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Tạp chí implant tháng 8 &9/ 2013 Vol 6 No4
clinical articles • management advice • practice profiles • technology reviews August/September 2013 – Vol No PROMOTING EXCELLENCE IN IMPLANTOLOGY Corporate profile Henry Schein Dental Surgical Solutions Minimally invasive crestal approach technique for sinus elevation Drs Ziv Mazor, Andreas Ioannou, Narayan Venkataraman, George Kotsakis, and Udatta Kher Practice profile Dr David Feinerman PAYING SUBSCRIBERS EARN 24 CONTINUING EDUCATION CREDITS PER YEAR! The evolution and advancement of dental implants Drs Robert J Miller and Randi J Korn Treatment planning of implants in the esthetic zone: part three Drs Sajid Jivraj, Mamaly Reshad, and Winston Chee WHEN THE OSTEOTOMY MUST BE NARROW - SO MUST YOUR IMPLANT CHOICE Choose the LOCATOR® Overdenture Implant System 2.5mm Cuff Heights 4mm 2.4mm Diameters 2.9mm included with each Implant It’s a fact – denture patients commonly have narrow ridges and will require bone grafting before standard implants can be placed Many of these patients will decline grafting due to the additional treatment time or cost For these patients, the new narrow diameter LOCATOR Overdenture Implant System (LODI) may be the perfect fit Make LODI your new go-to implant for overdenture patients with narrow ridges or limited finances and stop turning away patients who decline grafting Your referrals will love that LODI features all the benefits of the LOCATOR Attachment system that they prefer, and that all of the restorative components are included Discover the benefits that LODI can bring to your practice today by visiting www.zestanchors.com/LODI/31 or calling 855.868.LODI (5634) ©2013 ZEST Anchors LLC All rights reserved ZEST and LOCATOR are registered trademarks of ZEST IP Holdings, LLC EDITORIAL ADVISORS Steve Barter BDS, MSurgDent RCS Anthony Bendkowski BDS, LDS RCS, MFGDP, DipDSed, DPDS, MsurgDent Philip Bennett BDS, LDS RCS, FICOI Stephen Byfield BDS, MFGDP, FICD Sanjay Chopra BDS Andrew Dawood BDS, MSc, MRD RCS Professor Nikolaos Donos DDS, MS, PhD Abid Faqir BDS, MFDS RCS, MSc (MedSci) Koray Feran BDS, MSC, LDS RCS, FDS RCS Philip Freiburger BDS, MFGDP (UK) Jeffrey Ganeles, DMD, FACD Mark Hamburger BDS, BChD Mark Haswell BDS, MSc Gareth Jenkins BDS, FDS RCS, MScD Stephen Jones BDS, MSc, MGDS RCS, MRD RCS Gregori M Kurtzman, DDS Jonathan Lack DDS, CertPerio, FCDS Samuel Lee, DDS David Little DDS Andrew Moore BDS, Dip Imp Dent RCS Ara Nazarian DDS Ken Nicholson BDS, MSc Michael R Norton BDS, FDS RCS(ed) Rob Oretti BDS, MGDS RCS Christopher Orr BDS, BSc Fazeela Khan-Osborne BDS, LDS RCS, BSc, MSc Jay B Reznick DMD, MD Nigel Saynor BDS Malcolm Schaller BDS Ashok Sethi BDS, DGDP, MGDS RCS, DUI Harry Shiers BDS, MSc, MGDS, MFDS Harris Sidelsky BDS, LDS RCS, MSc Paul Tipton BDS, MSc, DGDP(UK) Clive Waterman BDS, MDc, DGDP (UK) Peter Young BDS, PhD Brian T Young DDS, MS CE QUALITY ASSURANCE ADVISORY BOARD Dr Alexandra Day BDS, VT Julian English BA (Hons), editorial director FMC Dr Paul Langmaid CBE, BDS, ex chief dental officer to the Government for Wales Dr Ellis Paul BDS, LDS, FFGDP (UK), FICD, editor-in-chief Private Dentistry Dr Chris Potts BDS, DGDP (UK), business advisor and ex-head of Boots Dental, BUPA Dentalcover, Virgin Dr Harry Shiers BDS, MSc (implant surgery), MGDS, MFDS, Harley St referral implant surgeon PUBLISHER | Lisa Moler Email: lmoler@medmarkaz.com Tel: (480) 403-1505 MANAGING EDITOR | Mali Schantz-Feld Email: mali@medmarkaz.com Tel: (727) 515-5118 ASSISTANT EDITOR | Kay Harwell Fernández Email: kay@medmarkaz.com Tel: (386) 212-0413 EDITORIAL ASSISTANT | Mandi Gross Email: mandi@medmarkaz.com Tel: (727) 393-3394 DIRECTOR OF SALES | Michelle Manning Email: michelle@medmarkaz.com Tel: (480) 621-8955 NATIONAL SALES/MARKETING MANAGER Drew Thornley Email: drew@medmarkaz.com Tel: (619) 459-9595 NATIONAL SALES REPRESENTATIVE Sharon Conti Email: sharon@medmarkaz.com Tel: (724) 496-6820 PRODUCTION/DIGITAL MARKETING MANAGER Greg McGuire Tel: (480) 621-8955 Email: greg@medmarkaz.com PRODUCTION ASST./SUBSCRIPTION COORD Lauren Peyton Email: lauren@medmarkaz.com Tel: (480) 621-8955 MedMark, LLC 15720 N Greenway-Hayden Loop #9 Scottsdale, AZ 85260 Tel: (480) 621-8955 Fax: (480) 629-4002 Toll-free: (866) 579-9496 Web: www.implantpracticeus.com SUBSCRIPTION RATES year (6 issues) years (18 issues) $99 $239 © FMC 2013 All rights reserved FMC is part of the specialist publishing group Springer Science+Business Media The publisher’s written consent must be obtained before any part of this publication may be reproduced in any form whatsoever, including photocopies and information retrieval systems While every care has been taken in the preparation of this magazine, the publisher cannot be held responsible for the accuracy of the information printed herein, or in any consequence arising from it The views expressed herein are those of the author(s) and not necessarily the opinion of either Implant Practice or the publisher Volume Number This is no longer your father’s implant dentistry! T he axiom “I placed the implant where the bone was” is a dated concept in implant dentistry today and no longer accepted as the “norm.” Osseous grafting has become an integral part of implant treatment, allowing ideal implant placement without the compromises we accepted in the past related to where the residual bone remained Practitioners who have been involved with implant treatment, both surgically and restoratively for 20 or more years have witnessed the evolution afforded by advances in creating bone where is it needed so that the fixtures can be placed where restorative demands dictate It has been long preached that implant dentistry is a restorative treatment with a surgical component In the past due to resorptive patterns, restoratively we had to compromise in some patients where the fixtures could be placed This often forced compromises in the esthetic results or created challenges to home hygiene care for the patient Advances in grafting materials and techniques permit a true restorative-driven treatment resulting in ideal placement of the fixtures regardless of where the bone lies prior to treatment Predictability was not always the word associated with oral osseous grafting Early endeavors using rib, tibia, hip, and other areas distant from the oral cavity resulted in mixed results, often demonstrating resorption of the host graft over time and postoperative issues (i.e., discomfort) at the donor site Yet, what “goes around comes around.” Philip Boyne, one of the early pioneers (1970s) in the use of titanium mesh as a cage to contain graft materials at the host site, has seen his concepts generally embraced with the advances in grafting materials Titanium mesh is available from multiple manufacturers, pre-shaped to the different regions of the arch that can be placed either with or without simultaneous fixture placement, allowing the graft to be undisturbed until integration has occurred to the underlaying bed The sinus augmentation techniques of Hilt Tatum, also from the 1970s, have seen new light with embracing of his pioneering approach of crestal-driven augmentation Simpler, easier, more predictable crestal sinus augmentation has opened the door to more practitioners being able to provide this service and allow implant placement in the deficient posterior maxilla, as well as providing the patient with a less traumatic approach to improving bone height in this region of the mouth We have also witnessed remarkable improvements in the osseous graft materials themselves The demineralized bottled bone allograft materials that were the standard years ago have been replaced by materials that are better processed and engineered to direct bone growth (osseoconductive) and stimulate bone growth (osseoinductive), and provide improved handling Bovine osseous products continue to be utilized, but synthetic osseous grafting materials have evolved to provide grafts that are completely replaced by native host bone leaving no remnants behind following healing of the site Bone morphogenic proteins (BMP) provided from select companies, along with factors derived from the patient’s own plasma, are helping us better engineer our grafts providing better quality results in less time Additionally, “putty” forms of osseous graft materials available, both alloplastic and synthetic, allow improved ease of placement without unwanted distribution of the graft material beyond the site, and shaping of the graft to the dimensions of the desired ridge at placement This circumvents the issues associated with granular graft materials that had been accepted yet undesired CBCT has opened new frontiers permitting better evaluation of osseous structure and related anatomical features The CAD/CAM-derived surgical stents from the 3D planning allow the restorative team to determine where the coronal portion of the restoration needs to be placed and where bone may need to be created to accomplish those restorative goals Today, implant dentistry is truly a restoratively-driven treatment modality allowing us to replicate what Mother Nature had originally provided the patient Gregori M Kurtzman DDS, MAGD, FACD, FPFA, FADI, DICOI, DADIA Implant practice INTRODUCTION August/September 2013 - Volume Number TABLE OF CONTENTS Case study An advanced mini dental implant case: 25 extractions and insertion of 15 MDIs for a Practice profile Dr David Feinerman: Communication, attention to detail, and hard work This clinician strives to balance a full-scope oral and maxillofacial surgery practice and family fun quadriplegic patient Dr M Dean Wright uses MDIs to treat a challenging case 14 Adjunctive laser treatment in extraction/immediate implant placement Dr Robert J Miller discusses technology that is changing the face of implants at the speed of light 18 Clinical Minimally invasive crestal approach technique for sinus elevation utilizing a cartridge Corporate profile 12 Henry Schein Dental Surgical Solutions From cotton rolls to cone beams, this new division is a one-stop shop for the specialty practice Implant practice delivery system Drs Ziv Mazor, Andreas Ioannou, Narayan Venkataraman, George Kotsakis, and Udatta Kher delve into ways to overcome insufficient vertical bone height in the posterior maxilla in conjunction with maxillary sinus lift 20 An affordable overdenture option for an edentulous ridge Dr Ara Nazarian discusses the benefits of a small diameter implant 26 Volume Number TABLE OF CONTENTS Best of class Implant Practice US congratulates the 18 winners of Pride Institute’s “Best of Class” Technology Awards 30 Continuing education Treatment planning of implants in the esthetic zone: part In the final part of the series, Drs Sajid Jivraj, Mamaly Reshad, and Winston Chee look at the considerations for multiple implant placement 32 36 Monitoring, diagnosis, and treatment of peri-implant diseases treatment of peri-implant diseases Drs Cemal Ucer, David Speechley, Simon Wright, and Eddie Scher look at the clinical headlines from the Association of Dental Implantology UK’s consensus meeting .36 Step-by-step Osstell ISQ As easy as 1, 42 Technology The evolution and advancement of dental implants Drs Robert J Miller and Randi J Korn discuss some history behind new implant technology 44 Implant practice Product profile Innovative practices and Monitoring, diagnosis, and On the horizon LAPIP protocol from Millennium Dental Technologies, Inc offers a patient-friendly, predictable solution for ailing implants .54 innovations in technology Dr Justin Moody introduces his technology column with insights to improve the implant planning and placement process 48 Industry news Straumann® introduces Emdogain™ 015 – designed to provide versatility in patient treatment New smaller size syringes will help clinicians provide Emdogain regenerative therapy to more patients .50 Zimmer Dental Implant receives Southern Anesthesia & Surgical Inc adds synthetics to the Osteo-i® line of regenerative products .56 Luster® kits by MEISINGER .58 Diary .60 Materials & equipment .64 2013 MDEA Silver Medal 52 Volume Number DENTSPLY Implants offers a comprehensive line of implants, including ASTRA TECH Implant System™, ANKYLOS® and XiVE®, digital technologies such as ATLANTIS™ patient-specific abutments, regenerative bone products and professional development programs We are dedicated to continuing the tradition of DENTSPLY International, the world leader in dentistry with 110 years of industry experience, by providing high quality and groundbreaking oral healthcare solutions that create value for dental professionals, and allows for predictable and lasting implant treatment outcomes, resulting in enhanced quality of life for patients We invite you to join us on our journey to redefine implant dentistry For more information, visit www.dentsplyimplants.com Facilitate™ www.dentsplyimplants.com 79570-US-1212 © 2012 DENTSPLY International, Inc DENTSPLY Implants is the union of two successful and innovative dental implant businesses: DENTSPLY Friadent and Astra Tech Dental PRACTICE PROFILE Dr David Feinerman Communication, attention to detail, and hard work What can you tell us about your background? I am Board Certified as an Oral and Maxillofacial Surgeon and have been practicing oral surgery since 1995 Originally from Queens, New York, I moved to South Florida in 1997 and opened Boynton Oral and Maxillofacial Surgery and Implant Center, PA I graduated Summa Cum Laude from the State University of New York at Albany (SUNY), and received my DMD (Cum Laude) from Harvard School of Dental Medicine and my MD degree from The University of Connecticut Following completion of a 1-year General Surgery and 4-year Oral and Maxillofacial Surgery internship and residency at The University of Connecticut, I went on to a 1-year hospital-based maxillofacial surgery fellowship at St Francis Hospital and Medical Center During this time, I received post-graduate training in advanced aspects of oral and maxillofacial surgery, dental implantology, head and neck oncologic surgery, maxillofacial reconstruction, and cosmetic facial surgery From 1995–1997, I was an associate with Connecticut Maxillofacial Surgeons, LLC in Hartford, Connecticut, as well as a clinical instructor in oral and maxillofacial surgery at The University of Connecticut School of Dental Medicine In addition to private practice, I am an Adjunct Clinical Professor at Nova Southeastern University College of Dental Medicine, co-chairman of the Oral Implantology Course at the Atlantic Coast Dental Research Clinic, and I lecture nationally at oral and maxillofacial surgery and oral implantology conferences I have published several articles in peer reviewed journals on various oral surgery topics and currently serve as a reviewer for several journals including the International Journal of Oral and Maxillofacial Surgery, the Journal of Oral and Maxillofacial Surgery and the Oral Surgery, Oral Pathology, Oral Medicine, Oral Radiology and Endodontics Journal I have served on the South Palm Beach County Dental Association Board for the past years and am currently on staff at Delray Medical Center and Boca Implant practice David M Feinerman, DMD, MD Raton Outpatient Laser and Surgery Center I am a Diplomate of the American Board of Oral and Maxillofacial Surgery, fellow of the American Association of Oral and Maxillofacial Surgeons, a member of the Florida Society of Oral and Maxillofacial Surgeons, the American Dental Association, Florida Dental Association, American Medical Association, Florida Medical Association, Atlantic Coast Dental Association, South Palm Beach County Dental Association, the Academy of Osseointegration, the International Team of Implantology, and the American Academy of Implant Dentistry Is your practice implants? limited to My practice is a full-scope oral and maxillofacial surgery practice consisting of dental implantology, dentoalveolar surgery, oral pathology, facial trauma, orthognathic surgery, orofacial reconstruction, and ambulatory anesthesia Why did you decide to focus on implantology? When I practiced in Connecticut, I worked in a hospital-based oral and maxillofacial surgery practice with a heavy emphasis on orthognathic surgery, TMJ surgery, and cancer reconstruction When I moved to Florida, the demographics of the surrounding population leant itself to a more office-based practice Many patients were being sent 15 miles north (to Palm Beach) and 15 miles south (to Boca Raton) for their implant surgery There seemed to be a void in my area (Boynton Beach), and I decided to focus my practice in the area of implantology How long have you been practicing, and what systems you use? I have been in private practice since 1995 The Straumann® Dental Implant System is the one I use most, but I occasionally place Zimmer®, Nobel Biocare®, Astra, Ankylos® and Biomet 3i™ We have all the systems in the office What training undertaken? have you As an oral and maxillofacial surgeon, I did years of dental school (with one extra Volume Number ROXOLID FOR ALL ® THREE INNOVATIONS ■ ■ ■ ■ ALL DIAMETERS ■ AWARD WINNING TECHNOLOGIES STRENGTH - The Advanced Roxolid Material ® SURFACE - The SLActive Technology SIMPLICITY - The Loxim™ Transfer Piece ® Designed to increase your treatment options and help to increase patient acceptance of implant therapy www.straumann.us 800/448 8168 PRACTICE PROFILE year of research at Harvard) and a 5-year oral and maxillofacial surgery residency This included a 1-year internship in general surgery that afforded me the time to complete my medical degree When the residency concluded, I completed a 1-year hospital-based fellowship in advanced maxillofacial reconstruction, which included many aspects of dental implantology and bone grafting My training began at the Harvard School of Dental Medicine Harvard had a very strong pre-doctoral implant program because of the pioneering work being I am proud that we have an established reputation and that dentists from all over the country feel comfortable to call me if one of their patients is vacationing in Florida and experiences an issue that requires attention The staff at Boynton Oral and Maxillofacial Surgery and Implant Center Feinerman family in Beaver Creek, Colorado done there by Dr Paul Schnitman As an oral and maxillofacial surgery resident at the University of CT, I had the benefit of additional instruction and clinical training because of Dr Tom Taylor and Dr Leon Assael (who were both heavily involved early on with the ITI) At that time, only oral surgeons were allowed to take surgical implant training courses and, as a resident, I took the ITI, Branemark, and IMZ implant courses Today, I pursue as much continuing education as my schedule will allow for, and I am involved with the ITI refer patients to the practice Some of them have become very close personal friends, and it makes it easy and enjoyable to discuss cases while working together daily to provide comprehensive patient care Who has inspired you? When I was a first-year resident in oral surgery at the University of CT, Drs Belzer and Buser visited from Switzerland and gave a lecture to the oral surgeons It was a “private” lecture with only 20-30 of us in the room, and they presented the most unbelievable, cutting-edge, implant-related Implant practice treatment We were all amazed at what they were doing Also, at the University of CT, I was fortunate to be taught by great surgeons and terrific people Many of them have been mentors and role models not only professionally, but personally as well Lastly, having a loving wife and family is extremely motivating; it pushes me to be the very best that I can be What is the most satisfying aspect of your practice? Our goal in the practice is to deliver superior oral surgical care Providing great service to our patients is not only satisfying to the patients, but to the entire practice We become very close with some patients, and it is rewarding to help someone who is in need of your expertise Equal to this are the professional and personal relationships I have developed with the dentists who Professionally, what are you most proud of? Professionally, I am proud of a few things I am proud that our practice has become one of the largest implant practices in Florida as well as nationally I am proud that we have an established reputation and that dentists from all over the country feel comfortable to call me if one of their patients is vacationing in Florida and experiences an issue that requires attention I am proud that many of my staff members have been with me since the day I started my practice in Florida My two surgical assistants have been with me for 15 and 16 years, my office manager for Volume Number INDUSTRY NEWS Zimmer Dental Implant receives 2013 MDEA Silver Medal Z immer Dental Inc., a leading provider of dental oral rehabilitation products and a subsidiary of Zimmer Holdings, Inc., was recently honored with a Silver Medal at the 2013 Medical Design Excellence Awards (MDEA) in the category of “Dental Instruments, Equipment, and Supplies” for its revolutionary Zimmer® Trabecular Metal™ Dental Implant Zimmer Dental’s entry stands out as the only dental implant recognized in the highly regarded, global competition, which is sponsored by the Medical Device and Diagnostic Industry (MD+DI) According to the MD+DI website, the MDEA competition is the premier awards program for the medical technology community, recognizing the achievements of medical product manufacturers and the many people behind the scenes — engineers, scientists, designers, and clinicians — who are responsible for the groundbreaking innovations that are changing the face of healthcare This recognition follows the recent coining of the term “osseoincorporation” in describing the unique bone development process made possible with this porous dental implant Osseoincorporation refers to the growth potential of bone, both onto an implant surface and into an implant structure The Trabecular Metal Dental Implant features an osteoconductive mid- 52 Implant practice section, formed from Trabecular Metal material, designed for ingrowth as well as ongrowth in a process new to implant dentistry—osseoincorporation Manufactured In the U.S at Zimmer’s TMT facility in Parsippany, New Jersey, and used in Zimmer’s cutting-edge orthopaedic devices for more than 15 years, Trabecular Metal material is a threedimensional, highly biocompatible material — not an implant surface or coating — with up to 80% porosity for bone ingrowth and a structure comparable to cancellous bone The interconnected porosity is designed to enhance secondary stability through a high volume of ingrowth For decades, Zimmer Dental has gained the trust of thousands of clinicians worldwide who count on its comprehensive line of products to deliver successful patient outcomes By looking to new and innovative technologies and leveraging its relationship with its parent company, Zimmer Holdings, Zimmer Dental continues to reinforce its commitment to offering state-of-the-art dental solutions For more information, contact a Zimmer Dental sales consultant or customer service at 800-854-7019 or 760-929-4300, or visit TrabecularMetal ZimmerDental.com IP This information was provided by Zimmer Volume Number PRODUCT PROFILE LAPIP protocol: patient-friendly, predictable solution for ailing implants T he LAPIP™ protocol from Millennium Dental Technologies, Inc offers a patient-friendly, predictable solution for ailing and failing implants The LAPIP protocol is an implantspecific modification of the well-defined LANAP® protocol for the treatment of periodontitis redesigned to treat periimplantitis The LAPIP protocol uses a selective denaturing of pathologic proteins to reduce the inflammatory response, remove inflamed pocket tissue, disrupt biofilms, and decontaminate the implant surface A laser-induced hemostasis step further decontaminates the tissue and creates a durable blood clot to close the system The LANAP protocol is an FDAcleared treatment that provides cementum-mediated new periodontal ligament attachment to root surfaces in the absence of long junctional epithelium This patientfriendly periodontal surgery treats the periodontal pocket walls to remove diseased epithelium, and then seals them with a laser-generated blood clot The therapy results in greater probing depth reduction and clinical probing attachment level gains of a vertically oriented flap is needed, the integrity of the structural tissue is retained Thus, all other future treatment options remain possible Patient-preferred treatment option Unique power of the Nd:YAG PerioLase MVP-7 What makes the LAPIP protocol unique is that it actually brings the tissue back to health, regrowing bone, and allowing for reintegration of the implant There is no need for removal of the implant, waiting for the healing to take place, and then replacement weeks after, if at all The process requires a single appointment with shorter recovery time – key benefits for your patients In addition, patient satisfaction increases with the ability to retain the implant The LAPIP protocol leverages the positive effects that the optimally configured PerioLase® MVP-7™, a free-running pulsed Nd:YAG laser, has on treating peri-implantitis Specifically, the PerioLase MVP-7’s ability to penetrate the soft tissue to achieve an effective kill of bacteria and promote hemostasis without damaging healthy tissue, make it uniquely designed to support the LAPIP protocol Successful and versatile Multiple case studies indicate ailing or failing implants treated with the LAPIP protocol have reintegrated in the pocket and stabilized with bone growth of threeeight threads Because no resection or reflection 54 Implant practice Training to ensure success Millennium Dental Technologies understands the key to success is the clinician’s ability to replicate results in his/her own patients For most dentists, hands-on learning in a small group environment is the best possible structure for comprehensive learning, therefore, we include days of live-patient training with a three-student to one-instructor ratio This training is a comprehensive coverage of the LANAP and LAPIP protocols to promote clinical success Even after training is completed, each student has access to his or her clinical instructor and the founders of the company for support IP For more information visit www.LANAP.com or call 877-LANAP-LZR This information was provided Millennium Dental Technologies by About Millennium Dental Technologies, Inc Millennium Dental Technologies, Inc., a manufacturer and distributor of dental products, seeks to bridge the growing divide between gum disease patients and treating clinicians by providing simple and comfortable patient experiences with bone-building clinical results By removing their fear, the dental community has the opportunity to bring patients back to seek treatment for their gum disease The FDA-cleared and patented LANAP® protocol offers a proven patient-friendly treatment alternative to conventional scalpel/suture flap surgery; and the LAPIP™ protocol offers a solution for ailing/failing implants Volume Number PRODUCT PROFILE Southern Anesthesia & Surgical Inc adds synthetics to the Osteo-i® line of regenerative products S ynthetics offer freedom from inherent risks of allograft and xenograft products like prions, viruses, extraneous DNA and RNA, and animal antigens They are often less expensive while providing the same clinical outcome, but all synthetic bone graft materials are not the same There are those that resorb too quickly and not provide a scaffold for new vital bone to grow on and into, and there are those that never resorb, preventing the implant space from ever becoming all new vital bone Therefore, attention to detail in the manufacture of bone graft products is essential to creating a product that both resorbs and allows complete bone replacement of the implant material with new vital bone in an ideal time frame How we it All steps of the process are controlled inhouse to ensure the best possible product characteristics • All materials used in the manufacture of our synthetic bone graft products are sourced in the US • All packaging for our synthetic bone graft products are sourced in the US • Well-known and recognized vendors are used for our raw materials, and they supply certificates of analysis with those raw materials to document their quality • Additional testing of raw materials is conducted to meet our high standards Specific characteristics created in manufacturing Materials Porosity Porosity increases surface area of product exposed to cellular action for maximum bioactivity Microporosity helps to wick up fluids and the essential growth components carried in them Macroporosity of the correct dimensions (100-600 microns) encourages cells to grow on and in the pores of the particles more than seen in comparable nonporous materials Ideal raw materials are necessary to manufacture the best possible bone graft products Good and/or bad trace minerals and impurities in raw materials can make their way into the final product Finding raw materials without any trace impurities is not feasible Knowing what these impurities are, and at what level they occur, allows these considerations to be interwoven into the final product performance at the outset of manufacturing In fact, human bone contains carbonate and low levels of minerals that play important and specific roles in bone formation and maintenance The key is getting the right ones and in the right concentrations That takes a thorough understanding and a commitment to make the best possible bone graft material Sintering Sintering is one of the final stages in manufacturing synthetic bone graft materials, and it is critical to achieve the correct in vivo residence time for the graft material Minimal or no sintering creates a soft product that will handle poorly and resorb too quickly resulting in a scaffold inadequate for osteoconductivity The literature defines this as graft failure Excessive sintering makes a product that is too hard and a product that will not be resorbed in an appropriate time period Extreme sintering of certain bone graft products can create a product that will never resorb Incomplete resorption results in a graft site that does not contain the 8WK rabbit, H&E stain showing bone apposition on Osteo-i ß-TCP ceramic granules, H&E, original magnification = 79x 56 Implant practice 8WK rabbit, H&E stain showing incorporation of Osteo-i ß-TCP ceramic granules into the healing defect, H&E, original magnification = 50x normal ratio of mineral phase to collagen, which creates the full strength of natural bone Additionally, unchanged graft particles may be hard or impossible to drill through and will not accept implants properly Purity Avoiding the introduction of new metals to the product prevents discoloration and altered performance Our product design avoids nonresorbable components Some products contain components like PMMA (polymethyl methacrylate) that will not metabolize or resorb These components then prevent the complete turnover of the implant material to new vital bone, and as a result, these components remain as a permanent implant IP This information was provided by Southern Anesthesia & Surgical, Inc Southern Anesthesia & Surgical, Inc (SAS) is the exclusive distributor of Osteo-i® regenerative products SAS has been in business since 1984, specializing in pharmaceuticals and surgical supplies for the oral surgery, periodontal, and dental markets SAS is best known for its knowledgeable customer service, competitive pricing, and ability to maintain consistent availability of key pharmaceutical products The company is keenly focused on customer satisfaction It is our goal to be our customers’ single source for their pharmaceutical and surgical supply needs Visit www.southernanesthesia.com or call 800-624-5926 for more information Volume Number ® R e g e n e t i ve P r o d u c t s Osteo-i® products are produced to provide predictable outcomes for surgeons and their patients Processing is executed to meet or exceed Food and Drug Administration (FDA) regulations and American Association of Tissue Banks (AATB) Standards A l l o g f t All Osteo-i products are offered with a 100% money back guarantee Buy Get FREE on all Particulate - Allograft & Synthetic same item number, no mix and match Particulate Cortical Mineralized Particulate: 250 - 1,000µm OST010 0.5cc OST011 1.0cc Cortical Demineralized Particulate: 125 - 850µm OST002 0.5cc OST003 1.0cc OST012 2.0cc OST004 2.0cc Cancellous Mineralized Particulate: 250 - 1,000µm OST036 0.5cc OST037 1.0cc OST038 2.0cc Cancellous Mineralized Particulate: 1,000 - 2,000µm OST028 0.5cc OST029 1.0cc OST030 2.0cc Cortico Cancellous Mineralized Particulate: 250 - 1,000µm OST025 0.5cc OST026 1.0cc OST027 2.0cc Cortico Cancellous Mineralized Particulate: 500 - 1,000µm OST021 0.5cc Visit us at the following events 99 Annual Meeting Exhibition of the American Academy of Periodontology th September 29 - October Booth #633 OST023 2.0cc Platform J Platform OST041 1.0cm Unicortical Cancellous OST039 0.9 x 1.2cm OST042 1.5cm OST040 0.9 x 1.5cm M e m b n e Pericardium Membrane OST048 1.5cm x 2.0cm AAOMS 95 Annual Meeting, Scientific Sessions and Exhibition OST022 1.0cc OST050 2.0cm x 3.0cm OST051 3.0cm x 4.0cm th October 10 - October 12 Booth #603 Synthetic Buy Get FREE on all Particulate - Allograft & Synthetic same item number, no mix and match Particulate ß-TCP (100% Beta-Tricalcium Phosphate) OST404 0.5cc OST405 1.0cc OST406 2.5cc Biphasic (40% Beta- Tricalcium Phosphate and 60% Hydroxyapatite) di st r ib uted exc l us ively by: OST401 0.5cc OST402 1.0cc OST403 2.5cc Call for pricing & information p: 1.800.624.5926 • m-f 8am to 6pm est or visit www.osteoi.com PRODUCT PROFILE Luster® kits by MEISINGER Luster® Lithium Disilicate and Zirconia Polishers by MEISINGER Ideal for today’s new dental restorations Luster® for Zirconia Adjusting and Polishing Kit #LUS85 Extraoral adjusting and polishing kit Extraoral Kits Luster® for Lithium Disilicate Adjusting and Polishing Kit #LUS80 Extraoral adjusting and polishing kit This kit was designed to adjust and reglaze monolithic zirconia restorations such as BruxZir® crowns Luster® for Zirconia Adjusting and Polishing Kit #LUS91 Intraoral adjusting and polishing kit This kit features the MEISINGER specially designed polishers for Lithium Disilicate restorations The 9736G wheel allows for adjustments, and the two-step polishing system will reglaze the restoration Intraoral Kits Luster® for Lithium Disilicate Adjusting and Polishing Kit #LUS100 Intraoral adjusting and polishing kit This kit, with specially formulated polishers, was designed to adjust and reglaze monolithic zirconia restorations such as BruxZir® crowns intraorally This kit contains specially formulated diamonds to make adjustments to Lithium Disilicate as well as the two-step polishing system to reglaze Lithium Disilicate intraorally after the restoration has been placed All four kits are rated “CR Choice” by Clinicians Report®* for best polishing on Lithium Disilicate and Zirconia In a recent clinical study conducted by “THE DENTAL ADVISOR” all four MEISINGER kits received a ++++1/2 rating IP This information was provided by Meisinger *“An independent, nonprofit, dental education and product testing foundation, Clinicians Report®, February 2013 For the full report to be sent directly to you, please contact MEISINGER USA customer service.” 58 Implant practice Volume Number n only Registratio 00 ,495! $1 ll Today Ca 4th Annual High Altitude Bone Management® Winter Camp February 5th – February 8th 2014 Beaver Creek, Colorado, USA Scan to watch our Bone Management® Winter Camp Video 2013! Case presenters were excellent, hotel was comfortable, topics were excellent Dr Tina Kokosis Wide variety of speakers, newer techniques, skiing was great Dr Bob Hunt Availability of speakers, Clarity of topics Dr Art Missirlian Quality of lectures was 1st class!, Combination of Lectures + hands-on, Location, Location-Stay in Colorado Dr Michael Schwab Meisinger USA L.L.C • 10200 E Easter Avenue • Centennial, Colorado 80112 • USA Phone: +1 (303) 268-5400 • Toll free: +1 (866) 634-7464 • Fax: +1 (303) 268-5407 • E-Mail: info@meisingerusa.com • Internet: http://meisingerusa.com DIARY lllllllllllllllllllllll OF EVENTS llllllllllllllllllllllllllllllllllllllllllllllllllll Implant Dentistry Continuum 2013 Miami September 7-8 October 5-6 Miami, FL www.implantseminars.com The GHSU/AAID Maxi-Course – Comprehensive Training Program In Implant Dentistry September 19-22 Atlanta, GA www.straumann.us Implant I – Rocky Mountain Dental Institute September 19-21 Denver, CO www.rockymountaindentalinstitute.com Ohio Dental Association Annual Session September 19-22 Columbus, OH www.oda.org 2-D and 3-D Imaging: The Future Is Now September 21 San Francisco, CA Dental.pacific.edu 60 Implant practice Implant Dentistry Continuum 2013 New York September 21-22 New York, NY www.implantseminars.com American Academy of Small Diameter Implants October 4-5 Dallas, TX www.aaosdi.com Aesthetics Through Innovation September 25 Palm Beach Gardens, FL www.biomet3i.com The Art and Science of Aesthetic Dentistry October 4-6 San Francisco, CA Dental.pacific.edu Implant Dentistry Continuum 2013 Washington DC September 28-29 Washington, DC www.implantseminars.com American Academy Of Periodontology Annual Meeting (AAP) September 28-October 1st 2013 Philadelphia, PA www.perio.org American Association of Oral & Maxillofacial Surgeons Annual Meeting (AAOMS) October 10-12 Orlando, FL www.aaaoms.org 7th Annual Aiden Morris Memorial Symposium October 16 Long Grove, IL www.biomet3i.com Advanced Live Surgery October 3-5 Denver, CO www.rockymountaindentalinstitute.com Practical Solutions For Immediate Full Arch Restoration With Hands-On October Glen Cove, NY www.biomet3i.com Volume Number MATERIALS lllllllllllll & lllllllllllll EQUIPMENT Crosstex® launches RAPICIDE® OPA/28 highlevel disinfectant Crosstex International, a leading global provider of infection prevention and control products, has introduced RAPICIDE OPA/28, an ortho-phthalaldehyde (OPA)based high-level disinfectant for the reprocessing of heat-sensitive semi-critical devices RAPICIDE OPA/28 is an FDA, 510K cleared product that has a reuse period of 28 days, twice the reuse life of all other OPAbased high level disinfectants available on the market with the fastest disinfection time – 10 minutes at room temperature Unlike glutaraldehydes that are recognized causes of occupational asthma and skin irritations, RAPICIDE OPA/28 has only 55% of the active ingredient so it causes less irritation to the eyes, nose, and throat For more information, contact Crosstex International Customer Care at 1-888-CROSSTEX or visit www.crosstex.com Introducing Straumann’s Sterile Healing Solution Straumann is Simply Doing MoreSM by providing simplicity through two new offerings: New Sterile Packaging for all Straumann Healing Components - Straumann healing components in their new sterile packaging are designed for convenient handling with direct pick-up from the package with an SCS screwdriver This new packaging is easy to open and provides a solution for organized storage* and maintenance of a practice’s inventory Improved Bone Level RC Healing Abutments - The improved BL RC Healing Abutments feature a modified shape that more closely matches the dimensions of respective BL final abutments This change to the company’s existing offering is designed to address a clinician’s needs for improved handling and patient comfort during final restoration Netsertive: Local patients rely on the Internet Local patients rely on the Internet to find the right clinician for their needs Practices can now increase production and attract qualified patients with Netsertive’s Digital Extend™ marketing programs that combine the power of search, display, mobile, retargeting, and other online tactics to ensure that practices and top services are highly visible to patients doing research in specific local markets The company’s experts will review the practitioner’s marketing goals and estimate what can be achieved within budget using the firm’s patent-pending technology For more information, visit www.netsertive.com/ dental or call 800-940-4351 Essential Dental Systems introduces C-Mor™ Ultra-Bright Mouth Mirrors Essential Dental Systems new ultra-bright mouth mirror makes performing all aspects of dentistry easier by allowing dentists to see-more clinically These mirrors revolutionize the visual field of dentistry by incorporating a special hi-tech process giving the practitioner the highest reflectance, light, and definition available With superior reflection, sharpness, and contrast the practitioner can literally see more without distortion or cloudiness For more information on the C-Mor Ultra-Bright Front Surface Mirrors and other products, please visit www.edsdental.com or call 201-487-9090 Air Techniques, Inc., has announced the latest solution for digital radiography with the all new ScanX Swift™ ScanX Swift is a chairside digital radiography system that is fast, easy, more comfortable for patients, and offers a better value for the dental practice Using flexible, cordless phosphor sensors, ScanX Swift delivers exceptional diagnostic clarity while offering a convenient workflow for the dental staff This digital system fits on the countertop in the operatory and produces images in seconds or less It provides a larger image area, greatly reducing the need for retakes The workflow with the ScanX Swift is virtually identical to film It’s the same easy technique but with sharp, high contrast digital images in a fraction of the time, and no messy, costly chemicals For more information on Air Techniques, visit: www.airtechniques com “Like” Air Techniques on Facebook, and follow the company on Twitter To learn more about Straumann, visit www.straumann.us 64 Implant practice Volume Number The Ideal 3D Imaging Systems • Availability of multiple imaging modalities in one machine (3D, anatomically accurate extraoral bitewing program, panoramic, and cephalometric) • Versatile volume sizes (small ø4 x cm, medium ø8 x cm, large ø8 x 11 cm or ø8 x 14 cm with vertical blending) for a single impaction to full dentition, and beyond • Over 30+ Imaging Programs • Space saving - small footprint and compact design • Delivered with PLANMECA Romexis™ software for viewing, image enhancement, and treatment planning • Mac OS compatible and DICOM compliant Optional 2D SmartPan Panoramic and bitewing images are taken with the same flat panel sensor as the 3D images are taken, eliminating the risk of equipment damage and time constraints from switching sensors PLANMECA® Not ready for 3D yet? Enter for your chance to win an upgradeable, 3D-ready ProMax S3 panoramic machine! Schedule a free in-office demo and be entered automatically for a chance to win a FREE ProMax S3-2D panoramic machine! For a free in-office consultation, please call 1-855-245-2908 or email WinProMaxS3@planmecausa.com Winner will be announced live at the 2014 Chicago Midwinter Dental Conference!!! Dare to Compare on Innovation, Quality, Service and Value Legacy™3 Implant All-in-1 Packaging includes implant, abutment, transfer, cover screw & healing collar $200 vs $6331 from Zimmer Dental Reality Check Zimmer Customers Save $433 with Legacy3 SwishPlant™ Implant All-in-1 Packaging includes implant, abutment, transfer, cover screw, healing collar & comfort cap $200 vs $737 from Straumann® Reality Check Straumann Customers Save $537 with SwishPlant ReActive™ Implant All-in-1 Packaging includes implant, abutment, transfer & cover screw $200 vs $718 from Nobel Biocare™ Reality Check Nobel Customers Save $518 with ReActive Implant Product Page NEW All-in-1 Shopping Visit our new online store, find the implant you want and the compatible components, abutments, instruments, biologics, literature are just a click away! There’s no need to jump through different product categories or pages, you can find it all in one spot 16 CE CREDITS 3D Implantology: Day Advanced Course Featuring Anatomage Passage surgical guide starter software August 16-17 | October 18-19 View Dr Niznick’s 2-hour lecture & earn CE credits FREE Dr Gerald Niznick discusses how the latest implant design innovations are shaping the future of implantology Introductory Offer: Make the switch & receive three FREE implants.4 Price comparisons based upon US list prices as of January 2013 All trademarks are property of their respective companies US list price for Tapered Screw-Vent with micro grooves, healing collar & straight abutment US list price for SLActive Tapered Effect implant, closure screw, healing abutment, solid abutment, transfer and comfort cap US list price for NobelActive with cover screw, impression coping & abutment Terms and conditions apply www.implantdirect.com | 888-649-6425 Approved PACE Program Provider FAGD/MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement 8/1/2012 to 7/31/2015 Provider ID# 316714 ... lauren@medmarkaz.com Tel: ( 480 ) 62 1 -89 55 MedMark, LLC 15720 N Greenway-Hayden Loop #9 Scottsdale, AZ 85 260 Tel: ( 480 ) 62 1 -89 55 Fax: ( 480 ) 62 9-4002 Toll-free: ( 86 6) 579-94 96 Web: www.implantpracticeus.com SUBSCRIPTION... Annual Meeting in Orlando, Booth #63 4 ORDER TODAY! 1 -87 7-GUIDOR1 (1 -87 7- 484 - 367 1) www.GUIDOR.com ©2012 Sunstar Americas, Inc GDR120 36 80 812 v1 Volume Number Implant practice 19 CLINICAL Minimally... Wang, DDS, MSD, PhD To register, call Jeni Coy at 1 .88 8.7 96. 1923 or visit osteogenics.com/courses FOR MORE INFO osteogenics.com/courses | 88 8.7 96. 1923 PRACTICE PROFILE 14 years and other staff for