Techniques and Technologies Integrated Abutment Crown IACs clinical

Techniques and Technologies Integrated Abutment Crown™ “ IAC’s clinical performance compares favorably to screw and cement retained single implant restorations. ” Rainier A. Urdaneta, Mauro Marincola, The Integrated Abutment Crown™, a Screwless and Cementless Restoration for Single-Tooth Implants: A Report on a New Technique, Journal of Prosthodontics, Vol. 16: 311 -318, 2007

Five factors associated with Bone Gain Peri-implant Bone Levels • Implant size 5 x 8 is more likely than 5 x 11 • Occluding with teeth • CP Coating • Larger the Titanium Spherical base • NSAIDs Rainier A. Urdaneta, Shadi Daher, Joseph Leary, Kimberly Emanuel, Sung-K Chuang, Factors Associated with Crestal Bone Gain on Single-Tooth Locking-Taper Implants: The Effect of Nonsteroidal Anti-Inflammatory Drugs, The International Journal of Oral & Maxillofacial Implants, Vol. 26, 1063 -78, 2011

Are they necessary? Radiographic Study says they are. 431 patients: Maxilla: 62% had less than 6 mm of bone height Mandible: 50% had less than 6 mm of bone height Oikarinen K, Raustia AM, Hartikain en M, General and local contraindications for endosteal implants. An epidemiological panoramic radiographic study in 65 -year-old subjects. Community Dentistry and Oral Epidemiology, 1995; 23: 114 -118.

Are they reliable? Newer literature says, Yes ! Short implants with large diameter (6 x 5. 7 mm) have a long-term (>5 years) survival rate and crestal bone level maintenance similar to that observed for non 6 x 5. 7 mm implants. M. A. Gentile, S. K. Chuang, and T. B. Dodson. The International Journal of Oral & Maxillofacial Implants, Vol. 20, No. 5, p. 732 -737, September 2005. Crown-to-implant ratio guidelines for natural teeth should not be applied to potential implant site or existing implant restoration. John K. Schulte. Crown-to-implant ratios of single tooth implant-supported restorations. Journal of Prosthetic Dentistry, Vol 98, (1), 1 -5, 2007.

Are they reliable? Newer literature says, Yes ! “ Crown-to-implant ratios do not affect the success of short-length plateau-design implants. ” Hardeep Birdi, DMD, MS, John Schulte, DDS, MSD, et al, “ Crown-to-implant ratios of Short-Length Implants. Journal of Oral Implantology, 2010, 36: 425 -433. Plateau implants may be restored with single tooth restorations in situations where the length of the proposed crown is up to 4. 95 times the length of the implant within the bone. Urdaneta RA, Rodriguez S, Mc. Neil C, Weed M, Chuang SK. “The Effect of Increased Crown-to-Implant Ratio on Single-tooth Locking taper implants. ” International Journal of Oral Maxillofacial Implants, July-August 2010; 25: 729 -743

How are they better? Avoid Fatal Bleeding! “Both at the midline and lateral to it, one to five arteries were shown to approach the mandible lingually and enter it. They originated from the territory of the sublingual artery in the oral floor. ” Watzek G, Implants in Qualitatively Compromised Bone Quintessence, 2004, p 48 -49

How do they work? Wolff’s Law (1892) “Every change in the function of a bone is followed by certain definite changes in its internal architecture and its external conformation. ” German Anatomist/Surgeon Julius Wolff (1836– 1902) Wolff J. Das Gesetz der Transformation der Knochen. Berlin: Verlag von August Hirschwald, 1892

How do they work? Bone Healing is uniquely different!

How do they work? Rapid healing with cortical-like haversian bone! Plateau Implant presents a unique healing pattern leading to rapid plateau filling with bone with high remodeling potential, leading to unique long-term haversian-like bone morphology Plateau Implant healing: Leonard et al, 2009 COIR; Coelho et al. , CIDRR 2009; Suzuki et al. , 2008 JOMS; Granato et al. , 2009 JBMR-B, CIDRR. Plateau Implant long-term morphology: Coelho et al. , 2010

How do they work? 8 years. Rapid healing with cortical-like haversian bone! Cortical-Like Haversian Bone Paulo G. Coelho, DDS, Ph. D Assistant Professor of Biomaterials and Biomimetics Director for Research, Department of Periodontology and Implant Dentistry New York University College of Dentistry

How do they work? 10 years. Rapid healing with cortical-like haversian bone! 10 years after loading Development of a unique haversian-like channel system like the one observed in cortical bone, high mechanical properties P. G. Coelho, C. Marin, R. Granato, M. Suzuki; Clinical Device-Related Article, HIstomorphologic Analysis of 30 Plateau Root Form Implants Retrieved After 8 to 13 years in Function. A Human Retrieval Study, Wiley Inter. Science 2009, Department of Biomaterials and Biomimetrics, New York University

How do they work? 13 years. Rapid healing with cortical-like haversian bone! 13 years in function: Arrows depict remodeling cycles over the time Paulo G. Coelho, DDS, Ph. D Assistant Professor of Biomaterials and Biomimetics Director for Research, Department of Periodontology and Implant Dentistry New York University College of Dentistry

How do they work? 23 years in function! Lamellar bone (White allows) Osteonic Structures (Red allows) Development of a unique haversian-like channel system like the one observed in cortical bone, high mechanical properties P. G. Coelho, C. Marin, R. Granato, M. Suzuki; , Histomorphologic Analysis of Plateau Root Form Implants Retrieved After 23 years in Function. A Human Retrieval Study, Department of Biomaterials and Biomimetrics, New York University

How do they work? Plateaus Provide Greater Surface Area 5 mmx 8. 3 mm 5. 1 mmx 9. 4 mm 5. 4 mmx 8. 6 mm 5. 7 mmx 8 mm 4. 8 mmx 8 mm Müftü S. , Bozkaya D, Müftü A, Evaluation of load transfer characteristics of five different implants in compact bone at different load levels by finite elements analysis, Journal of Prosthetic Dentistry, Volume 92, Issue 6, December 2004

How do they work? Plateaus Provide Greater Surface Area Stress = Force / Given Area More surface area at bottom An increase in functional surface area serves to decrease the magnitude of mechanical stress imposed on prosthesis, implant, and biologic tissues. Bidz MW, Misch CE ; Force Transfer in Implant Dentistry : basic concepts and principles, Oral Implantology 18: 264 -274, 306, 1992

How do they work? Better distribution of compressive forces! Type II bone Type IV bone 20 N Horizontal Displacement 14 mm Long Implant 5. 7 mm Short Implant Stress Distribution Characteristics of Various Implant Systems due to Non-central Occlusal Loads, AO Annual Meeting, Boston, MA, March, 2003 Bozkaya, D. , Müftü, S. and Müftü, A.

How do they work? Better distribution of compressive forces! Type II bone Type IV bone 100 N Vertical Displacement 14 mm Long Implant 5. 7 mm Short Implant Stress Distribution Characteristics of Various Implant Systems due to Non-central Occlusal Loads, AO Annual Meeting, Boston, MA, March, 2003 Bozkaya, D. , Müftü, S. and Müftü, A.

How do they work? Better distribution of compressive forces! “The distribution of mature bone was greatest along the apical portions of Plateau implants. ” Mitchell, S. , Lemons, J. , & Wellons, H. , Tissue Interfaces for Titanium Alloy Plateau Implants, IADR General Session and Exhibition, March 1994, Seattle, Washington, University of Alabama and Stryker Dental Implants, Kalamazoo, MI, USA

How do they work? Bacterially Sealed Locking Taper Connection! “The seal provided by the locking taper design has been demonstrated to be hermetic with regard to bacterial invasion in vitro. ” Dibart, S. , Warbington, M. , Su, M. F. , Skobe, Z. , In Vitro Evaluation of the Implant-Abutment Bacterial Seal: The Locking Taper System, Journal of Oral and Maxillofacial Surgery, Vol. 20, No. 5, p. 732 -737, September 2005.

How do they work? Micromovement with all screw retained designs! Video Loop “All implant-abutment connections with a clearance fit exhibit a micro motion. ” Zipprich, Holger , Weigl, Paul/lange, Bodo/Lauer, Hans-Christoph, Micromovements at the Implant-Abutment Interface: Measurement, Cause , and Consequences, German Implantologie, Vol. 15, No. 1, p. 31 -46, 2007.

CONCLUSION: Reliability for a mission of 50 K cycles at 200 N was not significantly different between different abutment designs. Failure modes differed. Bonfante, EA • Suzuki, M • Lubelski, W • Silva, NR • Coelho, PG University of São Paulo, Bauru School of Dentistry, Brazil Tufts University School of Dental Medicine, USA Plateaue Implant Dental Implant Center, USA New York University, Biomaterials and Biomimetics, USA IADR, Barcelona, Spain, July 2010

Staining on nano-ceramic material Remove stains easily • “Staining is superficial (20µm) and original composite color can be reestablished by polishing. ” Taciana Emilia de Almeida Anfe, Carlos Martins AGRA, Glauco Fioranelli Vieira, Journal of Esthetic and Restorative Dentistry, Vol. 23, No. 4, 260 -267, 2011

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