Versah, a company started by Michigan Periodontist, Dr. Salah Huwais , have designed a
set of multi-fluted osseodensification burs for implant placement. Osseodensification is a novel, biomechanical, non-excavation preparation method that compacts and autografts bone during the osteotomy. The burs will remove bone when spun clockwise, however when spun counterclockwise they collect and compact bone chips into the osteotomy wall and result in greater local bone density and higher insertion torques. They can also be
used for internal sinus lifts and ridge expansion. Read more…..
Author Archives: Editor
Versah, a company started by Michigan Periodontist, Dr. Salah Huwais , have designed a
To cement or to screw – that is the question. Not anymore, startup RODO Medical has added a new option. Reversible retention using a shape memory metal dental retention system which uses one or more compression plates made from various shape memory materials, e.g., nickel-titanium alloys such as Nitinol. By applying energy via heat or electrical energy, the memory metal elements change shape. To remove a crown, energy is applied via a wand and the memory metal retentive element shape shifts allowing the crown to me removed, thus avoiding the need for pulling, tugging or cutting to get the crown off the implant. A bonus is that no cement is involved avoiding the risk of cement-induced peri-implantitis and bone loss. Straumann has acquired approximately 12% of RODO Medical’s shares for an undisclosed sum and ClearChoice has announced a strategic alliance between the two companies. Rodo Medical has 8 patents on this technology.
In a deal worth $13.35, which has been approved by both companies’ boards, positions Zimmer, based in Warsaw since 1927, to become the second largest company by revenue in the $45 billion global market for artificial knees, hips and other orthopedic and bone-mending implants. The acquisition price, which includes the assumption of debt, consists of $10.35 billion in cash and $3 billion in Zimmer shares.
The Zimmer-Biomet merger is the largest in the medical-devices industry since Johnson & Johnson purchased Synthes Inc. for $21.3 billion in 2012, and highlights the desire of device companies to cut costs and become more efficient in the face of pricing pressure from hospitals, combined with lower surgical-procedure volumes because of consumer uncertainty about the economy, analysts said.
In the case of the recall of the Trabecular Metal dental implant: The Zimmer Dental voluntary device recall resulted from an investigation into the February 2012 complaint involving an apical tip of a 4.1mm D Trabecular Metal Implant which separated from the implant assembly during surgery on a patient with a dense (Type D1), thick, inferior border. The recall correction includes adding precautions to the Instructions for Use regarding the placement of a 4.1mm Trabecular Metal implant.
While the shoulder implant recall: Zimmer Trabecular Metal TM Humeral Stem is a shoulder prosthetic replacement device that is indicated for the treatment of severe pain or significant disability in degenerative, rheumatoid, or traumatic disease of the glenohumeral joint as well as humeral fractures. The humeral stem uses. Trabecular Metal around the proximal part of the stem for biological ingrowth. This single manufacturing lot has the potential for the bond strength between the Trabecular Metal material and substrate to be below the minimum required specification. Testing found bond strength approximately 80% of the minimum required by specification in one of the three zones of the Trabecular Metal. The other two zones exceeded the minimum specification.
An Massachusetts Institute of Technology (MIT) research team that may have found a way to make bone implants less likely to fail using a high-tech adhesive that more securely bonds implants to bone by promoting cell growth between natural and artificial body parts.
In a study published in the June 26 online edition of Science Translational Medicine, the MIT team and its collaborators from several other institutions reported that the implant adhesive — a multilayered coating of ceramic and nanolayers of polymers infused with proteins — worked so well on lab rats that they will soon be ready to test it in humans.
The nanolayers, or super-thin sheets of material, hold therapies such as growth factors
that attract and encourage the formation of bone cells, causing them to firmly attach to the titanium implant. The coated implants required significantly more force to pull free than uncoated ones; indeed, the researchers said the resulting bond is so strong that under stress, the bone would fracture first before the interface with the implant.
The implant coating works like a tiny, elegant machine. The top coating consists of repeating layers, each impossibly thin, that contain the bone growth factor BMP-2. The layers gradually break apart over a period of weeks, releasing BMP-2 into the body. The factor then stimulates stem cells in bone marrow to transform themselves into new bone cells.
The bottom part of the coating is made of a ceramic that mimics bone, thereby attracting bone cells to its surface. This side of the coating is attached to the implant, and recently formed bone cells tend to affix to this ceramic and grow outward, adhering like “superglue” to attach the implant to the bone.
Tantalum, element #73 on the periodic table has found its way into dental implants thanks to mega dental implant manufacturer, Zimmer. They have tranferred it from use in hip implants to dental implants. The trabecular metal material structure and stiffness similar to trabecular bone and is fabricated by coating a vitreous carbon skeleton with tantalum through a proprietary chemical vapor deposition coating process. The tantalum exhibits a crystallographic growth on the vitreous carbon surface of the interconnecting struts that form the material. Trabecular metal technology differs from sintered bead surfaces, titanium plasma-sprayed surfaces, titanium fiber mesh and titanium foam in the high degree of its interconnected porosity (up to 80%) and the regularity of its pore size and shape. In contrast to conventional bone-to-implant contact achieved by non-porous surfaces, Trabecular Metal Technology’s geometrical network of interconnected pores is designed for biological ingrowth through the pores.
The implant’s coronal, apical and internal implant structures are made of titanium alloy (Ti-6Al-4V grade 5) with a microtextured surface created by grit-blasting with hydroxylapatite.. The coronal section features cervical micro-grooves and Zimmer Dental’s internal hex, friction-fit connection, and the apical section features self-tapping threads. In the midsection of the implant, the Trabecular Metal Material is made of tantalum (98%) over a vitreous carbon substrate (2%).
Zimmer decribes the implant as having osseoincorporation properties refering to the healing potential of bone onto an implant surface and into an implant structure. The trabecular metal dental implant features an osteoconductive mid-section, formed from the trabecular metal material, designed for ingrowth as well as ongrowth in a process new to implant dentistry—osseoincorporation.
Italian Manufacturer Sweden and Martina’s Magnetic Mallet is an innovative tool for Dental Surgery and Implantology. The magnetic mallet’s main application is in the maxillary sinus for use in bone compaction protocols and vertical and horizontal compaction. It is also useful in cases that call for the use of a surgical hammer.
The device exploits electromagnetic impact, which allows an impact force of high intensity and short duration to produce plastic deformation of bone, without propagating the force throughout the whole cranium, as is usually the case with the use of a surgical hammer. This is why the use of Magnetic Mallet prevents the patient developing so-called benign paroxysmal vertiginous syndrome, a type of postoperative dizziness.
There are 4 different intensity settings for the instrument allowing the surgeon to modulate the pressure according to the type of procedure and bone density, this allows for a greater margin of safety and precision.
BioImplant is an Austrian dental implant company with a radical new solution to immediate dental implant placement. The patient`s extracted tooth is laser scanned and modified in CAD software, then machined out of zirconium and implanted in the still healing socket for incredibly natural looking results.
IV International Congress of Computer Aided Implantology Academy: VERONA – ITALY, October 28-29, 2011
The 6th International Congress of the CAI Academy will be held in Verona, Italy from October 28 to 19, 2011. Computer aided implant surgery has reached peak levels of acceptance giving proof of the clinical efficacy of computerized procedures. The Congress will focus on the need of defining the state of the art in research and clinical application. Two main areas will be analyzed: topics of current research and current clinical application. Amongst the speaker are: Dr. Scott Ganz, Dr. Kurt Alexander Schicho, Dr. Gerlig Widmann, Dr. Luc Vrielinck, and Dr. Oguz Ozan.
Researchers at the California Institute of Technology have developed a Palladium based glass that is an alloy of the noble metal palladium, a small fraction of silver, and a mixture of other metalloids—has shown itself in tests to have a combination of strength and toughness at a level that has not previously been seen in any other material. “Our study demonstrates for the first time that this class of materials, the metallic glasses, has the capacity to become the toughest and strongest ever known,” Demetriou says. Indeed, the researchers write in their paper, these materials allow for “pushing the envelope of damage tolerance accessible to a structural metal.” The palladium alloy described in the paper could soon be of use in biomedical implants, says Demetriou. “One example is dental implants,” Demetriou says. “Many noble-metal alloys, including palladium, are currently used in dentistry due to their chemical inertness and resistance to oxidation, tarnish, and corrosion. Owing to its superior damage tolerance, the present palladium glass can be thought of as a superior alternative to conventional palladium dental alloys. Plus, the absence of any elements considered toxic or allergenic—nickel, copper, aluminum—from the composition of this alloy will likely promote good biological compatibility.”
BioImplant, an Austrian company, has developed the BioImplant, a CAD/CAM Zirconium implant used in immediate placement. The hopeless tooth is extracted gently by means of a periotome to avoid any damage to the extraction socket, which is to be used as implant site. Particular care has to be taken not to destroy the thin buccal cortical bone. The root of the extracted tooth or an impression of the extraction socket serves as basis for the production of the individualized immediate implant. Macro-retentions, strictly limited to the interdental space, are designed, the buccal and lingual face is slightly reduced and a crown stump is constructed for later connection to the crown in the laboratory. The prepared root is then laser scanned and the implant milled from a medical-grade Zirconia block, the surface is roughened by sandblasting and sintered for eight hours to achieve the desired mechanical properties. Thereafter the implant is cleaned in an ultrasonic bath containing 96% ethanol for 10 minutes, packaged and steam sterilized. Within 10 hours the customized root analogue implant is ready for use.
Sonitus Medica of San Mateo, California has received FDA clearance for SoundBite, a dental hearing aid for people with deafness in one ear. The system works much like a cochlear implant, except for the implantation. A behind the ear device wirelessly transmits audio from the affected ear to a little receiver attached to a tooth that resonates the teeth, that in turn stimulate both cochlea. The removable In-The-Mouth (ITM) device showed no long-term effects on dental or periodontal soft or hard tissues and was determined to be safe for long-term dental wear. The device was worn on patients` natural teeth, as well as on those with fillings, restorations, crowns, root canals, and dental implants.
The use in spine surgery of bone-growth proteins like Medtronic Inc.’s product Infuse has led to widespread nationwide increases in hospital charges ranging from 11% to 41% above conventional surgical costs, researchers found.
The researchers studied the results of a broad U.S. sample of 328,000 spine surgeries from 2002 through 2006. They report their findings this week in JAMA, the Journal of the American Medical Association.
The authors, from both Brigham & Women’s Hospital in Boston and from Yale, also found that by 2006 the use of the new bone proteins, especially Infuse, had increased to nearly 25% of all operations in which spinal vertebrae are fused together to alleviate back pain.
“People know bone-growth protein is expensive, but this gives an idea of how expensive,” said Kevin S. Cahill, the lead author and a neurosurgeon at Brigham & Women’s hospital.
A new peptide, embedded in a soft gel or a thin, flexible film and placed next to a cavity, encourages cells inside teeth to regenerate in about a month, according to a new study in the journal ACS Nano. This technology is the first of its kind.
The new gel or thin film could eliminate the need to fill painful cavities or drill deep into the root canal of an infected tooth.
The gel or thin film contains a peptide known as MSH, or melanocyte-stimulating hormone. Previous experiments, reported in the Proceedings of the National Academy of Sciences, showed that MSH encourages bone regeneration.
Bone and teeth are fairly similar, so the French scientists reasoned that if the MSH were applied to teeth, it should help healing as well.
To test their theory, the French scientists applied either a film or gel, both of which contained MSH, to cavity-filled mice teeth. After about one month, the cavities had disappeared, said Benkirane-Jessel, a scientist at the Institut National de la Sante et de la Recherche Medicale and a co-author of the recent paper.
Keystone Dental`s Genesis Implant has been cleared by regulators. The implant system features a patented BioSpark™ surface, a nano-surface that mimics the structure of bone, creating a healing environment to optimize bone integration. In addition, the unique AnaTite™ process results in the first-ever marketed pink implant collar and a complete line of pink prosthetics. The aesthetic breakthrough of the AnaTite process allows the Genesis System to project a more natural hue through the patient`s gum tissue for a more natural looking smile.
Dental Implant Prices Decline by 3.3% in Europe as Practitioners Purchase Implants From Low-Cost Manufacturers, According to Millennium Research Group. Average selling prices of dental implant fixtures and final abutments have decreased 3.3% and 8.1%, respectively, over the past year. This occurred as dentists attempted to maintain profitability during the economic crisis by demanding greater discounts and increasingly purchasing implants from low-cost manufacturers.
AstraZeneca is considering spinning off a Swedish business that makes dental implants and medical devices for $2bn (£1.25bn). The Anglo-Swedish drugmaker said today that it had hired JP Morgan Chase to help with a strategic review of the firm. In 2009 the industry suffered its weakest year, with sales falling by 3% to 5%. This year the market has been flat but it is slowly recovering.
Potential suitors for Astra Tech include US rivals such as privately held Biomet, along with 3M, Zimmer, Danaher and Dentsply International, as well as private equity firms, according to industry analysts. Medical technology firms such as Medtronic and Johnson & Johnson seeking to enter the dental implant market could also be interested.
In Europe, the most likely bidders are Swiss firms Nobel and Straumann, the market leaders controlling 21% and 22% of the dental implants market.
Because children and adolescents are particularly vulnerable to radiation, doctors three years ago mounted a national campaign to protect them by reducing diagnostic radiation to only those levels seen as absolutely necessary. Not only do most dentists continue to use outmoded X-ray film requiring higher amounts of radiation, but orthodontists and other specialists are embracing a new scanning device that emits significantly more radiation than conventional methods, an examination by The New York Times has found. Some orthodontists now use cone-beam CT scans to screen all patients, even though a number of dental groups in this country and in Europe have questioned whether the benefit of routine use justifies the added risk. The cone-beam business is lucrative for manufacturers and dentists. According to one industry estimate, more than 3,000 scanners and about 30 different models have been sold, at prices up to $250,000.
Dentists, some of whom charge several hundred dollars per scan, can profit by owning their own machines. “More profit per unit chair time,” promises Imaging Sciences, the cone-beam manufacturer. The company’s i-CAT scanner is one of the most popular on the market.
“I use my i-CAT for everything,” one orthodontist, Dr. Edward Y. Lin, proclaimed in a full-page advertisement in one magazine.
Whatever the radiation levels from a particular cone-beam scan, the risk is small, said Dr. Brenner, the Columbia University radiation researcher. But it is only worth taking, he said, if there is demonstrable benefit, particularly for young patients who are “typically 5 to 10 times more sensitive than adults.”
Dr. Brenner said that a child faces up to a 1-in-10,000 chance of developing cancer from a single cone-beam scan. Yet orthodontic patients frequently get more than one scan during treatment and face a lifetime of additional X-rays, all of which scientists believe are cumulative. “You double the dose, you double the risk,” Dr. Brenner said
Swedish Oral Hygiene manufacturer, Tepe, has released their new implant toothbrush design specifically shaped to allow dental implant recipients to maintain excellent oral hygiene. The Tepe Implant Care brush has angled neck and slim brush head for easy access to the lingual and palatal surfaces of implants.
Nobel Biocare has been sued by a California dentist seeking class-action status on behalf of dentists whose patients have suffered complications such as bone loss from one of its products namely the NobelDirect dental implant. The suit by Jason M Yamada, a periodontist, seeks compensation for dentists who have had to perform surgery on their patients, or pay for restorative surgery, after complications from the implants, which it said were defectively designed. The suit proposed a class action to cover thousands of dentists in the U.S. who have used the NobelDirect implant, adding that Nobel Biocare had knowledge of the defect, but marketed the implant as safe and effective.
The New York Times has published a consumer-oriented article on dental implants. They discuss the options: dental implant versus bridge and the coverage dental insurance companies provide for this service. This well written article is an excellent introduction to dental implants especially useful to share with patients considering this treatment.
Scientists at North Carolina State University have developed a new lightweight “metal foam” with elasticity similar to bone that could lead to a new generation of medical implants, likely overcoming a range of problems associated with devices currently in widespread use. “Our composite foam can be a perfect implant material to prevent stress shielding,” said Rabiei, the lead researcher. “This is because the modulus of our composite foam is matching perfectly with that of bone. That means when the implant is in the body and a load is applied to the bone, as a result of walking, chewing, etc., both the implant and the surrounding bone will take a fair share of the load,” Rabiei said. “It is unlike bulk metal implants, in which the metal takes on the majority of load.” When this occurs, “the bone starts to become lazy and eventually dies because it is ‘left out,’ and is not active anymore,” she added.
Cerapedic`s i-FACTOR bone graft is the only biologic bone graft that combines a unique anorganic bone mineral (ABM) and small peptide (P-15™) to act as an attachment factor for specific integrins on osteogenic cells. This novel mechanism of action enhances the body’s natural bone healing process resulting in safe, predictable bone formation at a lower cost than growth factors. ABM/P-15 has been in human clinical use for more than thirteen years in an estimated 500,000 patients worldwide. P-15 is a synthetic fifteen amino acid peptide that mimics the cell-binding domain of Type I human collagen and is responsible for osteogenic cell attachment to Type 1 human collagen.
Dr. Kirk Johnson, an Anchorage Alaska dentist spread holiday cheer by performing an unusual operation on an unusual patient. A bald eagle came to Anchorage`s bird treatment and learning center with a severely damaged beak possibly caused by fishing line. Dr. Johnson made a mold using dental impression material with which he fashioned a temporary beak implant.
The body can heal minor bone injuries itself – but with major injuries, it needs help. Researchers at the Fraunhofer Institute for Laser Technology have developed a process called Selective Laser Melting (SLM) by which a razor-thin laser beam melts pulverized material layer-by-layer to produce structures that may be as delicate as 80 to 100 micrometers. The porous canals create a lattice structure which the adjacent bones can grow into. Its basic structure consists of the synthetic polylactide, or PLA for short. Stored granules from tricalcium phosphate (TCP) ensure rigidity and stimulate the bone‘s natural healing process. As pastes, granulates and semi-finished products, TCP and PLA already have proven to be degradable implants. The body can catabolize both substances as rapidly as the natural bones can regrow. But the material can only be applied in places where it will not be subject to severe stress: Thus, the »Resobone« implants will primarily replace missing facial, maxillary and cranial bones
To see how the brain responds to pain emanating from different teeth, researchers led by Clemens Forster of the University of Erlangen-Nuremberg in Germany used fMRI to monitor changes in activity when the upper tooth or the lower tooth was zapped. “At the beginning, we expected a good difference, but that was not the case,” Forster says. Because the same regions were active in both toothaches, the brain — and the person — couldn’t tell where the pain was coming from. “Dentists should be aware that patients aren’t always able to locate the pain,” Forster says. “There are physiological and anatomical reasons for that.”
Developed by a practicing dentist, the Zosseo Universal Implant Drill Stop kit
allows for osteotomies that do not require as precise a visualization for depth control. It has a single width for all drills – only requires length determination for the osteotomy and has precise depth penetration – eliminating the risk of over drilling and potential sinus or nerve complications.
The million or so artificial hips and knees implanted each year in the United States are normally not guaranteed. Instead, the costs of replacing implants that fail early because of design or mechanical problems — devices that sell for as much as $15,000 each — are largely paid by Medicare, insurance companies and patients.
Implants can fail for many reasons, but if only a small percentage of them fail prematurely because they are substandard, the costs to taxpayers, policyholders and patients can run into the tens of millions of dollars each year, health care experts estimate.
Orthopedic producers may sometimes even profit from the failures because they sell the replacements at full price.
“Companies have dumped these costs into the health care system,” said Dr. Lawrence D. Dorr, an orthopedic surgeon in Los Angeles who two years ago took the unusual step of drawing attention to one problematic hip device. “They don’t have any skin in the game.”
A Las Vegas dentist has filed a FDA Med Watch report regarding the integrity and therefore sterility of Nobel Biocare Replace Implants. To quote from the report:
“I have experienced substantial and unexplainable failures with Nobel Biocare`s (“Nobel”) Replace(TM) Implants. Of 88 consecutively placed implants,34 required removal due to pain or infection for a failure rate of 38.6% (Attachment #1). I doubt these failures are caused entirely by my case selection or surgical skill because I also recorded the clinical success of 51 consecutively places Implant Direct RePlant(TM) Implants from 2008-2009 with only 2 requiring removal for a failure rate of 3.9% I brought this information to Nobel Biocare`s attention, as shown in my letter of October 27, 2008 (Attachment #3) and submitted failure reports on their forms (Attachment #4). Nobel refused to take back my remaining implant inventory, contending that the problem lay with my surgical skills rather than with their implants. After Nobel`s refusal, I continued to use some of my remaining inventory of Nobel Replace implants while also incorporating Implant Direct`s RePlant implants into my practice. After experiencing a significantly higher failure rate with the Nobel Replace implants compared to Implant Direct`s RePlant implants, I stopped using the Nobel implants altogether. Seven Nobel implants from my inventory were sent to Nelson Labs (Attachment #5) and eight were sent to an ISTA Certified Lab (Attachment #6) for dye immersion tests. As can be seen on these reports, all of the implants tested failed to provide a seal required to assure the maintenance of sterility of the contents.”
Dr. Paul Sharpe`s company Odontis Ltd. has been awarded US Patent #7588936 for the regeneration of teeth primordia using bone marrow cells. Bone marrow cells may be employed to generate teeth without the need for purification and expansion of a population of cells. The group of British scientists claim that they have figured out a way to make dentures obsolete, with the power of stem cells. Simply put, stem cells taken from a patient will be used to grow a bunch of cells that will grow into a tooth. The cells will then be implanted in an incision in the patient’s gum. Even more amazing, the process of “nudging” the stem cells to turn into a “ball of cells” that will in turn become a tooth supposedly takes only two weeks. The scientists have formed a company, Odontis, to capitalize on their technique, and they are calling their (potential) product the BioTooth.
Dental implant makers lost their shine as a recession-proof investment during the global crisis, which turned fixing smiles into a luxury for consumers who struggled to pay for non-essential work on their mouths. “In spite of their rather functional nature, implants are similar to luxury goods in the sense that they are expensive, discretionary items,” Jefferies analyst Stephan Gasteyger said. The dental implant market earned a reputation for being recession-proof by maintaining double-digit growth rates in prior downturns, but the exceptionally tight credit markets during the recent crisis killed growth last year.
Implants have proven to be more cyclical than other parts of the medical technology sector as patients usually have to pay for the often expensive treatments themselves and are rarely reimbursed by insurance policies.
“We are talking about a price category that is similar to a nice Swiss watch,” Gasteyger said.
With economic pressures affecting millions of Americans, dentists may have noticed a drop in patients opting for a brighter smile, but they are seeing another phenomenon: a rise in the number of teeth grinders. “I’m seeing a lot more people that are anxious, stressed out and very concerned about their financial futures and they’re taking it out on their teeth,” said Dr. Steven Butensky, a dentist with a specialty in prosthodontics (aesthetic, implant and reconstructive dentistry) in Manhattan.
One of his patients lost hundreds of thousands of dollars invested with Bernard L. Madoff. Another reported that he had lost a job with a seven-figure salary. A third, a single mother with a floral design business on Long Island, said she was working twice as hard for half as much.
Numerous dental implant company`s have sprung up over the last 3 years that aim to deliver either very similar designs or almost direct copies of established company`s design. These clone implants are often substantially less expense i.e. 1/4 the cost of full service dental implant company`s implants. In addition to mimicking the implant, they have also expanded into compatible prosthetic parts and coverscrews. Especially prominent clone makers Blue Sky Bio (Clone: Straumann, Nobel Biocare and Zimmer) and Dr. Niznick`s Implant Direct (Clone: Straumann, Nobel Biocare, Astra, Zimmer, 3i) are an attractive temptation during less sunny economic times. With some newer designs from the large manufacturers costing close to $500US for the implant and coverscrew, the $100US “out the door” pricing argument of the clone makers is compelling.
The Large Manufacturer`s Argument: We invest huge sums in R&D, Service and Support so we want a return on our investment.
The Clones` Argument: Marketing+Distribution+Recruitment of Opinion Leaders = 50% the cost of overhead – we dispense with that and pass on the savings to the dentist.
Both are reasonable arguments. One thing is for sure, competition is never a bad thing.
Anna Tampieri at the Institute of Science and Technology for Ceramics, Faenza, and colleagues have turned wood into bone mimics that could be used to repair damaged limbs. The Italian scientists were inspired by nature`s highly organised hierarchial structures to make porous hydroxyapatite scaffolds with structures similar to that of real bone. The scaffolds `pave the way for realising prosthetic devices which could get closer to the extraordinary performance of human tissues`, they claim.
The team heated the wood to decompose the organic parts that make up most of its weight, leaving behind the carbon template. They reacted the template first with calcium, then oxygen and then carbon dioxide to form calcium carbonate. Finally, they converted it to hydroxyapatite using a phosphate donor. The material keeps its original microstructure, exploiting the unique architectural properties of the wood`s cellular make-up, explains Tampieri. This means cells and blood vessels can grow through the structure and incorporate it into the original bone.
The New York Times health section recently published an informative article on the trend away from using bridges to replace missing teeth and toward replacement with dental implants. The comments section of this article is also particularly lively and well-worth reading.
The Powertome 100S from Westport Medical is a powered periotome used in the extraction of teeth. It features a powered periotome blade that is precisely guided in the periodontal ligament by a microprocessor controlled, solenoid actuator. It features a footswitch activated handle similar to other dental hand pieces and the operation, actuation and sterilization are therefore intuitive.
A former US Army orthropedic surgeon, Dr. Timothy Kuklo, previously accused of falsifying a study on a bone growth product used on severely injured Iraq war veterans has resigned his teaching position at Washington University in St. Louis. He was placed on leave earlier this year while the university investigated charges against him. Medtronic, a maker of the bone growth product Infuse, also suspended his consulting contract. The company paid him nearly $800,000 the last few years. An investigation last year by Walter Reed Army Medical Center in Washington, where Dr. Kuklo worked before joining the university, concluded that he had falsified parts of a study that claimed greater benefits than other Army surgeons reported for the Medtronic bone growth product. The Army reported its findings to the university and a medical journal. Dr. Kuklo was also found to have forged the signatures of four listed co-authors, who told Army investigators that they did not approve the study. The British Journal of Bone and Joint Surgery retracted the study earlier this year
Tel Aviv University researcher Prof. Noam Eliaz of the TAU School of Mechanical Engineering has developed an electrochemical process for coating metal implants which vastly improves their functionality, longevity and integration into the body. “The surface chemistry, structure and morphology of our new coatings resemble biological material,” explains Prof. Eliaz. “We`ve been able to enhance the integration of the coating with the mineralized tissue of the body, allowing more peoples` bodies to accept implants.” His new coating resulted in a 33% decrease in the level of materials failure, or delamination, in these implants.
The next-generation coating will include nano-particles to reinforce the coating. It will also have the potential to incorporate biological material or drugs during the process itself.
Patients who subconsciously take out stress on their teeth at night is nothing new. But the recession is. A periodontist, Dr. David Samuels reports that he can practically see the impact of the economy in his patients’ X-rays.
“On these films right here that we’re looking at, this area right here represents the top of the tooth – a fracture of the top of the tooth from clenching and grinding,” Samuels says. “You also see flattened surfaces on tops of the teeth. And then if you look down here below, you’ll see the bone loss associated with clenching and grinding. So even on the X-rays, you can see evidence, if you will, of increased stress in someone’s life. And we do see more of that now than we used to.”
About twice as much. Samuels is also the head of the Massachusetts Dental Society. A survey of its 5,000 members reveals business from stress-related tooth injuries has generally doubled.
The most common remedy for teeth grinding is a preventative bite guard. Generic ones you can buy a drugstore cost about $25. Samuels says they’re better than nothing. But he recommends custom-fit ones.
Martin Jones, 42-year-old builder, was left blind after an accident at work more than a decade ago. After a remarkable operation in which part of his tooth was implanted in his eye, he can now regain some of his lost sight. The procedure involved taking a minute section of a patient`s tooth, reshaping and chiselling through to grip the man-made lens which was then placed in its core.
It is implanted under an eyelid where it become covered in tissue.
The process required a living tooth as an implant because doctors suggest there are chances the eye would reject a plastic equivalent.
So a canine – which is the best option due to its shape and size – was taken out of Mr Jones` mouth.
A patch of skin is then taken from the inside of the cheek and placed in the eye for two months, where it gradually acquires its own blood supply.
The tooth segment is finally transplanted into the eye socket. The flap of grafted skin is then partially lifted from the eye and placed over its new sturdy base. Finally, surgeons cut a hole in the grafted cornea to let light through.
Manhattan Scientifics has announced that its NanoTitanium product has been approved by the FDA. The patented new form of titanium metal originally developed by Russian scientists in concert with scientists at the Los Alamos National Laboratory is expected to significantly improve dental implants. Studies have shown that bone integrates with these new metals up to 20 times faster than with conventional metals. Patients should experience shorter post surgery healing times and a more reliable integration of these new implants into their body. NanoTitanium is highly compatible with bone and is
thought to provide stronger, faster bonding with improved strength, biocompatibility, longer life and improved wear and tear.
Founded in 2001, Metallicum (recently acquired by Manhattan Scientifics) has developed methods to modify the microstructure of metals by “nanostructuring”
them. This procedure simultaneously increases
the biocompatibility and strength of virtually any
metal. For example, nanostructuring pure titanium
(the material that is most commonly used in dental
implants) can more than double its strength, making it
stronger than most existing titanium alloys. The ability
of bone cells to attach to nanostructured pure titanium
surfaces at rates greater than 100% higher than
with conventional alloys enables the development
and marketing of a dental implant that can be fully
integrated and useable with half the healing time of
Brookhaven Science Associates, the company that operates and manages the U.S. Department of Energy’s Brookhaven National Laboratory (BNL), and Biosurface Engineering Technologies, Inc. (BioSET), have been issued a U.S. patent on a synthetic peptide, called B2A. B2A enhances the effects of a tissue growth factor known as bone morphogenetic protein 2, or BMP-2. BMPs are a family of proteins in the human body responsible for the proliferation, repair and differentiation of cells in many tissues, including bone. Tom Rouche, BioSET President and CEO said “We have developed a novel combination medical device, called AMPLEX, that incorporates B2A osteo-inductive growth factor with an ultra-high grade ceramic bone substitute for use in this type of surgery. Preclinical studies have found that it is a safe and highly effective.”
This interesting article about `Titanium uses in Industry` reveals some facts you may not have known about your favorite metal:
- It has an extremely low response to magnetism
- Its use in medicine also encompasses surgical instruments and those used in image-guided surgery and magnetic resonance imagery.
- It is the ninth most plentiful element present in the Earths crust. It has been found in meteorites and detected in the sun and class M stars.
- The Apollo 17 moon mission brought back rocks containing Titanium compounds.
- Russia made an attempt to corner the market in Titanium to deprive the US and its allies of the material.
- Many more fun facts in the article
Among the new products presented by Straumann at the International Dental Show (IDS) in Cologne, Germany is a comprehensive instrument kit for guided implant surgery. The kit contains all the instruments, drills, profilers and taps needed to place Straumann implants with surgical templates currently made with open-library (non-exclusive) 3D software systems, including IVS, Materialise, med3D, iDent, and siCAT.
Scientists at Oregon State University have found a gene involved in enamel production.
In the latest research, published in Proceedings of the National Academy of Sciences, a team led by Chrissa Kioussi and Mark Leid bred mice that lacked a gene known as Ctip2. The gene, called Ctip2, is a “transcription factor” that was already known to have several functions – in immune response, and the development of skin and the nervous system. Scientists can now add tooth development to that list. The discovery was made after researchers noticed that mice born without the gene grew teeth lacking enamel.
By understanding the genetics of tooth development, Kioussi said it may be possible to repair damaged enamel and even produce new teeth in the laboratory.
Paul Sharpe, an expert on tooth development at the Dental Institute at King`s College London, said: “If you could find some way of growing ameloblasts that make enamel, you could find a way to repair teeth.
“Any gene like this is worth understanding. The more we learn about it the more we can use the information to make biological models of tooth repair.”
Swiss implant manufacturer, Thommen Medical, have developed a new implant packaging system which allows chairside surface conditioning of their implant. The applicator makes effective chairside surface conditioning fast and intuitive. In a matter of seconds, the conditioning agent contained in the applicator hydroxylates the implant surface to achieve the super-hydrophilic INICELL surface.
During the chairside conditioning with APLIQUIQ the surface chemistry is slightly modified by hydroxylation. The result of this process is increased surface energy and improved wettability.
The superhydrophilic INICELL surface exhibits a water contact angle of less than 5 degrees. A hydrophilic surface, by comparison, is generally considered to have a contact angle of 90 degrees or less.
These properties of the INICELL surface promote spontaneous and complete wetting with physiological fluids, particularly blood.
The JDMultiscraper is designed for autologous bone harvesting. It features a autoclavable body with interchangeable blades, which can be changed once cutting performance degrades.
Université de Montréal Researchers have modified metal surfaces such as titanium producing a sponge-like pattern of nano pits that increased growth of bone cells, decreased growth of unwanted cells and stimulated stem cells, relative to untreated smooth ones. In addition, expression of genes required for cell adhesion and growth were increased in contact with the nanoporous surfaces. “We demonstrated that some cells stick better to these surfaces than they do to the traditional smooth ones,” says Dr. Nanci. “This is already an improvement to the standard available biomaterial.” “Using chemical modification, we have produced metals with intelligent surfaces that positively interact with cells and help control the biological healing response. These will be the building-blocks of new and improved metal implants that are expected to significantly affect the success of orthopedic, dental and cardiovascular prostheses.”
SinusTech America have released a sinus lift kit that features a unique reamer design that cuts, lifts and elevates the floor of the sinus with minimal danger of damage. They claim that the technique minimizes the possibility of damage to the sinus membrane, forms an appropriate sized osteotomy site for implant placement and allows for the placement of bone grafting materials into the elevated sinus cavity.
A study in the November issue of the Journal of Endodontics claims that dental implants require much more follow-up treatment than root canals, according to a study by researchers at the University of Alabama at Birmingham. Their study results reported that the success rate for the dental implants was 98.4 percent; for root canals it was 99.3 percent. However, 12.4 percent of the dental implants required additional interventions, compared with 1.4 percent of the root canals.
“Considering these results in light of the growing body of evidence on the impact of oral health on overall health, it is imperative for dental professionals to partner with endodontists who have advanced training in examining whether a natural tooth can be saved through root canal treatment,” said Dr. Louis Rossman, an endodontist and president of the American Association of Endodontists.