Volume 6 / Issue 1 / Spring 2010
WELCOME
Table Of Contents
FROM
THE
PRESIDENT
Page
Welcome From The President
1
Product Innovations
Expanding Your Restorative Options
With The Encode® Impression System
2
An Inexpensive Tool To Indicate Accurate High
Torque Readings In Dental Implant Procedures
Endobon® Xenograft Granules - Now
Available In A Larger Particle-Size Range
BIOMET 3i Offers A Comprehensive Line
Of Allograft Tissue Materials
Technology In Motion
4
Replacement Of Congenitally Missing Lateral
Incisors With Encode Zirconia Abutments
Technical Tips
The BIOMET 3i Tapered Implant System:
Placement in Dense Bone
6
Point Of View
7
Lars Zetterqvist, DDS Shares His Experience
As Lead Investigator In A Recently Published
Clinical Study - Evaluating The Risk Of
Peri-implantitis With OSSEOTITE® Implants
Literature Review
Placement Of Immediate Implants
And A Fixed Provisional Restoration To
Replace The Four Mandibular Incisors
8
Biomechanical Repercussions Of Bone
Resorption Related To Biologic Width:
A Finite Element Analysis Of Three
Implant-Abutment Configurations
Going Green With The Upcoming Issue
Of The Journal Of Implant And Reconstructive
Dentistry® (JIRD)®
Professional Development Corner
9
Professional And Practice Development With
Continuing Education: A Winning Combination
Welcome to another
edition of Eye On 3i!
Since the last edition of
Eye on 3i in the Fall of
2009, I have been
traveling extensively to
meet with customers and
Maggie Anderson - President employees from around
the globe and now, more
than ever, I am optimistic about the future of this
organization. In 2010 and beyond we are focused
on the innovation process to improve our ability
to turn customer input into new products and
services. BIOMET 3i will continue to be customer
focused and is committed to backing products
with evidence-based research while supporting a
strong team-based approach to dental implant
therapy.
In today’s increasing competitive business
environment and difficult economic times, rest
assured that we are all doing what we can to
support you. I encourage you to read about our
educational programs and value added services
like the BIOMET 3i Innovative Dental Seminars®
(BIOMET 3i IDS™) Quicksteps Guide that’s inside
this issue. This tool, among our many other
offerings, can help you expand your dental
practice with continuing education.
abutments such as, GingiHue®, UCLA and
LOCATOR®. This will give you flexibility with your
cases while still allowing you to benefit from not
having to use or inventory impression copings.
Also coming soon is the High Torque Ratchet
Wrench, which is an inexpensive tool that
indicates accurate high torque readings in dental
implant procedures. Finally, we are pleased to
announce the launch of Endobon® Xenograft
Granules in a larger particle-size range providing
clinicians with more options for regeneration.
I also want to share with you that BIOMET 3i
strives to be a good corporate citizen and provide
help and support to those less fortunate. In that
spirit, this issue highlights the collaboration of
BIOMET 3i and Operation Smile.
As we enter the renewal of springtime please rest
assured that BIOMET 3i will continue to do
everything we can to strengthen your practice and
your trust in our organization.
Warm Regards,
Maggie Anderson
President
On the product innovation front, we are
expanding the Encode® Impression System and
will soon be offering this system for stock
Corporate News - BIOMET 3i
10
BIOMET 3i Products And Operation Smile Help
Those Suffering From Inadequate Dental Care
Affiliate Spotlight
Poland’s Dental Depot Wasio
11
Global Meetings Of Interest
North America
Europe
Latin America
12
1
P R O D U C T
I N N O V A T I O N S
Expanding Your Restorative Options With The Encode® Impression System
Many clinicians are providing their patients with aesthetic and precise
restorations developed through BIOMET 3i’s Encode Impression System
technology. This easy and time saving alternative to traditional
impression copings is presently available for CAD/CAM abutments, but
will soon be available for stock abutments.
Robot used to place
implant analogs
Soon, clinicians will be able to make a
simple closed tray impression of an
Encode Healing Abutment and receive a
cast with a robotically placed implant
analog and definitive restoration for many
of BIOMET 3i’s Stock Abutments. Some of
these include GingiHue®, ZiReal®, UCLA
and LOCATOR® Abutments and
PreFormance® Provisional Components.
Impression and cast of the
Encode Healing Abutment
Implant analog placed
in cast robotically
The Encode Impression System with expanded restorative options will be
available in Spring 2010.
For more information, please contact your local BIOMET 3i Sales
Representative.
An Inexpensive Tool To Indicate Accurate High Torque Readings In Dental Implant Procedures*
Introducing a tool specifically designed for working with dental
implants: A unique high torque wrench for surgical use – The H-TIRW.
The High Torque Indicating Wrench is sleek and easy to use, providing
clinicians with an option they may not have had before: an inexpensive
tool for instant, accurate high torque indications during manual dental
implant placement.
The new High Torque Indicating Ratchet Wrench from BIOMET 3i
provides the clinician with these user friendly benefits:
• Convenient - Ratchet Wrench And Torque Indicator Are In One Device
• Maintenance Free - Does Not Require Re-calibration
• Unique - Provides Instant Torque Indication Of 50-90Ncm
• Functional - Bodies And Heads From Additional H-TIRW Torque
Wrenches Can Be Mixed
• Minimal Pieces - Consists Of Only Two Pieces For Minimal
Inventory And Ease Of Disassembly For Autoclaving
High Torque Indicating Ratchet Wrench
*The High Torque Indicating Ratchet Wrench (H-TIRW) will be available
in Spring 2010. Please check with your BIOMET 3i Sales Representative
for availability in your market.
Please Note: Not all products are available outside the U.S. Please contact your local BIOMET 3i Sales Representative for availability.
2
P R O D U C T
I N N O V A T I O N S
Endobon® Xenograft Granules - Now Available In A Larger Particle Size Range
With more than 10 years of combined use in oral maxillofacial and
orthopedic procedures, Endobon Xenograft Granules are indicated for
use in a variety of dental and/or oral surgical procedures including:
• Filling Defects After Resection, Cystectomy, Apicoectomy Or
Other Defects In The Alveolar Ridge Or Wall
• Peri-implant Defects
• Alveolar Ridge Augmentation Including Aesthetic Contouring
Defects
Endobon Xenograft Large Granules
• Extraction Socket Grafting
Endobon Xenograft Granules, a RegenerOss® Product, are now
available in a 1000–2000μm granule size, providing the clinician with
more options for the regeneration of defects when effective space
maintenance is required.
The addition of the new, larger particle size range to the existing
500-1000μm particle size offering, gives clinicians the ability to
choose the granule size that best meets their needs.
BIOMET 3i Offers A Comprehensive Line Of Allograft Tissue Materials
BIOMET 3i Offers Allograft Tissue Products From The University Of
Miami Tissue Bank (UMTB) For Your Regeneration Needs
All grafts are excised aseptically by UMTB from a carefully selected
donor base and all processing is performed using aseptic techniques.
The donors are subjected to extensive screening tests and studies in
accordance with the recommendations provided by AATB (American
Association of Tissue Banks) and FDA (Food and Drug Administration),
among others. For the options you want, the results you expect and the
safety you demand, keep these products in mind for your next case
requiring hard and/or soft tissue regeneration.
Mandibles
For jaw reconstruction, BIOMET 3i offers left and
right hemi mandibles as well as full mandibles.
These mandibles are aseptically processed in order
to preserve the inherent biological and mechanical
properties for optimal bone regeneration. In
addition, the mandibles undergo extensive microbiological monitoring
from recovery to final packaging and ethylene oxide sterilization (ETO) to
ensure that the graft is safe from disease transmission.
Dental Skin
The Dental Skin is an effective alternative to freegingival and connective tissue grafts. Due to it’s
propensity for gingival attachment, it is primarily
used in soft tissue augmentation, such as root
coverage.
Other benefits include:
1. You are not limited by the amount of existing palatal tissue
2. It eliminates the need for a second surgical site, which reduces
patient discomfort and saves time
Dental Skin is currently available in two sizes: 10cm2 and 20cm2.
Mandible And Maxilla Blocks
Mandible and Maxilla Blocks are wedge-shaped
blocks of allograft bone sourced from the iliac
crest and consist of cancellous tissue surrounded
by a layer of cortical bone on two sides.
Mandible and Maxilla Blocks can be utilized in cases where existing
bone volume is inadequate for implant placement and the amount of
harvestable autogenous bone is insufficient. The corticocancellous
blocks are chosen as bone graft substitutes because they eliminate the
need for a second surgical site, reducing patient discomfort, donor site
morbidity and valuable chair time. Both aseptic alloy processed (nonirradiated) and gamma irradiated configurations are available for all
three sizes offered.
Dura Mater Membrane
Dura Mater tissue is derived from the inelastic
membrane that encloses the brain. It has been used
in the dental field as a membrane for many years
and is well supported by published articles .1-3 This
allograft membrane can be used as a barrier
membrane for onlay graft procedures. It is aseptically processed and
sterilized by ethylene oxide. The Dura Mater membrane is freeze-dried
and must be rehydrated until soft and pliable prior to use. Currently, this
membrane is offered in an 8-30cm2 (minimum surface area) size.
1.
2.
3.
Shah AV, Jathal BS. Evaluation of Freeze-Dried Dura Mater Allograft as a
Collagen Based Barrier (an experimental animal study). Cell Tissue Bank.
2003;4(2-4):133-9.
Piattelli M, Scarano A, Piattelli A. Dental School, University of Chieti, Italy.
Histological evaluation of freeze-dried dura mater (FDDMA) used in guided
bone regeneration (GBR): a time course study in man. Biomaterials. 1996
Dec;17(24):2319-23.
Fontana E, Trisi P, Piattelli A. Dental School, University of Chieti, Italy. Freeze-dried
dura mater for guided tissue regeneration in post-extraction dental implants: a
clinical and histologic study. J Periodontol. 1994 Jul;65(7):658-65.
For more information on these regenerative products, please contact your local BIOMET 3i Sales Representative.
Please Note: Not all products are available outside the U.S. Please contact your local BIOMET 3i Sales Representative for availability.
3
T E C H N O L O G Y
Replacement Of Congenitally Missing Lateral
Gary A. Morris, DDS
Fig. 1
Fig. 3
Fig. 5
Fig. 2
Fig. 4
Fig. 6
Patients with congenitally missing maxillary lateral
incisors represent a growing segment of the population who benefit from implant therapy. Typically,
these patients have less than ideal alveolar width due
to the absence of the development of secondary
teeth. In these clinical situations, the placement of
small diameter implants, i.e., 3.25mm, provides an opportunity to
meet the demands of the clinical situation without the need for more
invasive grafting or ridge expansion techniques. Further, with the
recent expansion of Encode® Abutment options, these 3.25mm
implants can be restored with custom Encode Zirconia Abutments,
thus affording clinicians the opportunity to fabricate aesthetic allceramic restorations with optimal gingival contours.
The clinical presentation to follow demonstrates the treatment of a
patient with congenitally missing teeth. A 26-year-old female patient
presented for the replacement of congenitally missing maxillary lateral
incisors, teeth Nos. 7 and 10 [12 and 22]. Following a detailed
medical and dental history, which included regular visits to her
pediatric dentist, the patient was considered suitable for implant
therapy. The patient received orthodontic treatment as an adolescent
during which time the spaces corresponding to the missing lateral
incisors were established/maintained for optimally contoured,
implant-retained restorations.
The patient presented with resin-bonded restorations (Maryland
Bridges) to maintain the spaces and for aesthetics/phonetics during
her developmental years (Figs. 1 and 2). Radiographic and clinical
findings revealed a healthy periodontium within normal limits; and the
absence of probing depths, mobility or gingival recession (Fig. 3). The
patient had optimal oral hygiene with no bleeding upon probing. She
presented with bilateral Class I occlusion with limited interdental
space—6.8mm at tooth site No. 7 [12] and 6.6mm at site No. 10 [22].
Evaluation of the patient’s masticatory system was within normal
limits; there was no soft or hard tissue pathology.
Evaluation of the existing aesthetics revealed asymmetric gingival
margins with the clinical crown height longer on the maxillary right as
compared to the contralateral side. The entire gingival emergence
complex was displayed due to a high smile line and the incisal edges
of the maxillary anterior teeth were visible with the lips at rest. The
gingival biotype was recorded as thin/scalloped with a tapered tooth
phenotype; interdental contacts were noted in the middle third. Her
shade was recorded as 1M1 on the VITA® Classic Shade Guide
(Vident®, Bad Sackingen, Germany).
Fig. 7
Fig. 9
Fig. 8
Fig. 10
The treatment plan included use of SimPlant® 3D dental planning
software and a computer-guided surgical protocol. After acquiring the
CT scan and during development of the treatment plan, 3.25mm
diameter by 10mm length NanoTite™ Certain® Implants were selected
and placed virtually in the software (Fig. 4). Care was taken to orient the
implants relative to the existing alveolar bone. A Navigator® Surgical
Guide was ordered from Materialise Dental, Inc. (Glen Burnie, MD).
At the surgical appointment, the resin-bonded restorations were
removed and the Navigator Surgical Guide was tried-in (Fig. 5).
Following administration of local anesthesia, the center points within
the Master Tubes were marked and a tissue punch was used to
expose the alveolar bone. The punch was angled slightly to the palatal
aspect in order to preserve the facial attached gingiva for optimal softtissue contouring and aesthetics. The prescribed surgical protocol
was performed (Fig. 6) and dental implants were placed per the
Navigator Surgical Plan; both were inserted with greater than 50Ncm
of final placement torque (Fig. 7).
Please Note: Not all products are available outside the U.S. Please
4
I N
M O T I O N
l Incisors With Encode® Zirconia Abutments
PreFormance® Posts consistent with the restorative seating surfaces
of the implants were selected. These were modified slightly to ensure
that the contours of the abutments matched the emergence profile of
the maxillary lateral incisors. The heights of the interim abutments
were reduced to provide clearance for the replacement of the preexisting restorations (Fig. 8). The screw access openings were
blocked out with occlusal registration material and the resin-bonded
restorations were replaced on the adjacent teeth. Oral hygiene
instructions were given and the patient was released.
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16
Wrench, please contact your local BIOMET 3i Sales Representative.
Fig. 17
Fig. 18
Gary A. Morris, DDS, received his dental degree from the University of
Illinois and completed his residency in Prosthodontics at the University
of Missouri, Kansas City, Missouri. He is a member of the American
College of Prosthodontics, International College of Prosthodontics,
Academy of Osseointegration and the International College of Oral
Implantologists. Dr. Morris has lectured extensively both nationally and
internationally on implant prosthodontics and related implant topics and
maintains a private practice, limited to prosthodontics and restorative
dentistry, in Buffalo Grove, Illinois.
Fig. 19
Fig. 20
Three months following placement of the dental implants, the patient
was seen for evaluation. Healing was uneventful. The pre-existing
restorations (Fig. 9) and the PreFormance Posts were removed
(Fig. 10); the implants were torque tested forward and in reverse first
at 10Ncm, then at 20Ncm. There was no discomfort or mobility,
therefore the implants were deemed to be integrated. Appropriate
sized (3.4mm restorative seating surface x 3mm height x 3.8mm
diameter) Encode® Healing Abutments were placed into the internal
interface of the implants (Fig. 11), then verified radiographically. An
impression was made with polyvinylsiloxane impression material.
In the laboratory, an Encode Master Cast was fabricated with soft
tissue (Fig. 12). The casts were mounted in an articulator on Adesso®
Magnetic Mounting Plates (Ivoclar Vivadent, Inc., Amherst, NY).
The mounted casts were then sent to the BIOMET 3i PSP Department
for scanning and milling of Encode Zirconia Abutments. The Robocast
and definitive abutments were returned to the dental laboratory
(Figs. 13 and 14) for fabrication of Lava™ Zirconia Crowns (3M ESPE,
St. Paul, MN) (Figs. 15 and 16).
The resin-bonded restorations and PreFormance Posts were removed
and the definitive Encode Zirconia Abutments were placed. The fit and
aesthetics were verified clinically and radiographically. Gold-Tite®
Abutment Screws were placed and tightened to 20Ncm with a Low
Torque Indicating Ratchet Wrench* (Fig. 17). Occlusal registration
material was placed in the screw access openings, followed by
composite resin. The Lava crowns were tried-in, adjusted, polished
and cemented with NX3 Nexus® Third Generation cement (Kerr
Corporation, Orange, CA). Periapical radiographs were taken to
confirm removal of excess cement (Fig. 18). Oral hygiene instructions
were given. The patient was seen for follow-up visits at one, three, and
six months. At the follow-up appointments, the gingival tissues were
healthy and responded favorably to the zirconia abutments and
restorations (Figs. 19 and 20). The interdental papillae continue to
form and fill the interdental spaces.
Surgical Colleague: Gregory A. Lehman, DDS, Crystal Lake, IL.
*For more information on the BIOMET 3i Torque Indicating Ratchet
contact your local BIOMET 3i Sales Representative for availability.
5
T E C H N I C A L
T I P S
The BIOMET 3i Tapered Implant System: Placement In Dense Bone
By Alan Meltzer, DMD, MScD, Voorhees, NJ, USA
The specifications of the BIOMET 3i Tapered Implant and the corresponding Quad Shaping Drills (QSDs) and Depth and Direction Indicators (NTDIs)
are held to rigorous tolerances, which is intended to provide a closely integrated implant-to-osteotomy fit and primary stability. Because of the precise
implant-to-osteotomy fit, the Tapered Implant may require reasonably higher levels of insertion torque (cutting torque resistance — the resistance
created by the implant threads cutting a path into the osteotomy walls) to seat completely within the osteotomy. Higher torque may be equated with
higher primary stability and hand ratcheting the implant to the final position may be required. Therefore, when placing a Tapered Implant, the insertion
torque required to fully seat the implant may exceed the maximum torque capable of being delivered by an implant drill unit (typically 50Ncm) and the
need to tap the osteotomy may occur, especially in dense bone (Type I). Importantly, tapping (pre-threading) the osteotomy wall reduces cutting torque
resistance so that the implant can be placed more passively while still maintaining a precise implant-to-osteotomy fit. The Technical Tips to follow
provide guidelines for placement of high torque BIOMET 3i Tapered Implants in dense bone.
Preparation Of An Osteotomy In Dense Bone
The QSDs for placement of BIOMET 3i Tapered Implants are designed to
prepare the osteotomy to match the dimension of the minor diameter of the
Tapered Implant (i.e. the implant body without the threads). The Tapered
Implant NTDI is also precisely matched to the minor diameter of the
implant. Therefore, in order to verify the accuracy of the desired placement
(bucco-lingually, mesio-distally and apico-occlusally), the NTDI should be
placed into the prepared site after irrigating and suctioning bone debris from
the osteotomy. The NTDI should fit smoothly and cleanly (without binding
or snapping) to the exact depth of the preparation, mimicking the final
position of the implant. Should the NTDI not seat to the desired depth of the
final seating position of the implant, it is likely because the drill was not
advanced to the appropriate depth landmark on the QSD or the site was
inadvertently ledged (subcrestal, crestal or supracrestal). If this occurs,
additional drilling may be necessary to achieve the desired position using
the QSD depth landmark as guidance. When Tapered Implants are placed
subcrestally, care should be taken to ensure the residual supracrestal bone
does not interfere with complete seating of the implant (Figs. 1a and 1b).
Adjustment of the supracrestal bone may be required as illustrated in Figure
2a. After adjustment, the fit of the NTDI should be verified (Fig. 2b). Figures
3a and 3b demonstrate excessive supracrestal bone and the appropriate
adjustment performed to permit a smooth and passive fit of the NTDI.
Fig. 1a
Fig. 2a
Fig. 1b
Fig. 2b
Fig. 3a
Using Dense Bone Taps
In dense bone (Type I), it is often
necessary to tap the osteotomy in
order to fully seat the implant and
reduce insertion torque. If tapping is
not performed, deformation of the
internal interface of the implant or
placement driver tip may occur.
Length and diameter specific Dense
Bone Taps should be advanced into
the prepared osteotomy with the
drilling unit set to 50Ncm and
20rpm. It is not unusual for the
handpiece to stop prior to the tap
reaching the full depth of the
osteotomy. Therefore, a hand
ratchet should be used to complete
the tapping process (Fig. 4).
Fig. 3b
Fig. 4
Fig. 5
Clinical Tip: A thumb or forefinger
should be placed on top of the
Ratchet Wrench with light
Fig. 6
downward pressure applied (Fig. 5).
This helps ensure continued full
engagement of the driver, prevents
implant wobble during insertion and
assists in keeping the orientation in
the proper plane.
Lavage Of The Osteotomy
Bone debris remaining in the
osteotomy after site preparation with the drills or taps should be removed
by irrigation with sterile saline and suction (Fig. 6), as debris in the site may
increase cutting torque resistance during tapping and implant placement or
prevent the implant from fully seating.
For a complete list of recommendations, please refer to the BIOMET 3i
Surgical Manual (CATRM).
Please Note: Not all products are available outside the U.S. Please contact your local BIOMET 3i Sales Representative for availability.
6
P O I N T
O F
V I E W
Lars Zetterqvist, DDS
Shares His Experience As Lead Investigator
In A Recently Published Clinical Study
Evaluating The Risk Of Peri-implantitis
With OSSEOTITE® Implants
Q: Recently, a clinical study was published in the Journal of
Periodontology1, which looked at the risk of peri-implantitis for
implants with an etched surface. As the lead investigator, can you tell
us about the study’s background?
A: The incidence of peri-implantitis has been reported to be as high as 14%
in the prior literature. Because peri-implantitis may lead to progressive
bone loss and is difficult to treat, it often leads to implant failure.
Implants with a roughened collar surface are perceived to be at a higher
risk for peri-implantitis and other mucosal complications, but we wanted
to determine whether that perception was justified.
Hybrid Dual-Acid Etched (DAE)
OSSEOTITE Implant
Full Dual-Acid Etched (DAE)
OSSEOTITE Implant (FOSS)
Q: How was the study designed?
A: To determine whether any peri-implantitis would develop around either
full Dual-Acid Etched (DAE) OSSEOTITE® Implants (FOSS) or controls of
hybrid OSSEOTITE Implants, we enrolled 112 patients, in whom 165 test
and 139 control implants were placed, supporting 127 prostheses.
Follow-up evaluations included Sulcus Bleeding Index scores (SBI),
probing for suppuration, assessments for mobility, and periapical
radiographs to identify radiolucencies and crestal bone levels. We also
assessed implant mobility – radiographs were taken at the time of
implant placement, placement of the prosthesis and then at annual
intervals for five years. All the implants were placed in a single-stage
protocol with healing abutments. Prostheses were placed at eight weeks
post-implant placement.
Q: What were the outcomes?
A: Only one implant exhibited peri-implantitis. Interestingly, that was a
control hybrid implant, and the inflammation was resolved with
appropriate treatment. No incidence of peri-implantitis was observed
around any full-surfaced test implant.
In the past, I had used Titanium Plasma Sprayed (TPS) implants with poor
results and bone loss leading to disastrous failures. Problems at first
appeared early on with peri-implant mucositis shortly after restoration. In
those instances, bacteria in the sulcus after formation of the biologic width
had led to circumferential bone lesions around the implant, like what is
seen with a natural tooth. This occurred in partially edentulous and fully
edentulous cases as well. In contrast to that, the results of this comparative
study are very comforting.
Long-term implant success is key. A surface that is not associated with the
incidence of peri-implant diseases allows me to treat more patients in less
time. I began placing full-surfaced OSSEOTITE Implants in my practice
almost 10 years ago. These patients continue to be followed; the results
continue to show no association with peri-implantitis.
1. Zetterqvist L, Feldman S, Rotter B, Vincenzi G, Wennström J, Chierico A, Stach A, Kenealy
J. A Prospective, Multicenter, Randomized-Controlled Five-Year Study of Hybrid and FullyEtched Implants for the Incidence of Peri-Implantitis. e-pub ahead of print: J Perio; 2010.
No substantial differences in mucosal health outcomes were observed
between the test and control groups throughout the five-year follow-up.
Q: What do these results mean to you in terms of implant choice and
patient selection?
A: Since this particular roughened surface is a benefit to the bone in the
osseointegration process, why not take it to the top of the implant? It is
important to maximize bone support over the mental nerve, under the
sinus, in poor bone volume, or poor bone quality. In these clinical
situations, it is ideal to have as much bone apposition as possible.
Lars Zetterqvist, DDS, received his dental degree and his Certificate as a
specialist in Oral and Maxillofacial Surgery at Karolinska Institutet in
Stockholm, Sweden. He lectures both nationally and internationally and has
published more than 20 papers in the field of implantology. Dr. Zetterqvist
maintains a private practice in Gefle, Sweden, limited to oral surgery with
strong emphasis on implant surgery and regenerative procedures. He is also
on a consultative basis performing implant surgery in a number of private
practices in Sweden and Norway.
Please Note: Not all products are available outside the U.S. Please contact your local BIOMET 3i Sales Representative for availability.
7
L I T E R A T U R E
R E V I E W
Placement Of Immediate Implants And A Fixed Provisional Restoration To
Replace The Four Mandibular Incisors
Richard B. Smith, DDS; Dennis P. Tarnow, DDS; Marion Brown, DMD;
Stephen Chu, DMD; Jonathan Zamzok, DMD
Compend Contin Educ Dent 2009;30:408-410,413-415
Abstract
A new approach to the replacement of four mandibular incisors with
localized, chronic, severe periodontitis is proposed in this clinical report.
Their replacement with immediately placed implants and a nonocclusally
loaded provisional restoration is a simple, predictable, and successful
treatment modality. Data from 10 consecutive clinical cases are
presented, and a 100% implant survival rate is reported for a 6-year
period of follow-up. Treatment outcomes for this approach compare
favorably with alternative treatment options and should be considered an
important primary treatment option for most patients requiring the
replacement of the four mandibular incisors.
Biomechanical Repercussions Of Bone Resorption Related To Biologic Width:
A Finite Element Analysis Of Three Implant-Abutment Configurations
Xavier Rodríguez-Ciurana, MD, PhD; Xavier Vela-Nebot, MD, DDS;
Maribel Segalà-Torres, MD, DDS; Carlos Rodado-Alonso, MD;
Víctor Méndez-Blanco, DDS; Marta Mata-Bugueroles
Int J Periodontics Restorative Dent 2009;29:479–487
Abstract
Most biomechanical studies of implant-supported restorations have not
taken into account the biologic changes that occur following exposure of
the implants to the oral environment. Therefore, the present finite element
analysis study was designed to compare the biomechanical response of
three types of implant-abutment configurations both before and after
establishment of a new biologic width. The three functional units studied
were: a 5-mm implant platform connected with an external hexagon to a
5-mm-diameter abutment (type 1), a 5-mm implant platform connected
with an external hexagon to a 4.1-mm-diameter abutment (type 2), and a
4.8-mm implant platform connected with an internal hexagon to a 4.1mm-diameter abutment (type 3). The type 3 design, which combined
platform switching with an internal connection, exhibited the smallest
distortions in stress distribution after bone modeling, and the stress was
distributed over the entire contact surface most smoothly and uniformly.
Bone resorption following creation of the biologic width changes the
biomechanical behavior of a restoration. In this study, the two implantabutment designs featuring a smaller-diameter abutment on a
larger-diameter implant platform achieved better results than the implant
featuring the same-diameter implant platform and abutment, even though
their initial bio-mechanical load potential was lower.
Going Green With The Upcoming Issue Of The Journal Of Implant And Reconstructive Dentistry® (JIRD)®
Prof. Dr. Tomas Albrektsson
Dept. Of Biomaterials,
Inst. For Clinical Sciences
Sahlgrenska Academy,
University Of Gothenburg
The next issue of the Journal of Implant and Reconstructive Dentistry (JIRD) will be
available online at www.JIRD-online.com and is exclusively devoted to reporting on
the recent Gothenburg Research and Technology Forum held in Gothenburg,
Sweden, October 30-31, 2009. Sponsored by BIOMET 3i and conducted in
association with the Sahlgrenska Academy of the University of Gothenburg, the
gathering provided an opportunity to discuss current research in the field of implant
and reconstructive dentistry. Pioneering researcher Prof. Dr. Tomas Albrektsson,
who served as Director for the Forum, commented, “The future of osseointegration
has already begun. We are constantly trying to widen our indications, to treat more
and more patients.”
Look for the next issue to be published in the Spring of 2010. All current e-JIRD
subscribers will be notified via email once the issue is available. Not a subscriber to
e-JIRD? Please take a moment to visit the journal online at www.JIRD-online.com
and sign up for e-JIRD, a free electronic subscription to the journal.
For more information on JIRD, please contact your local BIOMET 3i Sales Representative today.
8
P R O F E S S I O N A L
D E V E L O P M E N T
C O R N E R
Professional And Practice Development With Continuing Education: A Winning Combination
If you ask any of the world’s most successful clinicians or laboratory
owners how to develop your dental business, they will tell you one of
the most effective ways to establish or grow the business is with wellorchestrated continuing education for the entire team. Whether you are
an experienced educator seeking new ideas or an aspiring educator,
BIOMET 3i has a beneficial combination of tools and support aimed at
assisting you in becoming an educational leader.
We are pleased to announce the immediate availability of the exclusive
complimentary BIOMET 3i Innovative Dental Seminars® (BIOMET 3i
IDS™) Quicksteps Guide, authored by Dr. Gregory J. Keiser. The
Quicksteps Guide is a companion guide to the BIOMET 3i IDS Creating
and Driving Your Own Study Club Guidebook (ART895). It is in
electronic format and is filled with high-impact, low-cost, easy-toimplement continuing dental education program ideas for the entire
dental team.
In the Quicksteps Guide, Dr. Keiser shares what he has learned in his
many years of conducting hundreds of local level education programs,
which may help you to conserve the business resources you value the
most – your time and your money.
BIOMET 3i IDS Creating And Driving
Your Own Study Club Guidebook
For more information on how BIOMET 3i can
help you expand your dental practice with
continuing education, please contact
your local BIOMET 3i Sales
Representative today.
Importantly, BIOMET 3i has a
team of consultants to advise
and support you on the
steps you’ll need to take
towards educational
leadership.
Please Note: Not all products are available outside the U.S. Please contact your local BIOMET 3i Sales Representative for availability.
9
C O R P O R A T E
N E W S
BIOMET 3i Products And Operation Smile Help Those Suffering From Inadequate Dental Care
In November, Operation Smile Vietnam set
Bob Decidue from Jefferson University, to local Vietnamese dentists to
out on a mission trip appropriately named A
help them continue to provide dental implant procedures at the Hue
Journey of Miracles, in which 16
Odonto Stomotologic Clinic in Hue, Vietnam.
simultaneous medical programs were
conducted throughout Vietnam during the
Operation Smile is a worldwide
course of one week. It was estimated that
children’s medical charity with a
over 6,600 treatments were received during
network of volunteers who work to
this week long trip. This and all other
repair childhood facial deformities,
missions rely on donors and corporate
particularly cleft lips and cleft
sponsors, along with the long hours given
palates. The organization has a
by a worldwide network of medical and
presence in over 50 countries, and since 1982, has changed the lives
non-medical personnel. BIOMET 3i donated
of over 140,000 children and young adults.
dental drill units, kits, implants and
regenerative materials to this mission. In
addition, education and training were provided by Operation Smile
For more information about Operation Smile please visit
www.operationsmile.org.
clinicians, Dr. Dominic Gioffre from Delaware, Dr. Dan Taub and Dr.
Please Note: Not all products are available outside the U.S. Please contact your local BIOMET 3i Sales Representative for availability.
10
A F F I L I A T E
S P O T L I G H T
BIOMET 3i Affiliate Spotlight – Poland’s Dental Depot Wasio
Dental Depot originally
started nearly a century
ago in the garage of
founder Andrzej Wasio,
which served as a simple
laboratory and a workshop
that produced a material
used to make acrylic
prosthetic plates. The
opportunity to dental surgeons from all over Europe to perform dental
company survived the
implant procedures and familiarize themselves with advanced surgical
Dental Depot Workshop, 1932
upheaval of the Second
procedures as well as BIOMET 3i Products. Dental Depot Wasio also
World War, the imprisonment of its owner Andrzej, as well as his tragic
launched its own training center and permanent product warehouse in
death and the death of his son Eugeniusz. After World War II, the
Poland. By creating individualized marketing campaigns, fostering
company endured under its new leadership of Lucyna and Janusz
strong family bonds and attentively listening to its customers’ needs,
Wasio. Changes came in 1989, when Poland regained its freedom and
Dental Depot Wasio assumed the market leader position for
opened up its economy to the world. In 1997, the company managed
implantology in Poland.
to embark on a new chapter in its history; it changed its operating
strategy and transformed itself from a typical dental wholesaler into a
In 2008, the company opened an office-warehouse in the Polish
specialized dealer.
capital, Warsaw, to ensure customers have regular access to its
products. This gave BIOMET 3i the recognition of the first company to
The company began its distribution
have two branches and warehouses in the Polish market.
partnership with BIOMET 3i in 1999. Within
Dental Depot, Wroclaw
the first year, the company managed to sell
In 2009, Dental Depot continues to be the
its first dental implant, launch its first
market leader in Poland as a fourth
training center and create a unique clinical
generation family owned and operated
support program called 3i Support, where
company of 23 led by Lucyna Wasio, owner
dental surgeons performed dental implant procedures without capital
and manager of Dental Depot Wasio. Other
investments for surgical equipment.
members of the team include: Malgorzata
Wasio-Malinka, Lucyna’s daughter and Vice
In 2004, the Jagiellonian University and BIOMET 3i joined forces,
President of Marketing, Maciej Wasio,
paving the way for the creation of the Central European Implant
Academy (CEIA) under Dr. Piotr Majewski. The CEIA gives a unique
Lucyna’s son and Vice President of Sales,
Lucyna Wasio, owner
Michal Malinka, Malgorzata’s husband and
Director of International Operations and Beata Czekaj, Maciej’s fiancé
and Professional Education Manager.
“Our success comes down to a combination of factors,” says Wasio,
“A multi-generational tradition, the ability to adapt quickly to market
conditions, ambition, a desire to broaden knowledge, organizational
talent and a passion for hard work.”
For more information about Dental Depot Wasio please visit their
website at ww.dental-depot.com.
Dr. Dennis Tarnow conducting a lecture at CEIA
For more information about BIOMET 3i’s Affiliates please visit
www.biomet3i.com
Please Note: Not all products are available outside the U.S. Please contact your local BIOMET 3i Sales Representative for availability.
11
G L O B A L
M E E T I N G S
O F
I N T E R E S T
3rd Annual NYU/BIOMET 3i International
Implantology Week
August 2-6, 2010
New York University College of Dentistry,
New York, NY
Faculty: Dr. Harold Baumgarten, Dr. Alan Meltzer
New Treatment Protocols For Challenging
Clinical Situations: Management Of Infected
Sites, Immediate Placement Within The
Aesthetic Zone, Immediate Replacement Of
Molars, Biomechanical And Aesthetic
Considerations
May 7, 2010
Sainte-Foy, QC
To register: www.osseo.org
Faculty: Dr. Alan Meltzer
For more information, please visit
www.nyu.edu/dental/ce
For more information and to register, please visit
educational opportunities at www.biomet3i.com or
call Professional Education: inside the U.S.
800-717-4143; outside the U.S. +1-561-776-6700
For more information, please visit www.ulaval.ca
North America
Hands-On Computer-Guided Technology –
Pre-AO Presentation
March 3, 2010
Gaylord Palms Hotel, Orlando, FL
AO Corporate Forum
March 4, 2010
Walt Disney World Dolphin, Orlando, FL
Moderator: Dr. Richard Lazzara
Faculty: Dr. Michael Block, Dr. Stephen Chu, Dr.
Robert del Castillo, Dr. Tiziano Testori
ASM10 (ODA)- Annual Spring meeting
Ontario Dental Association
May 13-15, 2010
Toronto, ON - Be sure to visit us at Booth #1838.
For more information, please visit
[email protected]
Predictable Anterior Implant Esthetics:
Must Know Concepts For 2010
May 14, 2010
McGill University, Montreal, QC
Faculty: Dr. Jay Malmquist, Dr. Alan Meltzer, Dr.
George Priest, Dr. Michael Sonick, Dr. Dean Vafiadis
Europe
BIOMET 3i France, 6th International
Symposium
March 19-20, 2010
Paris, France
2nd International Visitors Program
May 20-21, 2010
Gothenburg, Sweden
Taking Your Implant Practice To The
Next Level
March 19-20, 2010
The Westin Buckhead Atlanta, GA
Faculty: Dr. Joseph Carpentieri
EAED 2010
May 27-29, 2010
London, UK
For more information, please contact BIOMET 3i
Canada at 514-956-9843 ext. 2221
Sponsored Speakers on Main Podium: Dr. Oriol
Llena & Mr. August Bruguera (Spain)
Faculty: Ms. Cynthia Bollinger, Ms. Heather Collins
Canadian Academy of Periodontology (CAP)
May 27-29, 2010
Vancouver, BC
For additional information and registration for these
European events, please call Ms. Barbara De
Wildemann at +34-93-445-81-28 or email
[email protected]
For more information, please visit www.osseo.org
For more information and to register, please visit
educational opportunities at www.biomet3i.com or
call Professional Education: inside the U.S.
800-717-4143; outside the U.S. +1-561-776-6700
Hinman Dental Meeting
March 26, 2010 1-4pm and
March 27, 2010 8:30-11:30am
Atlanta, GA
Soft Tissue Development Using Implant Level
Provisional Restorations
Faculty: Dr. George Priest
For more information, please visit www.hinman.org
Enhancing The Success Of Your Implant
Practice
April 9-10, 2010
New York Marriott Marquis, New York, NY
Faculty: Dr. Robert Blackwell, Ms. Cynthia Bollinger
For more information and to register, please visit
educational opportunities at www.biomet3i.com or
call Professional Education: inside the U.S.
800-717-4143; outside the U.S. +1-561-776-6700
Pacific Dental Conference (PDC)
April 15-17, 2010
Vancouver, BC
For more information, please contact
[email protected]
Contemporary Treatment Of The Atrophic
Posterior Maxilla
April 30 - May 1, 2010
New York University College of Dentistry,
New York, NY
Faculty: Dr. Harold Baumgarten
Latin America
For more information, please visit www.cap-acp.ca
Jasper Dental Congress
May 27-30, 2010
Jasper, AB
For more information, please contact Pat Winget at
780-432-1012
Journées dentaires internationales
du Québec (JDIQ)
May 29-June 1, 2010
Montreal, QC - Be sure to visit us at Booth #310 and #312.
For more information, please contact
[email protected]
The 10th Annual International Symposium
on Periodontics & Restorative Dentistry
June 10, 2010
The Marriott Hotel Copley Place, Boston, MA
Academia Latinoamericana de
Oseointegración – X Congreso Internacional
de Implantología (ALAO)
June 5, 2010
City & Tower de Buenos Aires, Argentina
Faculty: Dr. Ronnie Goene
For more information, please contact
Mónica Ameijide - Secretaría ALAO at
[email protected]
APA – Prótesis 2010 - XVIII Jornadas
Internacionales de APA. V Congreso de
Odontología Restauradora
July 20-23, 2010
Hotel Panamericano, Buenos Aires, Argentina
Faculty: Dr. Stephen Chu, Dr. Dennis Tarnow
Contemporary Concepts In Implant Dentistry
Moderator: Dr. Richard Lazzara
For more information, please contact
http://www.protesis2010.com/
Faculty: Dr. Michael Block, Dr. Stephen Chu,
Dr. Ueli Grunder, Dr. Markus Huerzeler, Dr. Ziv Mazor,
Dr. Alan Meltzer, Dr. Craig Misch, Dr. George Priest
3rd BIM – Brazilian International Meeting
July 22-24, 2010
Centro De Eventos Brasil 21, Brasilia, Brazil
For more information, please visit
www.quintpub.com/isprd
Faculty: Dr. Hiron Andreaza, Dr. Luiz Baratieri, Dr.
José Luis Calvo, Dr. Hugo Nary, Dr. Dennis Tarnow,
Dr. Tiziano Testori, Dr. Stephen Wallace
For more information, please visit
www.meeting3i.com.br
Faculty: Dr. Tiziano Testori, Dr. Stephen Wallace
For more information, please visit
www.nyu.edu/dental/ce
Certain, Encode, GingiHue, Gold-Tite, Innovative Dental Seminars, JIRD, Journal of Implant and Reconstructive Dentistry, Navigator, OSSEOTITE, PreFormance, RegenerOss and ZiReal are registered trademarks and
IDS and NanoTite are trademarks of BIOMET 3i LLC. Endobon is a registered trademark of BIOMET Deutschland GmbH. Signature is a trademark, Surgeon designed. Patient matched. is a service mark and Vanguard is
a registered trademark of Biomet, Inc. BIOMET is a registered trademark and BIOMET 3i and design are trademarks of BIOMET, Inc. LOCATOR is a trademark of Zest Anchors, Inc. SimPlant is a registered trademark of
Materialise Dental, Inc. Adesso is a registered trademark of Ivoclar Vivadent, Inc. Lava is a trademark of 3M. Nexus is a registered trademark of Kerr Corporation. Vident and VITA are registered trademarks of Vident,
Inc. ©2010 BIOMET 3i LLC. All rights reserved.
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