Dental Tribune U.S. Edition

It is estimated that 6 percent of the American population — 18 million people — are congenitally missing a maxillary lateral incisor. To address this need, DMX Implant Corp., the dental implant division of Dentatus Ltd. (www.Dentatus. com, (800) 323-3136) has creat- ed a unique narrow-body implant called the ANEW Implant System. ANEW is the only narrow diam- eter implant that accepts a screw- retained abutment. This advantage affords prosthetic options unlike other narrow diameter implants. The high success rate of nar- row-body implants has expanded treatment options for both dentist and patient. Primarily, narrow- body implants can be placed into anatomically challenging areas that would be contraindicated for standard diameter implants with- out site modification procedures, such as bone grafting and ortho- dontics. These procedures increase treatment time, cost to the patient and morbidity. This can deter the patient from dental implant thera- py, thereby subjecting the patient to limiting their treatment plan to less definitive options such as “flipper” appliances, removable partial dentures and “bonded” and conventional bridges. In 2001, in conjunction with the NYU Department of Dentist- ry, DMX established a specific prosthetic protocol. In 2004, the FDA approved ANEW Implants for “long-term use or any length of time as determined by the health- care provider.” The low profile 3 mm head accommodates divergent angles, offering natural looking esthetics. The non-hygroscopic screw-cap abutment facilitates fabrication of a fixed transitional restoration at the time of implant placement, thereby providing the patient with an immediate, predictable and cosmetic result. During the heal- ing period, the restoration con- tours can be easily modified to the contours of the tissue architecture, thereby eliminating a final “black triangle” result. ANEW narrow-diameter implants are minimally invasive and designed to fit into narrow spaces with implant diameters of 1.8, 2.2 and 2.4 mm respec- tively. The ANEW tapered, one- piece implant design eliminates microgap related crestal bone loss, facilitates one-stage surgery, pro- vides immediate restoration and is more conducive to flapless implant placement. Additionally, utilizing a mini- mally invasive flapless procedure with an immediate restoration eliminates many postoperative challenges as well as reduces total treatment time. ANEW narrow diameter implants have been tested with university-based research from the around the world. In 2007, Dr. Stuart Froum and his col- leagues from the New York Uni- versity Department of Implant Dentistry published a study in the International Journal of Perio and Restorative Dentistry stating “40 Anew Implants in patients for 1 to 5 years postloading. No implant failures were reported, yielding a 100% survival rating.” In 2005, the Journal of Oral and Maxillofacial Implants pub- lished Dr. Michael Rohrer’s histol- ogy study on Dentatus implants. Dr. Rohrer determined that the percentage of bone in contact with the body of Dentatus implants in “the same range and sometimes higher than what is usually seen with conventional implants.” These results support well- known literature about implant design and materials in the fol- lowing ways: ANEW narrow-body dental implants are composed of Grade V titanium alloy; the threaded portion of the implant is mechanically roughened to increase surface area and maxi- mize the bone-implant interface; and the tapered design better facilitates implant placement, pro- motes initial implant stability and better distributes occlusal loads along the body of the implant. Predictably, ANEW implants have been placed in various places within the mouth with high suc- cess. Case study A 15-year-old girl and her father came to the office for diagnosis and treatment planning as her orthodontic treatment was com- ing to an end. She presented with congenitally missing lateral inci- sors. Her orthodontic treatment had provided appropriate root sep- aration of the cuspids and centrals as well as good esthetics during treatment. This was accomplished by having a prosthetic tooth, #7, suspended from the archwire and retention of the upper left decidu- ous lateral incisor throughout the entire treatment course (Figs. 1–3). The treatment plan accepted was to proceed with the comple- tion of the orthodontic treatment and debracketing (Fig. 4) that same day, extract the upper left deciduous lateral incisor and then place ANEW implants in the later- al incisor positions of #7 and #10. Once the ANEW implants were placed, an immediate fixed provi- sional crown would be fabricated on each implant. They would then be held in static occlusion as part of the orthodontic retention as well as to help provide initial sta- bility for the ANEW implants dur- ing osseointegration (Figs. 5, 6). It was clearly understood that as the still growing patient would continue to mature, the provisional crowns would need to be removed and revised and/or remade in order to properly form the papillae and modify the incisal length. This would easily be accom- plished with the ANEW screw- retained abutment and provisional crown possibilities (Figs. 7–9). The final restorations supported by the ANEW Implants will be fabricated when the growth of the premaxilla is complete in 4 to 5 years at age 19 and 20. DT Replacing congenitally missing lateral incisors By Robert M. D’Orazio, DDS, FAGD, MIIF, ABOI/ID and Mark A. Iacobelli, DDS, FAGF, FICD, MIIF Fig. 2 Fig. 3 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Industry News DENTAL TRIBUNE | September 201124A Fig. 1 Fig. 4 ADA BOOtH nO. 1021 About the authors Robert M. D’Orazio, DDS, ABOI/ID, is a graduate of the University of Detroit, School of Dentistry. He is a fellow at the Midwest Implant Insti- tute and the American Academy of Implant Dentistry, as well as a Dip- lomate of the American Board of Implant Dentistry. D’Orazio currently maintains a referral-based implant dental practice located in Sterling Heights, Mich. Mark A. Iacobelli, DDS, FAGD, FICD, MIIF, is a graduate of Case Western Reserve School of Dentistry. He has been in private practice since June 1982 and holds licenses and sedation permits in the states of Ohio and Florida. Iacobelli is a fellow of the Academy of General Den- tistry, the Midwest Implant Institute and the International College of Dentists. He is also a past president and board member of the Midwest Implant Institute Fellowship. Iacobelli lectures for The Center for Occlu- sal Studies, Camlog Corporation, the Midwest Implant Institute Fellows, Jamison Consulting of Florida, the Midwest Implant Institute and the DMX Implant Corporation.