today EAO Madrid October 05, 2017

“The RFA technique must be accurate and reliable” An interview with Prof. Lars Sennerby, Sweden business (cid:132) Resonance Frequency Analysis (RFA) is today a standard method to measure implant stability, but the measurement unit ISQ itself needs to be explained. Prof. Lars Sennerby is one of the developers and researchers behind the RFA technique and will sort things out for us below. Prof. Sennerby, what is your experi- ence of the RFA technique? Prof. Neil Meredith showed me a prototype of his invention al- ready in 1992 and we have since then used RFA for implant stability meas- urements in numerous experi- mental and clinical studies: first as part of the early devel- opment work and Dr Meredith’s Swedish PhD thesis (1997), which I supervised, and then as a clini- cal routine diagnostic instru- ment. I find it to give valuable and relevant information about implant stability at any time point during implant treatment and follow-up. What is the background to the ISQ unit? The whole purpose of intro- ducing the ISQ (Implant Stabil- ity Quotient) was to give clini- cians a unique and easy quantity on a scale from 1–100; the higher the value the better the stability. ISQ was introduced in 2001 and derives from a linear recalculation of the resonance frequencies (RF) in Hertz (Hz) obtained from measure- ments of dental implants with the first generation of wire-bound transducers. How do you define the ISQ unit? ISQ is calculated from the under- lying RF of the transducer peg using a mathematical equation. The ISQ unit has not yet been defined using any other general or specific unit, simply because there is no such unit available. Instead, empirical data from more than 800 scientific publica- tions has guided clinicians how to use the ISQ scale clin- ically. How do we then know that implants with the same sta- bility have the same ISQ? It is of course desirable that different pegs for different implant designs give the same ISQ value if they have the same implant stability. This is a known problem when calibrat- ing transducer pegs for different implant designs. It has not been so easy to solve, since implant stability per se has not been defined using any other quantity, and a reference had to be created. The refer- ence can then be used when transducers are designed and developed. To explain the prob- lem, think of two different im- plant designs that are placed in The MulTipeg device. (cid:24)Prof. Lars Sennerby identical material and two different ISQ values are obtained. It is impossi- ble to know if the difference depends on the fact that the two pegs are differ- ent or if it is because the stability is ac- tually different, or a combination of the two. So a reference is indeed neces- sary. So how did you solve this problem? Studies have shown that bone den- sity at the implant site determines the ISQ value and that it correlates with the implant’s micro-mobility. This re- flects the clamping ability of the bone, which in turn defines the micro-mobil- ity. The problem is that different im- plant designs behave differently also in the same bone density, depending on surgical technique, design and self-tapping properties. So when cali- brating pegs for different implant types, we embedded the different im- plant types in a dense material in an identical way. In addition, we gave all implants an identical outer geometry by molding each implant type into identical cylinders. The stability of each implant/cylinder can then be var- ied with a clamping device in a stand- ardised manner. This also gave us the possibility to calibrate the pegs over the full ISQ scale and not only for a sin- gle value. How do you use this calibration method? With the method described above, a reference ISQ/stability relationship has been established, which is used when manufacturing MulTipegs for different implant designs. Each type of MulTipeg is designed to follow the standard ISQ/stability curve to assure that different types of implants show the same ISQ value for the same stabil- ity. It is also an excellent method to as- sure that the peg has an optimal fit to the implant. Why is the above important? RFA is a great clinical tool, how- ever, it is absolutely necessary that the technique is accurate, reliable and is based on a standard reference so that the stability of different implant types can be compared. This is particularly important if the academic and scien- tific community is going to agree on dif- ferent clinical protocols based on ISQ values, for instance, when it is safe to apply immediate/early loading proto- cols. Thank you for the interview. (cid:26) Contact Integration Diagnostics Sweden AB Nedergårdsgatan 5 416 54 Göteborg, Sweden Tel.: +46 733 842860 info@penguinRFA.com www.penguinrfa.com PREMIUM PRODUCTS AND TRENDSETTING SOLUTIONS BY CAMLOG (cid:132) CAMLOG is cordially inviting visi- tors to EAO 2017 to take a closer look at the full range of its products at Booth G11. There, they can experi- ence how the innovative CAMLOG products and implant systems can be used in the digital workflow and what possibilities they offer to im- prove work efficiency. CAMLOG pro- vides the expertise to expand the dig- ital process chain in the field of oral implantology and in the network be- tween surgeons, prosthodontists and dental technicians. One highlight being presented at EAO is the iSy Implant System, which is very efficient owing to its new and innovative product components. The perfectly adapted workflow with the One Click, One Scan, One Shift con- cept will guide clinicians into the fu- ture of digital dentistry. Tailored to the individual needs of modern den- tal practices, iSy allows for a highly efficient workflow and optimised value chain. It also benefits patients, requiring less surgery, offering shorter treatment times and a com- petitive cost–benefit ratio together with CAMLOG quality and thus mak- ing implant restorations possible for more people. During a lunch symposium on Saturday, 7 October, Dr Carlos Repullo from Spain will be providing (cid:24)Dr Carlos Repullo a detailed overview of iSy’s possibili- ties when used in combination with the CEREC system. The presentation will be held in English and take place at 13:00 in Room 113. Another highlight presented by CAMLOG is the new CERALOG ce- ramic implant system, which offers highly aesthetic restoration options, according to the company. Made of yttria-tetragonal stabilised zirconia, it is said to possess good mechanical properties, comparable to those of titanium. The zirconia implant port- folio includes two different types of implants. The two-piece CERALOG Hexalobe implant is a true two-piece design with reversible screw-re- tained abutments made of the high- performance polymer PEKK. The abutment can optionally be attached 26 26th EAO Annual Scientific Meeting to the implant with a titanium or gold screw. Alternatively, the one-piece CERALOG Monobloc implant can be used for purely ceramic solutions. The CAMLOG implant systems offer easy and efficient handling. The Tube-in-Tube implant–abutment con- nection of CAMLOG with its distinc- tive three cams has become well es- tablished, with millions of implants placed. The implant design allows quick and easy insertion, as well as alignment of the abutment. Accurate transfer and economic handling are only a few of the many benefits of the CAMLOG Tube-in-Tube connection. CAMLOG has also fol- lowed these principles with the CONELOG Implant System, featuring a conical implant–abutment connec- tion. Both systems have the same outer geometry (SCREW-LINE), which only requires one surgical set for both systems. A new package design for CAMLOG and CONELOG underlines the efficiency in handling during the surgical workflow. The ergonomic blister pack allows easy handling and safe transfer of the implant to the sterile area. The heart of the new packaging concept is the innovative implant holder that secures both the implant and the locking screw with a ideal for reduced click mechanism. The new insertion post has a narrow head diameter and is interdental spaces. It can be picked up directly with a manual insertion device or an- gle piece and inserted accordingly. The transition to the new packaging concept is gradual. In addition to the wide range of prosthetic possibilities provided by the CAMLOG and CONELOG sys- tems, the multi-optional COMFOUR abutment system, a precise guide system and the customised manu- facturing services of DEDICAM, CAMLOG has a comprehensive prod- uct offering. (cid:26)

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