Straumann® Bone Level Tapered Implant - Clinical Review

Clinical Review

Straumann速

Bone Level Tapered Implant

Designed for primary stability Fast osseointegration Immediate function Broad treatment options

STRAUMANN® CROSSFIT® CONNECTION Restorative flexibility with the prosthetic ­components of the Straumann® Bone Level Implant line

Roxolid® An alloy of titanium and zirconium with excellent mechanical properties

Apically tapered implant body design allows underpreparation and is designed to support primary stability in soft bone

SLActive® surface allows fast and predictable osseointegration

HIGH PRIMARY STABILITY Primary stability of dental implants, defined as the stability at the time of implant placement, is an important prerequisite for achieving successful osseointegration (Branemark et al., 1977; Meredith, 1998). High primary stability prevents micromovements of the implant and therefore warrants its rigidity. This is important since the implant should not be subjected to micromotion of more than 50‒150 µm during the heal- ing phase in order to avoid fibrous tissue encapsulation (Cameron et al., 1973; Szmukler-Moncler et al., 1998). A study demonstrated that for tapered implants the initial stability is secured over the bone remodeling stages (Rokn et al., 2011).

One reason for this is that the tapered implant body design allows for preparing the site with tools one size smaller than the diameter of the implant, thus increasing the resistance to implant insertion. The lateral compression of the bone around the underprepared osteotomy walls leads to a continuous increase of insertion torque, an important observation especially for soft bone types as increasing peak torque values have been correlated to increased implant stability during the healing phase (Molly, 2006).

Straumann® Bone Level Tapered Implants have an apically tapered implant body and are designed for primary stability in soft bone and fresh extraction sockets.

FAST OSSEOINTEGRATION Surface modifications play an important role in the speed of osseointegration and thereby influence implant stability as well as success of immediate and early loading protocols (Buser et al., 1991; Coelho et al., 2011; Elias et al., 2008; Shalabi et al., 2006). Straumann® SLActive® is a chemically modified hydrophilic surface which is clinically proven to accelerate the osseous healing* (Buser et al., 2004; Lang et al., 2011; Oates et al., 2007; Schwarz et al., 2007). The hydrophilic and chemically active properties of SLActive® provide a larger accessible surface area for increased blood protein adsorption (Kopf et al., 2015), greater osteoblast differentiation and increased production of bone-building osteocalcin (Zhao et al., 2005) as well as stimulated blood vessel growth

*Compared to SLA

(Schwarz et al., 2008). Beyond that, studies with Roxolid® Implants with the SLActive® surface have osseointegration properties similar or even better than those of titanium SLActive® implants (Gottlow et al., 2012; Lang et al., 2011; Wen et al., 2013). Roxolid® is a metal alloy composed of ~15 % zirconium and ~85 % titanium, the only two metals commonly used in implantology that do not inhibit the growth of osteoblasts (Steinemann, 1998). Interestingly, titanium-zirconium alloys like Roxolid® have better biocompatibility than titanium (Ikarashi Y et al., 2005) and an up to 40 % higher fatigue strength than comparable titanium implants (Straumann data on file). Straumann® Bone Level Tapered Implants with the combination of Roxolid® and SLActive® surface speed up the process of new bone formation on the implant and thereby shorten the critical transition phase between primary and secondary stability.

DID YOU KNOW? The current global tapered design implants market is continuously growing (Fig. 1).

More and more dental experts use tapered implants. The trend is driven by the growing patient demand for the immediate restoration of esthetics and function, but with simpler, more cost-effective and less time-consuming treatment procedures.

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Design (Canada)

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2500 2000 1500 1000 500 0 2013

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Fig. 1: Current global tapered design implants market trends (iData Research Inc., 2013; Millenium Research Group, 2015).

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IMMEDIATE FUNCTION Immediate function can offer many potential advantages such as reduced number of surgical procedures and an immediate esthetic and functional solution. It has been demonstrated that Straumann® Bone Level implants with SLActive® surface can successfully be used in early treatment protocols (Cordaro et al., 2012; Bornstein et al., 2010; Buser et al., 2013b). The micro-gap of the Straumann® CrossFit® connection is extremely small and is designed to reduce inflammation, which helps to preserve bone (Cochran et al., 2013; Heitz-Mayfield et al., 2013; Jung et al., 2008).

Thus, tapered implants are suitable for placement into fresh extraction sockets or into bone of low quality (Akkocaoglu et al., 2005) and can be successfully used in conjunction with immediate and early loading protocols when good primary stability and appropriate occlusal load are achieved.

BROAD TREATMENT OPTIONS Many patients have difficult health conditions which could compromise the treatment outcome of implant therapy. In challenging indications especially, the use of an implant system which is clinically proven and backed by scientific literature is important to minimize the risk of treatment failure. High predictability of implant placement in augmented sites has been shown (Chiapasco et al., 2012a; Chiapasco et al., 2012b; Santing et al., 2013). The Straumann® Bone Level Tapered Implant mimics the shape of a natural tooth root which is advantageous in cases with anatomic constraints (Fig. 2), including facial undercuts, converging root tips, concave jaw structure or narrow atrophied ridges.

Immediate loading of overdentures supported by two implants reached 99 % survival rate after 12 – 40 months (Stoker and Wismeijer, 2011). Additionally, the tapered design is advantageous for full-arch fixed restorations, as the temporary prosthesis is often placed at the day of surgery. For this indication, Straumann® Bone Level Tapered Implants are designed to provide the

primary implant stability, which is needed for reliable anchorage of the temporary prosthesis in the bone. From an esthetic point of view, Straumann® Bone Level Implants have demonstrated excellent esthetic results and high patient satisfaction in daily dental practice (Filippi et al., 2013; Furze et al., 2012). Pleasing esthetic outcomes after early loading with healthy and stable peri-implant soft tissues in the anterior maxilla even after 9 years have been reported (Buser et al., 2013a; Buser et al., 2013c; Buser et al., 2009; Buser et al., 2011). Therefore, Straumann® Bone Level Roxolid® SLActive® Implants have been tested in very challenging indications and successful treatment outcomes have been documented.

Fig. 2: Female patient presenting with a prior oral-antral fistula. The fistula with the prior implant was obturated and the Straumann® Bone Level Tapered Implant offered the opportunity to avoid sinus involvement. Courtesy of Dr. Robert L. Holt.

DID YOU KNOW? A recent global survey among dental experts from 19 countries showed that ѹѹ There is a high level of satisfaction with the Straumann® Bone Level Tapered Implant (Average rating 8.5 out of 10) ѹѹ The reason for satisfaction is mainly due to the ease of use, the advantages of the Roxolid® material and the SLActive® surface Straumann data on file

Straumann North American Headquarters Straumann USA, LLC 60 Minuteman Road Andover, MA 01810 Phone 800/448 8168 (US)  800/363 4024 (CA) Fax 978/747 2490 www.straumann.us  www.straumann.ca

© Straumann USA, LLC 2015. All rights reserved.

Straumann® and/or other trademarks and logos from Straumann® that are mentioned herein are the trademarks or registered trademarks of Straumann Holding AG and/or its affiliates. All rights reserved.

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International Headquarters Institut Straumann AG Peter Merian-Weg 12 CH-4002 Basel, Switzerland Phone +41 (0)61 965 11 11 Fax +41 (0)61 965 11 01

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