IMPLANT INNOVATIONS

IMPLANT INNOVATIONS

Manufacturers and researchers have been sweating the small stuff to make current dental implant systems more reliable and treatment more accessible than ever

Most of the buzz about current trends in implantology focuses on technologies and workflow in the digital realm. And granted, the use of 3D imaging and other advanced digital modalities for diagnosis, treatment planning, and guided surgery has probably been the most significant change in implant dentistry over the past decade or so. Running a close second might be improvements in materials and techniques for tissue regeneration and bone grafting.

Behind the scenes and less frequently discussed, however, the elements of implant design—composition, size, coating, threading, angulation, and other characteristics—have evolved and improved, and have played a significant role in climbing clinical success rates. Dental Product Shopper recently spoke with a few of the key players on the latest trends and innovations.

Size Matters
In the more than 50 years since Dr. Per-Ingvar Brånemark placed the first dental implant, they have gotten smaller, both in length and diameter.

“Reducing size without compromising clinical success has been consistently the most notable trend in implant design,” said Denise Manekas, product manager for Dentatus USA, one of the early proponents of narrowdiameter implants. The company’s ANEW implants are available in diameters as small as 1.8 mm.
  Bicon’s flagship line is aptly dubbed SHORT Implants, and comes in lengths as short as 6 mm. Dentsply Sirona Implants’ AstraTech family includes short and narrowdiameter systems in the OsseoSpeed EV line.

“We now have long-term clinical studies showing that these smaller implants are highly successful when used appropriately,” Manekas said.

Zest Dental Solutions offers the SATURNO, a one-piece narrow-diameter implant with an O-ball connection. The implant system features a pivoting cap technology designed for maximum resiliency while maintaining a minimized profile.
  With expanding applications and proven efficacy, look for these shorter and narrower implants to continue their popularity.

On and Below the Surface
“One aspect of a dental implant system that we see as extremely important is the implant surface,” says Dr. Stefan Holst, Vice President of Implant Systems and Research at Nobel Biocare. “Not only is surface roughness a factor, but research findings underline the core role of surface chemistry, which can impact clinical success significantly— to the benefit of the patient.”

Nobel Biocare uses its proprietary TiUnite surface to maintain the implant stability achieved at placement during the early healing phase through enhanced osseointegration with the surrounding bone.

Straumann’s SLActive surface treatment is engineered to speed osseointegration and healing time in stability-critical treatment protocols.

Implants are becoming increasingly available in nontraditional materials. Zimmer Biomet borrows from its orthopedics line, where it’s been used for more than 19 years, with the Trabecular Metal technology. Not a coating, Trabecular Metal is made of a highly porous biomaterial with structural, functional, and physiological properties similar to those of bone, and an interconnected pore structure to support bony in-growth and vascularization.

Additionally, the PURE Ceramic Implant from Straumann is an esthetic solution for patients requiring or simply wanting a nonmetal alternative. Manufactured from a high-performance zirconia (Y-TZP), these implants are designed and produced to mitigate the risks of fracturing and instability. Form and Function
Die makers involved in dental implant manufacturing are a busy lot, considering the constant design tweaks being developed to meet clinical challenges. For example, to address sloped ridge situations, Dentsply Sirona Implants offers the OsseoSpeed Profile EV, whose platform matches the patient’s alveolar crest. Dr. Homa Zadeh, DDS, PhD, tenured associate professor and interim director of the postdoctoral periodontology program at the USC Herman Ostrow School of Dentistry, noted, “This minimizes 3 unfavorable scenarios: the need for bone reduction before implant placement to create an even alveolar crest; deep implant placements to position the facial platform of the implant relative to the bone crest; and bone augmentation to increase the facial alveolar bone width. Because of the slope of the OsseoSpeed Profile EV platform, I have had to perform less alveoloplasty or bone graft to reconstruct those sites.”

Ongoing innovations in threading, angled abutments, and the shift to screw-retained systems further enhance performance and predictability.

The industry reps who shared their observations all agreed that the goals of continuing research and development in implant design are improving the predictability of implant therapy, expanding applications, reducing surgical trauma, shortening treatment time, and lowering costs—in other words, making dental implants readily available from all dentists to all patients.