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Michael Gahlert: Full ceramic implants – scientific evidence and clinical application (video lecture – 23:17 min)

  Ceramic implants, out of zirconium-dioxide, have come in the focus of the discussion in the recent years. Compared to the well-established titanium implants, ceramic implants can now be used as a valuable alternative in clinical practice. Ceramic dental implants can offer new clinical opportunities, such as the treatment of challenging esthetic cases or for patients with specific demands. Micro-rough surfaces are one of the key factors for predictable and successful osseointegration for titanium implants. An implant surface with equivalent surface characteristics like the well proven SLA® surface has been developed for ceramic implants. Recent preclinical studies compare the biomechanical and histological bone tissue response of a novel ceramic implant to the well-established titanium implant with SLA® surface. Results are showing no statistically significant differences at any time point between both materials, indicating an excellent osseointegration performance also for the ceramic implants. In addition the clinical performance of this ceramic dental implant has been evaluated in a prospective multicenter trial. Success- and survival rates of 97.6% and pleasing esthetic results after one year indicate the potential of a safe and predictable use of ceramic dental implants in clinical use. This presentation was held at the ITI World Symposium 2014, April 24, within the Straumann Corporate Forum. Michael Gahlert Dr. med. dent. Munich, Germany Dr. Gahlert studied at the University of Freiburg, Germany, where he obtained his diploma as a dentist.  He has a Doctorate in the area of experimental microbiology and has worked in the Oral Surgery Department of the University Clinic of Freiburg with further training in the areas of dentoalveolar surgery, periodontology and implant dentistry. In 1990 he obtained his diploma as a dental surgeon, and joined the practice of  Professor Dr. Heinz Kniha in Munich, focussing on implant dentistry and periodontology. He is a fellow of the International Team of Implantology (ITI), and was a member of its Development Commission. In 2001 he initiated the first development project related to the ceramic implant, starting at the Technical University in Munich. He is a member of the University Clinic of Basel since 2011, where he does scientific collaboration at the high-tech research area of Basel University Hospital under the leadership of Professor Hans Florian Zeilhofer. Additional research has been done in co-operation with the University of Bern Dental Clinic, the University of Munich’s Institute of Anatomy, and the Medical Health Centre in San Antonio under the leadership of Prof. Dr. David Cochran. The post Michael Gahlert: Full ceramic implants – scientific evidence and clinical application (video lecture – 23:17 min) appeared first on STARGET COM.

Call for case submission: send us your Straumann® Standard Plus Short Implant 4 mm case report and receive 5 implants for free!

  Dentists who have treated patients with the Straumann® Standard Plus Short Implant Ø 4.8, Regular or Wide Neck, can send us now their X-ray with 1-year+ follow-up case report. The first 30 entries receive 5 Straumann implants for free. If you are interested in participating, read carefully the requirements and conditions below. THE THREE STEPS TO YOUR FREE IMPLANTS First of all, read the guidelines (see below) carefully. Then: 1. Download the submission form (on the right). 2. Enter all the required information. Please fill in the whole form and sign it. If you submit more than one case report: one complete form for each case! 3. Send it per e-mail, together with your pictures, to sps@straumann.com.* After your submission has been registered at Straumann Headquarters in Basel, Switzerland, it will be evaluated for accuracy by the committee in charge. If the submission is correct and complete and you are within the first 30 entries, you will receive a notification and the free implants you have selected (see submission form). SUBMISSION FORM Download this submission form, complete it (one form for every case, if you are submitting more than one) and send it, together with the X-ray documentation, as a packed ZIP file to sps@straumann.com. Click here * Electronic transmission is strongly recommended. However, if post is preferred, send it alternatively to: Institut Straumann AG, c/o SPS Susanne Wesch, Peter-Merian-Weg 12, 4052 Basel, Switzerland Sample X-rays with courtesy of Charlotte Jensen-Louwerse DDS, University Medical Center Groningen, Netherlands SUBMISSION GUIDELINES FOR STRAUMANN STANDARD PLUS 4MM SHORT IMPLANT CASE REPORTS 1. CLINICAL CASE REPORT INFORMATION 1.1 Submitter will provide Straumann with clinical case report(s) (“Clinical Case Report”), in which Straumann® Standard Plus Implant Ø4.8mm RN SLActive® 4mm TiZr, (part no 033.044S) or Standard Plus Implant Ø4.8mm WN SLActive® 4mm TiZr (part no 033.045S) have been used (“Clinical Case”). Only Clinical Case Reports submitted with the form provided will be considered. 1.2 The Clinical Case Report shall include a short implant placed (4mm, Ø4.8mm) in one of the following indications: – Splinted units (one implant per unit, minimum of one 4mm with Ø4.8mm). – Pontic cases in combination with at least one longer implant. – Fully edentulous cases with at least two 4 mm Short Implants in combination with 2 longer implants – At least 1 year of follow-up after loading – X-rays available (after implant placement and after 1 year) – Bone level measurements (if available) 1.3 Submitter will assure, that all Clinical Case Reports are anonymised and that all treated patients either explicitly consent to a publication and/or transmission of the Clinical Case Report or must never be identifiable. Submitter is responsible to obtain ethical approval for conducting the Clinical Cases, if necessary. Upon written request by Straumann Submitter shall provide Straumann with a copy of the patient consent template and ethical approval. 1.4 Submitter will ensure that all Clinical Case Reports are made in compliance with the applicable laws and regulations and are not based on a protocol. 2. AFFIRMATION OF ORIGINALITY AND COPYRIGHT TRANSFER STATEMENT 2.1 Submitter assures that the Clinical Case Report and the data therein is created by himself/herself, that he/she has exclusive rights on and is the exclusive owner of such Clinical Case Report, that the pictorial material has not been technically altered prior to the submission to Straumann and that all information given in connection with the Clinical Case is true and valid. 2.2 Submitter herewith grants Straumann and the Straumann Affiliates the exclusive right to use, transmit, distribute and publish (by any media, print or online) the content of the Clinical Case Report worldwide and unrestricted at no additional cost for publication, training, educational, product registration, promotional and other purposes. 2.3 Straumann is not obliged to publish the Clinical Case Report. 3. GENERAL PROVISIONS 3.1 These submission guidelines for Straumann Standard Plus 4mm short implant case reports and all disputes including those concerning any statute of limitations, set-off claims, tort claims and interest claims, shall be governed by the laws of Switzerland excluding its conflict of laws rules. 3.2 All disputes arising out of or in connection with the Clinical Case Report submitted shall be exclusively resolved by the ordinary courts of Basel-Stadt. The post Call for case submission: send us your Straumann® Standard Plus Short Implant 4 mm case report and receive 5 implants for free! appeared first on STARGET COM.

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.

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Annual Report 2015