Astratech has released a customized version of Simplant for use with their implant system. The software program also contains 3D images of implants, abutments and teeth. This ensures efficient, accurate and reliable planning of implant positions, sizes and number of implants, and abutments to be used. In addition it provides better control over the esthetic outcome. When the case is planned, a surgical guide is ordered to make sure that the planning result will be replicated in the real surgical situation.
Straumann has been granted a US Patent on its new implant delivery mount. The much needed redesign features `keyless` removal and incorporates an innovative implant indexing system into the mount, anticipating that implant indexing will increasingly be done at the time of implant placement.
Ceraroot which makes various anatomically shaped single piece zirconium implants has released another `extraction and immediate implant` video on Google video. This one features a maxillary pre-molar.
MIS has released a specially designed diamond bur kit for use in modifying and customizing Zirconium abutments. The Zircon Diamond burr set has been designed to enable easy grinding and preparation of Zircon abutments. The set combines all burrs that are necessary for adjustment procedures and preparation of crowns and structures made of ZrO2.
Dentsply Friadent had released their next generation implant surface which features a thermal etching process called BioPoreStructuring. They claim the specific etching acid they use creates an ideal physical, chemical and biological surface needed to attract osteoblasts to the implant surface.
Zimmer`s Socket Repair Membrane is a specially shaped collagen membrane designed to assist wound healing in alveolar facial plate repair and residual ridge preservation following atraumatic, flapless single-root tooth extractions. It is pre-cut to fit single root sockets, saving the clinician time and limiting waste. The membrane contains graft material by capping the socket with the circular portion of the membrane and helps retain the post extraction buccal wall preventing the bone particles from dispersing into the tissue and preventing the migration of the epithelial cells into the site. Developed in conjunction with Dr. Dennis Tarnow at NYU to help maximize long term esthetic results and function.
Dr. Gerald Niznick of Implant Direct sent a letter to the Editor of IJOMI taking issue with its recent Editorial (JOMI 2006; 21:6) that claimed a direct correlation between innovation and high prices for dental implants. Dr. Niznick`s letter analyzes the published financial statements of Nobel Biocare and Straumann showing their cost of goods at 16% to 20% with marketing expenses in excess of 40% and research costs of only 3.5% – 5% of gross revenues. The editor saw fit not to publish the letter. The Editor acknowledges that Dr. Niznick`s Letter “raised interesting issues” and “describes financial issues that the readership rarely sees.” The Editor stated that JOMI “simply cannot afford to use pages for such letters,” to which Dr. Niznick points out that the journal contained 34 pages of advertising, many from the same companies who benefit from high implant prices.
A robotic smart drill developed by Aston University(UK) and clinically tested at the University Hospital Birmingham offers a more precise means of drilling. Tested in a cochlear implant procedure, the device is able to detect the approach of the drill tip as it approaches this tissue interface. It is then able to avoid penetrating the membrane, so avoiding drilling and other debris dropping into the ear. It is expected that this more precise means of drilling will lead to improved hearing for the patient following implantation. It has been tested on three human patients — all with successful out comes. It drills a perfect hole, the perfect size, in the perfect place and to a perfect depth. The robotic smart drill is currently only being used for cochlear implants, but the potentials for wider surgery applications in the future are extensive.
Innovative Implant Technology has released an innovative kit to aid in the planning and placement of dental implants in a variety of clinical situations. It features colour-coded `measuring blades` that aid in determining the optimal implant size for a particular edentulous space. The measuring pins are used during placement to ensure optimal implant-tooth and implant-implant spacing.
The friendly takeover is Straumann`s largest to date and will position the group as a “one-stop shop” by providing solutions such as bone augmentation as well as implants and prosthetics, the firm said. “Overall it is a positive strategic move. They are copying the strategy of other major competitors, such as Nobel Biocare, by providing both implants and prosthetics,” said Vontobel analyst Christoph Gubler. Straumann has struggled to match Nobel`s presence in the U.S., where fewer dentists have used implants than in Europe, making it one of the fastest-growing markets for dental implants.
Munich-based Etkon is a leader in computer-aided design and manufacturing (CAD/CAM), which uses computers to scan models of patients` mouths to provide customized bridges and crowns, using ceramics.
Biomet / 3i has released their upgraded surface, Nanotite. Nanotite features their previous Osseotite surface treated with discrete crystalline deposition of Calcium Phosphate (CaP) resulting in a more complex surface topography. They claim that the biologic benefits Of CaP may play a key role in enhanced site response, potentially improving clinical predictability and outcomes. – This surface is named the same as one released by Bicon a few months ago, are they the same?
Researchers from the Institute of Biotechnology at the University of Helsinki and their collaborators from Berlin and Kyoto have now shown that continuous tooth generation can be induced in mammals. The research results were published in `Proceedings of the National Academy of Sciences,` (PNAS). The researchers activated the Wnt signaling pathway in mouse tissue; this signaling pathway is one of those used for cell communication and plays an important role in embryonic development. As a result of stimulating this particular signaling pathway, one mouse molar developed dozens of new teeth with normal dentin, tooth enamel and developing roots. The crowns were, however, simple and cone-shaped, unlike the typically more complex multiple cusps of mouse molars.
Nobel Biocare refuted criticism voiced by Swedish scientists, saying its implant product `teeth-in-an-hour` is a scientifically proven concept with high success rates.
The Swiss-Swedish implant maker said that one of its `ongoing studies with 19 patients and a total of 118 implants shows that after three years, 96.3 pct of all implants still function`.
The complete report will be available in April, it said.
The group`s statement came in reaction to a study by Sweden`s Karolinska Institute published on Saturday saying that its Teeth-in-an-Hour implant system may carry more risk of complications than conventional methods
Swiss-Swedish Nobel Biocare`s Teeth-in-an-Hour implant system may carry more risk of complications than conventional methods, an abstract of a study by Sweden`s Karolinska Institutet showed on Saturday.
The study examined 31 patients treated using the method, which uses computer modeling to reduce implant installation time and showed that complications such as the loss of fixtures and the need for adjustments arose for nearly a third.
Nine percent of the 175 fixtures examined were lost, said Bjorn Klinge, professor of periodontology at Karolinska Institutet and one of the study`s authors.
This compared with a loss rate of roughly 2 to 3 percent using conventional and more time-consuming methods, he added.
“My assessment is that this is still at the trial stage and therefore can`t be recommended for general use,” Klinge told Reuters.
“Our data shows rather unequivocally that there is a lot of development left before one can say if this is a good or a bad product,” he added.
The study, presented at a dental conference in Venice on Saturday, has not yet been published in a scientific journal or peer-reviewed, but Klinge said an article was being prepared.
Straumann’s academic partner, the International Team for Implantology (ITI), introduced the first Volume of the ITI Treatment Guide in cooperation with Quintessence publishing. Volume 1, entitled `Implant Therapy in the Esthetic Zone – Single-Tooth Replacements` was introduced to the professional community at the EAO’s 15th Annual Scientific Meeting in Zurich.It takes its readers through the entire process, starting with the assessment of the patient’s individual esthetic risk profile and proceeding to through ideal three-dimensional implant placement and proven prosthetic management options.
The various aspects are illustrated using patient case studies. Detailed illustrations serve to clarify any potential ambiguities. An analysis of potential complications in esthetic implant dentistry completes this first volume.
The Fraunhofer Institute for Biomedical Engineering IBMT in Germany have developed a dental prosthesis consisting of a drug-filled reservoir, a valve, two sensors and several electronic components. Saliva enters the reservoir via a membrane, dissolves part of the solid drug and flows through a small duct into the mouth cavity, where it is absorbed by the mucous membranes in the patient’s cheeks. The duct is fitted with two sensors that monitor the amount of medicine being released into the body. The patient has to have the agent refilled every few weeks.
Osteohealth`s GEM 21S is a wound healing and bone regeneration technology termed growth-factor enhanced matrix (GEM). It has recently become available for clinical use. This graft material consists of a concentrated solution of pure recombinant human platelet-derived growth factor (rhPDGF-BB), the synthetic form of the body’s key natural wound healing stimulator PDGF-BB, and an osteoconductive (bone scaffold) matrix. This is the first available purified, recombinant (synthetic) growth factor product and is the result of over a decade of extensive research. Clinical and animal study results with this graft material demonstrate that it is capable of simultaneously promoting wound healing, regeneration of bone and acceleration of gingival attachment gain in challenging periodontal and periimplant defects.
Using stem cells harvested from the extracted wisdom teeth of young adults, researchers have successfully generated tooth root and supporting tooth ligaments to support a crown restoration in experiments using miniature pigs.
The restored tooth mirrored the original tooth in function and strength, the research team reports in the December issue of the open access medical journal PLoS ONE. The technique holds promise for use in humans, the investigators say.
Dr. Songtao Shi said: “In this study, we use stem cell technology to generate `a bio-root and periodontal tissue` along with dental clinical porcelain crown technique to restore tooth function in swine (mini-pig). Implant patients must have sufficient bone in the jaw to support the implant. For those who don`t, this therapy would be a great alternative,” Shi said in a statement.
The Swedish Medical Products Agency investigation of the dental implants NobelDirect and NobelPerfect show that there can be deficiencies in the instructions for use for the products.The MPA decision directs Nobel Biocare to clearly describe possible causes for the breakdown of the jawbone in the instructions for use and training programs. In addition, the company must describe how the risk for breakdown can be avoided. In sales and promotion information and instructions for use, the company shall indicate the user qualifications and skills required so that a dentist can use the implants safely. Nobel Biocare may not actively market the dental implants until the information activities are carried out.
The MPA`s report gives an interesting insight into the basis and timeline of this investigation.
In the course of a routine inspection of Biora AB, Straumann`s oral regenerative product company in Sweden, in October 2006, a U.S. Food and Drug Administration (FDA) investigator made a number of observations predominantly concerning maintenance of quality system documentation and procedures associated with the company`s products. Biora has received a “warning letter“ from the FDA, which indicated that its “dental bone grafting materials“ are on import detention in the U.S., until the inspectional observations are resolved. No other countries apart from the U.S. are affected. The products concerned are: Straumann BoneCeramic, Emdogain, and PrefGel.
Medtronic recently announced that the FDA Dental Products Advisory Panel has unanimously voted to recommend approval, with a condition the use of INFUSE® Bone Graft for certain oral and maxillofacial bone grafting procedures. INFUSE Bone Graft is recombinant human bone morphogenetic protein-2 (rhBMP-2) applied to an absorbable collagen sponge carrier. The purpose of the protein, which occurs naturally in the body, is to stimulate bone formation. It has been previously approved by the FDA for use in certain lumbar spine fusion and tibial fracture repair procedures. Implanted into a bone-deficient site, INFUSE Bone Graft works with the body’s own biology to induce normal physiologic bone formation.
DentalXP is an educational website with videos, images, protocols and articles related to implantology and cosmetic dentistry. The Salama brothers and Dr. Garber and Goldstein seem to be the principle contributors. Content is free after registering. Some cutting-edge technique videos as well as clinically-useful forms are the chief attractions.
A Merril Lynch analyst`s report on the dental implant industry has been released. Issues discussed include: the risk of increasing regulation of implant placement, image guided surgery`s growing importance, Nobel Biocare`s sales strategy and various implant company`s product launches. As always, a very interesting read.
3i has introduced their CAD/CAM precision bar milling system. This system produces a computer designed superstructure that is milled out of a solid billet of titanium alloy to ensure a passive fit. Six different types of implant systems are supported.
Sirona have received the FDA`s 510K approval for their Galileos 3D X-ray imaging system. This system uses a Cone Beam-based technology that calculates a large volume 3D image set, more than 200 exposures, in a single low-dose 3D scan of 15 seconds or less. This 3D image set is processed and presented in the new GALILEOS software, an advanced extension of Sirona’s SIDEXIS XG imaging software.
Sweden`s Medical Products Agency has made a preliminary finding that Nobel Biocare AG`s dental implant Nobel Direct, is too risky to use except with `great care`. The regulator said it will over the next few weeks come to a final view on Nobel Direct and what eventual warnings will be attached to the implant. The agency issued its statement after investigating the results of Nobel Biocare`s own two year study and said this study was not based on a representative sample, and that up to two thirds of the requisite information from the study was not included in the report it received. `Against this background, …. it is our view that implants of the Nobel Direct type should only be used with great care,` the agency said.
Meisinger has released their balloon based sinus lift system. It uses a system of precision drills and drill guides to allow the introduction of a saline-filled balloon into the sinus. This balloon is then filled to gently push the sinus up. They report up to 10mm of lift height with minimal invasiveness.
The General Dental Council (UK) convened a small working group in December 2005 to to consider what training standards would be necessary for a general dental practitioner before practising implant dentistry, to publish those standards and then periodically to review them in the light of developments in implant dentistry. Such standards could be used not only by practitioners but also by the GDC in the consideration of patient complaints against dental practitioners who, allegedly, practise implant dentistry beyond the limits of their competence. The GDC and the working group wanted to ensure patient protection by establishing and maintaining standards of training in implant dentistry.
Implant Direct LLC has received a FDA 510(K) Marketing Clearance for their Spectra System. Dr Niznick, inventor of the internal anti-rotational connection, has started his own dental implant design and manufacturing company that employs a web-based order and support model to deliver a versatile line of implants at about 50% of the price of the major manufacturers.
Astratech has released their Cresco(r) system for ensuring passive fit on screw-retained implant bridges. This system allows for up to 17 degrees of angle correction for screw-retained bridges using bendable wax tubes giving maximum flexibility in terms of being able to compensate for angled implant placement when bone quality and quantity are poor. Using a Cad-Cam-like milling machine corrects the casting distortion of prosthetic superstructures to a very high degree of precision. The majority of implant systems are supported.
MIS Implant Technologies Ltd has released a Crest Widener used to widen a narrow alveolar crest which has sufficient height for implant placement. The cortical plates are separated and the crest widener distracts the plates so that new bone is created between the plates and the attached gingiva. They have a step-by-step guide and video of the surgical technique on their website.
The University of Connecticut Health Center has received a five-year, $2.6 million grant from the US National Institutes of Health to study the relationship between osteoporosis and the success or failure of regeneration and dental implants. They plan to recruit 120 women for the study. Specifically, the study is designed to help the researchers develop a reliable estimate of the two-year success rate of bone augmentation and dental implants in women with broadly varying bone density measurements.
Preclinical results were presented recently at the EAO meeting for Straumann`s innovative hydrogel-based membrane, which confirmed the product`s efficacy and ease of handling. The first clinical trial was successfully completed in the third quarter, with each of the endpoints being met. On this basis, applications for regulatory clearance should be submitted in the current quarter. Straumann and Kuros Biosurgery, a spin-off from the Swiss Federal Institute, ETHZ and the University of Zurich, applied for a patent on this technology in 2003.
The perils of living in New York go beyond the grave. The directors of seven funeral homes have been stripped of their licenses and face jail after pleading guilty to their role in what one US official called “the crime of the century” – whenever they got hold of a suitable corpse, they would tip off a team of illegal body harvesters led by Michael Mastromarino, a former oral surgeon who had lost his dentist`s license. Operating out of a secret room in a Brooklyn funeral home, Mastromarino would extract useful skin, organs and even bones which would be replaced with pieces of PVC piping so as to not arouse suspicion at open-casket funerals. The body of British broadcaster Alistair Cooke, of Masterpiece Theater fame, was plundered by the harvesters and paperwork altered to record his age as 85 rather than 95. The body snatchers allegedly surgically removed Mr. Cooke`s bones and sold them for more than $7,000 to a company supplying parts for use in dental implants and various orthopedic procedures.
Sweden`s Medical Product Agency (SMPA) has announced it will delay its final verdict on the safety of Nobel Biocare AB`s dental implant NobelDirect, which is alleged to cause bone-loss, until November. The agency cited a delay in the release of Nobel Biocare`s two-year follow-up study as being responsible.
Two Swedish dentists in May 2005 alleged that the product is causing bone-loss, prompting investigations by the heathcare authority.
Bicon have developed a new surface process, NanoTite™. A high-energy ion beam source aims a beam of ions at the surface of a target treated with HA. These high-energy ions eject the HA from the target/substrate and create a molecular cloud whose molecules bond with the surface of the Bicon Ti 6Al-4V ELI implant. This Ion-Beam Assisted Deposition process, which provides increased integration with the implant surface, is known as High-Energy Sputter Deposition. Using an Ion-Beam Assisted Deposition process, the titanium alloy is modified with a thin (less than 1 micrometer) amorphous calcium phosphate compound with HA-like chemistry and physical properties for enhancement of bone integration.
Ulf Wikesjö of the Medical College of Georgia has demonstrated impressive osseous regeneration around dental implants coated with recombinant human Bone Morphogenic Protein (rhBMP-2). Dr. Wikesjö is researching wound-healing and tissue regeneration with a $1.4 million grant from Nobel Biocare. In laboratory tests, rhBMP-2 applied onto implants directs endogenous stem cells to become bone-forming cells. The result was a nearly complete regeneration of lost tissue. He hopes to start clinical trials in the summer of 2006.
Famous mafia boss John Gotti, Dr Leonard Linkow and blade implants – all part of the history of implantology. An amazing story reported by the NY Daily News in 2002. Enjoy:
Around 1988, after losing several teeth, Gotti tired of dentures and had
permanent implants surgically installed and his remaining teeth capped. He visited the E. 50th St. offices of Dr. Leonard Linkow, a frank-talking New
Yorker with a shock of white hair. Linkow had been famous among dentists
worldwide since the late 1960s, when he introduced a new type of implant as an
alternative to dentures. As a show of gratitude, Gotti wanted to have a custom suit made for Linkow. The offer came via Jack (The Nose) D`Amico, one of Gotti`s closest associates. Linkow said. “I said, `No, no, I got plenty of suits, and I don`t have enough time in the world to wear the suit,`” But D`Amico insisted, repeatedly, until Linkow recognized it was an offer he couldn`t refuse…. [story continues]
IVS Solutions AG has released a 2-dimensional implant placement planner that uses panoromic and peri-apical xrays for the implantologist to design the type and position of the implant(s). The software then produces a surgical plan which lists the implants planned for placement as well as an image of the planned implant positioned on the xray.
BEGO Implant Systems GmbH & Co has designed a customizable healing abutment designed to shape the soft tissue. By customizing the PEEK blank at the chairside the emergence profile can be shaped, elliptical or even triangular, depending on the circumferential shape of the tooth that is to be replaced. It is made of a high-strength and completely biocompatible plastic abutment made of (implantable) polyether-ether-ketone (PEEK). This material is trimmed into the required shape with the handpiece at the chairside and is used in place of a conventional healing abutment to sculpt the peri-implant soft tissue emergence profile.
Brown University engineers have shown that both zinc and titanium oxide nanosurfaces can reduce the presence of bacteria. Discs with nanostructured surfaces had bumps that measured only .023 microns in diameter. Discs with microstructured surfaces had bumps that measured about 5 microns in diameter. Microstructured zinc oxide discs were host to 1,000 times more bacteria than the nanostructured zinc oxide discs. Similar, but less striking, results were duplicated on titanium oxide discs. The engineer`s hypothesis is that: `with the nanostructured surfaces we created, surface area increased by 25 to 35 percent. We think that this additional area, along with the unique surface energetics of these nanomaterials, gave bone-forming cells more places to adhere. But with bacteria, increased surface area may work the other way, exposing the bugs to more of the germ-fighting properties of the zinc oxide.`
Ceraroot have designed five ziconium-based one-stage implants for use in different areas of the mouth. The anatomically designed implants incorporate the abutment into the implant for a very esthetic result. An interesting video is posted on Google Video showing the use of a Ceraroot implant in an immmediate placement procedure.
Dental Implan Inc , has released patient education software to assist practitioners in explaining to patients what a proposed treatment plan will involve. The software was developed for Jeffrey Ganeles, a florida periodontist, to enhance and streamline patient consultations.
Merrill Lynch and UBS have released stock research reports regarding Nobel Biocare`s NobelDirect implant design. Several recent studies suggest more than 3mm of bone loss in 14-55% of patients. An expert panel advising the Swedish Medical Products Agency on the safety of the NobelDirect implant has responded to a recent Nobel Biocare rebuttal letter in a critical manner. The Merrill Lynch analyst suggests a NobelDirect withdrawal may be ahead.
Thommen Medical has redesigned their VECTOdrill™ twist drills in a high-strength, alumina-toughened zirconia (ATZ). The drills` ATZ ceramic ensures efficient and consistent cutting performance throughout the life of the twist drill. The pilot drill design features a high efficiency cutting tip which initiates the pilot hole without the need for a round bur and has the ability to cut laterally to correct osteotomy location. These are similar in design to the MIS ceramic drills reported on previously.
Straumann has received a US patent for a bioactive coating for their implants. Their modified sandblasted and acid-etched (SLA) surface is coated with an
Arg–Gly–Asp (RGD)-peptide-modified polymer (PLL-g-PEG/PEG–RGD). According to a study by Danny Buser, RGD-coated implants demonstrated significantly higher percentages of bone-to-implant contact as compared with controls at 2 weeks. The hypothesized mechanism is that the attachment of RGD peptides directed towards integrin receptors on the PEGylated surface promotes adhesion of cells of mesenchymal origin e.g. osteoblasts to the implant surface.
Dentaurum Inc has designed a kit for the placement of their `TOMAS` orthodontic anchors. The anchor head features
a bracket design which works as a temporary anchor (approx. 6 – 12 months) allowing for various orthodontic tooth alignments.
Meisinger`s Benex Control system is part of their `Bone Management` instrument collection. It uses a teflon coated tooth-borne ratchet system to extract the tooth root. This is a variation on the `easy-x-trac` system profiled earlier this year.
Karl Schumacher`s Proximator extraction kit consists of 7 periotome-like elevators designed to fit different aspects of the tooth. They are designed to eliminate the fibrous attachment where a periotome does not have sufficient strength.
Nobel Biocare makes mention of their new all-ceramic implant design that uses a zirconium based surface in their annual report (page 35). Clinical trials are in progress. It seems interest in Zirconium Oxide based implants is on the rise by the big companies. Definitely a trend to keep an eye on.