#Immediacy 22. Apr 2022

TLX: Immediate protocols welcome: Sound biology meets digital efficiency

Jan H. Koch

The new Straumann® TLX Implant System was developed on the basis of its model, the iconic Tissue Level. This means that long-term tissue stability, high primary stability and prosthetic efficiency combine to provide patients with the clinical results they desire. For this purpose, the designs of both the TLX implant screw and abutment connection have been optimized for immediate and CADCAM protocols. They facilitate treatment by reducing the number of sessions and avoiding augmentation surgery (1, 2). In recent years these benefits have made immediate digital protocols more popular among both patients and clinicians (2, 3).

Photo from the (beautiful!) case presentation by Dr. Piano on youTooth

Taking immediacy to the next level

Patients prefer shorter treatment times, with less surgery involved. As evidence grows for immediate protocols the stage is set for ImmediaXy by Straumann®.

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Immediate design reloaded

With its conical and progressively threaded screw design the Straumann® TLX is ideally suited for immediate placement and restoration. The endosteal part of the implant is identical with the Straumann® BLX bone level optimized for immediacy. Both implants are based on the high-strength material Roxolid® and the hydrophilic SLActive® surface designed for excellent healing capacity. This is combined with the slim and fully tapered core and the minimized shoulder diameter. Both features facilitate the preparation of undersized osteotomies and reduce the need for augmentation, depending on the individual situation4.

Features and benefits

Straumann® developed the TLX Implant System for efficient protocols, both from a surgical and prosthetic point of view.

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To achieve the high primary stability necessary for immediate placement and restoration, the Straumann® TLX has a conical and progressively cutting thread design5, 6. This is combined with a dynamic flute for the collection and condensing of bone chips during preparation, and bi-directional elements for reverse and forward cutting. Together with the deep apical threads designed for maximum engagement and stability, these features facilitate insertion, especially in immediate placement cases.

Scan your patient

All treatments start with taking a detailed history and clinical examination of the individual patient. This is also true for therapy using the Straumann® digital ecosystem, which is consistently integrated with the TLX (“born digital”). Following intra-oral or model-based scans and, if indicated, a cone beam computed tomography scan, the resulting data can be synchronized in a planning program like Straumann® coDiagnostiX® to find a clinically sound and minimally invasive protocol (Fig. 1). Again, both the narrow 3.75 mm diameter and the progressive thread design of the TLX are streamlined with this clinical approach.

Learn more about the potentials of the Straumann® TLX Implant System:

Photos (Figs. 1-3) courtesy of Dr. Matthieu Collin (France) see case report here

Prosthetic versatility

The TLX Implant System is an integral part of the versatile and proven Straumann® prosthetic portfolio. As in the BLX Implant System, the TLX has also been equipped with the TorcFit™ implant-abutment connection optimized for digital workflows. This interface allows easy placement of abutments at soft tissue level and, alternatively, easy handling of direct-to-implant restorations.

Screw-retained solutions facilitate retrieval e.g., for maintenance, and reduce concerns about peri-implant inflammation. Based on the open CADCAM platforms, either validated Straumann® or external workflows can be realized. This relates to both single-gap (Figs. 4-6), partially edentulous and full-arch (Figs. 2, 3) implant-retained restorations, in both straightforward and advanced cases.

Photos (Figs. 4-6) courtesy of doctors Waldemar Polido, Wei-shao Lin and Dean Morton (USA) see case report here

References:

  1. Buser D, Chappuis V, Belser UC, Chen S. Implant placement post extraction in esthetic single tooth sites: when immediate, when early, when late? Periodontol 2000 2017;73:84-102. 
  2. Gallucci GO, Hamilton A, Zhou W, Buser D, Chen S. Implant placement and loading protocols in partially edentulous patients: A systematic review. Clin Oral Implants Res 2018;29 Suppl 16:106-134. 
  3. Joda T, Gintaute A, Brägger U, Ferrari M, Weber K, Zitzmann NU. Time-efficiency and cost-analysis comparing three digital workflows for treatment with monolithic zirconia implant fixed dental prostheses: A double-blinded RCT. J Dent 2021;113:103779. 
  4. Schiegnitz E, Kämmerer PW, Hellwich P, König J, Sagheb K, Al-Nawas B. Treatment concepts of horizontally deficient ridges-A retrospective study comparing narrow-diameter implants in pristine bone with standard-diameter implants in augmented bone. Clin Oral Implants Res 2021;32:1159-1167. 
  5. Torroella-Saura G, Mareque-Bueno J, Cabratosa-Termes J, Hernandez-Alfaro F, Ferres-Padro E, Calvo-Guirado JL. Effect of implant design in immediate loading. A randomized, controlled, split-mouth, prospective clinical trial. Clin Oral Implants Res 2015;26:240-244. 
  6. Pariente L, Dada K, Daas M, Linder S, Dard M. Evaluation of the Treatment of Partially Edentulous Patients With Bone Level Tapered Implants: 24-Month Clinical and Radiographic Follow-Up. J Oral Implantol 2020;46:407-413.

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