Patient expectation drives change in implant dentistry

Everyone faces pressure on their time, including patients.  The following approaches simplify implant placement and allow clinicians to meet expectations while remaining within safe and reproducible limits.

Atraumatic extraction

Prior to placement, new devices are available to aid extraction and degranulate the site ensuring a fresh bone bed for unchallenged healing.

Early loading protocols with simultaneous grafting

According to studies placing the implant 4 weeks after extraction, augmenting the bone around the implant utilizing fully resorbable, biomechanically stable alloplastic materials such as Gelos or Powerbone Dental Putty, allows loading at 12 to 16 weeks saving significant time compared with traditional approaches.

Implant Design

The design of dental implants follows trends with broad agreement on key factors. Grade 23 titanium alloy reduces fractures and  allow for narrow diameters.

Hybrid thread are increasingly adopted as part of  3rd generation implant designs which deliver superior mechanical and biological performance. 

Paltop Dynamic incorporate these with an Internal Hex Connection whilst Bioner TopDM incorporate such designs with a conical connection shown to preserve crestal bone and provide all-round, greater implant stability.

Implant Design

The design of dental implants follows trends with broad agreement on key factors. Grade 23 titanium alloy reduces fractures and  allow for narrow diameters.

Hybrid thread are increasingly adopted as part of  3rd generation implant designs which deliver superior mechanical and biological performance. 

Paltop Dynamic incorporate these with an Internal Hex Connection whilst Bioner TopDM incorporate such designs with a conical connection shown to preserve crestal bone and provide all-round, greater implant stability.

Surface Treatment Impacts Osseointegration

The success of dental implants is based on a process known as osseointegration (when bone cells attach themselves directly to the titanium surface) which locks the implant into the bone. Osseointegration is linked to patient health and implant surface morphology.  Surface treatments include sandblasting and acid-etching to create a macro, micro and nano surface structure. These treatments enlarge the bone to implant contact (BIC), promoting osseointegration and early restoration.

Surface Treatment Impacts Osseointegration

The success of dental implants is based on a process known as osseointegration (when bone cells attach themselves directly to the titanium surface) which locks the implant into the bone. Osseointegration is linked to patient health and implant surface morphology.  Surface treatments include sandblasting and acid-etching to create a macro, micro and nano surface structure. These treatments enlarge the bone to implant contact (BIC), promoting osseointegration and early restoration.

Processing impurities impact early healing

The traditional Sand Blasted Acid Etched (SLA) create a rough surface favouring bone anchoring and biomechanical stability.  

However, the Clean Implant Foundation highlight studies showing how healing and long-term performance of dental implants is greatly dependent on the degree to which residual processing particles and impurities are eliminated.

For its Dynamic Implant PALTOP employs an extensive ultra-high purity process cleaning protocol using ultra-pure water to yield a contamination-free surface and chemically stabilized titanium-oxide layer.  An independent BDIZ EDI study examined 120 worldwide implants and reported that the unique Paltop process provides “a very homogenized surface texture without traces of inorganic or organic residues shows a very well controlled manufacturing process

Spanish manufacturer Bioner patented its Biotech® surface for their TOP DM implant. This unique process produces a macro and micro textured surface without sand-blasting eliminating altogether the problem of surface contamination. The treatment is reported to stimulates osseointegration and shorten load time.

Simplification

TopDM implant from Bioner Spain utilises a single diameter platform and uniform emergence profiles for surgical efficiency and reduced post-operative soft tissue disturbance. Efficiency extends to the surgical kit with dual-diameter drills and drill stopper systems all incorporated into a kit 15cm x 10cm.  

Surgical-Kit-for-TopDM-and-Bioner-DM+-Dental-Implant

Immediate Placement

Designed for sub crestal placement the TopDM implant from Bioner reduces post-surgical tension and prevents marginal bone loss.  The thread presents a dual pitch with a conical cylindrical shape with neutral apex for quick, safe insertion and optimal primary stability making it ideal for post-extraction and immediate loading. 

Early loading

Immediate or 12 week loading following simultaneous grafting procedures is shown to allow successful long-term functional results regarding alveolar bone regeneration and implant rehabilitation.  Doubt regarding stability can be reduced with RFA technologies such as Penguin RFA that allows comparisons between stability at placement and prior to loading.

Customised Restorations

Cutting edge 3D printing and milling technologies are now widely available that utilize state-of-the-art machines to produce surgical guides and custom abutments which help clinicians ensure the critical alignment of the implant osteotomy.

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