There are currently likely around 500 implant brands in the world today. In 2003 there were 69.
Neodent is the forth largest implant company in the world. Later this year, they expect to be number 3. 40% of market share in Brazil. 24 years in business. Also #1 in Portugal. They are now owned by Straumann.
Instradent: institute Straumann Dental: ABUTMENT Direct is also owned by Straumann. Mike Parsons is the President and located in Toronto. Medentika: multi-platform systems manufactured in Germany.
Implant growth in USA is 12%, Neodent has triple digit growth currently.
Neodent is also involved with ClearChoice. 34 dental centres. They place 34,000 implants a year. They replaced Nobel. Their focus is on Practice Performance Programs vs. selling implants as a product.
Dr. Alexandre Molinari
Cone Morse Implants ( the Morse taper )
The question they are asking is how long will the crown last in the mouth?
Originally, there was a lot of concern about biologic width but now this is less prevalent. Now, the concern is with reduced bone loss and bone growth through bone augmentation. Up to 2 mm. loss is now considered normal.
Abutment characteristics: what considerations are required when selecting the components and how they effect the aesthetics of the final prosthesis.
The abutment plays a major role in the final outcome of the restoration. Optimizing bone and soft tissue maintenance.
Use a Try In kit and use this to determine which system to use. High frequency of prosthetic complications associated with the use of titanium screws.
Crestal bone remodeling: microbal colonization of the microgap, micromovements of the abutment, interruption of the blood supply. The issue of micromovement is worse than the micro gap. Platform switching alter the amount of crestal bone loss. If implants are placed incorrectly, then try to change your protocol to placing at crestal bone level.
But, what about placing the implants sub crestally? Placing the bone differently with a space for soft tissue growth, allows for better aesthetics.
The Morse Taper is a mechanical change: vertical change and additional friction factors for enhanced initial torque forces so that immediate loading is now possible.
The use of the Morse Taper allows for improved bone growth at the crest of the ridge.
Therefore, they conclude that the use of a Morse Taper and platform switching is the best option for reducing bone loss.
The beauty lies in the soft tissue modelling. The tissue is the issue but the connection is the partner that ensures success.
Placing sub crestally provides better papilla profiling. Abutment collar height is a key factor in peri-implant marginal bone loss.
Keep the margin at least 1 mm. away. 1 to 3 mm. is a good distance for sub crestal to bone level distance.
Soft tissue behavior is related to bone depth. 1 mm. probe depth is best.
He uses a socket measuring tool to determine what implant length would be best for each case, relative to soft tissue and hard tissue success.
Sub crestally placed implants with a long/high collar is the most successful regime, with a Morse taper.
The bending relationship between zirconia abutments and metal implants is not the best.
Bone remodelling can be either vertical or horizontal. There are important differences to consider.
Placing the implant at the crest of the ridge or sub-crestally is affected by the shape of the implant.
You want the fibre turning oblique to the implant collar area for maximum success and reduced bone loss.
Use of a Morse taper reduces the propensity of bone loss, both longitudinal and horizontal.
Short collar height leads to vertical bone loss.
He uses micro tomography to verify the osseointegration around the length of the implant.
Tips about Morse Taper connections: place implants sub-crestally. Select an ideal gingiva collar height. The abutment for provisional and final crown is the same. The impression for the final restoration has to be on abutment the level.
Notes taken by Richard Murray while attending this Neodent seminar in Toronto. e&oe