Paragon Implant™ Company Insider: Products, Perspectives & Promotions

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GEN5+ NIZPLANT TM

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Interview with Gerald Niznick DMD, MSD, President of Paragon Implant Company Dr. Gerald Niznick, DMD, MSD has a 44-year history in the implant industry including Core-Vent, Paragon and Implant Direct. In early 2022 at the same Los Angeles factory that he built in 1994 he started his 4th implant company that he again called Paragon. Dr. Niznick was recently featured in a webinar put on by SmartonX where he addressed the claims made by representatives of 8 major implant companies, billed as the "Implant Faceoff". Each had one minute to represent their company’s products on 10 topics. Dr. Niznick’s response webinar was billed as "Dr. Niznick’s Penalty Shots", critiquing the marketing claims of the respective companies made by their representatives. Dental Tribune sat down with Dr. Niznick to talk about what dentists can learn from this webinar.

Question: Which of the 10 categories did you make the argument Paragon’s implants offered features and benefits that distinguished itself from these 8 leading implant companies and why was Straumann not included in the participants?

Straumann was invited but did not send a representative. Since it is the largest implant company when combined with its subsidiary, Neodent, I included it in my discussions. This image was the first slide in my presentation. One feature that 7 of the 8 (9 counting Straumann’s bone level implants) have in common is a rough, blasted surface to the top, and in some cases, also threads to the top. I presented scientific articles showing that exposure of a rough surface to the soft tissue is one of the primary causes of peri-implantitis. The research shows that the rougher the exposed surface, the higher the incidence of biofilm formation that contributes to peri-implantitis. Because of that fact, many dentists place the top of the implant subcrestal which creates its own set of complications including bone loss to the level of the implant-abutment junction.

The treatment of peri-implantitis is to smooth the rough surface, so why wouldn’t you start with a smoother trans-crestal surface, which has been shown as the best way to minimize peri-implantitis. Furthermore, scaling of the implant with a rough surface has been shown to release titanium particles and induce inflammation and osteolysis. Having a 2mm machined neck on the implant, especially if it has depth-gauge lines, facilitates vertical flexibility on placement. A neck that protrudes through the crestal cortical plate provides a zone of soft tissue attachment that is not disturbed every time a healing collar, transfer, scan adapter or abutment is attached and/or removed.

I also presented a study showing that placing an implant sub-crestal results in reduced stability because it is no longer in contact with the dense crestal, cortical bone. Another reason for placing an implant sub-crestal is if the implant system has only one diameter internal shaft across all implant diameters. This makes it necessary to place the implant sub-crestal in order to create enough running room for the abutment to start to develop an acceptable emergence profile.

The reality of sub-crestal implant placement is: • Bone will be lost to the level of the implant abutment junction no matter the connection • Placing the implant sub-crestal often requires profiling the bone at the entrance to the socket to accommodate for flared healing collars and abutments.

• Ridges are often uneven necessitating sub-crestal placement in one area to avoid exposure of the blasted and threaded surface in other areas.

Here are 8 of the 10 categories that I demonstrated Paragon’s implants have significant advantages. The other 2 categories, Armamentarium and Customer Support could not be distinguished because the design of a surgical kit is a personal preference. I did point out that when I was president of Implant Direct in 2011, an independent survey by Millennium Research ranked Implant Direct as the highest in customer satisfaction, and that I would be employing the same sales strategy with teams of inside and outside sales people. Having the largest sales force is no guarantee of superior customer support because of the high turnover of salespeople and they generally focus on the high volume users.

• Primary Stability in Soft Bone: Paragon’s even taper with progressively deeper threads assures initial stability. Many of the other implants are straight for the top half of the implant, and in the case of the Neodent and Straumann’s BLX, straight over the majority of their length.

• Restorative Ease: Many of the implant systems cite having only 1 platform across 6-7 diameters as an advantage but it compromises emergence profile and strength on wider implants. Paragon’s GEN5 has two color coded platforms and its GEN5+ and NizPlant Application Specific Implants have a single platform.

• Cost: Paragon’s GEN5 @ $125, GEN5+ with MUA @ $175 and NizPlant with Locator Compatible platform that also functions as an MUA @$135 are unmatched in innovation and value.

• Quality: Paragon is made in the U.S. by a core manufacturing team with over 500 years of combined experience. Paragon, in an article in Manufacturing Today, was referred to as a company “Where precision engineering and dental expertise converge”.

• Bone Maintenance: Paragon’s implants all have a 2mm machined, anodized neck with depth gauge score lines (Pat. Pend.), designed to provide unparalleled vertical flexibility with uneven ridges.

• Soft Tissue Health: Paragon’s 2mm anodized neck, it placed trans-cortical with 1mm supra-crestal and 1mm sub-crestal, assures that a zone of undisturbed soft tissue attachment supra-crestal and a smooth surface even with 1mm of bone remodeling.

• Inventory Management: The two application specific implants GEN5+ and NizPlant, eliminate the need for purchasing an abutment, and the machined neck with depth gauge lines reduce the need for inventorying abutments with different collar heights. Paragon implants’ evenly tapered body assures stability with short implants, reducing the need for angled implants with expensive angled abutments.

• Restorative Connection: GEN5 has the standard 45 degree lead-in bevel with two color-coded platforms to simplify abutment selection, assure strength and a good emergence profile. GEN5+ has a friction-fit 2mm extender that converts to a Standard MUA by the attachment of a $25 prosthetic screw available in three heights.

Watch the full webinar!

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The NeXt generation GEN5

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Industry Standard 45° lead-in Conical Connection (Niznick US Patent #4,960,381) maximizes wall thickness on narrow implants

Two Platforms

Color-coded internalhex conical connections

Straight Neck

Two Platform Diameters (3.5mmD & 4.5mmD) optimize emergence profile

Crestal bone seal and increased stability

Anodized Neck with Gauge Lines Accommodate uneven ridges and immediate extraction sites by varying insertion depth

Progressive Thread Depth

1mm added to the standard lengths provides vertical flexibility for placement in uneven ridges and extraction sockets

Double-lead, reverse buttress threads for increased bone contact

Cutting Grooves

Tapered Body

Two full-length, selftapping cutting grooves

Tapered body for increased initial stability

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Restorative Flexibility

Detachable 2mm friction-fit extender for 1-Stage Surgery, simplifies restorative procedures by elevating platform

Friction-Fit Extender

Friction-Fit extender can be converted to standard MUA, Overdenture Abutment or a variety of Abutment Options

Anodized Neck with Gauge Lines

Crestal bone seal and increased stability

Accommodate uneven ridges and immediate extraction sites by varying insertion depth

Progressive Thread Depth

Same GEN5™ body, with a factory installed, friction-fit 2mm contoured extender for one-stage surgery

Extender can be removed to allow prosthetic connection to the implant platform for esthetics if tissue recedes Attachment of application-specific prosthetic screws converts platform to standard MUA or a variety of other abutment options

Straight Neck

Double-lead, reverse buttress threads for increased bone contact

Cutting Grooves Two full-length, selftapping cutting grooves

Tapered Body Tapered body for increased initial stability

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Dual-Function

Platform can function as an overdenture or a multi-unit abutment

Compatible Platform

1-piece implant with a dual-function platform that allows it to be used to initially retain an overdenture, and then be converted to a full-arch fixed restoration

External wall provides Locator® compatible platform*

Straight Neck Anodized Neck with Gauge Lines

Crestal bone seal and increased stability

Accommodate uneven ridges and immediate extraction sites by varying insertion depth

Progressive Thread Depth

Cutting Grooves Two full-length, selftapping cutting grooves

2mm extender for height ranges 1-5mm NizPlant™ has a 45° lead-in bevel, internal hex, and internal threads for attachment of a fixed full-arch hybrid restoration

Double-lead, reverse buttress threads for increased bone contact

Tapered Body Tapered body for increased initial stability *Locator is a registered trademark of Zest IP Holdings

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VERSATILE IMPLANT DESIGNS FOR INTRODUCING VERTICAL FLEXIBILITY

A machined and anodized collar design can be particularly advantageous when managing uneven ridges.

By minimizing rough surface exposure in the collar region, this design supports healthier soft-tissue interaction, reduces plaque accumulation, and facilitates improved hygiene access—key factors in peri-implantitis prevention.

1mm supracrestal placement creates a zone of undisturbed tissue attachment

Accommodate uneven ridges and avoid exposure of rough surface

Bone-level placement for aesthetic applications

What are the benefits of Vertical Flexibility?

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Control depth placement relative to anatomy of hard and soft tissues

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Decrease risk of exposing rough surfaces to the tissue

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Optimize emergence profile with a prosthetically-driven approach

Learn More!

$375 Value

Try THREE GEN5™ Implants for FREE

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Trial Case Offer USE COUPON CODE:

TRY3GEN5

Watch Dr. Niznick’s 1.5 hour lecture on the design advantages of the Next Generation of Implant Systems!

Customer responsible for shipping cost.

One introductory offer per office.

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A SEAMLESS CLINICAL WORKFLOW FULL-ARCH APPLICATION-SPECIFIC IMPLANTS GEN5+ NIZPLANT TM

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FROM OVERDENTURE TO FIXED FULL‑ARCH WITH ONE SYSTEM

A PARADIGM SHIFT IN FULL-ARCH TREATMENT

Strength One-Piece Implant with Hybrid Surface Value 2mm Extender for height range of 1-5mm Flexibility Dual Function Platform: Locator compatible for overdentures and internal connection for conversion to fixed full-arch

Simplicity One Prosthetic Platform Value Extender Converts to MUA and OD Abutment with $25 Screw Reduced Prosthetic Inventory – only four Screws for All-on-4 Case Flexibility Full Range of Straight, Angled, ASC and Temporary Abutments

1° Taper

$150

Overdenture Attachment Friction-fit

NIZPLANT

GEN5+

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$25

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$150

$135 Screw Removed

Screw converts to MUA

$175

Fixed bridge

All Paragon implant systems feature an Anodized Neck with Depth Gauge Lines

Standard MUA

Providing Vertical Flexibility to accommodate different soft tissue heights

Universal Compatibility

Reduce Inventory 20% Savings

Chairside Flexibility

Purchase 20 Implants, get 5 FREE! Shop Now!

up to $750 Value

USE COUPON CODE:

IMPLANTS20 Offer applies to GEN5™, GEN5+™ and NIZPLANT™.

Customer responsible for shipping cost. One introductory offer per office. Purchase 20 implants, receive 5 free. If not satisfied, return 20 implants for a full refund.

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GEN5+ NIZPLANT TM

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Controversies in Implant Dentistry - Hybrid Implant Surfaces Gerald Niznick, DMD, MSD Many of the popular implant designs carry the textured surface and threads to the top of the implant, often requiring sub-crestal placement to minimize exposure of the rough surface to the soft tissue. Research¹ has proven that rough surfaces, exposed to soft tissue, will contribute to peri-implantitis. Research² further proves that routine scaling of rough surfaces results in particles of titanium in the soft tissue that can contribute to inflammation. Studies³ show that placing the implant sub-crestal reduces initial stability. Another study4 showed there was more bone loss with sub-crestal vs supra-crestal placement, which would be expected because bone will not osseointegrate above the implant-abutment junction. An important reason for designing an implant with a machined neck is that most ridges are uneven, so placing the implant level with the highest point on the ridge will require bone grafting to cover the exposed rough surface.

Immediate placement of implants into extraction sockets routinely requires bone grafting with inevitable resorption. By designing the implant with a 2mm machined neck, the need for bone grafting will be greatly reduced.

While it is well documented that initial bone loss will be less with a rough surface, this only amounts to about 0.3mm-0.5mm difference. This is insignificant considering that having a labial

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plate less than 1mm in width can result in up to 2mm of bone loss. Experienced clinicians understand that placement of implants in extraction sockets may further contributes to bone loss. Uncovering implants placed sub-crestal can also potentially require an additional surgical step of removing bone over the cover screw. Attaching a flared abutment to a submerged implant can necessitate additional bone removal as well. All these additional steps can be avoided by simply placing the implant level with or 1mm above the crest of the ridge.

These facts dictate that the neck of the implant should be machined for 2mm coronally with ideal placement having 1mm exposed above the height of the ridge. This will distance the implant-abutment junction above the bone, minimizing the effect of any micro-leakage or bacteria in the crevice. It will also allow a 1mm zone for soft tissue adhesion above the crest that will not be disturbed by removing and re-attaching healing collars, transfers and abutments. Any bone loss will expose the smooth neck originally sub-crestal, potentially minimizing the risk of peri-implantitis.

1. Periimplantitis and Implant Body Roughness: A Systematic Review of Literature IMPLANT DENTISTRY / VOLUME 27, NUMBER 6 2018 2. Scaling of titanium implants entrains inflammation-induced osteolysisScientific RepoRts | 7:39612 | DOI: 10.1038/srep39612 3. Effect of Implant Length and insertion Depth on Primary Stability JOMI: Volume 38, Number 12, 2023 4. Influence of Implant Placement Depth…on Crestal Bone Stability. International Journal of Periodontics and Restorative Dentistry. Vol. 41, No 3, 19

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Controversies in Implant Dentistry - Implant-Abutment Connections Gerald Niznick, DMD, MSD There are over 150 dental implant companies worldwide offering a wide variety of implant- abutment connections. In 1986 Core-Vent Corporation introduced the Screw-Vent implant with the first internal conical connection (Niznick Patent #4,960,381). This patent became the cornerstone for future implant designs in the industry. The Screw-Vent’s connection included a 45° lead-in bevel above an internal hex, but the patent covered any degree of bevel and any wrench-engaging surface. That patent expired in October 2007 and in 2008, NobelBiocare® launched the NobelActive™ implant with a 78 degree lead-in bevel and internal hex. Steeper lead-in bevels thin the walls, which can lead to fractures in narrow diameter implants, and deepen the internal hex, which can preclude making a 6mm long implant.

While these are the two most copied internal connections today, a wide variety of other conical connections have emerged on the market in an effort to differentiate a company’s implants.

A conical connection achieves a seal at the opening of the internal shaft by having the mating angle of the abutment approximately 1/2° less as measured from the vertical axis of the implant. Because of this fact, a lead-in bevel steeper than 45° offers no significant advantage for seal or stability. A study (J Oral Implantol (2021) 47 (6): 485–490) comparing 3-year post loading outcomes of implants with 45° vs 78° lead-in bevels from the same manufacturer concluded: “no statistically significant differences in marginal bone remodeling or complications (including implant/prosthesis failure) 3-years after loading.”

In 1994, a patent was issued on an interference fit connection (Niznick Patent #5,334,024) created by tapering the male hex of the abutment 1 degree, requiring 10-30Ncm of torque to the fixation screw to fully seat the abutment. This design feature has been incorporated into the extender attached to the GEN5™ implant to create GEN5+™, forming a permanent connection that can only be separated with a retrieval screw. The extender functions as a healing collar and a standard MUA by attaching a prosthetic screw.

Straumann’s implant systems include 6 different angled lead-in bevels with the steeper bevels achieving a friction-fit connection that requires a retrieval tool to separate.

1. Straumann’s “Nuvo™” implant with standard 45° lead-in bevel 2. Neodent’s new “Helix Short” implant with a 45° lead-in bevel 3. Neodent® “Grand Morse®” connection with a 74° lead-in bevel (Note: A Morse Taper is 88.5-89.0 degrees) 4. Straumann’s “CrossFit” connection with a 75° lead-in bevel 5. Straumann’s “synOcta®” connection with a 82° lead-in bevel 6. Straumann’s “TorcFit™” BLX/TLX connection with a 83° lead-in bevel A number of implant systems, including Straumann’s iExcel and Neodent’s GM Implants offer, offer only one connection diameter that compromises emergence profile.

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• Placement bone level or supra-crestal • Drill stops in two heights, inserted through sleeves in surgical guides • Eliminates need for surgical guide keys or length specific drills

40+ YEARS OF INNOVATION 35 PATENTS - 3 SPECIFIC TO THE PARAGON™ SYSTEM

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