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Sven-Olaf Börner: Environmental dentistry – what is the role of ceramic implants?

  “Environmental dentistry is a new interdisciplinary field encompassing dentists, other medical specialists and dental technicians. The focus of environmental dentistry is on the holistic dental treatment of chronically ill patients, as well as the application of individual preventive treatment concepts with the aim of preventing or relieving chronic inflammatory diseases, including those not related to the oral cavity.” (Definition according to the German Society of Environmental Dentistry, www.deguz.de) Dr. Börner, how did you become involved in environmental dentistry? I came to holistic environmental dentistry through caring for risk patients. I am a classically trained oral surgeon, and my work in our practice focuses on oral surgery and environmental dentistry. Through daily treatment of risk patients, i.e. patients with chronic inflammatory diseases, multisystem disorders, allergies, diabetes, autoimmune diseases, cancer and cardiovascular diseases, as well as of periodontitis patients, I developed an awareness of general medical issues and immunological associations. And this, ultimately, is exactly what environmental dentistry is about: recognizing the interplay between the mouth and the organs, and correctly interpreting the pathological influences of the oral cavity on the immune system. The aim is to find out what most commonly triggers immunosuppressed patients, and this can only work if we study them in detail. An accurate medical history and extensive information are extremely important in this regard. How do patients find about your practice? Normally on referral by their GP or dentist. Also, of course, through recommendations by patients – classic word-of-mouth advertising. As a result, we also have many patients who come to us from other regions. Do patients these days come to you already informed about implants? Yes, but not necessarily in terms of the implant materials available. There are patients who would like a prosthetic but refuse to have any metal in their mouth. This is becoming increasingly common. What is an “environmental dentistry patient”? Basically, every patient is an environmental dentistry patient! The next step, however, is to make a distinction and ask: to what extent is the patient predisposed to develop an immunologically relevant reaction? This ability to distinguish – this is key in how we treat our patients. Can you explain more about this ability to differentiate? We have lots of patients suffering from inflammatory diseases and in need of intensive periodontal and prophylactic care. In addition to this – and this is an extremely important part and ultimately also a reason for our ongoing development in practice – I also receive highly concrete patient referrals from general practitioners. These patients are suffering from cancer, multisystem disorders, chronic infectious diseases or severe allergies. “The patient is first examined on the basis of conventional medicine. The next step, however, is to look for any hidden immunological triggers that may not seem obvious at first glance, for example.” These are, therfore, patients with autoimmune diseases or immunosuppression who come to me from the beginning with the question of whether incompatible materials or confounding factors in the oral cavity could be the trigger for their chronic inflammatory diseases, or any treatment failures. In such patients with a long history of illness, I carry out a very different diagnostic procedure than in a healthy patient who comes to me for the purpose of prevention and check-up. In some ways, for me environmental dentistry is a further development of oral surgery. The patient is first examined on the basis of conventional medicine for inflammation in the mouth and jaw area in an oral surgical approach. The next step, however, is to look for any hidden immunological triggers that may not seem obvious at first glance, for example. The materials used in the oral cavity are studied, any existing endodontic therapy is critically assessed and the results are viewed in the context of the patient’s specific medical history. What could possibly be associated with this or that clinical picture? If an association is identified, a blood test is carried out. In addition, it is also determined whether the patient has craniomandibular dysfunction, which affects the jaw and the skeletal apparatus. Dr. Sven-Olaf Börner treating a patient in his practice in Grünwald, Germany. How does such a blood test work? Blood is taken from the patient and analyzed on the basis of the question in hand, and conclusions are drawn as to whether a systemic disease or a disorder is associated with an allergy to or intolerance of a material. Allergy to titanium is extremely rare*, but allergies are not the only cause of immunology-related intolerances. Immunological reactions, i.e. release of the body’s own pro-inflammatory antibodies known as cytokines, are becoming increasingly common. MORE? All about the STRAUMANN® PURE CERAMIC IMPLANT on STARGET at a glance. Click here What is measured in these tests? The release of cytokines can be ­qualitatively­ and quantitatively measured. This is not the only criterion, however – ultimately the key lies in genetic interleukin polymorphism, which we also identify in parodontology and in connection with peri-implantitis, and in the release of the proinflammatory cytokines IL1-ß and TNF-a in order to establish a link with these through stimulation by titanium dioxide. The intensity with which the immune system reacts to titanium dioxide, for example, is individual and a temporary value. “It can be taken for granted that ceramic implants are biocompatible. In future, higher flexibility in prosthetics and long-term data would be desirable.” In addition to this, every one of us has a specific degree of personal, genetically determined inflammatory reaction. This inflammation level 0 – 4 is thus also jointly responsible for determining the future development of the material’s tolerability and hence for its immunological relevance. If a patient is classified as level 3 or 4, then they are considered to be a “high responder”. This means that in these patients the genotype constellation is accompanied by an increased production of proinflammatory cytokines with a simultaneous reduction in anti-inflammatory receptor antagonists. This group therefore reacts very strongly to a source of inflammation and is at increased risk of implant loss. A completely different approach must therefore be taken to high responders with level 3 or 4 than to level 0 or 1 responders. Are these tests covered by health insurers? The titanium stimulation test aimed at determining cytokine release and the determination of the genetic inflammation level in association with the implant are not subsidized by statutory health insurers. An allowance may be provided for a lymphocyte transformation (allergy) test on materials in the event of a patient with multiple allergies and the corresponding justification. Queries and reimbursement difficulties also tend to be common with private health insurers. For me, therefore, ceramic implants are increasingly becoming a standard instrument. And they save the patient the cost of the test, which is around 180 – 200 euros. Treatment room of Dr. Sven-Olaf Börner’s practice. How long have you been working with ceramic implants? I have been gaining experience with one-piece ceramic implants in my practice for seven years now. It has long been known for longer, however, that ceramic implants are clinically effective. I completed my training in oral surgery in Baden-Württemberg, and at the beginning of the 1990s I gained retrospective experience with Tübingen immediate implants made of aluminum oxide ceramic. Surprisingly, these were often excellently osseointegrated, but unfortunately showed insufficient fracture strength. What do you believe are the most important features of ceramic implants today? Strength, naturally, combined with excellent osseointegrative properties. It can be taken for granted that ceramic implants are biocompatible. In future, higher flexibility in prosthetics and secure long-term data would be desirable. “Then I show the patients the bright, metal-free, one-piece ceramic implant. This inspires positive emotions, creates trust and makes it easier to provide the patient with further information.” What are the benefits of ceramic implants in your opinion? In the event of thin gingiva, a ceramic implant helps to avoid a grey shimmer. This pleases both the patient and the practitioner (laughs). The result is a more attractive, cleaner look. Also, I have observed that patients who perhaps do not maintain optimal oral hygiene clearly experience more extensive plaque accumulation with titanium implants than with ceramic ones. In addition to this, irritation around the implants or secondary parts also appears to be considerably less common with ceramic implants. What type of implant does a typical patient in your practice request? The patients sitting opposite me are saying more and more often: “I do not want an implant, because I do not want any metal in my body”. Then I show the patients the bright, metal-free, one-piece ceramic implant. This inspires positive emotions, creates trust and makes it easier to provide the patient with further information.” Just one more question: What has been your experience with the Straumann® PURE Ceramic Implant (monotype)? I am completely satisfied with the clinical results. Dr. Börner, many thanks for providing a fascinating insight into environmental dentistry and your day-to-day work. * Comment by Dr. Volker von Baehr from the Laboratory for Special Immunology at the Institute of Medical Diagnostics in Berlin-Potsdam, Germany: “Real titanium allergies are rare, however. Unlike other metals, titanium (oxide) cannot function as an ion and modify endogenous proteins. Metal allergies such as those we are familiar with in the context of nickel and cobalt are therefore not possible. The problem occurs when patients have an increased susceptibility to an inflammatory reaction caused by titanium particles. This is caused by polymorphism in the genes of our proinflammatory key cytokines, which affects approximately 15 % of the population in Central Europe. This does not mean that all of these 15 % will experience an increase inflammatory reaction to titanium, but it is a risk factor similar to diabetes and smoking. Naturally, these 15% are also more or less found via genetic tests. Added to this are the approximately 3 – 4 % with abnormal results in the functional test (titanium stimulation test) who do not have a (known) genetic predisposition. This is most likely due to less common genetic constellations in inflammation modulation, which are not found in the standard test. It can therefore be concluded that in immunological terms, this risk constellation is present in almost 20 %.” Sven-Olaf Börner boerner_p Sven-Olaf Börner Dr. med. dent. Oral surgeon. Studied at the Freie Universität Berlin, Germany. Training at an oral and maxillofacial practice. Doctorate at RWTH Aachen University, Germany. In 1998, establishment of own practice near Munich, Germany. Since 2005, network-oriented, holistic care concept. Since 2014, OCplus practice. National and international speaker. www.ocplus.de   CLINICAL REVIEW The clinical facts behind the Straumann® PURE Ceramic Implant. Click here BROCHURE Download the brochure for the Straumann® PURE Ceramic Implant. Click here SUBSCRIBE Subscribe to our monthly STARGET newsletter to receive the latest news about implant dentistry. Click here The post Sven-Olaf Börner: Environmental dentistry – what is the role of ceramic implants? appeared first on STARGET COM.

Straumann® Novaloc® Retentive System for hybrid dentures: a reliable connection that endures

  There are moments in life when you want a connection to be extremely reliable. So far hybrid denture attachment systems may have been facing their limits in challenging implant situations. Now, there’s Novaloc®… The Straumann® Novaloc® Retentive System for hybrid dentures offers an innovative carbon-based abutment coating (ADLC, amorphous diamond-like carbon) with excellent wear resistance, overcoming up to 60° implant divergence. Both a straight and a 15° angled abutment, available in various gingiva heights, cover a broad range of clinical implant situations. Together with its durable PEEK (Polyether ether ketone) matrices,  the Novaloc® Retentive System provides a reliable connection that endures. This results in low maintenance and high patient comfort. Let your patients profit from the endurance of a reliable treatment solution. Diamonds are forever… As the name implies, “amorphous diamond-like carbon” (ADLC) is a class of carbon bonds which displays several of the desirable qualities of a diamond. ADLC coatings are commonly used in the medical device field (e.g. hip joints) and reduce abrasive wear prolonging the lifetime of the medical appliance. Brochure Browse and dowload our brochure for more information on this product. Interview Read the interview with Albin Gygli, Global Product Manager at Straumann, who was part of the development project. Teaser trailer Come close as the “drama” unfolds in our teaser trailer! Novaloc® is a registered trademark of Valoc AG, Switzerland. For availability information in your country contact your official Straumann representative. The post Straumann® Novaloc® Retentive System for hybrid dentures: a reliable connection that endures appeared first on STARGET COM.

Straumann® Original Quality Label: Show that your lab does not compromise on quality and precision

  In partnership with Straumann, your lab can benefit from innovative products and tailored services that will make your daily work easier and more efficient, while further strengthening your position within the treatment team. Learn more on how you can make your lab stand out with our new Straumann® ­Original Quality label. Dental technicians resemble artists in many respects It’s their love of detail, high-standard craftsmanship and in-depth know-how that form the basis for outstanding restorations, giving many people back a quality of life long forgotten. But are these high standards of dental labs noticed by their target groups? Are dentists actually aware of the small nuances that can lead to either success or failure of an implant-borne restoration? The workmanship of labs is one of the pillars that ensure treatment success. Straumann wants to support labs in showing off their expertise to customers. As a leading supplier in the field of implant dentistry, Straumann itself has a reputation for its passion for precision. With the use of premium quality products from Straumann, labs can underline their value proposition. With a new marketing package, Straumann wants to support labs using original Straumann components in raising awareness of the high-quality services that are offered by them. Our mission is clear Because your business is constantly evolving, Straumann is evolving with you. Our clear mission is to offer you continuous and strong support for making your dental lab business a success. Because, for every Straumann implant restored by your lab, you can rely on quality, outstanding precision and the protection of your margins. We share the same passion for quality and precision – so let’s reach our goals together!   Your lab: with your craftsmanship – Straumann: with our reliable technologies, services and products that ensure precise and high-quality ­restorations that meet the demands of today’s dentists and patients. STRAUMANN® ORIGINAL QUALITY LABEL: STAND OUT FROM THE CROWD! For every Straumann implant restored by your lab, you can rely on quality, outstanding precision and the protection of your margins. From the very first purchase of an original Straumann abutment, labs not only benefit from Straumann’s proven quality, but are also supported in promoting their expertise to current and potential customers. The Straumann® Original Quality label plays a substantial role in this promotion flow. EVEN MORE BENEFITS FOR “STRAUMANN® ORIGINAL AMBASSADORS”! Labs that are fully convinced by the exclusive use of original Straumann components can become “Straumann® Original Ambassadors” and use this unique selling proposition for their promotion. Customized certificate: show that your lab does not compromise on quality and that it does not work with look-alike products but only uses original high-quality components. Quality label: use the Straumann® Original Quality label on your documents and in your communication channels (e.g. invoices, stationery, website, social media etc.) Sample letter: a template letter to inform your customers or prospects about the high quality your lab is delivering Lab finder: “Straumann® Original Ambassadors” are listed in our lab finder. This is an online platform where dentists can search for labs that meet the strict criteria for inclusion. This way, searching dentists are immediately drawn to the exclusive selection of Straumann® Original Ambassadors. Workflow: How to use the Straumann® Original Quality Label CLICK TO ENLARGE Interested? If you like to learn more about this special initiative for your lab or if you would like to become an ambassador of original Straumann products, get in touch with your local Straumann sales rep for more information. Availability: Please note that the products, solutions, services or initiatives described in this article may not (yet) be available everywhere. Please contact the official Straumann representative in your country for specific information. The post Straumann® Original Quality Label: Show that your lab does not compromise on quality and precision appeared first on STARGET COM.

Straumann® Pro Arch step by step (video)

  Respecting individual patients’ needs and expectations, the Straumann® Pro Arch solution offers dental professionals the opportunity to provide fixed full-arch treatments with an immediate temporary restoration. This animated video shows the procedure step by step. The benefits: 1. Reduced complexity by addressing the individual anatomical situation and leveraging the unique Roxolid® material 2. Predictability even in challenging cases thanks to the SLActive® surface 3. Time-saving treatment with the option for immediate temporization 4. Increased efficiency with adapted prosthetic portfolio. Brochure Download the Straumann® Pro Arch brochure. Scientific review The scientific facts about the Straumann® Pro Arch solution. More All about the Straumann® Pro Arch solution at a glance. The post Straumann® Pro Arch step by step (video) appeared first on STARGET COM.

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