Identify Implants and Explain Prosthetics?
This patient presented to my office two and one half years post implant placement and post-prosthetic placement. The patient states that she had 20 teeth removed and in the same visit had these 22 implants placed on the same day. The soft tissue is healthy and the prosthetics looks well done. The procedure was done in Israel. Can you identify the manufacturer of these implants? They appear to be one-piece implants. Can you also comment on how one could place a connected round house bridge on so many implants which apparently are not all parallel. How did this doctor insert the bridge which must have had an apparently impossible path of insertion?
28 Comments on Identify Implants and Explain Prosthetics?
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mark
10/17/2019
Have the patient provide the name of the dentist who placed and restored them for accuracy and for your records this is the standard of care. Contact that dentist for the information.
Peter Sabolch, DMD
10/17/2019
If all looks good and healthy, just prep the cemented crowns for the round-house - having discussed it with the lab - surveying the preps/model, possibly placing gold copings on the preps for a surveyed parallelism of the super structure.
Sam Barr
10/17/2019
Copings.
sergio
10/17/2019
Looks like a bunch of basal implants.
Popular in some parts of Europe , India and some other areas.
These ARE one piece implants. They usually bend so that they become pararell.
They do work though looks strange with that many units in.
Craig
10/17/2019
Photoshop!
K kavvouras
10/17/2019
These are TRATE ROOT implants in Europe and all the implants are one piece and the abutment is bendable about 10°
Jackie
10/17/2019
That person is a T1000 Cybernetic organism created by Cyberdyne systems here in Fremont, California prior to the building being destroyed.
Dr. Moe
10/17/2019
Jackie,
LOL!! that's got to go down as one of the funniest comment on this site. The question is, has it become self aware? Nice use of movie reference. Thanks for the laugh.
Avi. G.
10/29/2019
This is Alfa Gate implants. One piece. It is possible to bend the abutments and to place all abutments parallel
Jen
10/17/2019
I agree - Jackie's comment made me laugh out loud!
Alejandro Berg
10/17/2019
This look like arrow press implants from alpha bio or some israeli equivalent. They are one piece bendable and have the full set of impression copings, analogs and over castable copings... Very easy and simple, not my thing though
Mahi
10/17/2019
These are Basal /Cortical implants; single piece; kind of close relatives to mini-implants. But they are aggressive. In the right hand works well. There are many variations, just like in two-piece implants.
Mr. SR
10/17/2019
Yes could be the arrow alpha bio implant - an is Israeli system but also looks very familiar to the old Trinon implant (prep-able) system:
https://images.app.goo.gl/6GrGw2YVqJQGYqGn8
When I see cases like this I just want to throw out all the text books and scratch my head - it does make one wonder what planet the patient is from ( and the dentist) !
Denchev
10/18/2019
The Implants are KOS from IhdeDental - Gommiswald
Switzerland
Katja
10/18/2019
Hi, these might be one-piece implants by MIS. That’s an Israeli company. You can prep the abutments.
Dr. Gerald Rudick
10/18/2019
My advice is to contact Ami Hantman , one of the owners of ADIN DENTAL IMPLANTS in Israel.... he is very knowlegible and will direct you to the prosthetic components you will need. I have been dealing with Ami and his company for 25 years, and if they are not Adin Implants.... he will know who the manufacturer is....and on more thing...please send my regards.
Alex
10/18/2019
This kind of implants are called "compressive screw", and are based upon design by dr Ernst Bauer from Germany, who patented them during early '80s. Since the patent expired, there is a multitude of manufacturers worldwide that use this design in original or a bit changed. There are at least three Swiss manufacturers - Ihde Dental, Roott, Monoimplant and few Israeli (MIS, Noris Medical, ADIN) I can think of. Doesn't matter. These are ONE PIECE implants. Some of them can be bent, if the primary stability is good and if the neck is not wider than 2, or 2.05 mm, abutments can be prepped and manufacturers usually sell cementable angulation adapters, or the lab can cast one. They are principally used for immediate load protocols, so installing 10-12 implants per jaw is a norm. Abutment paralelity is acomplished by bending and/or prepping abutments. Cemented angulation adapters are rarely used, usually when implant axis is unusually angled - tuberopterygoid implants for example.
As per dr Stefan Ihde's protocol, long term temporary (with metal core) is manufactured and cemented 72h post insertion, not later (this is strict for basal implants, compressive ones can tolerate up to 10 days) and is in function 6 - 12 months (depends on a case) and then the workpiece is cut off, dismantled and manufactured definitive one.
Because of immediate loading protocol, rules about number of implants and occlusal schemes are specific and pretty strict.
I hope this all helps
Al
10/18/2019
I used them before. 3M used to have them and they come with burning cap for the coping that can waxup to any angle.
AT
10/18/2019
HI
it seems to me ,this is bendable one piece implant like kos dental implant
Mazin
10/18/2019
It’s really a compressive one-piece implants, I agree completely with Alex, thanks for the detailed replay, in such cases the clinician apply bends to some of the abatements ( implants neck ) to gain the most parallelism , then-after the lab. will construct a plastic guides ( 2-3 pieces) with holes to be fitted on implants and the implants abatement that emerge from the guide will be trimmed inside patient mouth directly then the final prosthesis will be fitted
I notice some expose threads in mandible, as these compressive screws are un like basal implants smooth, so this may cause problem
Satish
10/20/2019
I have been using Adin for more 10 years and have not seen anything from them ever. They appear to be from IHDE DENTAL or KOS .I believe there are some manufacturers in Brazil also.
Barrow Marks
10/20/2019
Thank you Mazin for your comment. Could you elaborate on the acrylic guides and how that would aid in completing a case like this? And thank you all to my colleagues for helping me to clear up the logic of these particular implants.
Barrow Marks
10/20/2019
Alex could you comment on why there would be a waiting period to load these implants. And why would it be different for compressive implants as compared to basal implants?
Alex
10/21/2019
There is no obligate waiting period. Basal implants can not wait, because remodeling starts 72h hours after inserting, they are losing initial primary stability and must be shielded against forces that could produce micromotion over 100 -150 micrometers. In other words, must be splinted (3 or more) with reliable temporary (metal core) and reliable cement (RMGIC for example).
Why is all that? Because loss of retention (due to using Temp Bond or any "implant temporary cement") or breaking acrylic temporary will overload some of the implants and they will fail.
Basal implants, due to their design, have very sharp, blade like threads that CUT through bone (compression is minimal), bone damage is minimal and remodeling starts right away.
Compressive implants are designed to compress trabecular bone - in other words they crash and push bone trabecules away during insertion (the term is "corticalisation") - as dr Ihde explains - tissue arhitecture is lost in the vicinity of implant, blood vessels are being destroyed and occluded, so the crashed bone itself can not initiate remodeling by itself. It is all mineralized rubble and blood mix. "Point of entry" for BMUs (remodeling units) is dislocated a few milimeters away. This fact buys us additional time untill remodeling of the compressed bone starts (usually 7-10 days is given to fit and cement prosthetic workpiece, not only 3 as with basal implants).
Not every lab can produce metal cored temporary during 72h.
Talking about compressive, they are not recommended for immediate implantation, they are usually used in healed areas, we are pretty sure the gum level will not drasticaly change, so 7-10 days time window can be used to produce definitive prosthetic workpiece. If we use them as immediates anyway, must be sure that rough part is placed inside solid bone completely. If they are contaminated, the will fail most definitely as would any two piece rough implant would.
The basal ones, since they have machined surface, and since there is only about 6mm od threads placed deep inside bone (they MUST reach opposing corticalis) and the rest is slender 2-2.5 mm shaft, they can withstand pus drainage from alveolus without contamination (believe it or not) as long as they are relliably splinted and occlusion is meticulously designed and watched.
Alex
10/21/2019
If You would like more informations, i suggest You to follow "Open dental community" on Facebook, especially Henry Diedrich posts (community gathers clinicians who use preferably "Roott" implant system) and "Simpladent India" on You Tube (there are plenty of lectures regarding compressive and basal implantology) that gathers clinicians who use "Ihde Dental" implant systems.
Hope this helps.
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5/4/2020
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dr n b singh
5/9/2020
KOS DESIGNS are defferent, more conical rough surface with 2.5 mm crestal smooth threaded surface. These are root implants and selling in in dia by name Gen XT
Mr SR
5/9/2020
Possibly Trinon prepable implants
https://www.trinon.com/en/medicine/q-implant-system/concept.html