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issn 1868-3207 • Vol. 21 • Issue 3/2020 3/20 implants international magazine of oral implantology industry New zygomatic implant design feature The art of ultra- aesthetic dentistry DGZI Special Onward to new horizons
editorial | Dr Georg Bach President of the DGZI The second half of this year will be crucial Dear readers, The crisis in the first half of 2020 has forced consider- able challenges upon us, which are here to stay for the months and probably years to come. As is the case with many crises, however, there are also opportunities and positive aspects, in contrast to the economic damage and the structural disruptions. We as dentists, together with our teams, are currently doing everything we can to re-establish regular practice routines and to get our patients back into dental care—in accordance with the necessary infection prevention measures, of course. Re- cent weeks have shown that dentistry has a clear obliga- tion regarding the general health of the population. There is no other medical profession that provides the popula- tion in all its variety with such regular care, through den- tists working in public clinics and private practices. Es- pecially within the German healthcare system, patients in risk groups, the old and the young, the chronically ill and emergency patients receive reliable dental treatment of the highest standard. After all, oral health plays a crucial part in maintaining the systemic health of patients. Un- treated inflammation in the oral cavity, denture pressure points, caries, periodontal disease and other conditions can cause not only adverse situations in the masticatory apparatus but also damage to the entire body. surgical protocols in such an individually tailored and so- phisticated way. Undoubtedly, there is a medical neces- sity for and effectiveness in rehabilitating masticatory function with dental implants, even in high-risk patients. We as professional implantologists should thus con- tinue our efforts with great courage to educate our pa- tients regarding the best possible treatment options even in these challenging times. The second half of this year will be decisive in terms of not only crisis management but also further implantological training. In this light, it is my great pleasure to cordially invite you, on behalf of the German Association of Dental Implantology (DGZI), to Bremen in Germany on 6 and 7 November, for our 3rd Future Congress for Dental Implantology and a cele- bration of 50 years of DGZI. With this in mind, I wish you an enlightening read with this new issue of implants and a healthy late summer and au- tumn. I look forward to welcoming you to our special an- niversary congress in Bremen, the founding city of DGZI! Yours, Dental implantology plays a key role here, being the only dental therapy capable of treating patients of nearly all age groups with a myriad of prosthetic possibilities and Dr Georg Bach 3 2020 03
| content editorial The second half of this year will be crucial Dr Georg Bach case report page 16 Er:YAG laser scanner for implant site preparation Drs Norberto Berna, Giovanni Olivi, Luca Marigo & Massimo Cordaro Successful restoration of the maxilla and mandible Drs Branislav Fatori & Inge Schmitz industry New zygomatic implant design Drs Sepehr Zarrine, Carlos Aparicio & Edmond Bedrossian More effi cient workfl ows for crestal bone preservation page 26 feature The art of ultra-aesthetic dentistry Nasser Shademan interview Bringing titanium and zirconia together in one implant An interview with Dr Anders Henningsen page 34 DGZI Special Onward to new horizons An interview with Dr Georg Bach Refl ect on 50 years of implantology in Bremen this autumn DGZI news news manufacturer news news about the publisher imprint Cover image courtesy of Fotona d.o.o. www.fotona.com Original Background: © foxaon1987/Shutterstock.com issn 1868-3207 • Vol. 21 • Issue 3/2020 3/20 implants international magazine of oral implantology industry New zygomatic implant design feature The art of ultra- aesthetic dentistry DGZI Special Onward to new horizons 04 3 2020 03 06 12 16 24 26 28 34 36 38 30 40 42
| case report Er:YAG laser scanner for implant site preparation Drs Norberto Berna, Giovanni Olivi, Luca Marigo & Massimo Cordaro, Italy Introduction Numerous studies have reported the ability of mid-infra- red lasers (Er:YAG laser with a wavelength of 2,940 nm and Er,Cr:YSGG laser with a wavelength of 2,780 nm) to ablate hard biological tissue without creating thermal damage.1–5 Among the various applications, the possibil- ity of preparing the implant site entirely with laser irradi- ation was originally illustrated in vivo by Dr Berna, one of the authors of this article, in 2003. A patent for this form and method was issued and registered at that time. The first group of 62 patients received this method of treat- ment, using an Er,Cr:YSGG laser, between November 2001 and December 2002. Since then, another larger group of patients have been treated with this method. An Er:YAG laser and a dedicated laser scanner handpiece have never been used in human patients for this proce- dure, however. The major obstacles to the wide use of this technique are the time to create the osteotomy,6 the low energy capability of the devices previously available and the time required to learn to use a handpiece that works in no contact. In the present study, a high perfor- mance Er:YAG laser was used with a tipless laser scan- ner handpiece that allows more precision, a higher en- ergy output and a shorter pulse duration in comparison with the previously used device. Materials and methods A 67-year-old patient, a non-smoker without any sys- temic diseases, was examined using CBCT (PaX-i3D Smart, Vatech) in order to assess the surgical area, the bone volume and the bone density in the edentulous area, region #15 (Fig. 1). Before the surgery, the patient 1 2 3 Fig. 1: A CBCT scan was taken pre-op. Fig. 2: Flap incision using a LightWalker Nd:YAG laser head (200 µm diameter fibre, 3 W, 70 Hz, MSP). Fig. 3: Flap reflection was carried out with a Prichard elevator. 06 3 2020
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6 4 5 7 8 9 Fig. 4: The stabilised laser preparing the osteotomy, operated at 380 mJ, 20 Hz and 50 microseconds. Fig. 5: The Osstell handpiece detecting primary stability. Fig. 6: Determining the ISQ value. Fig. 7: Clinical situation post-op. Fig. 8: Radiograph taken immediately after surgery. Fig. 9: Radiograph taken after eight months of loading. 08 3 2020 had received all the information regarding the treatment and the possible alternative treatment through a person- alised informed consent form. The implant insertion axis has been planned for the best functional result of the prosthesis. A customised dental resin holder was cre- ated to support the laser scanner handpiece intra-orally, in the correct position according to the insertion axis of the implant. Local anaesthesia was administered using articaine (1 : 100,000). A full-thickness incision was per- formed using an Nd:YAG laser (1,064 nm wavelength; 200 µm diameter fibre; MSP: 3 W, 70 Hz; LightWalker AT, Fotona) on the palatal paramedian line; two mesial and distal releasing incisions were also performed without in- volving the papillae (Fig. 2). The access flap was then re- flected with a Prichard elevator (Fig. 3). An Er:YAG laser with a wavelength of 2,940 nm ( LightWalker AT) equipped with a laser scanner hand- piece (X-Runner, Fotona) was used (Fig. 4). The laser parameters used were 380 mJ and 20 Hz, delivered with a super-short pulse (50 microseconds). An external source of sterile saline solution stored at 5 °C in a refrigerator was used, and the saline was delivered via a peristaltic pump to promote photothermal ablation and to reduce the temperature in the surgical site. The scanner allows one to program and precisely perform a circular osteotomy of 3.5 mm in diameter, the same diameter as the implant manufacturer’s final drill. During the osteotomy, the inser- tion depth was checked using a millimetre probe, until the preset depth of 12 mm was reached. The author prefers to place implants 2 mm deeper sub-crestally to prevent angular resorption and to manage the emergence profile of the prosthesis more effectively. A tapered screw im- plant made of Grade IV titanium and with a sandblasted and acid-etched surface (HELI, IDC) was inserted. It had a maximum diameter of 4.2 mm on the external thread and a length of 10.0 mm. Once inserted, the implant sta- bility quotient (ISQ) was determined using the Osstell handpiece (Osstell; Figs. 5 & 6). The flap was sutured (Fig. 7), a postoperative radiograph was taken (Fig. 8), and after five days, the sutures were removed. At that time, the patient was asked to assess the post operative pain he had experienced by assigning a numeric value of between 0 and 10 on a verbal numeric scale. Results The total clinical time for preparing the osteotomy was approximately 7 minutes. The implant had a high primary stability value at the time of insertion: the ISQ score mea- sured in the buccolingual direction was 84 and the score measured in the mesiodistal direction was 81. The re- ported numeric value of postoperative pain was 1. At the second stage of the implant treatment, which was per- formed after 40 days, new ISQ values of 84 buccolin- gually and 82 mesiodistally were determined. After three months, the values had increased to 86 buccolingually
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| case report and 84 mesiodistally. The radiographic control image taken after eight months of loading showed complete osseointegration of the implant with very good healing of the bone around the neck of the abutment (Fig. 9). Discussion The Er:YAG laser technology used in this study allowed a reduction of bone preparation time compared with the la- ser system used previously. Also considering the absence of pauses needed to replace the drills, the total time for preparing the osteotomy was very close to that of the conventional method.7 However, there are other advan- tages of using a laser for preparing osteotomies. Besides a comparable preparation time, the higher energy delivered through a tipless stabilised laser scanner handpiece to the target, with a super-short pulse and efficient water spray, reduced the minor thermal damage to the bone cells ad- jacent to the osteotomy site and avoided the smear layer typically associated with conventional drill preparation.8, 9 This could reduce the time necessary for osseointegra- tion.10 The laser site preparation is very precise and com- patible with different implant geometries, owing to the ab- sence of micro-movements and skidding induced by the impact of drills on the bone, especially for large-diameter final drills.11 Such a scanner technology is of major signifi- cance for developing laser use in implantology further, as it allows osteotomies of different sizes and shapes (circular and possibly oval) to be created with very high precision and compatibility with new implant geometries. The ISQ score analysis used in this clinical study reports the values of resonance frequency analysis using the Osstell handpiece. The scale of values ranges from 0 to 100, and the lowest threshold value for single implant loading, even in cases of immediate placement, corre- sponds to 70. This is the only non-invasive method ac- cepted by the international scientific community for clini- cal evaluation of osseointegration.12–15 In the clinical case described in this article, the high primary stability value increased postoperatively over the course of 40 days, in- dicating the absence of bone damage during the laser procedure and that cell healing had started promptly and successfully. Indeed, erbium laser bone irradiation has been reported to increase release of bone morphoge- netic protein, suggesting quicker osseointegration and stability as a result.16 Among the other advantages of la- ser osteotomy preparation, the lack of contact, vibration and pressure made for a more comfortable experience for the patient during the intervention. Finally, the immedi- ate postoperative period, as reported by the patient, was free of pain and complications. Conclusion otomy without drills. The absence of postoperative pain and complications and the very high value of primary im- plant stability described in this case report suggest that the use of an Er:YAG laser and a dedicated laser scanner handpiece is a viable treatment alternative for creating osteotomies. These positive results support the realisa- tion of a pilot study with a greater number of implants. about the authors Dr Norberto Berna graduated in Medicine and Surgery and specialised in dentistry and stomatology. He holds an MSc in Odontology and Forensic Science. Since 1987, he has been working in his private office with la- sers of different wavelengths. He holds three patents and is frequently invited to speak at international conferences. He is a joint scientific coordinator of the master’s degree in laser dentistry at the Università Cattolica del Sacro Cuore in Rome in Italy. Between 2012 and 2018, he was an adjunct professor at the University of Genoa in Italy. Dr Giovanni Olivi graduated cum laude in Medicine and Surgery (MD) and in Dentistry (DDS) from universi- ties in Rome. He obtained a postgradu- ate diploma in laser dentistry from the University of Florence in Italy in 2002 and master status from the Academy of Laser Dentistry in Coral Springs in Florida in the US in 2009. Since 2007, Dr Olivi has been a contracted professor and a joint scientific coordinator of the master’s degree in laser dentistry at the Università Cattolica del Sacro Cuore. He is the author of over 70 peer-reviewed articles, several chapters in dentistry text- books and four books on laser dentistry. Dr Norberto Berna Author details Dr Giovanni Olivi Author details Literature contact Dr Norberto Berna info@laserimplantology.com This first clinical case highlights the many advantages of the use of the Er:YAG laser to perform an implant oste- Dr Giovanni Olivi olivi@inlaser.it 10 3 2020
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| case report Successful restoration of the maxilla and mandible Case report of a heavy smoker Drs Branislav Fatori & Inge Schmitz, Germany Introduction Dental implants represent the most cost-effective and long-term solution for the replacement of missing teeth and have a high average life expectancy. Presently, the failure rate of implants is higher among smokers than in non-smokers. There seems to be a correlation be- tween the implant failure rate and the number of ciga- rettes smoked daily—the higher the number of cigarettes smoked daily, the higher the implant failure rate. One of the authors of this article has extensive experience in treating smokers and has more than 30 years of experi- ence in inserting dental implants with a low implant fail- ure rate. To achieve a satisfactory result regarding implant survival, a variety of factors need to be taken into con- sideration, such as bone type and quality, bone density, placement and location of the implants, patient motiva- tion, and the patient’s financial situation. On smoking In general, smoking is considered to be one of the main risk factors for implant failure. Reports in the literature 1 Fig. 1: Radiographic evaluation of the mandible of the male patient, who was a heavy smoker and suffered from severe periodontitis. 12 3 2020 show a lower survival rate of dental implants in smokers as opposed to non-smokers. One possible mechanism by which smoking may affect osseointegration is lower- ing of the blood flow rate owing to increased peripheral resistance and platelet aggregation. Tobacco smoke di- rectly affects osteoblast function. Materials and methods Patient The patient was male and aged 65. He was a heavy smoker, smoking 60 cigarettes a day. In addition, he suffered from severe periodontitis (Fig. 1). Implants The implantation was carried out with six implants in the maxilla and ten implants in the mandible (Figs. 2–5). The implants used were OKTAGON DENTAL RATIO implants (DRS International) of 4.1 mm in diameter and 13.0 mm in length. The implants had a tapered bone- level design. Before insertion, each implant was wet- ted with either hyaluronic acid or the autologous blood of the patient. Preoperative medication As for premedication measures, Augmentin was given for a duration of one week. After microbiological examina- tion, an antibiotic (Clindamycin Aristo 600, Aristo Pharma) was prescribed (first one tablet three times a day and then one tablet twice a day until the day of surgery). In addition, the patient was instructed to rinse with Chlorhexamed (GlaxoSmithKline). Local anaesthesia was achieved with Ultracain D-S forte (Sanofi-Aventis Deutschland), and 40 mg Dexa-ratiopharm (ratiopharm) was administered intramuscularly at the same time. Augmentation Augmentation was carried out using NanoBone gran- ules (Artoss) and a Geistlich Bio-Gide membrane (Geistlich Biomaterials). NanoBone is a synthetic cal- cium phosphate. Its structure results in extremely quick bone formation.
D A Shortest Implants – Longest History. Think Short! For more than 30 years Bicon® short implants are unchanged in clinical use. According to the 11th European Consensus Conference (EuCC) 2016 in Cologne, provided the specific treatment parameters are ob- served, the use of short, angulated or diam- eter-reduced implants in sites with reduced bone volume can be a reliable treatment option, given the risks associated with the use of standard-dimension implants in combina- tion with augmentation procedures. For more Information: Bicon Europe Ltd. Dietrichshoehe 2 55491 Buechenbeuren Germany 2 3 4 5 Fig. 2: Diagnostic procedures. Fig. 3: Radiograph of the maxilla showing the situation after the placement of six OKTAGON DENTAL RATIO implants. Fig. 4: Frontal view showing the restorative situation of the maxilla and the mandible prior to tooth extraction. Fig. 5: Situation after implantation of ten implants in the mandible. Guided bone Phone +49 (0)6543 818200 regeneration was necessary (with NanoBone and Geistlich Bio-Gide). germany@bicon.com www.bicon.de.com Surgical technique Implant placement was performed un- der local anaesthesia. The osteotomies were extended gradually, according to the intended implant diameter, with the sequential order of drills that is recom- mended by the implant manufacturer. Thereafter, the oral cavity was cleaned and necrotic or inflamed tissue was re- moved. The implants were then inserted into the prepared sites to an insertion torque of 45 Ncm. Adequate primary stability was obtained. Resorbable 4/0 sutures were used for wound closure. Postoperative treatment Postoperative intra-oral periapical radio- graphs were taken, and these confirmed the accuracy of the implant placement. As for postoperative medication, an- Popular sizes: 3x6, 3x8, 3.5x8, 4x5, 4x6, 4x8, 4x11, 4.5x6, 4.5x8, 5x5, 5x6, 5x8, 6x5, 6x6, 6x8 mm
| case report 6 7 Fig. 6: Early loss of two implants in the mandible due to primary instability. Fig. 7: Provisional restoration of the mandible. tibiotics were prescribed. In addition, 20 mg predniso- lone was prescribed (first one tablet three times a day, then half a tablet three times a day and finally a quar- ter tablet three times a day). Five arnica globules were also prescribed daily to minimise swelling. Radiographs were taken digitally at the time of surgery, after 24 hours and after one month in order to evaluate implant suc- cess (Fig. 6). Follow-up examination Follow-up examinations employed the criteria of Al- brektsson et al. and Buser et al.1, 2 These criteria for im- plant success are widely cited and generally accepted. According to these, implant success is defined by the absence of persistent subjective complaints, including pain, foreign-body sensation and/or dysesthesia; the absence of recurrent peri-implant infection with suppu- ration; the absence of mobility; continuous radiopac- ity around the implant; and the possibility of prosthetic restoration. Ahead of the definitive restoration, a provi- sional restoration of the mandible was fabricated and inserted (Fig. 7). Results Editorial note: Dr Inge Schmitz declares that she has no conflicts of interest in relation to this article. Dr Branislav Fatori would like to thank Ulf-Christian Henschen of DRS International (Langenfeld, Germany) and Dr Walter Gerike from Artoss (Rostock, Germany) for their support. about the authors Dr Branislav Fatori has more than 41 years of experience in implantol- ogy and has placed more than 8,000 implants. He was trained at prominent clinics around the globe. Also, he has worked as a long-term training con- sultant for professional societies and implant manufacturers. Dr Inge Schmitz has worked at the Institute of Pathology of the Ruhr-Uni- versity Bochum in Germany since 1990. Her main interests are implantology, stents, electron microscopy and osteo- logy. She studied biology at the same University and completed her PhD at the University of Essen in Germany in 1989. Fourteen of the 16 inserted implants osseointegrated. During the healing phase, periosteal tests were per- formed (Periotest, Siemens), and the average values achieved ranged from 0.55 to 0.67 (on the plaque, gingi- val and papillary bleeding indices). Discussion contact Dr Branislav Fatori Rolandstraße 11 45128 Essen, Germany Phone: +49 201 82188890 info@fatori.de The healing process of the implants in the case described was good. Only two implants were lost. In conclusion, it can be argued that smoking tobacco is not a contra-in- dication for replacing missing teeth with dental implants. However, providing the smoker with detailed information about the smoking-related risk of implant failure is a ra- tional consensus from the vantage point of both patient and dentist. Dr Inge Schmitz Georgius Agricola Stiftung Ruhr Institut für Pathologie Ruhr-Universität Bochum Bürkle-de-la-Camp-Platz 1 44789 Bochum, Germany inge.schmitz@rub.de Author details Author details 14 3 2020
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| industry New zygomatic implant design Adapting to the anatomy Drs Sepehr Zarrine, France; Carlos Aparicio, Spain & Edmond Bedrossian, USA Introduction This article introduces and explains the rationale for the two different designs of the Straumann zygomatic implant, which is the result of a collaboration between the authors and engineers over the last several years. It is based on many years of the application of evidence-based clinical principles and clinical outcomes using this zygomatic implant and on common fundamental values. The evidence-based principles began with Per- Ingvar Brånemark in 1977 in severely atrophied maxillae caused by trauma, congenital conditions or tumour resection. Over the past three decades, many studies have re- ported a high success rate for rehabilitation with zygo- matic implants. Furthermore, retrospective studies span many years,1, 2 and many take into consideration implant survival, patient satisfaction, and success and function of the prostheses.3 A recent systematic review in 2016, which included 68 studies and a total 4,556 zygomatic implants placed in 2,161 patients, reported a cumula- tive survival rate of 95.21 % after 12 years of follow-up and concluded that zygomatic implants can be placed in patients with a high predictability of success.4 There- fore, zygomatic implants in combination with conven- tional implants in the anterior maxilla (Figs. 1 & 2) can be considered a valid alternative to grafting procedures in the atrophic maxilla (Figs. 3 & 4). The efficacy of this type of implant has also been highlighted in cases where to- tal absence of the maxillary alveolar bone does not al- 1 3 4 2 5 Fig. 1: Extremely resorbed maxilla visualised via 3D printing. Fig. 2: Severe alveolar bone resorption and maxillary sinus pneumatisation. Fig. 3: One zygomatic implant in combination with conventional implants placed where the bone quantity was sufficient. Fig. 4: Two zygomatic implants with two conventional im- plants. Fig. 5: Four zygomatic implants in extremely resorbed maxilla. 16 3 2020
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| industry 6 Straumann Zygomatic Implant low for the placement of axial implants in the low for the placement of axial implants in the anterior maxilla; instead, the “quad zygoma” anterior maxilla; instead, the “quad zygoma” concept is considered (Fig. 5). Implant teams concept is considered (Fig. 5). Implant teams should bear in mind that the use of zygomatic implants is considered an advanced procedure, and sur- geons placing this type of implant should be aware of the potential complications and the management of such complications.5 The common fundamental values are the importance of the patient, the service being provided to him or her, and the complications that we wish to avoid. The ultimate goal is to rehabilitate the masticatory function and aesthetics of the atrophied maxilla using a surgical and prosthetic procedure that is as safe and sustainable as possible. Im- plant design is crucial, and the key elements of success must be fully understood. An effective zygomatic implant requires multiple strategies, and each of its constituent parts must have a benefit, increase success and reduce risks. Changes to the original design include thread de- sign and distribution, surface enhancement, implant di- ameter, angulation of the implant platform and modifi- cations to the middle portion of the implant, resulting in two different zygomatic implant designs: round and flat. Threads and primary stability Primary stability must be obtained in cases of severe al- veolar bone resorption and maxillary sinus pneumati- sation combined with poor bone quality.6–8 This crestal bone situation does not allow for the placement of a conventional dental implant without bone augmentation techniques such as sinus floor elevation or onlay bone grafting from an intra-oral or extra-oral donor site. Zygo- matic implants are fixtures inserted through the residual alveolar crest, the final entry being into the base of the zygomatic bone and the exit of the apex of the implant at the lateral cortex of the zygomatic bone. Depending on the anatomy of the maxilla, the contour of the lateral max- illary sinus wall determines whether the middle portion of the implant is inside or outside of the sinus. Thus, an optimised thread pitch is needed in the por- tion of the implant that crosses the zygomatic bone, and a coronal thread and micro-thread are needed for the crestal part. In the crestal bone, being D4 bone, achiev- ing sufficient primary and secondary implant stability can be challenging. We must therefore achieve the highest possible osseointegration in the zygomatic bone. That is why the apical portion of the implant is tapered and sand- blasted (Fig. 6) for better bone-to-implant contact. The tapered design provides good grip and anchoring and is an important factor in primary stability, allowing for an immediate loading protocol. Freedman et al. showed in their 2013 and 2015 finite element analysis studies that the primary support of occlusal loads is the crestal bone, which is preferred.7, 8 To enhance the stability of the zygo- ZAGA™ Round ZAGA™ Flat 7 8 Fig. 6: Tapered design and sandblasted surface. Fig. 7: Coronal threads and micro-threads. Fig. 8: The combination of the two surfaces. matic implant at the maxillary crest, coronal threads and micro-threads are present (Fig. 7). These stabilise the im- plant at the crest and stabilise the final bone level in line with the threads. In cases where the minimal crestal bone resorbs over time, the potential for peri-implantitis is mi- nimised by the machined surface of the crestal threads. Surface and effi ciency Each surface, whether machined or rough, has a spe- cific benefit.9 Straumann® Zygomatic Implants combine the two, depending on their usefulness in each part of the implant (Fig. 8). The sandblasted rough surface in- side the zygoma improves bone apposition on to the ti- tanium surface and ensures higher osseointegration val- ues in shorter healing times during the crucial transition between initial mechanical stability and secondary bi- ological stability. This surface, combined with a high- grip design, allows for safer and faster osseointegration. However, it is important to wait six months for osseointe- gration before placing the definitive prosthesis, as a se- verely atrophied maxilla is being rehabilitated. Bacterial adhesion and biofilm formation on the implant surface are often early steps towards peri-implantitis. This consideration led to the choice of a machined surface for the crestal part, which has threads and micro-threads to reduce bacterial colonisation and bone loss around the implant neck. All implants are clinically integrated and sta- ble in the bone tissue; however, the machined surface requires more osseointegration time, but will have less bacterial adhesion. Moreover, immediately above the ma- 18 3 2020
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Straumann Zygomatic Implant ZAGA™ Round ZAGA™ Flat 10 9 Fig. 9: Tissue-level neck for periodontal stability. Fig. 10: The tip of the Straumann® Zygomatic Implant is round and smooth. chined part with threads within the bone, the platform of the implant, which is in contact with the gingiva, forms a neck-like tissue level that is smooth and without threads. Literature has confirmed that the source of sinus infections is not the presence of titanium within the sinus, but the introduction of bacteria into the maxillary sinus from the peri-implant sulcus in cases where crestal bone is absent. The machined surface of the implant collar has resulted in the periodontal success of Straumann® Tissue Level implants. The same surface has been reproduced on the new Straumann® Zygomatic Implant, for which stability of the peri-implant soft tissue is essential to avoid oral- antral communication at the implant platform (Fig. 9). By the same token, the tip of the Straumann® Zygomatic Implant is round and smooth to help minimise the risk of soft-tissue irritation (Fig. 10). Subperiosteal infections, swelling and skin irritation are caused by an overextended apical por- tion due to incorrect measurement and excessive implant length, or the creation of particles and a lack of cleaning and irrigation during osteotomy preparation.5 The correct surgical procedure must avoid this problem, and the api- cal portion of the implant must transfix the zygomatic bone for quadricortical stabilisation, but must not protrude out- side. The smooth and round tip of the Straumann zygo- matic implant comes close to the zygomatic bone surface and will not cause damage. Diameter and safety When the flap is raised and the zygomatic bone is visu- alised, we can see that the surface for anchorage of the d i - o n e h p S © 11 Fig. 11: Placement of two tips in the zygomatic bone. 20 3 2020 implants is not particularly large. Indeed, it is necessary implants is not particularly large. Indeed, it is necessary to consider placing two zygomatic implants on each side. to consider placing two zygomatic implants on each side. There are two positions for the placement of zygomatic implants (Fig. 11). The upper position is for the anterior implant in quad zygoma cases, and the lower position is for posterior zygoma cases in all other cases. Therefore, the surgeon should be conscious of the apical position of the zygomatic implant, even in cases where quad zy- gomatic implants are not planned. By keeping the apex of the zygomatic implant in the lower position, if needed, additional zygomatic implants may be placed in the up- per position in cases where the anterior implant fails and there is no residual bone. Furthermore, the tip should not be set too low so as not to fracture the zygomatic bone, nor should it be set too high so as not to penetrate the orbit or the infratemporal fossa. Owing to the long length of the implant and the com- plicated maxillary-zygomatic structure, it is crucial to have total mastery of the surgical procedure, mean- ing experienced surgeons with comprehensive training are required. To prevent penetration into the orbit or the infratemporal fossa, the basic surgical factor is direct visu- alisation of the tip of the drills as the osteotomies are pre- pared and of the tip of the implant as the fixture is inserted. As a result, the larger the implant, the greater the difficulty and risk. The size of the Straumann® Zygomatic Implant is ideal for improving patient safety: 2.6 mm at the apex and 3.4–3.9 mm for the tapered and threaded apical portion. Two designs and different anatomical situations The ZAGA (Zygoma Anatomy-Guided Approach) ana- tomic description takes into account the various relation- ships between both the implant platform and the middle portion of the zygomatic implant with the crest and the lateral maxillary wall (Fig. 12).10, 11 The anatomical classi- fication ranges from ZAGA 0—straight lateral maxillary wall with the platform on the crest and the middle portion of the zygomatic implant inside the sinus—to ZAGA 4— the most extreme resorption of the maxillary sinus with or without significant concavity of the lateral maxillary si- nus wall. The presence of bone around the implant plat- form allows for better occlusal force distribution and con- nective soft-tissue fibre insertion. This buccal bone has a crucial influence on the stability of the facial gingival margin. In this case, the Straumann® Zygomatic Implant ZAGA™ Round should be used (Fig. 13). Indeed, the cor- onal threads and micro-threads stabilise the implant in the residual crestal bone, as well as at the bone level in line with the threads, and at the gingiva level in a sustain- able manner. However, in cases of extreme maxillary resorption and concavity of the sinus wall such as ZAGA 4, or in cases of total or partial maxillectomy, the zygomatic implant
Straumann Zygomatic Implant ZAGA™ Flat ZAGA™ Round industry | will be immediately below the soft tissue will be immediately below the soft tissue of the vestibule. Vestibular dehiscence is of the vestibule. Vestibular dehiscence is difficult to prevent. This exposure of the plat- difficult to prevent. This exposure of the plat- form and the threads is due to muscle pull on the form and the threads is due to muscle pull on the unattached soft tissue. To minimise this risk in these unattached soft tissue. To minimise this risk in these cases, the ideal implant is the Straumann® Zygomatic cases, the ideal implant is the Straumann Zygomatic Implant ZAGA™ Flat because the flattened shaft allows Implant ZAGA™ Flat because the flattened shaft allows the neck and the body to be as submerged in the bone the neck and the body to be as submerged in the bone crest as possible (Figs. 14 & 15). The partial distribution crest as possible (Figs. 14 & 15). The partial distribution of the coronal threads helps to attain maximum bone-to- of the coronal threads helps to attain maximum bone-to- implant contact and completely seal the bone wound. implant contact and completely seal the bone wound. Therefore, this implant, being firmly seated in the bone, allows for high anchoring despite severe atrophy. The flattened middle part and flattened coronal part without vestibular threads do not compress soft-tissue vascular- ity. Therefore, they do not cause irritation over the sub- periosteal portion of the implant, and they avoid exposure and minimise long-term soft-tissue response. A 55° platform, screw-retained abutment and prosthetic versatility Zygomatic implants are inserted from the residual alveo- lar or basal bone to the frontal portion of the zygomatic bone. The axis between the bone crest and the zygo- matic bone is upwards and outwards. Furthermore, the emergence position of the zygomatic implant can be at a more medial position compared with standard max- illary implants. There must be angulation between the body of the implant and the head. An angled head is preferred to a straight implant head offset by a highly an- gled abutment for mechanical reasons. The one-piece angled head with an external hex connection increases mechanical strength, guaranteeing long-term mechan- ical behaviour. The 55° platform provides a higher an- gle and versatility for the restorative occlusal table, al- lowing for its location and emergence in the prosthetic arch (Figs. 16 & 17). In most cases, despite resorption, all screw access holes come out on the occlusal as- pect, and the implant neck in the bone crest, and are surrounded by bone as far as possible. The skills and abilities of the surgeon are necessary to achieve this and place a Straumann® Zygomatic Implant ZAGA™ Round. Unfortunately, severe resorption of the maxillary crest is centripetal and decreases in the sagittal plane and can be similar to pseudo-prognathism in extreme cases. This discrepancy between the two jaws creates problems in rehabilitation because placing the implant head in the anatomical dental position means that it exits alveolar bone. In this ZAGA 4 anatomy, the zygomatic implant is placed outside of the crest and has lateral bone sup- port at the implant platform. In this case, the bone is not sufficient to cover the middle portion or neck of the im- plant. It is important to perform an osteotomy, ensuring maximum coverage of the middle body and neck, and to place a Straumann® Zygomatic Implant ZAGA™ Flat, as 12 12 13 2 14 15 Fig. 12: Two designs for different anatomical situations. Fig. 13: Straumann® Zygomatic Implant ZAGA™ Round with coronal part surrounded by bone. Fig. 14: Straumann® Zygomatic Implant ZAGA™ Flat submerged as far as possible into bone crest. Fig. 15: The fl attened middle part does not compress soft-tissue vascularity. its coronal design and coronal micro-thread are adapted to this situation. The optimal abutment height of between 1.5 and 4.5 mm can be chosen at the end of surgery, and the abutment will be torqued to 35 Ncm (Fig. 18). A specific zygomatic screw-retained abutment was developed to ensure com- patibility with the Straumann bone-level (BL, BLT, BLX) prosthetic portfolio for fixed prostheses (Fig. 19). This 16 17 Fig. 16: The 55° platform provides a higher angle and versatility for the prosthesis. Fig. 17: Heal- ing caps on the screw-retained abutments and crestal emergence on the prosthetic arch. 3 2020 21
18 20 19 21 Fig. 18: One side with screw-retained abutment and one side before screwing on the abutments. Fig. 19: Specific zygomatic screw-retained abutment de- veloped to ensure compatibility with the Straumann bone-level prosthetic portfolio. Fig. 20: CAD/CAM high-precision milled titanium bar (Createch Medical). Fig. 21: A prosthetic design without any concavity that might trap food and with spaces for cleaning. means that the prosthetic steps, whether for a tempo- rary or definitive fixed restoration, are managed using existing products: Straumann screwdriver, impression copings, provisional titanium copings, and CAD/CAM high- precision milled titanium bar or cobalt–chromium framework ( Createch Medical). Prosthodontic rehabilitation also plays an important role, and it is important to empha- sise the design of a prosthesis without any concavity that could trap food and with cleaning spaces (Figs. 20 & 21). Conclusion When fixed rehabilitation for completely edentulous pa- tients cannot be achieved using conventional implants only owing to bone resorption, there are two surgical al- ternatives: grafting and a graftless solution. Bone grafting is a long process in cases of severe atrophy, and some- times the intra-oral donor sites are not sufficient and an extra-oral donor site is needed. Moreover, grafted bone resorption is common and unpredictable. A graftless solution using zygomatic implants is an effective option in atrophic jaws, and according to substantial data, it is a safe option in the management of severely resorbed edentulous maxillae. It decreases the time between sur- gery and fixed restoration, allows for a quick return to normal life thanks to immediate loading,12 and increases comfort and quality of life for patients.13 Obviously, the use of zygomatic implants by surgeons who are not comfort- able with the maxillofacial anatomy, the specific surgical protocol and the prosthetic vision is not recommended. that there can be various relationships between the zy- gomatic implant and the ridge and the lateral maxillary wall. Moreover, each side may be different in the same patient. When the bone volume and the sinus are not sufficient to maintain close contact between the crestal bone and the implant (ZAGA anatomy Type 4), the implant body and neck must be as submerged as possible in the bone crest in order to avoid soft-tissue compression and dehiscence. In such cases, the Straumann® Zygomatic Im- plant ZAGA™ Flat implant is indicated. Each implant has been designed to adapt to the patient’s anatomical situa- tion, and each part of the implants has been designed to be effective and safe. Literature about the authors Saint-Dié-des-Vosges based Dr Sepehr Zarrine specialises in complex implant rehabilitation, zygomatic implants and bone grafting. Dr Carlos Aparicio is the director of the zygomatic unit at the Hepler Bone Clinic and the ZAGA Centers in Barcelona. Dr Edmond Bedrossian is a Professor, Department of Oral & Maxillofacial Surgery, and the director of Implant Surgical Train- ing at the University of the Pacific, San Francisco. contact Author details The Straumann® Zygomatic Implant ZAGA™ Round and Straumann® Zygomatic Implant ZAGA™ Flat designs are the result of the work and collaboration of three sur- geons and engineers. Usually, the Straumann® Zygo- matic Implant ZAGA™ Round is inserted through the maxillary crestal bone and is apically stabilised in the zy- gomatic bone. Individual anatomical differences mean Dr Sepehr Zarrine 4 rue Alphonse Matter 88100 Saint-Dié-des-Vosges, France Phone: +33 663433624 dr.zarrine@gmail.com surgitechstudies.fr 22 3 2020
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| industry More effi cient workfl ows for crestal bone preservation BioHorizons Camlog, Switzerland The PROGRESSIVE-LINE implant system is an implant that is geared to facilitate various treatment concepts such as immediate placement and restoration. Combined with the new CAMLOG titanium base CAD/CAM PS, you have two powerful instruments at your disposal to minimise treatment time and improve aesthetic results. Time-effi ciency and precision PROGRESSIVE-LINE implants have been coupled with highly efficient protocols for the implant bed preparation in all bone types. Providing reliable support for demand- ing treatment plans, the well-thought-out features of this apically tapered implant are successfully tested to be particularly advantageous in soft bone and in combina- tion with sinus lift procedures. All PROGRESSIVE-LINE implants may be digitally planned and placed fully guided, and therefore go perfectly together with a final restoration placed in one session. The original implant–abutment connection Using the original titanium base CAD/CAM PS, you can rely on CAMLOG’s high standards in fitting accuracy and manufacturing preci- sion, ensuring abutment and implant are fully matched. In cooperation with dentists, the neck geometry of the abutment was adapted to the areas of CAMLOG implant applications, so that the concave emergence profile ideally supports the effect of platform switching. The outcome from the clinical test phase confirm the results of long-term stud- ies with CAMLOG implants:1 Platform-switching enables better clinical results than platform matching—especially regarding crestal bone preservation. The complete value chain in-house Marginal bone level six months after abutment placement. © Dr Frederic Hermann, TEAM 15 – Praxis für Zahnmedizin, Zug, Switzerland in-house. The CAMLOG titanium base CAD/CAM PS is available together with the abutment screw and bonding aid; the modelling aids are available separately and can be used as a base for a wax-up and for implementation in the casting or pressing technique. CAD libraries with the ge- ometries of the CAMLOG® titanium bases CAD/CAM PS for crowns, the scan body, and a suggestion for the milling geometry are available at www.camlog.de and www.camlog.com. Benefi ting the practice, laboratory, and patient The CAMLOG titanium base CAD/CAM PS is the adhe- sive base for customised crown abutments with platform switching. Thanks to integrated platform switching, the ti- tanium base PS helps you achieve aesthetic results more easily as well as optimised digital workflow in your prac- tice. Whether in cooperation with your laboratory or as complete in-house production, the production precision with original parts as well as time-efficient restoration ap- peals to practice, laboratory, and patients alike. contact Working with titanium bases CAD/CAM means taking advantage of the benefits of digital design and milling while optimising the workflow in practice. As a result, the treatment chair-time is minimised and—depending on the laboratory equipment—the complete added value of the prosthetic restoration of the implant can be kept BioHorizons Camlog Margarethenstr. 38 4053 Basel, Switzerland Phone: +41 61 5654154 www.biohorizonscamlog.com Literature 24 3 2020
BECOME AN AUTHOR for implants—international magazine of oral implantology Interdisciplinary, transparent & market orientated issn 1868-3207 • Vol. 21 • Issue 3/2020 3/20 implants international magazine of oral implantology industry New zygomatic implant design feature The art of ultra- aesthetic dentistry DGZI Special Onward to new horizons www.oemus.com Become part of a successful network and benefi t from a wide reach and high level of awareness Please send back your fax form or contact Mr Georg Isbaner: g.isbaner@oemus-media.de Phone: +49 341 48474-123 issn 1868-3207 Sondernummer • Vol. 4 • Issue 1/2020 1/20 ceramic implants international magazine of ceramic implant technology research Prosthetic complications after artificial ageing case report The key to optimal implant aesthetics interview ISMI and IAOCI join forces Fax: +49 341 48474-290 Yes, I want to become an author for implants—international magazine of oral implantology. I would like to submit an article on the following topic: Street, ZIP, City Last Name, First Name Yes, I want to become an author for ceramic implants—international magazine of ceramic implant technology. I would like to submit an article on the following topic: Phone, E-mail Stamp O EM U S M E D I A AG Holbeinstraße 29 · 04229 Leipzig · Germany · Phone: +49 341 48474-0 · info@oemus-media.de 0 2 / 3 s t n a p m l i
| feature The art of ultra-aesthetic dentistry Nasser Shademan, Malaysia 26 3 2020
feature | about the author Nasser Shademan is a certified dental tech- nologist and an internationally renowned smile designer, professional dental artist and ceramist with extensive knowledge and technical skill in the fields of aesthetic dentistry and micro- dental tech- nology. He is the founder of micro-aesthetic den- tistry and the developer of the “20-minute smile design” concept. He is currently a visiting professor at Goethe University in Frankfurt am Main in Ger- many. Shademan is an international speaker and conducts hands-on courses on different aspects of natural aesthetics and micro-dental artistry. He frequently publishes articles in dental journals throughout Asia, Australia, Europe and the US. when we pay close attention to detail in ev- ery step. I always produce the highest aes- thetic provisional restorations and test these closely for ultimate colour, form, texture and tooth arrangement with my type of most superior aesthetic provisional restorations, which I call “ultra-aesthetic provisional res- torations”. This is very helpful in guiding me and the entire aesthetics team towards un- derstanding all possible aesthetic challenges that may lie ahead, so we can plan the most natural and best-fitting solutions accordingly. Achieving highly aesthetic outcomes is only possible when dentists, ceramists and pa- tients team up in a sincere way in order to achieve individualised ideal outcomes. Techniques and materials This case shown in the image presented a number of aesthetic challenges, includ- ing discoloured natural abutments. Hence, a medium- transparency zirconia core was used with a multilayer ceramic build-up (according to the technique used to create ultra-aesthetic provisional restorations). The finest details were produced under 6–8 × magnification. contact Nasser Shademan Oral Max No. 21–2, 2nd Floor Jalan 26/70A, Desa Sri Hartamas 50480 Kuala Lumpur, Malaysia info@oralmaxinternational.com www.facebook.com/nasser.shademan.3 www.instagram.com/nassershademan There are times when we copy the natu- ral teeth of patients and fabricate an identi- cal yet improved version of them. This means that we apply improvements on many differ- ent levels, including colour or smile arrange- ments, in order to turn the old, misaligned and broken natural smile into an almost iden- tical but beautified version. Natural smiles are not always aesthetically suited to the individ- ual face of a person, and if a patient agrees to undergo aesthetic treatment, then we have a good opportunity to turn something good into something even better. There are some- times instances when a patient has ante- rior teeth that are relatively large in size and their anatomy, arrangement and texture do not particularly support the patient’s facial make-up, sex or age. In addition, there are situations where the patient has lateral inci- sors which are somewhat large in size or are deformed, or has poorly shaped canines. In many cases, we are able to improve the co- lour arrangements of teeth. Naturally, we do not follow the previous colour map of the pa- tient’s natural teeth, but we recast it into a new, more aesthetic tooth colour map. You might come across a patient who is very slim and small in size and has a tiny feminine face, but who has a surprisingly masculine smile owing to a relatively large set of anterior teeth. This is, of course, natural, but it might create an unpleasant impression regardless. Once aesthetically enhanced, the smile will actually appear more harmonious and there- fore even more natural-looking. Reproducing natural aesthetics is an uncom- promising journey, which is best completed 3 2020 27
| interview Bringing titanium and zirconia together in one implant In 1992 Prof. Günter Heimke proclaimed in Hamburg: “The goal is to have an implant body made from tita- nium on the inside, whereas the neck and the over-all shape on the outside are made of ceramics.” Now, af- ter more than 25 years, this vision has finally become reality in the form of the hybrid implant from TIZIO Hy- brid Implants. But how do you actually bring titanium and zirconia together in one system? And what role do glass solders play here? These are some of the ques- tions that Hamburg-based implant specialist Dr Anders Henningsen, M.A., answers in the following interview with implants. Dr Henningsen, the hybrid implant from TIZIO Hybrid Implants contains a grade IV titanium implant body with an outer shell made of alumina toughened zir- conia (ATZ). In which ways is such an implant differ- ent from conventional titanium or ceramic systems? A hybrid implant combines the advantages of both mate- rials. For example, zirconia provides high aesthetics ow- ing to its white tooth-like colour. Additionally, the hybrid The TIZIO implant system is available in two versions: as classic two-piece system (TIZIO F3), which enables implant placement at bone level and covered healing, and as a system with an extended neck made of ceramics (TIZIO H6), which allows implant placement at tissue level. In general, TIZIO offers a wide range of products for a variety of indications. 28 3 2020 Dr Anders Henningsen “[…] the hybrid implant possesses an improved tensile strength and it is able to absorb shear forces more effectively than conventional ceramic implants.” implant possesses an improved tensile strength and it is able to absorb shear forces more effectively than con- ventional ceramic implants. Thanks to the outer ceramic layer, a significantly higher biocompatibility is achieved compared to conventional implants. Apart from that, the roughness of the implant surface is not achieved by sub- stance removal, as is the case using sand-blasting, for instance. Instead, a glass layer is applied to the surface, which is fired. Using this method, the implant surface is roughened, which promotes osseointegration and tissue healing. The glass matrix adheres to the surface, does not peel off during insertion and is very biocompatible.
interview | With titanium and zirconia, the hybrid implant from TIZIO combines the two most prominent implant ma- terials. Which technology is required to bring these materials together in one system? With the aid of glass soldering, a strong and novel kind of bond is formed between the two materials. Titanium and zirconia are bonded together using glass solders, which diffuse into the materials at high temperatures. The ceramic and metallic materials must meet specific requirements, especially with regard to the CTE value (coefficient of thermal expansion), in order to work in this innovative production method. Alumina toughened zirconia and grade IV titanium have proven to be the most suitable materials. currently being tested. As for prosthetics, ceramic abut- ments based on the hybrid principle are already in de- velopment, too. “Thanks to the outer ceramic layer, a significantly higher biocompatibility is achieved compared to conventional implants.” The hybrid concept from TIZIO Hybrid Implants is quite a novelty. Are there any differences to conven- tional titanium or ceramic implants regarding long- term stability and implant loss rates? Concerning long-term stability, there are no factors which indicate that hybrid implants from TIZIO might be not as stable as other implants. Statements about implant loss rates are not yet available, however, and studies are still being carried out. Yet, animal experiments required for approval indicate that the hybrid implants are compara- ble with conventional implants in terms of osseointegra- tion and tissue integration. There are no significant differ- ences between TIZIO Hybrid Implants and a conventional titanium implant, for example. contact Dr Anders Henningsen, M.A. Specialist in Maxillofacial Surgery and Dental Implantology Elbe MKG Sülldorfer Kirchenweg 1 A 22587 Hamburg, Germany Phone: +49 40 8669366-0 www.elbe-mkg.de 3 2020 29 The hybrid implant from TIZIO was designed as two-piece system and is also available with an ex- tended ceramic neck. Which benefits does this offer? First, there is no need for scalloping or grinding, which is a significant benefit. Moreover, components can be re- placed at wish and at any time—when prosthetics need renewing, for example. Additionally, hybrid implants al- low clinicians to react flexibly to changes in the patients’ clinical situation. Free-hand situations can be mastered easily, crowns are easily removable, bridges can be real- ised and removable dentures can be anchored. Generally speaking, prosthetic restorations on hybrid implants can be extended or converted at any time. What are the advantages and challenges with regard to surgical and prosthetic handling? The implant is easier to handle than a conventional ce- ramic implant. Thanks to the titanium insert, there is sig- nificantly less prosthetic loosening. Additionally, angu- lation problems can be compensated with abutments, which leads to an increase in stability of prosthetic res- torations. During implant insertion, it is important to choose a torque that is not too high. Unfortunately, since reduced-diameter implants are not yet developed to market maturity, the hybrid implant is not suitable for all anatomical situations at this point. There are still tech- nical obstacles to overcome regarding the restoration of narrow tooth gaps with reduced-diameter implants. However, a hybrid implant with a diameter of 3.6 mm is
| manufacturer news bredent medical Highest primary stability—now with conical-parallel connection The new copaSKY implant line from bredent is particularly dis- tinguished by the stable and retrievable conical-parallel-walled interface, which enables easy removal of the prosthetics. The unique neck design and short implant–abutment connection also allows ultrashort implants. Due to the deposition of bone chips on the backtaper, a subcrestal implant position can also be selected. copaSKY uses the same surgical tray as all other SKY implants. And the enhanced prosthetic offering one connection that fi ts all diameters of implants, simplifying storage and reduc- ing inventory. The material of choice is BioHPP, which provides a natural chewing sensation and built-in shock absorber effect to protect implants. Also new is the form-fi t connection for bolted bridge components. The high accuracy of fi t directs the lateral load directly onto the abutment, i.e. the risk of screw loosening and fractures is greatly reduced. The integrated angled screw channel provides excellent aesthetic results when transversally threaded. bredent medical GmbH & Co. KG Weißenhorner Straße 2 89250 Senden, Germany www.bredent-implants.com TIZIO Hybrid Implants Implants made of titanium or ceramic? Neither dental practitioners, nor patients need to be confronted any longer to this either-or-question. Thanks to the innovative glass soldering technique, it will henceforth be possible to create a fi rmly bonded compound between titanium and dental ceramic in order to merge the benefi ts of both materials. The titanium core in- side the hybrid implant gives the usual safety and stability, as well as high prosthetic fl exibility and ultimately the required treatment quality. The outer ceramic shell coated with a glass matrix ensures an optimal tissue compatibility, improved aesthetics furthermore less plaque accumulation and thus a lower risk of peri-implantitis. Simultaneously, we constantly aim for innovative solutions in order to give both, patients as well as dental practitioners, the highest possible therapeutic safety and quality. For this purpose, we per- form research and development on innovative materials with peo- ple from various disciplines, being driven by our guiding principle: TIZIO—The best bonding between man and technology. TIZIO Hybrid Implants GmbH Breite Straße 16 18055 Rostock, Germany www.tizioimplants.com 30 3 2020
manufacturer news | Straumann MIS Flapless periodontal Flapless periodontal New 16 mm drill kit for conical regeneration regeneration connection implant procedures Literature This year marks the 25th anniversary of Straumann This year marks the 25th anniversary of Straumann® Emdogain®. The revolutionary technology induces true Emdogain . The revolutionary technology induces true regeneration, improves wound healing and increases regeneration, improves wound healing and increases the periodontal procedure predictability. But the periodontal procedure predictability. But innovation within the Emdogain® portfolio innovation within the Emdogain is only continuing. Thanks to the launch is only continuing. Thanks to the launch of Emdogain® FL, true periodontal regen- of Emdogain FL, true periodontal regen- eration1,2 is now possible in a minimally eration1,2 is now possible in a minimally invasive way. Cleaned pockets of between invasive way. Cleaned pockets of between 5–9 mm* deep can now be treated without 5–9 mm* deep can now be treated without a surgical fl ap. This is possible thanks to a surgical fl ap. This is possible thanks to Straumann® Emdogain®’s healing properties Straumann Emdogain ’s healing properties and a new applicator that is as thin as a peri- odontal probe. Emdogain® FL helps clinicians treat up to 42 % more pockets from the initial phase of periodontal therapy3, which reduces the need for follow-up treatments, including surgery. Emdogain® FL contains Straumann®’s unique enamel matrix protein formulation, which is backed up by over 1,000 studies4 and 25 years of clinical experience. Try Straumann® Emdogain® FL and differentiate your dental offi ce with fl apless periodontal regenerative therapy. * Without furcations or recession involvement. A thorough subgingival As part of the company’s continuing effort to offer comprehensive solutions for guided surgery procedures in all clinical scenarios, this spring, MIS released their new MGUIDE kit for 16 mm conical connection drills used in implant placement procedures. The new kit has already been implemented in MSOFT, the MIS software used for guided procedure planning, and is offered through an au- tomatic update. This new offering extends the existing solution for this range of implant lengths that were not previously available. The kit includes all drills for a complete procedure, as well as the addition of a marking drill which is intended for extraction sites. Orit Kario, MIS Digital Solutions Product Manager, highlights the marking drill, explaining that “it was designed for this “it was designed for this specifi c kit and enables drill- specifi c kit and enables drill- ing within sockets, providing ing within sockets, providing an added value in immediate an added value in immediate placement procedures within ex- placement procedures within ex- traction sites. The drill’s design al- traction sites. The drill’s design al- lows to drill in through the socket lows to drill in through the socket wall. In addition, the same kit wall. In addition, the same kit may be used for both standard and narrow sleeve drills. cleaning is the key to success. Institut Straumann AG Peter Merian-Weg 12 4000 Basel, Switzerland www.straumann.com BioHorizons Camlog MIS Implants Technologies GmbH Simeonscarré 2 32423 Minden, Germany 32423 Minden, Germany www.mis-implants.com The next generation soft-tissue augmentation material When choosing a biomaterial, there is a strong demand in clini- cal practice for predictable outcomes. For over 20 years, LifeCell, a leading global medical technology company, has developed innovative products for use in a wide range of applications. BioHorizons Camlog expands its soft-tissue portfolio to bring NovoMatrix, an innovative soft-tissue augmentation material. NovoMatrix is an acellular extracellular dermal matrix consist- ing of tissue-engineered porcine material. It is a breakthrough in xenogeneic processing ensuring a structurally intact, undamaged scaffold that supports cell and microvascular ingrowth. The proprietary tissue processing allows for rapid revascularisation, cell repopulation and minimal infl ammation. NovoMatrix comes pre-hydrated and ready to use and offers a true alternative to autogenous soft-tissue grafts and current products on the market. The NovoMatrix indications include guided tissue regeneration procedures in recession defects for root coverage, localised gingival augmentation to increase keratinised tissue (KT) around implants and natural teeth, and alveolar ridge reconstruction for prosthetic treatment. Camlog Biotechnologies GmbH Margarethenstr. 38 4053 Basel, Switzerland www.biohorizonscamlog.com 3 2020 31
| manufacturer news TBR Dental Tissue-level implant and digital workfl ow Combining a titanium body and a zirconia collar, the worldwide unique Z1® implant offers many advantages. It is a tissue-level implant and thus only one surgical procedure is required. In addition, the zirconia collar promotes soft-tissue healing and provides optimal aesthetic results for the patient. With the launch of its new range Index, TBR is now offering clinicians a complete digital workfl ow: from the scanning phase with intra-oral scanners and CBCT devices to the milling phase with machines adapted to your needs, including suitable CAD/CAM software, associated materials and consumables. The virtuous com- bination of implantology with the Z1 implant system and the Index digital workfl ow ensures optimal ergonomics and shorter chair times, which is essential in the daily dental practice. Combine superior aes- thetics and digital design with Z1 implants and TBR CAD/CAM Index dental solutions today! TBR Dental Group 24, impasse René Couzinet 31500 Toulouse, France www.tbr.dental PreXion Special autumn deal for CBCT system Special autumn deal for CBCT system The Japanese CBCT specialist PreXion enters the second half of this year The Japanese CBCT specialist PreXion enters the second half of this year with a special autumn offer for customers based in Germany, Austria and with a special autumn offer for customers based in Germany, Austria and Switzerland. The special price for the PreXion3D EXPLORER includes the Switzerland. The special price for the PreXion3D EXPLORER includes the CBCT system, installation, instruction, fi ve-year warranty, and a computer CBCT system, installation, instruction, fi ve-year warranty, and a computer running the PreXion Viewer Software. Additionally, customers can opt for running the PreXion Viewer Software. Additionally, customers can opt for the attractive package including the pre-installed SICAT Suite and receive a the attractive package including the pre-installed SICAT Suite and receive a special discount (66 per cent on the subscription price). With a focal point special discount (66 per cent on the subscription price). With a focal point of 0,3 mm and a voxel size of just 74 μm, the PreXion3D EXPLORER brings of 0,3 mm and a voxel size of just 74 μm, the PreXion3D EXPLORER brings an extraordinary combination of great image detail and low ra- an extraordinary combination of great image detail and low ra- diation exposure to dental practices and clinics. diation exposure to dental practices and clinics. Another highlight is the integrated cephalometric Another highlight is the integrated cephalometric “One-Shot” mode, which allows the work in limited “One-Shot” mode, which allows the work in limited spaces. Interested ones are warmly invited to live spaces. Interested ones are warmly invited to live demonstrations of the PreXion3D EXPLORER at the demonstrations of the PreXion3D EXPLORER at the PreXion showroom in Rüsselsheim in Germany. Ap- PreXion showroom in Rüsselsheim in Germany. Ap- pointments can be made online at www.prexion.eu, pointments can be made online at www.prexion.eu, via e-mail at info@prexion-eu.de or by phone under via e-mail at info@prexion-eu.de or by phone under +49 6142 407855. +49 6142 407855. PreXion (Europe) GmbH PreXion (Europe) GmbH Stahlstraße 42 65428 Rüsselsheim, Germany 65428 Rüsselsheim, Germany www.prexion.eu 32
manufacturer news | Dentsply Sirona Implants Bicon Versatility with the Astra Tech More than just an alternative to Implant System EV sinus lift and augmentation Dentsply Sirona Implants continues to deliver Dentsply Sirona Implants continues to deliver innovation, versatility and clinical benefi ts in im- innovation, versatility and clinical benefi ts in im- plant dentistry, based on the needs of customers plant dentistry, based on the needs of customers and centred around well-documented and clin- and centred around well-documented and clin- ically proven implant systems. With the latest ically proven implant systems. With the latest product development, the Astra Tech Implant product development, the Astra Tech Implant System—one of the most well-documented im- System—one of the most well-documented im- plant systems in the market today, documented plant systems in the market today, documented in over 1,000 publications in peer-reviewed in over 1,000 publications in peer-reviewed journals—just got even better: Astra Tech journals—just got even better: Astra Tech Implant EV has a revised implant design Implant EV has a revised implant design change that comes with signifi cant ad- change that comes with signifi cant ad- vantages—with a deeper implant thread vantages—with a deeper implant thread design apically, it is easier to reach pre- design apically, it is easier to reach pre- ferred primary stability and the handling ex- ferred primary stability and the handling ex- perience is enhanced for easy installation. With this perience is enhanced for easy installation. With this new change in design properties also comes the new name—Astra Tech Implant EV. Dentsply Sirona Implants continu- ally strives to increase the application of implant therapy, based on science and without compromising safety and effi cacy. The plateau design, which has been clinically proven for 35 years, and the self-locking tapered implant–abutment connection are the most important success factors of the popu- lar Bicon SHORT Implant™ system. While screw implants can cause bone loss un- der unfavourable conditions, experts as- sociate the so-called “plateau anchors” with possible bone gain. The plateau design, which offers at least 30 per cent more bone surface than comparable screw implants, makes all the difference. Studies indicate that the unique Bicon design favours the forma- tion of mature lamellar Haversian bone. In addition, the biomechan- ical advantages of the plateaus optimise lateral force distribution, which supports bone preservation. The self-locking, bacteria-proof connection and the integrated platform-switching additionally pro- mote the long-term success of the system in terms of function and aesthetics. With implant lengths of 5, 6, 8, and 11 mm, Bicon serves the entire range of indications in daily implant dentistry. Dentsply Sirona Implants Aminogatan 1 41321 Mölndal, Sweden www.dentsplysirona.com/implants Bicon 501 Arborway Boston, MA 02130, USA www.bicon.com Fotona Peri-implantitis treatment with TwinLight Fotona’s dual-wavelength LightWalker dental laser system is the ideal tool for effective minimally-invasive treatment of peri- implantitis. The system’s TwinLight (Er:YAG and Nd:YAG) treatment option successfully addresses infection control, detoxifi cation of implant surfaces, regeneration of lost tissues, and plaque-control regimens with no mechanical or chemical trauma, no danger of thermal damage to the surrounding bone and no signifi cant al- terations of the implant surface. First, the Er:YAG laser is used to remove microbial composition on the implant and to treat the damaged alveolar bone around the implant. Following Er:YAG treatment, the Nd:YAG laser wavelength is used for bacterial re- duction and biostimulation. Infl ammation, swelling, and bleeding of soft-tissue lesions, can be handled without surgery, and healthy peri-implant tissue assures greater long-term implant success. 1 2 3 Fig. 1: Removal of the soft-granulation tissue and ablation of the infected bone with Er:YAG. Fig. 2: Removal of the bacterial biofi lm on the implant sur- faces with Er:YAG. Fig. 3: Bacterial reduction and biostimulation of the bone tissue with Nd:YAG. Fotona d.o.o. Stegne 7 1000 Ljubljana, Slovenia www.fotona.com 3 2020 33
| DGZI Special Onward to new horizons In late 2019, long-standing board member of the Ger- man Association of Dental Implantology (DGZI) Dr Georg Bach was elected as new President of the professional society. In this interview, Bach talks about the impor- tance of DGZI, the oldest professional society for im- plantology in Europe, and what can be expected from the 3rd Future Congress for Dental Implantology, which is set to take place this autumn in Bremen in Germany. The society’s 50th anniversary will be celebrated at the congress too. Dr Bach, there are many other professional implan- tology associations in Germany. As Europe’s oldest professional implantology society, where does DGZI stand in comparison with the others? One thing upfront: DGZI is well positioned! As a profes- sional society, we are very stable and our members are steadily, albeit moderately, growing in numbers. DGZI is an internationally networked society and over the last de- cades, strong bonds and friendships have been estab- lished on a global scale. Here, I would like to mention our close ties to Japan and the Arab region in particu- lar. Of course, we are not alone in the world. There are many professional implantology associations. The fact that DGZI is the oldest of all European professional soci- eties is fascinating, but at the same time, it comes with a great deal of responsibility. Mere tradition is not enough to move things forward. A professional society must con- stantly question and redefine itself. I think that DGZI, by accepting young colleagues on to the board and by be- ing in solidarity with the dental technicians who are also members of the board, has tackled important questions about its future and answered them to a large extent. As far as the other professional associations are concerned, we at DGZI are committed to following the paths that we’ve previously taken and which have proved to be suc- cessful, as we constantly seek to engage in fruitful and harmonious cooperation. Despite frequent medical and academic collabora- tion, professional societies are often in competition with one another. Against this background, what dis- tinguishes DGZI? As is the case with any competition or any market, you can only survive by being appealing and performing well. Every day, you start anew. Yet, what we offer and our In conversation with Jürgen Isbaner (board member of OEMUS MEDIA AG), Dr Georg Bach (left) reveals DGZI’s recipe for success. 34
DGZI Special | range of services seem to have established quite a good reputation for us. Our members are growing in number, and there is a high level of satisfaction among the partici- pants in our training courses and curricula, which speaks for itself. I believe that our highly professional manage- ment is the bedrock of DGZI. Here, our board, our office in Düsseldorf and, above all, our business management led by Dr Torsten Hartmann must be mentioned. More- over, we are making an enormous impact with our Ger- man language Implantologie Journal. And then there’s “DGZI is an internationally networked society and over the last decades, strong bonds and friendships have been established on a global scale.” our international magazine implants, which is published in 98 countries across the globe and is vital for consol- idating our connection with our partners abroad. Inter- nationally speaking, I believe implants has a standing that is second to none. I would also like to mention the coaching books by DGZI Vice President and Treasurer Dr Rolf Vollmer, into which he has put an incredible amount of hard work and which have been particularly well received abroad. Lastly, I believe that our Future Congress is something that also sets us apart from the rest. What in particular makes the Future Congress so special? It’s not easy for professional societies to hold a success- ful congress every year and we assessed this problem together with our media partner OEMUS MEDIA. The concept of the classic parliamentary seating with a wide variety of parallel podiums has been successful for de- cades. However, we could see no way of developing this format further. We thus developed the Future Con- gress—an innovative concept involving first-rate lectures, the transmission of live operations into the conference hall, an extensive range of table clinics and the integra- tive industry exhibition. At our Future Congress, we raise new questions, try to give satisfactory answers and pres- ent new ways of interaction between participants, speak- ers and the industry. This approach is also reflected in an updated organisational concept in that the original frag- mentation of the congress into various different podiums, workshops and side programmes has been eliminated, and the overall appeal of the conference as an event for practitioners has been more focused. There is now an industry day on Friday and a science day on Saturday. In this way, the event has become particularly attractive to implantologists working in private practice and to the younger generation too. What can members, scientists and researchers, as well as industry partners, look forward to at your anniversary congress this autumn? This year, we’re celebrating not only 50 years of DGZI but also the birthday of established implantology, thanks to the courage and the visions of the DGZI founders back in the seventies. Back then, our profession was still in its in- fancy and often even frowned upon, and the formation of a dedicated professional society contributed to establish- ing implantology in Germany and enabling it to reach the level at which it is today. What we can accomplish today and the techniques we’ve been able to master are things that even many of us, even though optimistic, would not have dared to hope for back in 1970. I regard our an- niversary this autumn as also a birthday for European implantology, and I am pleased that the presidents and board members of other professional societies have ac- cepted the invitation to attend our 3rd Future Congress— the 50th DGZI International Annual Congress—which will be held on 6 and 7 November 2020 in Bremen, the city where DGZI was founded. We are going to reflect on the past and, at the same time, put a strong focus on look- ing ahead. Indeed, we are facing great challenges: im- plantology is constantly changing and will be revolution- ised in the coming years, owing to rapid advancements made in the field of digitalisation. As a professional soci- ety, we’ll have to find new ways to guide the next genera- tion on their way forward in the profession. In this respect, we noticed, at our 2019 congress in Munich, that DGZI is becoming increasingly successful in attracting young people. This rejuvenation process has reached the DGZI board too. In addition, last year, we appointed a woman to the board for the first time. As you can see, there’s a lot happening at DGZI. Thank you for these great insights, Dr Bach. contact Dr Georg Bach Rathausgasse 36 79098 Freiburg im Breisgau, Germany doc.bach@t-online.de 3 2020 35
| DGZI Special Refl ect on 50 years of implantology in Bremen this autumn OEMUS MEDIA AG, Germany definition into the conference room and online, an exten- sive range of table clinics with hands-on appeal, an inter- active digital poster presentation and a colourful industry exhibition by selected partners are an integral part of the autumn congress. At the Bremen event, attendees will be given the opportu- nity to reflect on 50 years of implantology, discuss topical questions and paint a picture of prospective implantology in a fruitful interprofessional exchange with dental enthu- siasts, renowned speakers and industry representatives from Germany and abroad. In addition, the organisers have developed a unique and updated congress struc- ture in that the usual fragmentation of the congress into various podiums, workshops and side programmes will be eliminated. On both congress days, all lectures, panel discussions, live surgeries and table clinics will take place on the main podium, which also serves as exhibition area. Parallel to the Future Congress of the DGZI, the annual meeting of the German Association for Laser Dentistry (DGL) will take place in Bremen. The two professional as- sociations will share the congress infrastructure, indus- trial exhibition area and facilities for the table clinics. Ad- ditionally, there will be a special programme dedicated to oral hygiene. For more information, go to www.dgzi-jahreskongress.de or contact the organiser at event@oemus-media.de. The DGZI and the organiser OEMUS MEDIA AG are look- ing forward to welcoming you to the Hanseatic city of Bremen this November. contact On 6 and 7 November 2020, the 3rd Future Congress for Dental Implantology/50th International Annual Congress of the German Association of Dental Implantology (DGZI) will take place in Bremen in Germany. Under the theme “Visions in Implantology: 50 Years—From single Implant to digital Workflow”, the professional association will be celebrating its 50th anniversary. It was in Bremen where a group of implantology enthusiasts helmed by dentist Hans L. Grafelmann founded the DGZI in 1970, the first European professional association dedicated to dental implantology. As one of the main highlights of the highly anticipated event, Presidents, chairmen and board members of the DGI, DGOI, BDO, DGZI as well as Past Presidents of numerous other professional societies will hold scientific lectures as part of the main programme. Being the oldest dental expert society for dental implan- tology in Europe, the DGZI still breaks the mould today and proves its forward-thinking attitude with a highly modern congress concept. First-rate lectures, the live streaming of surgeries and dental procedures in high OEMUS MEDIA AG Holbeinstraße 29 04229 Leipzig, Germany Phone: +49 341 48474-0 event@oemus-media.de 36 3 2020
50 Years – From single Implant to digital Workflow VISIONS IN IMPLANTOLOGY 3RD FUTURE CONGRESS FOR DENTAL IMPLANTOLOGY 6 –7 November 2020 Maritim Hotel & Congress Centrum Bremen/Germany DOWNLOAD REGISTRATION FORM event@oemus-media.de Simultaneous translation German/English. Register now at: event@oemus-media.de OEMUS MEDIA AG · Holbeinstraße 29 · 04229 Leipzig · Germany · Phone: +49 341 48474-308 · Fax: +49 341 48474-290 · event@oemus-media.de · www.oemus.com VISIONS IN IMPLANTOLOGYBREMEN6–7 November 202050th DGZI INTERNATIONAL ANNUAL CONGRESS3rd FUTURE CONGRESS FOR DENTAL IMPLANTOLOGYPremium partner:© Mapics – stock.adobe.com© Hennadii H/Shutterstock.com
| DGZI Special DGZI supports practitioners in Becoming ABOI/ID Diplomates In 2019 the American Board of Oral Implantology (ABOI) in the US decided to make the ABOI/ID Diplomate examination avail- able for experienced dental practitioners internationally. The ABOI has an independent examination committee chartered by the American Academy of Implant Dentistry (AAID), the official US partner of DGZI. The DGZI board has defined the necessary con- ditions. Graduates of the “DGZI Curricu- lum Implantology”, as well as holders of both “Expert in Dental Implantology” and “Specialist in Oral Implantology” certifica- tion are now eligible to apply for this ex- amination to become ABOI/ID Diplomates. DGZI can offer its support on request in preparing for the written and oral exam- ination through a preparatory seminar, in which situations similar to an examination are played through and specific contents DGZI Online Campus International online training wherever you are The structure and content of DGZI’s successful implantology curriculum was revised in 2019. All participants now have access to the ITI Academy, where young dentists with little experience in implantology can learn the basics of implant dentistry. All participants in the curriculum will start their training in the new “DGZI Online Campus”. This has been completely redesigned and enables e-learning from all devices and from anywhere you have online access. The theoretical basics of implant den- tistry are well presented and taught in sepa- rate modules. Each module ends with a learning success check, which can be practised as often as required in advance in test examinations. After successful online training, three practice-related compulsory modules and two therapy-related optional modules follow. The curriculum is supported by special learning materials of the DGZI Online Campus. Start with the new concept of the DGZI online training at home or wherever you are—that is Blended Learning! Now at DGZI! Contact: sekretariat@dgzi-info.de; info.vollmer@t-online.de 38 3 2020 for the oral examination are conveyed. The preparation for the written examination is based on our English language “Guide Book Implantology”, which helps applicants to comfortably pre- pare for the examination via distance e-learning. The e-learn- ing preparation can be started at short notice at any time. The first oral preparatory examination date is scheduled for the 50th International Annual Congress of DGZI, which will be held on 6 and 7 November in Bremen, Germany, and to which you are cordially invited. The examinations will take place one day ahead of the congress, on 5 November 2020. If you are interested in this new offer, please contact Dr Rolf Vollmer (First Vice President and Treasurer of DGZI) for more informa- tion via e-mail at info.vollmer@t-online.de. Source: DGZI m o c . k c o t s r e t t u h S / s s u m a e s / a d o o v a d ©
SUBSCRIBE NOW! implants—international magazine of oral implantology ONLINE SUBSCRIPTION HERE Interdisciplinary, transparent & market orientated www.oemus-shop.de 0 2 / 3 s t n a p m l i stay updated: industry New zygomatic implant design feature The art of ultra-aesthetic dentistry DGZI Special Onward to new horizons Fax: +49 341 48474-290 Last Name , First Name I would like to subscribe for the following journals: Company implants—international magazine of oral implantology 4 issues p.a. E 44* Street ceramic implants—international magazine of ZIP, City, Country ceramic implant technology 2 issues p.a. E 30* Terms & Conditions: The subscription may be cancelled in written form without due justification within 14 days of order by contacting OEMUS MEDIA AG, Holbeinstraße 29, 04229 Leipzig, Germany. Dispatching notification in good time will suffice. The subscription is automatically extended by another 12 months if it is not cancelled in written form 6 weeks prior to the end of the reference period. E-mail Signature * All prices include VAT, shipping and handling. Credit Card Number Expiration Date Security Code O EM U S M E D I A AG Holbeinstraße 29 · 04229 Leipzig · Germany · Phone: +49 341 48474-201 · s.schmehl@oemus-media.de 3/20issn 1868-3207 • Vol. 21 • Issue 3/2020implantsinternational magazine of oral implantologyindustryNew zygomatic implant designfeatureThe art of ultra- aesthetic dentistryDGZI SpecialOnward to new horizonsresearchProsthetic complications after artificial ageingcase reportThe key to optimal implant aestheticsinterviewISMI and IAOCI join forcesceramicinternational magazine of ceramic implant technologyimplantsissn 1868-3207 Sondernummer • Vol. 4 • Issue 1/20201/20
| news © Koelnmesse/IDS Cologne Organisers reveal COVID-19 Safety measures for IDS 2021 IDS 2021 is scheduled to take place from 9 to 13 March next year in Cologne in Germany. “In the past few months, we developed a comprehensive concept for restarting trade fairs in Cologne based on extensive processes and close cooperation with all the relevant authorities,” commented Oliver Frese, chief operating offi cer of Koelnmesse. A joint press release from the Association of the Ger- man Dental Industry (VDDI) and its business enterprise, the Society for the Advancement of the Dental Industry (GFDI), explained that Koelnmesse’s #B-SAFE4business health measures are grouped into the four sections: SHOW SAFE, MEET SAFE, STAY SAFE and VISIT SAFE. The measures will regulate interaction at the trade fair by providing ample space for spreading large numbers of partici- pants out safely throughout the exhibition halls, in which a digital signage system will enhance communication. Stands will be allot- ted more fl oor space so that the number of visitors at individual stands will not need to be limited, provided that a minimum distance of 1.5 m can be maintained. The distribution of trade fair partici- pants and the fl ow of visitors will be monitored and, if necessary, regulated using technical solutions. Visitors will only be able to pur- chase tickets online so that the organisers can ensure traceability of all participants. Koelnmesse said that it would review its safety concept on a regular basis and adapt it to changing conditions. Source: Koelnmesse/Dental Tribune International COVID-19 and domestic violence: How dentists can help those in need pandemic began. A paper recently published in the British Dental pandemic began. A paper recently published in the Journal (BDJ) sought to clarify what role dental professionals, Journal (BDJ) sought to clarify what role dental professionals, Journal (BDJ) sought to clarify what role dental professionals, Journal particularly oral and maxillofacial surgeons, play in such particularly oral and maxillofacial surgeons, play in such situations and how they can better help patients who situations and how they can better help patients who have been affected by this form of abuse. As empha- have been affected by this form of abuse. As empha- sised by the authors, studies suggest that between sised by the authors, studies suggest that between 65 and 95 % of physical domestic violence assaults 65 and 95 % of physical domestic violence assaults result in facial trauma for the victim. Therefore, den- tal professionals have an important duty to iden- tify patients who may have been assaulted in this manner and to refer them to the appropriate local manner and to refer them to the appropriate local agencies and services. Dr Paul Coulthard, co-author agencies and services. Dr Paul Coulthard, co-author of the study, told Dental Tribune International: “There of the study, told Dental Tribune International: “There has been a heightened awareness of the increased risk has been a heightened awareness of the increased risk of domestic violence and abuse because of restrictions on of domestic violence and abuse because of restrictions on movement and the need for household isolation, so dental movement and the need for household isolation, so dental professionals and the oral maxillofacial surgery team should professionals and the oral maxillofacial surgery team should be increasing their alertness and commitment to identifi cation be increasing their alertness and commitment to identifi cation and referral.” The paper, titled “COVID-19, domestic violence and abuse, and urgent dental and oral and maxillofacial surgery care”, was published online on 26 June 2020 in the British Dental Journal. Source: Dental Tribune International © Tinnakorn jorruang/Shutterstock.com According to UN Women, a United Nations body dedicated to gen- der equality, the outbreak of COVID-19 has been accompanied by a shadow pandemic of increased domestic violence against women. In Argentina, for example, emergency calls related directly to instances of domestic violence have risen by 25 % since the 40 3 2020
news | FDI disagrees with WHO’s latest guidance In early August the World Health Organization (WHO) released in- terim guidelines regarding dental visits, in which they advised that “routine non-essential oral health care—which usually includes oral health check-ups, dental cleanings and preventive care— be delayed until there has been sufficient reduction in COVID-19 transmission rates.” In response to the guidelines, the FDI World Dental Federation published a statement on their website, in which they argue that “[…] oral healthcare is essential to maintaining good overall health and routine care is necessary for the early detection, prevention, and control of oral diseases.” The statement further reads: “FDI and its approximately 200 member associa- tions in 130 countries have put measures in place to ensure that patients and staff are adequately protected from infection risk to avoid viral transmission […].” The statement concludes that “con- trary to recent media reports, people can safely visit the dentist and utilise oral health services, in the context of COVID-19, if a country’s regulations permit this.” The WHO have since released © dennizn – stock.adobe.com another statement, arguing that “misinterpretation of the WHO document has led to widespread confusion and the circulation of inaccurate and misleading information in some media outlets.” Source: FDI World Dental Federation “CleanImplant Certified Dentists” in 19 countries Initiative creates safety for implantologists and patients For many years, CleanImplant has been performing quality as- sessment studies on sterile packaged implants in accredited test- ing laboratories. The “Trusted Quality” seal for clean implants can only be awarded after an independent evaluation of test results has successfully been completed in a strict peer-review process. “Alarming contamination on many other test samples should raise concerns for every practitioner,” says Dirk Duddeck, dentist and founder of the non-profit CleanImplant Foundation. Study results show quite clearly that neither the exposed market position of manufacturers nor the country of production or the price alone can provide any certainty that the implants sold are actually clean. Sig- nificant residues of detergents, silicon compounds or polyacetal— even on ceramic implants—from the production and packaging process have been found on sterile packaged samples. “We’ve also seen metallic particles with nickel- or copper-containing com- pounds on dental implants. Implant quality seems to be getting out of hand—and we are no longer alone with this criticism. Three years ago, we launched an ini- tiative for residue-free implants on the internet. We never dreamed that we would have almost 100,000 dental professionals following us on Facebook in such a short time”. In the mean- time, implantologists from 19 countries are reg- istered as a “CleanImplant Certified Dentist”. They can be sure that they only use implants that have been tested as clean. On the new web- site www.cleanimplants4you.org, launched as an information campaign directed at patients, a list of practices that have already joined the initiative can be found. For more information, go to www.cleanimplant.org. Source: CleanImplant Foundation CIF GmbH CleanImplant-Certified Practices. 3 2020 41
| about the publisher Congresses, courses and symposia implants Designer Sandra Ehnert s.ehnert@oemus-media.de Customer Service Marius Mezger m.mezger@oemus-media.de Published by OEMUS MEDIA AG Holbeinstraße 29 04229 Leipzig, Germany Tel.: +49 341 48474-0 Fax: +49 341 48474-290 kontakt@oemus-media.de Printed by Silber Druck oHG Otto-Hahn-Straße 25 34253 Lohfelden, Germany implants international magazine of oral implantology is published in cooperation with the German Association of Dental Implantology (DGZI). DGZI DGZI Central Offi ce Paulusstraße 1 40237 Düsseldorf, Germany Tel.: +49 211 16970-77 Fax: +49 211 16970-66 offi ce@dgzi-info.de www.dgzi.de www.oemus.com www.implants.de EAO Digital Days 2020 5–11 October 2020 Berlin, Germany digitaldays.eao.org/en/ 50th DGZI International Annual Congress— Visions in Implantology 6–7 November 2020 Bremen, Germany www.dgzi-jahreskongress.de AAID Annual Conference 11–14 November 2020 Altlanta, GA, USA www.aaid.com/Annual_Conference/ Imprint Publisher Torsten R. Oemus oemus@oemus-media.de CEO Ingolf Döbbecke doebbecke@oemus-media.de Members of the Board Jürgen Isbaner isbaner@oemus-media.de Lutz V. Hiller hiller@oemus-media.de Chief Editorial Manager Dr Torsten Hartmann (V. i. S. d. P.) hartmann@dentalnet.de Editorial Council Dr Rolf Vollmer info.vollmer@t-online.de Dr Georg Bach doc.bach@t-online.de Dr Suheil Boutros SMBoutros@aol.com Editorial Offi ce Georg Isbaner g.isbaner@oemus-media.de Johannes Liebsch j.liebsch@oemus-media.de Executive Producer Gernot Meyer meyer@oemus-media.de Product Manager Timo Krause t.krause@oemus-media.de Art Director Alexander Jahn a.jahn@oemus-media.de Copyright Regulations implants international magazine of oral implantology is published by OEMUS MEDIA AG and will appear with one issue every quarter in 2020. The magazine and all articles and illustrations therein are protected by copyright. Any utilisation without the prior consent of editor and publisher is inadmi ssible and liable to prosecution. This applies in particular to duplicate copies, translations, microfi lms, and storage and processing in electronic systems. Reproductions, including extracts, may only be made with the permission of the publisher. Given no statement to the contrary, any submissions to the editorial department are understood to be in agreement with a full or partial publishing of said submission. The editorial department reserves the right to check all submitted articles for formal errors and factual authority, and to make amendments if necessary. No responsibility shall be taken for unsolicited books and manuscripts. Articles bearing symbols other than that of the editorial department, or which are distinguished by the name of the author, represent the opinion of the aforementioned, and do not have to comply with the views of OEMUS MEDIA AG. Responsibility for such articles shall be borne by the author. Responsibility for advertisements and other specially labeled items shall not be borne by the editorial department. Like- wise, no responsibility shall be assumed for information published about associations, companies and commercial markets. All cases of consequential liability arising from inaccurate or faulty representation are excluded. General terms and conditions apply, legal venue is Leipzig, Germany. 6th Annual Meeting of ISMI 7–8 May 2021 Düsseldorf, Germany 42 3 2020
Straumann® Pro Arch BLX New confidence, flexibility and efficiency with one system. One system for most full-arch challenges of the imme- diate rehabilitation with the Straumann® BLX implant system designed for primary stability. CONFIDENCE Implant design and FLEXIBILITY Broad range of 42 implants Dynamic Bone and optimized shallow EFFICIENCY One connection for all diameters. ∅ 3.75 mm Management™ for prima- ry stability, Roxolid® for strength¹, ² and SLActive® for faster healing³. threads of narrow implants designed for use in the soft implant for all indications and slim and smooth and hard bone. Screw-retained Abutments. REFERENCES 1 Steinemann S.G. `Titanium - the materials of choice?’ Periodontology 2000, Vol. 17, 1998, 7-21 2 Data on file for Straumann cold-worked titanium and Roxolid® Implants SLActive 3 Lang NP, Salvi GE, Huynh-Ba G, Ivanovski S, Donos N, Bosshardt DD. Early osseointegration to hydro- philic and hydrophobic implant surfaces in humans. Clin Oral Implants Res. 2011 A Experience Straumann® Pro Arch BLX. www.straumann.com/proarch Supported by digital service smile in a box A0026/en/A/00 07/20
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