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Clinical review: Straumann® CARES® Zirconium Dioxide Abutment

  Zirconia (zirconium dioxide, ZrO2) is a popular material in restorative dentistry for implant abutments due to its superior mechanical properties compared to other ceramics (Manicone et al., 2007). The whitish color allows for highly esthetic dental restorations especially in the anterior maxilla and for patients with thin mucosal biotype. An increasing number of third-party manufacturers now offer all-zirconia abutments. However, all-zirconia abutments are not all alike – quality and manufacturing expertise make a difference (Figs. 1, 2). DID YOU KNOW? • 1789 – Zirconia is discovered by German chemist Martin Heinrich Klaproth • 1969 – Zirconia is proposed as a new material for hip head replacement • 1990s – Introduction of Zirconia as an implant abutment material Fig. 1: Obvious difference: micrograph comparing precision of fit of a Straumann® CARES® all-zirconia abutment and a non-Straumann third-party all-zirconia abutment. Section cuts from randomly chosen samples. Straumann® inernal report MAT-13-526. PRECISE FUNCTIONALITY When it comes to implant therapy, most patients look for functionality, i.e. stable clinical outcomes of the implants and high esthetics of the prosthetic suprastructures. For Straumann, however, functionality is a by-product of precision. The precise fit of the interface between the implant and the all-zirconia abutment has a positive influence on implant-abutment stability (Saidin et al., 2012), stress load transfer (Nascimento and Albuquerque, 2011), as well as the biological response of the peri-implant tissue (Quirynen and van Steenberghe, 1993). Micro-gaps as small as 10 μm and resulting micromovements at the implant–abutment interface are gateways for bacterial colonization and plaque formation (Broggini et al., 2003), which can even lead to implant failure (Dhir, 2013). Therefore, every manufacturer defines exact dimensions and tolerances for the manufacture of abutments and implant-abutment connections. The precise fit of original Straumann implants and abutments has been clearly shown to be technically superior to results achieved by third-party abutments (Gigandet M. et al., 2012; Keilig L et al., 2013; Kim et al., 2012). In addition, Straumann has optimized the implant-abutment connection geometry to take into account the special material properties of zirconia: zirconia is more than five times harder than titanium (Vagkopoulou et al., 2009) but, like other ceramics, is sensitive to tensile stress. This difference in hardness, together with small, sharp-edged flaws or cracks at the implant-abutment interface can lead to wear and damage of the titanium implant (Klotz et al.,2011; Stimmelmayr et al., 2012). Therefore, sharp angles have been removed from the Straumann® CARES® all-zirconia abutment screw connection for a higher screw preload. The rotation protection of the CrossFit® connection and the precise matching dimensions of the screw body and the abutment provides the best prerequisites to prevent the screw from loosening, and thus, providing patients with the desired long-term functionality. Fig. 2: Straumann® CARES® zirconia abutments demonstrated 32.3 % higher strength (statistically significant) compared to a non-Straumann third-party all-zirconia abutment (adapted from Joda et al., 2015). DID YOU KNOW? The mouth is a dynamic and complex ecosystem with: • a virtually constant temperature of 36.6 °C • a buccal flora with more than 500 bacterial species able to constitute thick biofilms on teeth, crowns, fixed partial dentures or endosseous implants • biofilms are the main source of gingivitis, periodontitis, peri-implantitis, and may also contribute to implant failure LOW BACTERIAL COLONIZATION All-zirconia shows lower bacterial colonization on its surface compared to titanium (Rimondini et al., 2002; Scarano et al., 2004). Degidi et al. compared all-zirconia and titanium in permucosal applications. The biopsy of soft tissue from the study participants showed fewer inflammation processes around all-zirconia versus titanium healing abutments after six months (Degidi et al., 2006). Nitric oxide (NO) is an indicator of inflammatory processes, and bacterial infection generally results in the production of large quantities of NO. Lower activity of NO synthesis was observed in tissues around all-zirconia healing abutments (Degidi et al., 2006). This is an important observation, since bacterial infections can even lead to peri-implant infections and subsequently implant loss (Lindquist et al., 1996). In addition, a pre-clinical study showed that the proportion of pro-inflammatory leucocytes in the epithelium is lower around all-zirconia than titanium abutments (Welander et al., 2008), suggesting superiority of the gingival seal of zirconia. SUPERIOR ESTHETICS The use of Straumann® CARES® all-zirconia abutments is highly recommended in the esthetic zone and for patients with thin gingiva biotype due to their light color, favorable peri-implant soft tissue integration and resulting well-documented esthetic benefit (Cosgarea et al., 2015; de Medeiros et al., 2013; Jung et al., 2008). In addition, blood flow – an indicator of the health of the soft tissue around implants – is similar between all-zirconia abutments and natural teeth, and more favorable compared with titanium abutments (Kajiwara et al., 2015). PROVEN LONG-TERM PERFORMANCE All-zirconia abutments offer sufficient stability and clinical long-term success in dental applications, which has been confirmed in several clinical trials. A recent review reported that all-zirconia abutments are reliable in the anterior region from both biological and mechanical points of view (Nakamura et al., 2010). Another study showed that all-zirconia abutments (anterior and premolar single crowns) survived in 100 % of the cases after four years of functional loading (Glauser et al., 2004) and performed well even after evaluation up to twelve years in anterior areas (Passos et al., 2014). Two systematic reviews compared zirconia abutments (all-zirconia abutments and zirconia abutments with a metallic insert at the implant-abutment interface) with metal abutments and found no differences regarding survival rates as well as technical and biological outcomes after five years of clinical use (Sailer et al., 2009; Zembic et al., 2014). Currently, there are both HIP (hot isostatic pressing) zirconia and pre-sintered zirconia on the market. HIP zirconia has a more homogeneous quality paired with a higher compressive strength. Therefore, some manufacturers opt to do the trimming and shaping at the pre-sintered state (known as the “green state”), where the material still has a lower strength. But the following sintering process induces a ~20% sintering shrinkage, which can reduce the precision of fit of the abutment design when pre-milled. In addition, if flaws are already present at the green stage, they are incorporated into the sintered product. Straumann uses HIP zirconia which is CAD-milled at its final high strength. This process requires more time and expensive equipment, but the zirconia can be milled immediately to the final desired dimensions because no further sintering is required. Compared to pre-sintered zirconia, HIP zirconia has a more homogeneous quality, translating clinically into improved resistance to hydrothermal aging and long-term performance. DID YOU KNOW? • Straumann® CARES abutments are made from 100 % metal-free yttria-stabilized tetragonal zirconia (Y-TZP) • Yttrium oxide retains the zirconia crystals in a stable shape at room temperature • Y-TZP abutments on the market differ between manufacturers. The chemical composition is similar, but there are differences in physical and mechanical properties that affect their clinical performance Fig. 1 Clinical close-up view of a 27-year-old female patient who had lost her two maxillary central incisors in an accident. Two Straumann® Bone Level 4.1 RC implants were placed and subsequently restored with directly screw-retained provisional crowns for peri-implant soft tissue conditioning. Note the resulting harmoniously scalloped course of the mucosa. Fig. 2 Two CAD-CAM generated CARES® zirconia abutments were produced and veneered with pressable ceramics. Particular emphasis was placed on a flat cervical emergence profile. Fig. 3 During crown insertion, the distinctly distal eccentricity of the triangular neck configuration is apparent, ensuring a natural line of mucosal emergence with the zenith located distally to the longitudinal tooth axis. Fig. 4 Frontal view taken at the five-year follow-up confirming that the soft tissue continues to be stable and healthy. Fig. 5 The corresponding radiograph reveals favorable bone conditions, especially between the implants. Fig. 6 Patient is satisfied with esthetic and function. Case Courtesy of Dr. U. Belser and Dr. D. Buser. References Broggini N, McManus LM, Hermann JS, Medina RU, Oates TW, Schenk RK et al. (2003). Persistent acute inflammation at the implant-abutment interface. J Dent Res 82(3):232-237. — Cosgarea R, Gasparik C, Dudea D, Culic B, Dannewitz B, Sculean A (2015). Peri-implant soft tissue colour around titanium and zirconia abutments: a prospective randomized controlled clinical study. Clin Oral Implants Res 26(5):537-544. — de Medeiros RA, Vechiato-Filho AJ, Pellizzer EP, Mazaro JV, dos Santos DM, Goiato MC (2013). Analysis of the peri-implant soft tissues in contact with zirconia abutments: an evidence-based literature review. J Contemp Dent Pract 14(3):567-572. — Degidi M, Artese L, Scarano A, Perrotti V, Gehrke P, Piattelli A (2006). Inflammatory infiltrate, microvessel density, nitric oxide synthase expression, vascular endothelial growth factor expression, and proliferative activity in peri-implant soft tissues around titanium and zirconium oxide healing caps. J Periodontol 77(1):73-80. — Dhir S (2013). Biofilm and dental implant: The microbial link. — Gigandet M, Gianni B, Francisco F, Bürgin W, Brägger U (2012). Implants with Original and Non-Original Abutment Connections. Clinical Implant Dentistry and Related Research:n/a. — Glauser R, Sailer I, Wohlwend A, Studer S, Schibli M, Scharer P (2004). Experimental zirconia abutments for implant-supported single-tooth restorations in esthetically demanding regions: 4-year results of a prospective clinical study. Int J Prosthodont 17(3):285-290. — Joda T, Burki A, Bethge A, Bragger U, Zysset P (2015). Stiffness, strength and failure modes of implant-supported monolithic lithium-disilicate (LS2) crowns: influence of titanium and zirconia abutments. The International Journal of Oral & Maxillofacial Implants submitted. — Jung RE, Holderegger C, Sailer I, Khraisat A, Suter A, Hammerle CH (2008). The effect of all-ceramic and porcelain-fused-to-metal restorations on marginal peri-implant soft tissue color: a randomized controlled clinical trial. Int J Periodontics Restorative Dent 28(4):357-365. — Kajiwara N, Masaki C, Mukaibo T, Kondo Y, Nakamoto T, Hosokawa R (2015). Soft tissue biological response to zirconia and metal implant abutments compared with natural tooth: microcirculation monitoring as a novel bioindicator. Implant Dent 24(1):37-41. — Keilig L, Berg J, Söhnchen P, Kocherovskaya BC (2013). Micro-mobility of the implant/abutment interface for original and third-party abutments – a combined experimental and numerical study (abstract). Poster EAO Ref. no. 346. — Kim SK, Koak JY, Heo SJ, Taylor TD, Ryoo S, Lee SY (2012). Screw loosening with interchangeable abutments in internally connected implants after cyclic loading. Int J Oral Maxillofac Implants 27(1):42-47. — Klotz MW, Taylor TD, Goldberg AJ (2011). Wear at the titanium-zirconia implant-abutment interface: a pilot study. Int J Oral Maxillofac Implants 26(5):970-975. — Lindquist LW, Carlsson GE, Jemt T (1996). A prospective 15-year follow-up study of mandibular fixed prostheses supported by osseointegrated implants. Clinical results and marginal bone loss. Clin Oral Implants Res 7(4):329-336. — Manicone PF, Rossi IP, Raffaelli L (2007). An overview of zirconia ceramics: basic properties and clinical applications. J Dent 35(11):819-826. — Nakamura K, Kanno T, Milleding P, Ortengren U (2010). Zirconia as a dental implant abutment material: a systematic review. Int J Prosthodont 23(4):299-309. — Nascimento CC, Albuquerque RF (2011). Bacterial Leakage Along the Implant-Abutment Interface. — Passos SP, Torrealba Y, Major P, Linke B, Flores-Mir C, Nychka JA (2014). In Vitro Wear Behavior of Zirconia Opposing Enamel: A Systematic Review. J Prosthodont. — Quirynen M, van Steenberghe D (1993). Bacterial colonization of the internal part of two-stage implants. An in vivo study. Clin Oral Implants Res 4(3):158-161. — Rimondini L, Cerroni L, Carrassi A, Torricelli P (2002). Bacterial colonization of zirconia ceramic surfaces: an in vitro and in vivo study. Int J Oral Maxillofac Implants 17(6):793-798. — Saidin S, Abdul Kadir MR, Sulaiman E, Abu Kasim NH (2012). Effects of different implant-abutment connections on micromotion and stress distribution: prediction of microgap formation. J Dent 40(6):467-474. — Sailer I, Philipp A, Zembic A, Pjetursson BE, Hammerle CH, Zwahlen M (2009). A systematic review of the performance of ceramic and metal implant abutments supporting fixed implant reconstructions. Clin Oral Implants Res 20 Suppl 4:4-31. — Scarano A, Piattelli M, Caputi S, Favero GA, Piattelli A (2004). Bacterial adhesion on commercially pure titanium and zirconium oxide disks: an in vivo human study. J Periodontol 75(2):292-296. — Stimmelmayr M, Edelhoff D, Guth JF, Erdelt K, Happe A, Beuer F (2012). Wear at the titanium-titanium and the titanium-zirconia implant-abutment interface: a comparative in vitro study. Dent Mater 28(12):1215-1220. — Vagkopoulou T, Koutayas SO, Koidis P, Strub JR (2009). Zirconia in dentistry: Part 1. Discovering the nature of an upcoming bioceramic. Eur J Esthet Dent 4(2):130-151. — Welander M, Abrahamsson I, Berglundh T (2008). The mucosal barrier at implant abutments of different materials. Clin Oral Implants Res 19(7):635-641. — Zembic A, Kim S, Zwahlen M, Kelly JR (2014). Systematic review of the survival rate and incidence of biologic, technical, and esthetic complications of single implant abutments supporting fixed prostheses. Int J Oral Maxillofac Implants 29 Suppl:99-116. The post Clinical review: Straumann® CARES® Zirconium Dioxide Abutment appeared first on STARGET COM.

Straumann® CARES® Digital Solutions: Orchestrating dental efficiency

  We are continuously evolving our product portfolio to match the needs of your daily practice in a fast changing market environment. “CARES” stands for “Computer Aided REstoration Solutions” and delivers a complete digital dentistry workflow solution tailored to your needs – reliable, precise, and digitally validated, from scan to manufacture. Let’s work together and increase your competitiveness! OUR OFFERING FOR DENTAL LABS FOR DENTISTS The Straumann® CARES® offering for dental labs connects carefully selected, best-in-class dental equipment (scanners, CARES® Visual software, milling machines, high-temperature furnaces) with the latest digital technology and premium materials to provide a seamless, fully validated workflow for the state-of-the-art dental lab. You can be sure that our solution will 1. enable you to offer a broader range of prosthetic solutions and services, 2. increase your lab’s productivity and efficiency and 3. let you enjoy the benefits of future-proof hardware and software! Replace traditional dental impressions with highly accurate digital data! Based on our novel 3D capture technique called Multi-scan Imaging™, the extremely compact Straumann® CARES® Intraoral Scanner allows dentists and clinicians to quickly and easily create digital impressions. The remarkably small handpiece, one of the smallest on the market today, is particularly patient-friendly. Based on the open STL data format, digital impressions can be sent directly to your lab partner via Straumann® CARES® Connect. THE BROCHURES OUR “DIGITAL PERFORMANCE” ROADSHOW 2016/17 STAY TUNED! The post Straumann® CARES® Digital Solutions: Orchestrating dental efficiency appeared first on STARGET COM.

Young ITI Germany, version 2.0: Casting off towards new shores

  Best practice in the promotion of the young generation: the Young ITI Meeting – an event series of the ITI Section Germany – offers its participants young, but experienced lecturers as well as contemporary topics, addressing the expectations and requirements of the young generation. The collegial atmosphere is suitable for an easy exchange between lecturers and participants. The event  takes place every year in changing locations and is open to the public, with special conditions for ITI members. Fresh energy and new speakers Reinventing oneself is definitely no easy task but, from time to time, a necessity. First off: the organizers of the 9th Young ITI Germany meeting managed this feat, resulting in fresh energy and new speakers for this unique event presented by the German Section of the ITI that can be summed up as overall very satisfactory: Many new faces, a new look – it was clear that things had changed. What had not changed, however are the classic Young ITI qualities: communication during and after the presentations, cooperation between colleagues, often heated discussions, the possibility to network and benefit from an exchange of opinions. More than 180 participants made intensive use of this option and experienced an outstanding continuing education event.There is no doubt, the Hamburg meeting represented a milestone for Young ITI – the relaunch of Young ITI version 2.0. The speakers: Dr. Dr. Dr. Thomas Ziebart, (Marburg), Dr. Jochen Tunkel (Bad Oeynhausen), Dr. Anja Zembic (Zurich), PD Dr. Dr. Marcus O. Klein (Dusseldorf), Dr. Ulf Meisel (Nuremberg) “OUR YOUNG ITI FLAGSHIP IS IN FULL SAIL!” (J. KLEINHEINZ) REVIEW OF THE SCIENTIFIC PROGRAM Seamless interdisciplinary cooperation between prosthodontists and surgeons Could any German city other than Hamburg have been better suited as the location for the relaunch? According to the Chair of the German Section, Professor Dr. Dr. Johannes Kleinheinz, this Hanseatic city has always been known for its cosmopolitan and innovative approach. He continued that the aim was not to jettison the successful formula of the Young ITI meetings, but rather to adapt the congress to the expectations and needs of the younger generation of colleagues. The responsibility for carrying out this task belonged to Dr. Ulf Meisel’s planning team, which achieved magnificent results. The organizers of the Hamburg Young ITI meeting focused on seamless interdisciplinary cooperation between prosthodontists and surgeons as the basis for optimally safe, predictable and successful outcomes. The prosthodontic workflow for implants formed the focus of the congress, but active participation in discussion and hot debate – as particular features of the Young ITI – also had their place. Education program: outstanding with its variety and the excellence of its speakers After a Section Germany Study Club Directors meeting on the previous day, the continuing education day could be devoted fully to the Section’s membership, that is not only one of the strongest in terms of numbers, but is also a true asset to the unique global network of the International Team for Implantology – ITI. The recently launched “ITI Implantology curriculum” serves to support this claim and, along with the unique Young ITI format, yet another event will be joining these later this year that represents a first for the ITI: the German Section is launching its Online Symposium on October 23. Autologous transplants, their necessity and alternatives form the core of the discussions led by renowned lecturers. Substantial membership growth Hamburg, in the meantime, provided the stage for an exposition of this enterprising Section’s performance and various activities. This allowed its Chair, Professor Dr. Dr. Kleinheinz, to report on substantial membership growth within the Section as well as on its recent Fellow meeting in Eltville-Reinhartshausen. He focused on the German Section’s continuing education situation. And it was not without pride that Professor Kleinheinz outlined the relaunch of his Section’s continuing education program that, with its variety and the excellence of its speakers, need not shy comparison. QUOTE “There has been a distinct shift from classic print media to web-based online platforms.” Dr. Georg Bach, Communications Officer ITI Section Germany, Freiburg ITI Curriculum and ITI Study Clubs The demand for the curriculum launched in the previous year is now so great that two curricula are being run in parallel and an English version is being planned. A central pillar of the ITI are its Study Clubs that allow Fellows and Members to meet and exchange experiences within a relaxed atmosphere as well as to benefit from the incredible knowledge pool represented by its experts. In Germany, the Munich-based maxillofacial surgeon Professor Dr. Dr. Andreas Schlegel is responsible for the Study Clubs. While his initial years working in this area were marked by fast growth with the establishment of many new Study Clubs, the tempo has slowed considerably, in part, according to Schlegel, “as such a large number of Study Clubs must be nurtured and instilled with life.” A consequence of this rapid development is a massive increase in the number of people within the Section who are able to run these many events and meetings with the necessary professionalism. Schlegel draws a positive conclusion “The German Study Clubs are doing well!” From classic print media to web-based online platforms In his function as Communications Officer, Dr. Georg Bach, reported on the Section’s presence in the media as well as providing an overview of what is coming soon. It should be noted that there has been a distinct shift from classic print media to web-based online platforms. Young ITI Meeting “Our Young ITI flagship is in full sail!” The maxillofacial surgeon and Section Chair Professor Dr. Dr. Johannes Kleinheinz welcomed the more than 180 participants of the 9th Young ITI meeting and together with Dr. Sascha Pieger then presented the ITI Online Academy. The ITI’s web-based educational platform was launched during the last ITI World Symposium in Geneva and has developed both swiftly and positively. In the Asia region in particular, the Online Academy has been accepted as the standard reference work for research and study for everything connected with implant dentistry. The many various possibilities as well as the broad-ranging offering met with the participants’ unqualified approval – for once, in Kleinheinz’ words, it was “the right offering for the right target group”. Implants in medically compromised patients The first presentation was made by Dr. Dr. Dr. Thomas Ziebart – a maxillofacial surgeon from Marburg – who talked about implants in medically compromised patients. Ziebart called for boundary value analysis of patients leading to risk avoidance and reduction. “Recognition of boundaries, that is what we need!” he reiterated. Along with patients taking oral anticoagulants, Ziebart also talked about patients with stents. The first take-home message was: “Bridging with heparin is no longer the state of the art.” In regard to diabetes, Ziebart anticipated double the current number of cases in the next decade. With diabetes, whose side effects include reduced bone formation along with increased bone loss, it is important that the disease be well controlled before implants can be installed. Autoimmune diseases Ziebart further commented on patients suffering from autoimmune diseases whose therapy calls for stringent diagnosis as well as peri-operative treatment with antibiotics. HIV patients benefit from a much better long-term prognosis when treated using antiretroviral therapies, however, higher rates of osteoporosis are typically observed. The success of oral implants is significantly lower with bone physiology disorders (resulting from bisphosphonates or radiation – particularly at 50 Gy or more). Thorough risk analysis must be carried out here and should an implant be under consideration, the insertion technique should be minimally invasive along with the possible use of implants with an activated surface. Implants used in limited oral vestibular space This highly relevant topic was selected by PD Dr. Dr. Marcus O. Klein (Dusseldorf). His show-stopping start: “I cannot take you directly to reduced-diameter implants. First we need to go through the basics!” said the PD, who has his own practice. There followed explanations regarding oral vestibular deficits and rules for insertion that must be strictly observed before Klein shifted to the actual subject of his presentation. He recommended reduced-diameter implants for medically compromised patients as this makes it possible to avoid invasive and stressful therapies, along with the less need for augmentation procedures when reduced-diameter implants are used. A possible side-benefit is increased protection against resorption in the form of a biological buffer. Klein clarified, however, that very high demands are placed on the implant system (ideally conical) and the alloys used. “These small diameter implants must be able to withstand greater stress than standard diameter implants. According to Klein, the use of alloys like Roxolid that show 20% higher fatigue strength can present a good alternative. Prosthetic treatment planning – materials and methods With his presentation Dr. Sascha Pieger (Hamburg) was playing on home territory. Having already proved his affinity for the digital world during his presentation on the Online Academy, he progressed seamlessly by showcasing the options available for digital diagnosis and therapy. Beginning with the intra-oral scan, to digital implant planning, the results of which lead to a drilling template, Pieger proved himself to be a clear fan of virtual CAD/CAM-supported implant dentistry. The broader range of possibilities offered by today’s scanners that have moved from the purely therapeutic tool (mold) through to a diagnostic therapeutic instrument permits the seamless and continuous use of digital processes from first contact with the patient through to insertion of the restoration. This results, according to Pieger, in the perfect implant. Successful soft-tissue management With striking case studies, Dr. Jochen Tunkel (Bad Oeynhausen) managed to explain how important successful soft-tissue management is to the success of augmentation, implant placement and uncovering. Tunkel is not only an oral surgeon but also a periodontologist. “With soft tissue, what you don’t do is far more important than what you do!” From this point of view, immediate insertion that avoids surgical incisions and flaps would be the ideal approach. However, according to Tunkel, flapless surgery is not the universal solution. “In addition, it always fails when there is too little bone to place an implant.” He then went on to define the basics of incisions for augmentation and placement of implants. The speaker’s explanations were supported by well documented case studies – among them one on tunnel technique according to Khoury. Individualized abutments, how they should be used and their necessity Following a mega trend of recent years, Dr. Ulf Meisel (Nuremberg) analyzed individualized abutments and defined how they should be used and their necessity. Meisel was also responsible for putting together the scientific program of the 9th Young ITI meeting. Meisel stated clearly “In choosing the right abutment, one is simply reproducing the decision that was taken when planning the positioning of the implant!” The areas influenced by an individualized abutment are the suprastructure, the emergence profile, the abutment-crown interface, the sub-gingival area and finally the intra-implant space. Based on his own analyses as well as the analysis of the relevant literature, Meisel called for the exclusive use of original abutments from the respective manufacturer. Cemented versus screwed reconstructions on implants At a time when cement-associated peri-implantitis is much discussed, this was the “hot” topic selected by Dr. Anja Zembic (Zurich) for her contribution to the scientific program. At the very beginning of her presentation, the Swiss lecturer stated “Regardless of the approach you use to retain the implant, it is primarily a question of implant positioning!” If the implant is positioned too far buccally, screw retention is not possible as the screw access holes would impinge on the esthetic area. Presenting the advantages and disadvantages of both procedures took up a sunstantial proportion of Zembic’ presentation. Special attention was paid to the dangers of cementitis – an infection caused by cement residues, which is attributed with a considerable influence on the generation of peri-implant lesions. However, after five years the survival rate values for cemented crowns were actually higher than for the screw option. For the implants themselves, the same success rates were attributed to both retention methods. However, cement-retained crowns come off significantly better than screw-retained crowns in terms of technical complications; they are also more advantageous in terms of cost. When looking at biologic complications for both crowns and bridges, however, the picture is reversed. The highest rates of risk are found with cement reconstructions “and your patients need to know this!” says Zembic. Opportunities and benefits of recall Oral surgeon Dr. Anne Bauersachs (Munich) talked about the opportunities and benefits of recall appointments and assigned great importance to this tool. Our colleague, who spent many years at the University of Erlangen, then worked in Professor Schlegel’s practice before establishing her own practice, made a very impressive connection between an increase in complications and failure by the patient to attend aftercare appointments. “Recall appointments are for more than just a check-up, recall appointments are there to maintain and even restore oral structures” said Bauersachs. The check-up/maintenance/restoration triad is extremely important in implant dentistry, on the one hand because of the many attendant risk factors that can influence the long-term success of implant treatment, and on the other because of the structural and anatomic factors that enable the development of peri-implant lesions. Bauersachs finished off her presentation with a series of practical tips for implementing a recall system in practices dealing with dental implants. Professor Dr. Dr. Johannes Kleinheinz QUOTE “The aim is to adapt the congress to the expectations and needs of the younger generation of colleagues” Professor Dr. Dr. Johannes Kleinheinz, Chairman of the German ITI Section A classic: the Young ITI debate! The debate on a “hot” topic between acknowledged experts – traditionally placed at the end of a Young ITI meeting – is a time-honored item on the event agenda. The attraction of these heated and rather unconventional discussions has been recognized by many other event organizers and it has been widely copied, now to be found at many dental congresses. In Hamburg, the structure for the debate was defined by discussion of cases with the participation of Dr. Anjy Zembic, Dr. Sascha Pieger, Dr. Jochen Tunkel and – representing the founding team of Young ITI presenters – Professor Dr. Dr. Andreas Schlegel. At the end of the day, the organizers of the Young ITI meeting were able to say with a strong degree of satisfaction: Young ITI Version 2.0 is not just up, it is also running! The post Young ITI Germany, version 2.0: Casting off towards new shores appeared first on STARGET COM.

Straumann Connections 3/16: “Lifetime Plus Guarantee” for Straumann® Roxolid® implants

  Roxolid® has brought a new level of confidence to implant dentistry that enables Straumann to offer an industry leading guarantee. In this issue of “Straumann Connections”, Frank Hemm, Executive Vice President and Head of Customer Solutions & Education at Straumann, explains why Straumann has taken this decision and what it means for surgeons and patients. Background Roxolid® – the dental implant material for superior strength and more indications Roxolid® from Straumann (introduced 2009) has been specifically designed for use in dental implantology. It is a unique implant material – a metal alloy composed of ~15 % zirconium and ~ 85 % titanium – combining excellent osseointegrative properties with high mechanical strength. Roxolid® leads to increased mechanical resistance [R1] and up to 21 % higher fatigue strength compared to titanium implants [R2]. This allows dental professionals to use reduced diameter implants to preserve bone and reduce the number of invasive grafting procedures [R3]. In combination with Straumann’s unique SLActive® surface, Roxolid® implants offer increased predictability even in challenging protocols [R4-10], broader treatment possibilities even for patients with compromised health [R11-17] as well as safer and reduced treatment times (from 6 – 8 weeks down to 3 – 4 weeks) in all indications [R18]. SCIENTIFIC REFERENCES R1 Kobayashi E, Matsumoto S, Doi H, Yoneyama T, Hamanaka H. Mechanical properties of the binary titanium-zirconium alloys and their potential for biomedical materials. J Biomed Mater Res. 1995 Aug;29(8):943-50. R2 Bernhard N, Berner S, de Wild M, Wieland M: The binary TiZr Alloy – a newly developed Ti alloy for use in dental implants, Forum Implantol., 2009, 5, 30 -39. R3 Data on file R4 Benic G.I., Gallucci G.O., Mokti M., Hämmerle C.H., Weber H.P., Jung R.E., Titanium-zirconium narrow-diameter versus titanium regular diameter implants for anterior and premolar single crowns: one-year results of a randomized controlled clinical study. Journal of Clinical Periodontology 2013; [Epub ahead of print] R5Schwarz F., et al., Bone regeneration in dehiscence-type defects at chemically modified (SLActive®) and conventional SLA® titanium implants: a pilot study in dogs. J Clin. Periodontol. 34.1 (2007): 78–86 12 Lai H.C., Zhuang L.F., Zhang Z.Y., Wieland M., Liu X., Bone apposition around two different sandblasted, large-grit and acid-etched implant surfaces at sites with coronal circumferential defects: An experimental study in dogs. Clin. Oral Impl. Res. 2009; 20(3): 247–53. R6 Buser D., Wittneben J., Bornstein M.M., Grütter L., Chappuis V., Belser U.C., Stability of contour augmentation and esthetic outcomes of implant-supported single crowns in the esthetic zone: 3-year result of a prospective study with early implant placement post extraction. J. Periodontol. 2011 March; 82(3): 342–9. 7 Buser D., Chappuis V., Kuchler U., Bornstein M.M., Wittneben J.G., Buser R., Cavusoglu Y., Belser U.C., Long-term stability of early implant placement with contour augmentation. J. Dent Res. 2013 Dec; 92 (12 Suppl.): 176S-82S. R8 Nicolau P., Reis R., Guerra F., Rocha S., Tondela J., Brägger U., Immediate and early loading of Straumann® SLActive implants: A Five-Year Follow-up. Presented at the 19th Annual Scientific Meeting of the European Association of Osseointegration – 9 October 2010, Glasgow 10 International Diabetes Federation.   R11 6 Bo Wen et al. The osseointegration behavior of titanium-zirconium implants in ovariectomized rabbits. Clin Oral Implants Res. 2013 Feb 21. R12 Schlegel K.A., Prechtl C., Möst T., Seidl C., Lutz R., von Wilmowsky C., Osseointegration of SLActive® implants in diabetic pigs Clin. Oral Implants Res. 2013 Feb; 24 (2): 128–34. 13 Reginster J.Y., Burlet N., Osteoporosis: a still increasing prevalence. Bone. 2006 Feb; 38 (2 Suppl. 1): S4-9. R14 Mardas N., Schwarz F., Petrie A., Hakimi A.R., Donos N., The effect of SLActive® surface in guided bone formation in osteoporotic-like conditions Clin. Oral Implants Res. 2011 Apr; 22 (4): 406 15. 15 WHO: R16 iData Report, Dental Implants and Final Abutments, Europe 2012 17iData Report, Dental Implants and Final Abutments, USA 2012 R18 Rupp F., Scheideler L., Olshanska N., de Wild M., Wieland M., Geis-Gerstorfer J., Enhancing surface free energy and hydrophilicity through chemical modification of microstructured titanium implant surfaces. Journal of Biomedical Materials Research A, 76(2): 323–334, 2006. R19 De Wild M., Superhydrophilic SLActive® implants. Straumann document 151.52, 2005 20 Katharina Maniura, Laboratory for Materials – Biology Interactions Empa, St. Gallen, Switzerland, Protein and blood adsorption on Ti and TiZr implants as a model for osseointegration, EAO 22nd Annual Scientific Meeting, October 17–19 2013, Dublin R21 Schwarz F., et al., Bone regeneration in dehiscence-type defects at non-submerged and submerged chemically modified (SLActive®) and conventional SLA® titanium implants: an immunohistochemical study in dogs. J. Clin. Periodontol. 35.1 (2008): 64–75.R22 Rausch-fan X., Qu Z., Wieland M., Matejka M., Schedle A., Differentiation and cytokine synthesis of human alveolar osteoblasts compared to osteoblast-like cells (MG63) in response to titanium surfaces, Dental Materials 2008 Jan.; 24(1): 102-10. Epub 2007 Apr. 27. R23 Schwarz F., Herten M., Sager M., Wieland M., Dard M., Becker J., Histological and immunohistochemical analysis of initial and early osseous integration at chemically modified and conventional SLA®titanium implants: Preliminary results of a pilot study in dogs. Clinical Oral Implants Research, 11(4): 481–488, 2007. 24Lang, N.P., et al., Early osseointegration to hydrophilic and hydrophobic implant surfaces in humans, Clin. Oral Implants. Res 22.4 (2011): 349–56. R25 Raghavendra S., Wood M.C., Taylor T.D.. Int. J. Oral Maxillofac. Implants. 2005 May–Jun; 20(3): 425–31. R26 Oates T.W., Valderrama P., Bischof M., Nedir R., Jones A., Simpson J., Toutenburg H., Cochran D.L., Enhanced implant stability with a chemically modified SLA® surface: a randomized pilot study. Int. J. Oral Maxillofac. Implants. 2007; 22(5): 755–760. The post Straumann Connections 3/16: “Lifetime Plus Guarantee” for Straumann® Roxolid® implants appeared first on STARGET COM.


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