the implant’s
placement is required, as it does
not possess the same capability as
titanium implants to correct errors in placement with an angled
abutment. This inability to correct
errors in placement created the
demand for two-piece ceramic
The American Academy of
Implant Dentistry estimates that,
while three million Americans
currently have at least one dental
implant, this number is rising by
half a million each year. Given the
growing global demand for dental
implants, it is more important
than ever to provide patients with
options that best suit their individual needs. Although they are
an expensive option, ceramic implants are increasingly meeting
the standards for stability, compatibility and osseointegration
that titanium-based implants
have set. Combining this with
their aesthetic appeal and antiallergenic nature, ceramic implants should continue to grow in
popularity.
“Ceramic implants today, in
my experience and for many fellow ceramic implantologists, have
the same success rate as titanium
implants. They are now as versatile as metal implants thanks to
the evolution in design, surface
enhancement protocols and biomaterial improvements”, says
Dr Sammy Noumbisssi, President
of the International Academy of
Ceramic Implantology (IAOCI), an
association entirely dedicated to
ceramic alternatives of metal-based
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IMPLANT NEWS
14
implants. “Various treatment modalities are applicable with ceramic implants: immediate placement, immediate temporization,
full arch and full mouth rehabilitation can be performed with excellent and predictable outcomes.
I, however, believe that adopting
ceramic implants should be accompanied by training or shadowing from an experienced clinician, even if one has experience
with titanium implants.”
Only a few implant
manufacturers focus
on ceramics
Interestingly, most of the
major implant manufacturers do
not have a ceramic implant on the
market, let alone in development.
The most notable exception is
Straumann. Headquartered in
Basel, Switzerland, Straumann is
an international leader in implant
and restorative dentistry, with its
products and services available in
more than 100 countries. Strau-
mann currently offers Pure, a
completely zirconia-based implant that is ivory- coloured, similar to a natural tooth. The company recently announced that it
has entered into a partnership
with maxon motor, which will
allow it to develop dental implant
components through ceramic
injection moulding rather than
conventional cutting techniques.
The move demonstrates the company’s recognition of the growing market for aesthetically pleasing, metal-free implants. Given
that one of the main barriers to
zirconia implants is their comparatively high price, Straumann aims
to make it a more widely available
and affordable option.
In addition, TAV Dental is one
of the few companies that offer
both one-piece and two-piece
ceramic implants. Their primary
focus is to create state-of-the-art
zirconia dental products through
an innovative approach to technology, fostered by their parent
company, TAV Medical. TAV Den-
tal offers a variety of one-piece
and two-piece zirconia implants
that are entirely white, a distinct
aesthetic improvement from the
metallic colour of a titanium implant that is often visible. Furthermore, the inert nature of TAV Dental’s zirconia implants make them
less likely to fracture and highly
resistant to foreign compounds as
well as the application of heat, further beneitting patients.
Another company manufacturing ceramic implants, CeraRoot, introduced its zirconia implant system to the European market in 2005
and the US market in 2011. Located
in Barcelona, Spain, the company
utilised improvements in ceramic
materials to design a one-piece
ceramic implant. Whereas titanium-based implants have two separate parts—the ixture and the
abutment— CeraRoot’s product incorporates both elements into one
implant. This ensures that there is
no prosthetic connection where
bacteria can grow, theoretically
leading to better periodontal health.
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Implant Tribune United Kingdom Edition | 2/2017
One of the primary players in
ceramic implantology is Dentalpoint with their metal-free
Zeramex system. Established in
2005, the company spent four
years researching and developing
a two-part implant made of zirconia, presenting it to the world in
2009. Zeramex offers a revolutionary approach to ceramic implantology through their metalfree, screw-in implant, allowing
for a lexible restoration with a
high level of biocompatibility.
Combining this with a higher resistance to corrosion results in a
product that rivals titanium implants in performance.
Zsystems is a Switzerlandbased company that, through
their Zirkolith range of products,
offers extensive ceramic implant
options. Similar to TAV Dental,
they offer both one-piece and twopiece implants and their osseointegration rate is similar to leading
titanium implants. Another company, VITA Zahnfabrik, has entered the ceramic implant market
with its own one-piece cylindroconical ceramic implant. In operation since 1924, and with a focus
on innovation, VITA claims their
ceramic implant offers faster,
safer healing than titanium-based
implants. With a compatibility
rate of 98 per cent for more recent
models, zirconia-based ceramic
implants are increasingly matching the standards set by titanium
implants and have thereby become a more viable option.
As Noumbissi concludes, “The
future of ceramic implants is really bright for many reasons. Patients increasingly ask for safer,
less invasive solutions, as well as
metal-free alternatives for teeth
repair or replacement. Dental attitudes and understanding of zirconia and bioceramics are slowly but
steadily evolving, with a deinite
shift toward biological and inert
materials. There has also been a
shift in the health care industry
towards wellness and wellbeing,
and providing therapies that have
little to no side effects.”
Since some of the larger players in the implant industry are
incorporating, or have already
adopted ceramic implants in their
product lines, either by development or by corporate acquisitions, implantologists could eventually look at ceramic implants as
a viable alternative to titanium.
Treatment plan
should be adapted
for smokers
By DTI
XI’AN, China: A Chinese study comparing implant stability and
peri-implant tissue response in
heavy smokers and non-smokers
has found that smoking did not affect the overall success of implant
surgery, as all implants achieved
osseointegration without complications at least by the end of the
12th week after placement. However, smoking did cause the bone
around the implants to heal more
slowly; thus, implants began to
osseointegrate considerably later
than in the non-smoking group.
Research has demonstrated
that smoking can negatively affect implant and bone integration.
In order to improve treatment
outcomes and avoid implant failure, surgeons need to have a precise understanding of how the
habit will affect the healing process.
In the current study, 45 ITI
(Straumann) implants were
placed in the partially edentulous
posterior mandibles of 32 male
patients, of whom 16 were heavy
smokers and 16 did not smoke at
all. Implant stability and peri-implant tissue response were assessed at three, four, six, eight and
12 weeks post-surgery.
Although implants in both
groups achieved osseointegration
by the end of the 12th week, the
healing process differed signiicantly between non-smokers and
heavy smokers. In non-smokers,
stability improved and implants
began to better integrate into the
bone after the second week. In the
smoking group, however, implants only began to osseointegrate and become more stable
after the third week.
Despite successful short-term
outcomes in both groups, smokers
experienced more problems, including greater bone loss around
the implants and deeper softtissue pockets. However, smoking
had no signiicant effect on plaque
build-up or sulcular bleeding in
the study group.
In light of the indings, the researchers suggested that surgeons
might need to change their standard implant loading schedule for
patients who smoke heavily. In addition, smokers should be aware
that their habit promotes the loss
of marginal bone and the further
development of dental pockets
and could thereby lead to complications even after osseointegration, they concluded.
[3] =>
[4] =>
IMPLANT BUSINESS
16
Implant Tribune United Kingdom Edition | 2/2017
Shifting consumer preferences and
positive uptake of CAD/CAM technology
Current developments in the European dental implant market
By Artur Kim & Dr Kamran
Zamanian, Canada
Europe has some of the most
highly penetrated markets for
dental implants in the world, including Italy, Germany and Spain,
but it also contains regions with
considerably under-developed
markets, such as France and the
UK.1, 2 A shift in consumer preferences will be a key characteristic of
the European market in the future, in both the dental implant
fixture market and final abutment
market. Although the shifts will
contrast one another, they will
both have a significant impact on
the market in terms of overall
pricing, the competitive landscape
and technological innovation.
Historically, premium dental
implant companies have dominated in Europe, but have recently
faced increased competition from
the value and discount brands. A
growing prevalence of local manufacturers and an increasingly
cost-sensitive consumer demographic will contribute to overall
price depreciation and the declining presence of premium implants
in the future.1
Region-specific growth of the
premium segment is highly reliant
on the prevalence of domestic,
lower cost dental implant brands.
In countries such as Italy, Germany
and Spain, there is a plethora of
local value and discount dental
implant companies that have
emerged to cater to the growing
cost sensitivity expressed by dentists. Within these regions, the premium segment of the market has
lost significant market share and is
exhibiting far lower growth rela-
tive to the past. It is expected that
this trend will continue to spread
throughout Europe, as consumer
preferences shift towards lower
cost products. Several competitors
in the German and Italian implant
markets have been particularly
successful at capitalising on the
shift in consumer preferences and
now represent the top leading implant brands in those regions, both
in terms of volume and revenue.1
Premium implant companies
have acknowledged the impact of
value and discount brands on the
market, not only through discount
pricing, but also through acquisitions and strategic investments. In
April 2015, Straumann increased
its ownership of Neodent, a leading
value implant manufacturer from
Latin America, to 100 per cent in
order to strengthen its product
port-folio and maintain a competitive position in both the premium
and value segments.3 Straumann
has also invested in a number of
value and discount brands that
cater to the European market, including Biodenta, Medentika,
MegaGen and Anthogyr. These investments are supplemented by
Instradent, Straumann’s business platform established in
2014, which currently provides
distribution for Neodent and Medentika through an online store
and worldwide network.3 In June
2016, Dentsply Sirona continued
its expansion by announcing a definitive agreement to acquire MIS
Implants Technologies, an Israelbased company that has a leading
position in the value implant segment. 4 Large conglomerates too
have taken note of the changing
structure of the market, with
Henry Schein making strategic
investments in BioHorizons and
CAMLOG, while Danaher Corporation has invested in Nobel Biocare
and Implant Direct.
Rapidly growing CAD/
CAM segment in the
final abutment market
Similar to the historical dominance of the premium segment in
the implant market, the market for
final abutments has traditionally
been controlled by the stock abutment or prefabricated abutment
segment. Although the majority of
stock abutments lack many benefits associated with patient-individualised solutions found within
the custom-cast abutment and
CAD/CAM abutment segments,
they still provide a relatively simple and cost-efficient solution in
most implant procedures. The segment is expected to continue experiencing price erosion owing to
increasing pricing pressure from
local, low-cost and generic manufacturers.1 Another recent development within the stock abutment
segment also contributing to price
depreciation is the introduction of
Ti-base abutments.
Ti-base abutments, also known
as titanium bases or titanium
interfaces, are a recent innovation
within the stock abutment market
that are a cost-effective alternative
to traditional CAD/CAM abutments, since they are intended for
in-house or independent milling
machine use. Examples include
Straumann’s Variobase and Nobel
Biocare’s Universal Base, which
give dentists the option of placing
a cement-retained or screw-retained restoration. Ti-bases also
allow dentists to choose between a
hybrid abutment and a hybrid
abutment crown (a combination of
an abutment and a monolithic
crown). The presence of Ti-base
abutments has grown rapidly
across most regions in Europe and
it is expected to become the predominant stock abutment type in
the near future. The cost-effective
nature and flexibility of options offered with Ti-base abutments will
help maintain the position of the
total stock abutment segment in
the overall market. Stock abutments currently represent over 50
per cent of the total final abutment
volume in the majority of markets
across Europe, but this share is expected to steadily decrease.1
Recent improvements in production capability and technological innovation have made CAD/CAM
abutments significantly more affordable than in the past. CAD/CAM
abutments are now relatively comparable in price to custom-cast abutments and are more easily accessible, especially in regions where milling laboratories with CAD/CAM production are in greater abundance.
Furthermore, CAD/CAM zirconia
abutments are primarily required in
cases in which aesthetic outcomes
are of higher priority, such as the anterior region of the mouth.5 CAD/
CAM abutments are expected to
continue to experience double-digit
growth, and the expanding market
share of the segment will limit ASP
of the overall abutment market,
since it carries a price premium
relative to stock abutments and
custom-cast abutments.1
Editorial note: A list of references is
available from the publisher.
Consolidation and
emerging players in
the competitive
landscape
In addition to investments in
value and discount companies, the
market for dental implants has
been distinguished by consolidation among the top competitors.
Most recently, Dentsply Sirona was
established after the merger of
DENTSPLY International and
Sirona Dental Systems in February
2016, combining the strengths of
each company in dental consumables and innovative technology, respectively.6 The premium implant
company acquired ASTRA TECH in
2011 and announced the acquisition of MIS in June 2016. 4 In June
2015, Zimmer Biomet was formed
through the merger of Zimmer
and Biomet, combining the dental
divisions of each company, Zimmer
Dental and BIOMET 3i.7
Although the premium implant companies still collectively
maintain over 60 per cent of the
European market, they are expected to face competitive challenges from emerging players in
the value and discount segments.
Competitors that have been able to
secure a notable market share from
the premium companies include
BioHorizons, CAMLOG, Global D,
medentis medical, Sweden & Martina and regional manufacturers.1
Other notable developments in
the European market for dental
implants include the increased uptake of ceramic materials, growing
presence of implant companies in
the biomaterials space and rising
demand for modern surgical protocols, such as immediate loading
and full-arch restorations. Overall,
growth within each segment will
be highly dependent on the
afore-mentioned factors and region-specific characteristics.1
Artur Kim
is a research analyst at iData
Research in Canada and lead
researcher for
the 2017 Europe
Dental Implant
Report Suite. Her current work includes
the 2017 Europe Dental Bone Graft Substitute Suite and the 2017 Europe Orthopedic Soft Tissue Repair Suite.
Dr Kamran
Zamanian
is President, CEO
and founding
partner of iData
Research. He
has spent over
20 years working in the market research industry.
[5] =>
[6] =>
IMPLANT TRENDS
18
Implant Tribune United Kingdom Edition | 2/2017
One week diary with our X-Mind Trium
3D CBCT in practice
bearing in mind each practice’s
needs are different, but one thing
should be common above all, and
that is to assess every case individually and never take 3-D scans
routinely, even despite their clear
benefits.
When a 3-D image is necessary,
patients appreciate the information and education they get by discussing the case with them while
pointing to vital structures and
solutions in 3-D versus an old
fashioned 2-D image that did not
make sense to the untrained eye
in most cases.
By Dr Diyari Abdah,
UK
There is mounting
evidence in the literature in regards to
the diagnostic superiority of 3-D imaging versus 2-D. As a
result, many clinicians today are using
3-D imaging either by referring
their patients to a CBCT-scanning
centre or having mobile units visiting them, and the only benefit of
this method is that there is no
initial capital outlay to buy the
machine. In contrast, the benefits
of having your own in-house CBCT
machine are many, including the
total convenience of an on-demand service at any time (pre-op
or during and after if needed),
learning one software and fully
utilising it rather than having to
learn different software for different machines (manufacturers),
thus not utilising it to its fully intended use.
travel to another location and
that fact that you care enough to
have a machine installed in your
clinic for their convenience and
yours.
Our X-Mind Trium CBCT unit
from ACTEON is rather young in
our practice, and we have yet to
fully utilise it. Every day we find
new uses and ways to benefit our
patients by using 3-D imaging
where applicable.
Following the latest evidence
from experts in the utilisation of
3-D imaging can help a lot in deciding where and when to use it,
consequently minimising dosage
and improving diagnostics and
planning.
Judging every case individually is important in order for the
benefits of using a CBCT scan to
outweigh the potential risks involved with the use of any type of
X-ray unit. A modern CBCT machine should allow for different
fields of view (FoV) to be utilised,
in order to minimise the dose to
the patient.
So here are a small selection
from a week’s diary utilising the
X-Mind Trium 3D CBCT scan in
the clinic. More CBCT scans were
probably obtained on any one
day depending on the cases on
that day, however, due to space
limitations in this article, only
one to two cases per day were selected.
Despite the choice of four different FOV settings on the X-Mind
Trium, and other settings that reduce the radiation significantly,
individual assessment of every
case is still very important to get
the most of the 3-D image without
exposing the patient to extra radiation.
Day 1
Additionally, patient appreciation that they do not have to
We owe our patients the lowest possible dose with the corresponding acceptable diagnostic
value, and sometime a 2-D image
is just not enough to give
satisfactory diagnostic value. A
lot of guesswork is often involved
with 2-D imaging that could
affect our decision-making and
treatment planning.
In order to show how a CBCT
scanning machine can affect the
day-to-day dentistry in a small
family practice, it would be beneficial to share a week’s diary,
The patient had all his lower
teeth extracted many months
ago, due to mobility and infections and preferred to have a
fi xed solution through implant
therapy. Patient currently is
wearing a well-fitted temporary
lower denture. Initially the idea
was to take a scan of the existing
denture with radiopaque markers (gutta-percha in 6–8 holes
made in the denture) to plan for
the placement stage. However, a
decision was made to duplicate
the existing denture using a Lang
duplication flask in order to fabricate a clear acrylic radiographic
guide (Figs. 1 & 2).
1
2
3
4
6
7
In many cases, a small FoV
that is enough for one to several
teeth could be equal to a few periapical radiographs but with a
much higher diagnostic value.
A 3-D scan was obtained
using the X-Mind Trium 3D CBCT
scanner to be utilised as an invaluable resource in the treatment
planning of the case. Through
the scan, the type and position of
the implants in relation to the
density of the surrounding bone
were checked.
The AIS 3-D Software that
comes with the device, includes a
library of most current implants
on the market, allowing to place
the right implant in the right angulation plus abutments and crowns
in order to maximise the predictability of positioning the implants,
thus improving its success.
For clinicians who use more
than one implant system, to
change the implant model that
was inserted from the library, we
simply click in the middle of the
implant and the implant library
is opened again and it is possible
to choose another implant
model, the software will keep
the same insertion point and
direction of the previous one. In
addition, the software will easily
evaluate the bone density
around the implant. The aim is
to show, both through colour
maps and numerically (Figs. 3 &
4) the values before commencing surgery (green if the values
are acceptable and high and red
if the values are low—Fig. 5), allowing the clinician to make the
right decision. This can also be a
very good educational tool to
show patients how their bone
density potentially is around the
implants.
In our experience, patients
like this feature once shown what
they mean.
5
8
[7] =>
Implant Tribune United Kingdom Edition | 2/2017
Day 2
An implant is planned to replace a missing lower molar, and
the position of the mandibular
canal is not very clear on a 2-D
image anyway, and even on the
3-D image the position is still a little confusing. Here we decided to
use the AIS software’s FlyMode option, which is like a virtual endoscope that follows the mandibular
canal tract from within, and aids
to clarify the path and double
check if our nerve tracking was
correct (Fig. 6).
This is one of the unique features of the software that can help
clarifying and controlling nervetracking.
Day 3
Obtaining the correct position and trajectory of a retained
upper canine has been traditionally dealt with by taking different 2-D images (periapicals) at
different angles and possibly an
occlusal fi lm to determine the
correct position in the buccopalatal aspect together with some
guessing work.
3-D imaging can be an invaluable tool for this matter. The patient refused orthodontic extrusion of the upper left canine and
wanted both the deciduous and
permanent canines extracted in
order to be replaced by an implant support crown. In planning
the case, a CBCT scan was obtained to serve many purposes as
to assessing the positions including any anatomy and bone surrounding these teeth. Since this
image was taken, both teeth were
extracted and the socket was
grafted fully to prepare the site
for a later placement (Figs. 7 & 8).
the most posterior bridge abutment tooth was beyond saving
(visual inspection and probing).
3-D imaging helped with
planning the case. It helped
tracking the position of the mandibular canal in relation to the
proposed implants (Figs. 11 & 12).
In addition, the density of the
bone was also checked (Fig. 13), indicating that a wider implant
possibly is a better choice to improve integration rather than the
current one used from the implant library. This will also allow
us for deciding to perhaps perform an under preparation of the
osteotomy site in order for the
implant to engage in the bone
better, this obviously depends on
the type of implant used and
other factors that the expert clinician will be familiar with.
References
This case was performed by
another clinician who was hoping to achieve good integration
after placing two anterior implants with grafting material.
Ludlow JB, Laster WS, See M, Bailey LJ,
Hershey HG. Accuracy of measurements of mandibular anatomy in
cone-beam computed images. Oral
Surg Oral Med Oral Pathol Oral Radiol
Endod 2007;103:534–542.
According to the colleague,
primary stability was good at the
time of placement and the implants were ‘buried’ in the bone
with some buccal fenestrations,
hence the grafting. So everything
indicated success.
After the patient complaining about some threads showing
through the soft tissue, the colleague suggested further grafting to ‘secure’ the implants.
At this stage, different implant
sizes were tested to check for best
fit and maximum integration
prognosis in the future.
The AIS software indicated
that the first implant was too long
and there was a risk of nerve damage (Fig. 9), thus another implant
size was chosen to allow sufficient
clearance above the nerve and the
density of the bone was chosen at
the same time, indicating good
“green” values that the patient
also could understand (Fig. 10).
However and despite the outcome so far with these two implants, the patient appreciated the
high value of the 3-D technology
and being able to see the problem
clearly and from different perspectives, eliminating any guesswork that might affect the final
outcome, and guiding the treatment in the right direction.
Case 1
A lower molar case was in the
planning stage, and the position
of the mandibular canal was located.
These tools as mentioned
above can be quite an eye opener
for patients and their engagement
can affect the outcome positively.
Case 2
A broken and lose bridge was
planned to be removed. The lower
left second molar which served as
We know that 3-D imaging is
here to stay and in order to make
treatments safer and more predictable for our patients, we have
to engage in these technologies
and involve the patients more in
showing them their clinical conditions and perhaps the limitations (anatomical, structural
etc.) together with other factors
that may affect treatment planning and outcome, hopefully for
the better. We hope to be able to
use our CBCT scan for more indications, especially in endodontics as few times we have seen
amazingly positive results in
using a CBCT scan in some difficult endodontic cases since we
acquired this 3-D technology. It
is the way forward and we wish
we had the X-Mind Trium 3D
Scanner earlier.
Day 5
A CBCT scan was obtained
(Fig. 14) as part of case planning,
and clearly the scan shows that,
this may prove difficult or at
least very challenging. In addition, on the 3-D image we noted
that the tip of the implant on the
left side might be colliding with
the root of the adjacent tooth,
with long-term uncertainty as a
result (Fig. 15). In this scanning
slice (Fig. 16) we also noted the
challenge ahead for grafting this
implant successfully, which indicated that a lot of consideration
has to be given and careful planning has to be employed in order
to make the case successful.
Day 4
IMPLANT TRENDS
Conclusion
These cases and many more
every week pass through any dental clinic, with patients hoping for
best available treatment under
best circumstances (clinical,
timescale, financial etc).
19
9
10
11
Farman GA, Scarfe WC. The basics of maxillofacial cone beam
computed tomography. Semin Orthod
2009;15:2–13.
Holroyd JR, Gulson AD. The radiation protection implicatios of the use
of cone beam computed tomography
(CBCT) in Dentistry—What you need to
know. SEDENTEXCT 2009.
12
Harris D, Horner K, Grondahl K, et
al. E.A.O Guidelines for the use of diagnostic imaging in implant dentistry
2011. A consensus workshop organised
by the European Association for Osseointegration at the Medical University of Warsaw. Clin Oral Implants Res
2012;23:1243–1253.
Hultin M, Svensson KG, Trulsson
M. Clinical advantages of computer-guided implant placement: A systematic review. Clin Oral Implants Res
2012;23(Suppl 6):124–135.
14
Dr Diyari Abdah
DDS DDS MSc ImpDent, is a cosmetic
and implant expert in private practice
in Cambridge, UK. Passionate about
research and innovations, especially
in the fields of implantology and 3-D
imaging. He deals with all aspects
of implantology and grafting techniques, and has been actively promoting and teaching implantology
to GDPs worldwide for over 15 years
through lecturing, workshops, articles
and mentoring programmes. He is a
visiting academic at the University of
Warwick Medical School (UK) and runs
a successful mentoring programme on
avoiding and solving problems in implantology. Currently on the editorial
board of several dental publications.
He is a two times best-selling author
and an Emmy Award nominee for
his humanitarian documentary.
Dr Abdah can be reached through:
www.dentalCBCTtraining.com
15
16
13
[8] =>
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