Nobel Active Internal Hex Implant


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Nobel Active Internal Hex Implant

  1. 1. NobelActive Internal Hex Implant with Long Lead-in Bevel Nobel Marketing Claims this is the “Implant of the Future”
  2. 2. NobelActive Internal Hex Implant – Modified Alpha Bio Implant Nobel Marketing Claims this is the “Implant of the Future” Alpha Bio Israeli Implant with 45Deg. Bevel and Internal Hex
  3. 3. NobelActive is a Conglomeration of Common Features that work individually but not necessarily in combination Screw-Vent Internal Hex/bevel Niznick Patent 1986 Astra 11Deg. Bevel Osstem’s double Threads over entire length. NobelActive transition of sharp to flat threads not contusive for self-tapping insertion in dense bone Oraltronics’ Pitt-Easy Implant with Deep Apical Threads but threads consistent over entire length NobelActive hex too deep to allow for 8mm implant length 45 Deg. Bevel Bevel with proven 20 year history of stability
  4. 4. 1.5mm High External Hex 3.5mm Morse Taper Post NobelActive External -With External Locking Taper Connection Nobel Marketing Claims this is the “Implant of the Future”
  5. 5. NobelActive External - 5mm high tapered post requires parallelism Miter Implant with External Post – Evolved quickly to Internal Socket (Bicon) Driskell Patent 1985: Tapered Post on Implant “Locking taper concept – impacting the female taper of the implant head with the male counterpart on the root structure.” Driskell Patent 1988: Tapered Socket in Implant Locking Taper Concept “The head member has … a tapered rod or socket for connection to the root” “ Those who cannot remember the past are condemned to repeat it” QUOTATION: George Santayana (1863–1952), U.S. philosopher,
  6. 6. Nobel Biocare’s History of “Innovation” for Innovation Sake Are Nobel’s Exiting Implants the “Implants of the Past? NobelActive Niznick 1986 Internal Hex, Pitt-Easy deep apical threads, Osstem double threads, Alpha Bio Clone Tapered Groovy with diminishing apical threads and no cutting groove NobelPerfect $600 Implant Claiming to be Solution for “Black Hole” esthetic Problem NobelDirect Bone Loss Articles and Regulatory Problems
  7. 7. A Camel is a Horse Designed by a Committee NobelActive Internal NobelActive External
  8. 8. Research: 1 Poster + 2 “Ongoing” Nobel Company Studies
  9. 9. NobelActive (TiUnite) and Alpha Bio’s SFB (SLA) Implants BUT Nobel claims 98.3% Alpha Bio study applies to its new implant ABOVE: Nobel Claims NobelActive success of “98.3% for up to 4 years” BELOW: Alpha Bio’s Catalog Claims same 98.3% success “after more than 5 years” but the surface is SLA (sand blasted with large grit followed by acid etching) like Straumann’s Surface
  10. 10. Nobel Claims NobelActive Functions like “Corkscrew” Close Evaluation indicates they should have left it in the bottle
  11. 11. Nobel Biocare’s NobelActive Marketing Claims <ul><li>“ bone-condensing – expands indication range and gives even higher initial stability.” </li></ul><ul><li>“ self-drilling” </li></ul><ul><li>“ ability to change direction during surgery” </li></ul><ul><li>“ unique press-fit connection of abutment – </li></ul><ul><li>-removes risk of excess cement” </li></ul><ul><li>NobelActive Internal and External implants don’t cut through bone like </li></ul><ul><li>Higher than What – Replace? Increased stability achieved by spreading bone whereas deep threads cut bone </li></ul><ul><li>Self-threading – like any screw in soft bone. </li></ul><ul><li>Path of implant insertion should be established during surgery, not during implant insertion. That is what guide pins and end-cutting drills are for. </li></ul><ul><li>Nothing unique about press-fit connection. Miter Implant (1980) had external tapered post – evolved to internal press-fit connection of Bicon </li></ul><ul><li>If cement is a risk, why does NobelActive Internal have a screw-retained connection? </li></ul><ul><li>Why does NobelActive have spiral cutting grooves if not to “cut through bone like conventional (self-tapping) implants”? </li></ul>NobelActive Marketing Claims Questionable Validity of Marketing Claims conventional implants, they press through it like a corkscrew
  12. 12. <ul><li>It is not a “one-piece implant – requires an abutment. </li></ul><ul><li>Does not have 2-piece flexibility – Can not use angled heads greater than 12 degrees, ball, screw-receiving or ceramic abutments. Require parallel placement of implants for bridges. </li></ul><ul><li>A one-piece implant eliminates “micro gap” but a precise-fitting internal connections maintain marginal integrity anyway. Nobel still sells external hex implants – less stable </li></ul><ul><li>“ One piece implant </li></ul><ul><li>design with 2-piece flexibility” </li></ul><ul><li>locking tapered interface .. Eliminates bone level micro gap, micro-movement and the use of abutment screws.” </li></ul>NobelActive External Claims Claims are not Valid
  13. 13. Precision Manufacturing of Internal Connection Prevents both Micro-Movements and Micro-Gap Abutment ScrewPlant Implant Screw Precision Fit Cross-section of Abutment On ScrewPlant Implant
  14. 14. Compare Fit of ScrewPlant from Implant Direct, and the Screw-Vent Clone from Alpha Bio, the Israeli Implant Company owned by NobelActive Developer ScrewPlant – External Bevel Connection from Implant Direct Alpha Bio, Israeli Company owned by Dr Fromovitch, NobelActive Developer SBM to top Blast Surface 3mm Short of the top Note Pitted Surface and Gap Note Micro-threads and Sealed Margin
  15. 15. Very deep threads apically cuts rather than compresses soft bone - any screw implant will self-tap in soft bone. <ul><li>NobelActive™ Claim </li></ul><ul><li>The product is easy to use and provides high initial stability and good outcomes. </li></ul><ul><li>The Apical Threads are too aggressive for self-tapping insertion in Dense bone and are designed to cut threads in soft bone rather than expand and compress the bone for increased initial stability. Any Implant will self-tap in soft bone. </li></ul>NobelActive No Taper to OD of Threads ScrewPlant Gradual Taper for Bone Expansion Deep apical threads will not expand narrow ridge or compress soft bone Soft Bone (Balsa) = 3.91 in/lbs Insertion Torque Hard Bone (Oak) = 6.35 in/lbs Insertion Torque
  16. 16. Dense Bone Drill is 4.2mmD but Platform is 3.9mmD NobelActive Leaves Gap around neck of Implant in Dense Bone
  17. 17. Dense Bone Drill is 4.6mmD but Platform is 3.9mmD NobelActive Leaves Gap around neck of Implant in Dense Bone
  18. 18. Compare NobelActive External Hex with ScrewDirect One-Piece Implant The Prosthetic Advantages are Obvious & Cost Savings Significant NobelActive External Requires Attachment of one of these four abutments ScrewDirect $150 incl. Snap Transfer & Cap
  19. 19. Attach & Remove Long Friction Fit Head to NobelActive Straight Friction-fit abutment too long Heads of Implant exposed above bone Tried to remove abutment with Forceps
  20. 20. Attach Two Short Friction Fit Heads to NobelActive using Mallet Jack off abutment using Removal Screw Shorter Abutment attached to Implants Shorter Abutment attached to Distal Implant Tap on Taper Lock Abutments with Mallet
  21. 21. Need for parallelism is what dictates need to re-direct implant Establish alignment with paralleling pins and end-cutting drills
  22. 22. Preferred placement is angled between buccal and lingual plates Straight Post of NobelActive External requires vertical placement
  23. 23. NobelActive vs RePlus Implant From Implant Direct Why Change Drills and Platforms, just to change threads? <ul><li>RePlus has Tri-Lobe Connection </li></ul><ul><li>Both have Platform switching interface – of questionable value </li></ul><ul><li>RePlus has even taper and even depth to threads to allow insertion into an undersized socket for bone expansion, </li></ul><ul><li>NobelActive has no taper to outside threads and extreme taper to inside thread dimension </li></ul><ul><li>RePlus has Mini-threads whereas NobelActive has horizontal grooves. </li></ul><ul><li>RePlus major diameter is at top of implant whereas NobelActive 4.3 & 5.0 implants are narrower at top, leaving gap in dense bone </li></ul><ul><li>RePlus has double lead threads on body for faster insertion. </li></ul>Nobel Active RePlus Implant
  24. 24. ProActive with Tri-Lobe Connection and Platform Switching Projected Launch Date – January 2008 <ul><li>Same taper to body as RePlus Implants allow insertion in undersized socket for expansion </li></ul><ul><li>Flat-based deeper threads provide increased surface area for greater stability in soft bone </li></ul>
  25. 25. ProActive Implant Provided on Fixture-Mount that is Transfer and can be shortened to Final, Platform Switching Abutment
  26. 26. Get Connected to All-in-one Packaging, Simplified On-line Ordering and Unprecedented Low Prices [email_address] Dr. Jerry Niznick, President