Presentaciòn sistema de implantes biohorizons


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Presentaciòn sistema de implantes biohorizons

  1. 1. RBB<br />Macchu Picchu. The lost city of the Incas Cuzco-Perù<br />Song: “Tribute to Ayacucho” . Interpret: Dr. Raul Garcia Zarate<br />RBB<br />
  2. 2. COLEGIO ODONTOLÒGICO REGIONAL DE LIMA<br />Programa Acadèmico Anual<br />Prof. Ricardo Benza Bedoya<br />RBB<br />
  3. 3. Sistema de Implantes Biohorizons<br />RBB<br />
  4. 4. OBJETIVOS<br />Comprender las generalidades del sistema de implantes biohorizons<br />Explicar las innovaciones màs importantes del sistema de implantes biohorizons<br />
  5. 5. “Quien tiene muchos vicios, tiene muchos amos.”<br />Plutarco<br />
  6. 6. 6<br />Key features and benefits<br />Proprietary Laser-Lok® microchannels†<br />Anatomically tapered implant body<br />Patented reverse buttress threads‡<br />Proven internal hex connection<br />Titanium alloy<br />†Laser-Lok design patent #6,454,569 and 6,419,491<br />‡Reverse Buttress thread design patent #5,964,766<br />
  7. 7. 7<br />Resorbable blast texturing (RBT)<br />Highly complex surface texture<br />Increasedstability and osseointegration*<br />Biocompatible resorbableblast media<br />*Sawase T, Wennerberg A, Hallgren C, Miuyamoto I, Albrektsson T: Atomic force microscopic study of commercially available implant abutments. Clin Implant Dent Rel Res 1(2):92-97, 1999.<br />
  8. 8. 8<br />Reverse buttress threads<br />Wide, flat leading edge<br />Increased surface area<br />Improved axial load distribution<br />Improved primary stability<br />Patent# 5,964,766<br />
  9. 9. 9<br />Anatomically Tapered<br />1-2mm of taper based on implant diameter<br />Ideal profile for constrained spaces<br />Improved primary stability<br />Apical 6mm<br />tapered<br />
  10. 10. 10<br />Non-Laser-Lok (left) vs. Laser-Lok (right)80 newton side load<br />Courtesy of Jack Ricci, PhD, NYU<br />
  11. 11. 11<br />Thread Design<br />Defines the interaction between the implant and bone macrostructure<br />“Machine screw” thread versus “wood screw” thread: <br />Machine screw thread: Screw and substrate have the same or similar mechanical properties.<br />Threads are small, closely packed, and v-shaped.<br />Wood Screw: Screw and substrate are different materials (substrate has lower stiffness).<br />Threads are larger, with larger pitch.<br />Threads designed to dig into the substrate.<br />Courtesy of Jack Ricci PhD (NYU)<br />
  12. 12. 12<br />Thread Design<br />Courtesy of Jack Ricci PhD (NYU)<br />Square thread similar<br /> “Wood screw” thread designed for axial compression<br />F<br />S<br />C<br />bone<br />Reverse buttress design has larger, deeper thread, and a lower surface face designed to provide compressive force rather than shear force.<br />
  13. 13. 13<br />Laser-Lok® microchannels<br />Controls epithelial downgrowth<br />Attaches and retains crestal bone<br /> Patent# 6,454,569 & 6,419,491<br />
  14. 14. 14<br />Old and New Microtextures<br />Courtesy of Jack Ricci PhD (NYU)<br />RBT<br />Machined surface<br />
  15. 15. 15<br />Biologic width around natural teethminimal dimension – 3mm<br />
  16. 16. 16<br />Biologic width around traditional implants<br />Tissue level<br />at the time<br />of placement<br />Bone level<br />at the time<br />of placement<br />Microgap<br />Is there a better way?<br />
  17. 17. 17<br />Tapered Internal with Laser-Lok<br />
  18. 18. 18<br />Laser-Lok – proprietary<br />Only surface of its kind<br />Microgrooved surfaces for mechanical stability<br />Patented<br />FDA cleared claims<br />Inhibit epithelial downgrowth<br />Attach/retain crestal bone<br />
  19. 19. 19<br />In vitro studies of cell response to surface microtexture: cells on controlled microtextures<br />Microgrooved surfaces produced from silicon wafer templates.<br />Microgrooves inhibited colonization and caused directional colony formation (Contact Guidance).<br />Optimal groove sizefor inhibition of fibroblast colonization was 6-12 µm widthand >2 µm height.<br />Ricci JL, Charvet J, Frenkel SR, Chang R, Nadkarni P, Turner J, Alexander H: Bone Response to Laser Microtextured Surfaces. In: Bone Engineering, edited by JE Davies, Em2 Inc., Toronto, Ont. Canada, Chapter 25, 282-294, 2000.<br />Courtesy of Jack Ricci, PhD, NYU<br />
  20. 20. 20<br />Supracrestal biologic widthwith Laser-Lok<br />Tissue level<br />at the time<br />of placement<br />Bone level<br />at the time<br />of placement<br />
  21. 21. 21<br />
  22. 22. GOAL: complete case management<br />CROWN<br /><ul><li> CAD/CAM
  23. 23. Restorative planning software
  24. 24. Traditional lab processes</li></ul>ABUTMENT<br /><ul><li> CAD/CAM
  25. 25. Restorative planning software
  26. 26. Standard and esthetic</li></ul>IMPLANT<br /><ul><li> Biomechanically enhanced design
  27. 27. Surgical planning software</li></ul>SURGERY<br /><ul><li> CT
  28. 28. Intra-oral scanning
  29. 29. Surgical planning software
  30. 30. Surgical Guide
  31. 31. Instruments</li></li></ul><li>23<br />Laser-Lok clinically supported – in vitro<br />3-12µm microgeometries vs. random blasted surfaces<br />1¾-12µm microgrooves, controlled<br />2-12µm linear grooves vs. diamond patterns, controlled<br />8 & 12µm parallel grooves vs. square posts, controlled<br />8 & 12µm parallel grooves vs. square posts, controlled<br />8 & 12µm microgrooves vs. random blasted surfaces<br />Suppress fibrous encapsulation<br />Inhibit cell growth<br />Cell orientation & organization<br />Directed tissue response<br />Cellular contact guidance<br />Courtesy of Jack Ricci, PhD, NYU<br />Ricci<br />
  32. 32. 24<br />Laser-Lok clinically supported – human<br />Immediate, provisional load histology<br />Immediate, provisional load histology with sinus graft<br />Clinical, radiographic and histologic evaluation of hard and soft tissue attachment<br />Prospective, controlled, multi-center (37 mos. follow-up)<br />Prospective, randomized vs. Nobel and 3i (3 year follow-up)<br /><ul><li>No epithelial downgrowth
  33. 33. Strong bone integration
  34. 34. Reduced crestal bone loss</li></ul>Courtesy of Jack Ricci, PhD, NYU<br />Courtesy of Jack Ricci, PhD, NYU<br />
  35. 35. 25<br />Placement levels<br />May be placed either crestal or supracrestal<br />Laser-Lok is a transition zone for uneven ridges <br />Uneven ridge<br />Supracrestal<br />(machined and<br />8 micron Laser-Lok)<br />Crestal<br />
  36. 36. 26<br />Instrument sequence<br />Crestal Bone Drillsand Bone Taps(Site-specific)<br />2.0mm Starter Drill<br />2.5mm Depth Drill<br />Abutment-level Driver<br />Width Increasing Drills<br />Depth Gauge<br />
  37. 37. 27<br />1mm high silver bands determine crestal and supracrestal placement<br />Supracrestal<br />Placement<br />Crestal<br />Placement<br />Drill toleadingedge<br />Drill totrailingedge<br />
  38. 38. 28<br />Silver bands defined on drill wall chart and in the Surgical Manual (L0603)<br />
  39. 39. 29<br />Depth verification<br />Verify osteotomy depth<br />Manually insert Depth Gauge<br />12mm Implantwith Laser-Lok<br />DepthGauge<br />Width Increasing Drill<br />
  40. 40. 30<br />Bone Taps<br />Usage dependent on clinical assessment<br />Prepares sites with dense cortical bone <br />One Bone Tap for each body diameter<br />
  41. 41. 31<br />Crestal Bone Drills (for dense bone)<br />Example 1 (Supracrestal). Only partial cutting geometry used.<br />1mm left above osseous crest<br />Implant platform level with osseous crest<br />Example 2 (Crestal). Full cutting geometry used.<br />
  42. 42. 32<br />Abutment-level drivers<br />3inOne Abutment serves as surgical mount<br />Interfaces withsquare drive <br />Pick-up directlyfrom vial<br />Drivers for both Handpiece and Ratchet are included<br />
  43. 43. 33<br />Implant-level drivers<br />May be used following removal of 3inOne Abutment<br />Color-coded by prosthetic platform<br />Drivers for both Handpiece and Ratchet are included<br />
  44. 44. 34<br />Healing Abutments<br />3 heights (1, 3, 5mm)<br />3 Emergence<br />Narrow<br />Regular and <br />Wide Emergence<br />Suture groove to apically position tissue<br />
  45. 45. 35<br />Simple Solutions Healing Abutments<br />Used when a Simple Solutions restoration is planned<br />Develops soft tissue emergence<br />Order by platform and collar height<br />
  46. 46. 36<br />Courtesy of Craig Misch, DMD<br />Microgap <br />“Platform Switching<br />
  47. 47. 37<br />Immediately loaded, maxilla, 2 years <br />Courtesy of Cary Shapoff, DDS (CT)<br />
  48. 48. 38<br />Laser-Lok case: Stuart Froum, DDS, NYU<br />Pre-op<br />At placement<br />2 ½ years post-op<br />
  49. 49. 39<br />Courtesy of<br />Craig Misch, DMD<br />
  50. 50. 40<br />Comprehensive portfolio <br />Prosthetics<br />Implants<br />Soft & Hard Tissue<br />
  51. 51. 41<br />Restorative options<br />Simple Solutions Restorations<br />Traditional implant-level restorations<br />Implant-supported overdentures<br />Implant-stabilized overdentures<br />
  52. 52. 42<br />Proven internal hex connection<br />Supported by a comprehensive line of internally hexed prosthetics<br />
  53. 53. 43<br />Restorative options<br />Simple Solutions restorations<br />Traditional implant-level restorations<br />Implant-supported overdentures<br />Implant-stabilized overdentures<br />
  54. 54. 44<br />
  55. 55. 45<br />Simple Solutions concept<br />Cement-retained restorations in a minimal number of visits<br />Pre-tapered abutments designed to be restored without additional preparation<br />Patients can wear a tooth-colored healing cap over the abutment while the laboratory fabricates the final prosthesis<br />2. Make closed-tray,<br />pick-up impression<br />3. Seat Final<br />Restoration<br />1. Seat Simple<br />Solutions Abutment<br />