Transcript NobelActive Internal and External Hex Implants Nobel

NobelActive Internal and External Hex Implants Nobel
Marketing Claims this is the “Implant of the Future”
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NobelActive is a Conglomeration of Common Features that
work individually but not necessarily in combination
Screw-Vent Internal Hex/bevel
Niznick Patent 1986
45 Deg. Bevel
Bevel with proven
20 year history of
stability
Oraltronics’
Pitt-Easy
Implant with
Deep Apical
Threads
Alpha Bio
Clone with
Conical
Connection
Astra 11Deg. Bevel
NobelActive
hex too deep to
allow for 8mm
implant length
Osstem’s double
Threads over
entire length.
NobelActive
transition of
sharp to flat
threads not
conducive for
self-tapping
insertion in
dense bone
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NobelActive External -With External Locking Taper Connection
Nobel Marketing Claims this is the “Implant of the Future”
1.5mm High External Hex
3.5mm Morse Taper Post
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NobelActive External - 5mm high tapered post requires parallelism
Miter Implant with External Post – Evolved quickly to Internal Socket (Bicon)
“Those who cannot remember the past are condemned to repeat it”
QUOTATION: George Santayana (1863–1952), U.S. philosopher,
Driskell Patent 1985:
Tapered Post on Implant
Driskell Patent 1988:
Tapered Socket in Implant
“Locking taper concept – impacting the
female taper of the implant head with the
male counterpart on the root structure.”
Locking Taper Concept
“The head member has … a tapered rod
or socket for connection to the root”
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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
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Nobel Claims NobelActive Functions like “Corkscrew”
Close Evaluation indicates they should have left it in the bottle
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Nobel Biocare’s NobelActive Marketing Claims
NobelActive Marketing Claims
1.“bone-condensing – expands
indication range and gives
even higher initial stability.”
2. “self-drilling”
3.“ability to change direction
during surgery”
4.“unique press-fit connection
of abutment –
5.-removes risk of excess
cement”
6.NobelActive Internal and
External implants don’t cut
through bone like
conventional
implants, they
press through
it like a
corkscrew
Questionable Validity of Marketing Claims
1.Higher than What – Replace?
Increased stability achieved by spreading bone
whereas deep threads cut bone
2.Self-threading – like any screw in soft bone.
3.Path of implant insertion should be established
during surgery, not during implant insertion. That
is what guide pins and end-cutting drills are for.
4.Nothing unique about press-fit connection.
Miter Implant (1980) had external tapered post –
evolved to internal press-fit connection of Bicon
5.If cement is a risk, why does NobelActive
Internal have a screw-retained connection?
6.Why does NobelActive have spiral cutting
grooves if not to “cut through bone like
conventional (self-tapping) implants”?
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NobelActive External Claims
1. “One piece implant
2. design with 2-piece flexibility”
3. locking tapered interface .. Eliminates
bone level micro gap, micromovement and the use of abutment
screws.”
Claims are not Valid
1. It is not a “one-piece implant –
requires an abutment.
2. 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.
3. 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
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Dense Bone Drill is 4.6mmD but Platform is 3.9mmD
NobelActive Leaves Gap around neck of Implant in Dense Bone
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4.3mmD Replace Implant is better choice than 4.2mmD
NobelActive for insertion into Immediate Extraction Sockets
Narrow Neck of NobelActive Requires Bone and Soft
tissue Grafting to fill defect left at crest of ridge
5.0
5.0
3.9
5.0
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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
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Attach & Remove Long Friction Fit Head to NobelActive
Heads of Implant exposed above bone
Try in straight abutment.. Too long but locks in
Straight Friction-fit abutment too long
Tried to remove abutment with Forceps
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Attach Two Short Friction Fit Heads to NobelActive using Mallet
Jack off abutment using Removal Screw
Shorter Abutment attached to Distal Implant
Shorter Abutment attached to Implants
Tap on Taper Lock Abutments with Mallet
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Preferred placement is angled between buccal and lingual plates
Straight Post of NobelActive External requires vertical placement
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Why Change Drills and Platforms, just to change threads?
1.RePlus and ReActive have
compatible Tri-Lobe Connection
2.Both have Platform switching
interface – of questionable value
3.Both have even taper to allow
insertion into an undersized socket
for bone expansion,
4.Nobel Active has straight outer
threads with very tapered inside
thread dimension
5.RePlus and ReActive have Minithreads whereas NobelActive has
horizontal grooves.
6.RePlus and ReActive seal opening
at crest of ridge whereas
NobelActive 4.3 & 5.0 implants are
narrower at top, leaving gap
7.RePlus and ReActive have double
lead threads on body for faster
insertion.
RePlus
Nobel ReActive
Active
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Very deep threads apically cuts rather than compresses soft
bone - any screw implant will self-tap in soft bone.
NobelActive™ Claim
The product is easy to
use and provides high
initial stability and good
outcomes.
The Apical Threads are
too aggressive for selftapping 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.
NobelActive
No Taper to OD
of Threads
Deep apical threads
will not expand
narrow ridge or
compress soft bone
ScrewPlant
Gradual Taper for
Bone Expansion
Soft Bone (Balsa) = 3.91
in/lbs Insertion Torque
Hard Bone (Oak) = 6.35
in/lbs Insertion Torque
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ReActive with Tri-Lobe Connection and Platform Switching
Projected Launch Date – January 2008
•
Same taper to body as
RePlus Implants allow
insertion in undersized
socket for expansion
•
Flat-based deeper
threads provide
increased surface area
for greater stability in
soft bone
1.5Deg.
3.0Deg.
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