Logo 28_issue 4_en.pdf
ISSUE 4 2012
CAMLOG Partner Magazine
THE NEW CAMLOG APP FOR THE
Mobile end devices have long since found their way into the dental practice and for good reason. They inspire through technology and design and provide effective support in many work situations on demand. But there is more to it than just the end device: The right app makes all the difference! CAMLOG has developed an app that has it all; information about products, application and science make patient education, treatment planning and many processes in the organization a pleasure.
According to recent studies, the Apple And the desire for a stable system may Intuitive user interface, integration of iPad is particularly popular among be the motivation for some practice typical Apple gestures and functions, as doctors. About one third are already using owners. So for us, the decision for an iOS well as a good "flow" were also important one and the trend is only increasing. Its app was easy. The elegant design of the parameters in developing the app like almost unlimited mobility makes the tablets fits perfectly with the design of the the capability of providing all relevant tablet unbeatable compared to a laptop CAMLOG app designed according to the information in one application.
or monitor permanently installed on principle "form follows function". This the treatment unit. The smart tablet makes the app flexible and customizable accompanies the doctor from treatment in anticipation of future requirements.
room to treatment room and makes a much more personal experience possible Clean lines and clearly-arranged naviga-for the patient than its predecessor. tion make getting around the app simple.
The advantage lies in the hands
The result is clear to see and experience. The look & feel of the app make it an unmistakable CAMLOG tool – and wanting more. If you've ever gotten a hold of it, you may never want to put it down. Every tap provides the right content to best support dentists in their work.
The main focus is on the products and all information about their practical application. Tapping on the Product section provides access to information about the CAMLOG® and CONELOG® implant lines. The blue-gray double icon provides a clear view of all aspects important in making a decision for a suitable implant system and zeros in on the point: two implant systems – one surgical solution! The detailed view explains the product features and key benefits for the user in a straightforward, concise manner. The respective catalog with complete product details is in the immediate vicinity.
Die Promote® Oberfl äche
CAMLOG® Tube-in-Tube™ Verbindung
Die konische CONELOG® Verbindung
Die gestrahlte, säuregeätzte Promote® Oberfl äche CAMLOG®- und CONELOG® SCREW-LINE Implantate stellen CAMLOG steht für eine konsequent durchdachte, Das Herzstück des CAMLOG® Implantatsystems ist die international CONELOG® Implantate sind mit einem 7,5° Innenkonus entspricht dem neuesten Stand der Wissenschaft. in ihrer Geometrie konische Schraubenimplantate dar. logische Handhabung. Das clevere Design der CAMLOG®- patentierte Tube-in-Tube™ Implantat-Abutment-Verbindung. zur verlässlichen Kraft- / Drehmomentübertragung Sie ist bewährt und begünstigt eine rasche Osseointegration. Die Konizität des Implantatkörpers von 3°– 9° (längen- und und CONELOG® SCREW-LINE Implantate und die chirurgischen Das besondere geometrische Prinzip mit den drei Nuten/Nocken und den drei bewährten CAMLOG Nuten zur präzisen Wissenschaftliche Resultate aus Zellkulturen, durchmesserabhängig) ermöglicht einfaches Inserieren durch Instrumente vereinfachen die gesamte Chirurgie. Ob bei der und die Präzision der Verbindung resultieren in einer hohen Abutment-Positionierung versehen. Das lagerichtige der Knochenhistologie und klinische Studien dokumentieren Selbstzentrierung. In Kombination mit dem selbstschneidenden Einheilart, dem Weichgewebsmanagement oder der Prothetik, Positionierungsgenauigkeit bei optimaler Kraft- und Moment- Einsetzen des Abutments ist über die drei Nocken dies eindrucksvoll.
Gewinde kann eine hohe Primärstabilität erreicht werden.
CAMLOG®- und CONELOG® Implantate lassen Ihnen maximale verteilung zwischen den einzelnen Komponenten.
taktil deutlich wahrnehmbar.
Wahlfreiheit bei höchster Anwenderfreundlichkeit. Einige Vorteile auf einen Blick
Einige Vorteile auf einen Blick
Einige Vorteile auf einen Blick
Einige Vorteile auf einen Blick
Einige Vorteile auf einen Blick
Ein Chirurgie-Set für beide Implantatsysteme Präzise, selbsthemmende und rotationssichernde konische Gestrahlte, säuregeätze Promote® Oberfl äche für schnelle Osseointegration Einfaches Inserieren durch Selbstzentrierung Orientierungshilfe durch Farbcodierung und systematische Anordnung Präziser, rotationsstabiler Formschluss ermöglicht einfache Einheilzeiten von sechs Wochen bei guter Knochenqualität Selbstschneidendes der Bohrer entsprechend dem Behandlungsablauf Einfache, schnelle und präzise Positionierung der Abutments und dauerhafte prothetische Versorgung aufgrund der bewährten CAMLOG Indexierung Wissenschaftlich dokumentiert und klinisch erfolgreich Erweitertes Indikationsspektrum durch ein 7 mm CONELOG® Implantat Tiefenstopps und Lasermarkierungen für sichere und individuelle Verbindung mit drei Nuten (Implantat) und drei Nocken (Abutment) erlaubt die sichere und schnelle Abutmentpositionierung Optimale Verrundung der apikalen Geometrie gewährleistet Spezielles Design der Mehrwegbohrer ermöglicht schonendes, Vergleichsstudien mit renommierten Implantatsystemen bestätigen effi zientes und präzises Aufbereiten CAMLOG® Verbindung sehr gute Resultate bei der Passgenauigkeit Jedem Implantat liegt eine Verschlussschraube für die gedeckte TITLE STORY
hand. The intuitive menu makes finding Well-informed directly
the required information fast and easy. from the source
That is CAMLOG's credo in developing Catalogs, work instructions and case products and services. Of course, it was reports are organized thematically for Get CAMLOG news with all its services also our maxim for the app. The intention each implant system in Surgery and directly from the source. In the CAMLOG of the tool is to ensure that you always have Prosthetics sections, giving the user a section, the news ticker keeps you the right and current information at hand. clear overview despite the wealth of up-to-date, and in the course program, Gone are the days when you rummaged information provided. Interesting studies you find exciting suggestions for seminars around endlessly in shelves and cabinets and summaries complement the expertise and events to keep yourself and your or your own document folder for the through condensed knowledge from team abreast of treatment and practice work instructions or instructions for use practice. Of course, the E-Learning section management All kinds of interesting that more often than not turned out to has to be included. CAMLOG also just information about the company is also be hopelessly outdated if you found them recently began offering highly informative at all. The app not only makes this all so webinars with renowned speakers. You much faster and more convenient, but can find presentations and tutorials in the And as CAMLOG is constantly trying to also significantly more eco- and resource- "Video" section that show how CAMLOG improve, so will the CAMLOG app be friendly in the age of the "paperless products are used in application directly. continuously further developed.
office". By downloading the app from The app is also well-suited for self-the App Store, you automatically have directed, location- and time-independent all current digital and print media at continuing education, which is enjoying increased demand.
Many other practical features such as favorites selection, search functions and direct links to interesting websites give the tool versatility. From the Settings menu, all documents can be downloaded in a single process, making them available online and offline. The benefits of mobility are thus maximized. A particular highlight is the "My CAMLOG Area" where you'll find something very special; easily integrate your own documents by synchronization from your Dropbox folder. You then have access to what you need – always and everywhere.
What is "Dropbox"?
"Dropbox" is an online service that lets you save files in a central location that you want to access from anywhere. It can be very practical, for example, to save photos from your own smartphone in a folder that you can access on your PC at home. You can also save documents in a Dropbox folder and share access to anyone you want. No more unwieldy e-mail attachments, USB sticks or CDs – you can give anyone access to your files by simply sharing the respective folder. Dropbox offers 2 GB of storage free and additional storage is available for a fee. Details are available at: www.dropbox.com SCIENTIFIC / CLINICAL RESEARCH
IMPLANTS IN PATIENTS UNDERGOING
A. Spanou, K. Nelson, P. Voss /// Department of Dentistry, Oral and Maxillofacial Surgery
Hospital for Oral-Maxillofacial and Plastic Surgery, Hugstetter Str. 55, 79106 Freiburg, Germany Bisphosphonates (BP) have been used With an overall low side effect profile, necrosis and bone. 44 publications were increasingly since the 1980s in patients bisphosphonate-associated osteonecrosis identified dealing with dental implants with osteoporosis, multiple myeloma, (BP-ONJ) is of particular importance. The in patients taking BP medication. These breast or prostate cancer. incidence of BP-ONJ is estimated at 1% publications are found in the list of to 19% for patients under i.v. BP therapy literature (1–44). All publications have The active mechanisms of bisphosphonates and at 0.1–0.2% for patients taking oral been analyzed and are summarized in on the various cells in the body are not medication (22, 44, 45). The risk of BP- yet fully understood. However, it is ONJ increases as the bisphosphonate dose known that bisphosphonates inhibit the increases over the course of treatment, Most of the studies named have a low level activity and differentiation of osteoclasts as the age of the patient increases (over of evidence of 4 or 5 [Table 2]. Randomized leading to programmed cell death. An 65 years of age), the existence of chronic clinical trials (RCT) are missing completely. antiangiogenic effect of bisphosphonates periodontitis, for cigarette smokers or The sample sizes, length of the study and is also being discussed. The complex effect concomitant corticosteroid therapy and study parameters are usually inadequate of this group of drugs results in an overall for patients suffering from diabetes to identify the possible emergence of BP- reduction in "bone remodeling". The mellitus (37, 41).
ONJ or to assess long-term effects. biological half-life of bisphosphonates varies between a few months and years PubMed (http://www.ncbi.nlm.nih.gov/ Of critical importance in preventing and shows individual fluctuations (7, 8, pubmed) conducted a search of the BP-ONJ are the surgical procedure and the 16, 43).
literature using the following keywords: preoperative conditions in oral surgery, bisphosphonates & dental implants, jaw which include: BP prepara-
tion, form of
Jeffcoat 2006  Bedogni 2007 Wang 2007 Pirih 2009  Brooks 2007 Starck 1995 Marx 2007 [a] Shirota 2009  SCIENTIFIC / CLINICAL RESEARCH
1. Perioperative antibiotic prophylaxis, medication should be stopped 3 months 2. Atraumatic surgical procedure with prior to surgery and resumed 3 months economical periosteal denudation, 3. after the operative intervention (so- The guidelines for dental implant Smoothing sharp edges of bone, 4. The called "drug holiday"). The same applies treatment of patients under BP therapy primary plastic cover (46). Unfortunately, to patients treated with BP tablets for are built on expert opinions and are a description of the surgical procedure is more than three years regardless of any not evidence-based. Intravenous BP lacking in nearly all implant bisphosphonate possible corticosteroid administration. therapy for cancer indication is currently studies, i.e. the procedure was described In general, patients should be closely viewed as an absolute contraindication in only one study (18) and two studies monitored.
for dental implants. Although oral BP mention that implant insertion was carried therapy does not represent an absolute out under perioperative antibiotics (5, 18).
contraindication, patients should be informed that they are at increased risk Recommendations by AAOMS (39) For implantation under BP therapy, the for BP-ONJ and consequently implant and DGZMK (45) for patients under risk profile of each patient (underlying loss or the occurrence of peri-implantitis. bisphosphonate therapy: disease, type, duration, medication The effects of bisphosphonate therapy dosage, cofactors) must be determined. In on bone physiology and thus, the addition, no implants should be inserted if osseointegration of dental implants and there are sufficient prosthetic restoration their long-term success is currently still I.v. BP therapy for cancer patients is an alternatives for patients at increased risk. insufficiently documented and will keep absolute contraindication for implant Furthermore, an interruption in BP therapy us busy scientifically over the coming insertion. For patients who have is not evidence based as yet. Implantation years. The review article by Grötz et al. undergone less than three years of oral with St.p. BP-ONJ is considered a very high (45) and the guidelines available online BP therapy and exhibit no other risk risk and implant insertion is not advisable (46) are recommended for further details.
factors, implant insertion is possible. For here. For existing BP therapy, intensive patients under oral BP therapy with a follow-up (oral hygiene and plaque duration of therapy less than 3 years and control) as part of frequent monitoring adjuvant corticosteroid therapy, the BP makes sense.
Table 2: Evidence class recommendations of the AHRQ (Agency for Healthcare Research and Quality) Evidence obtained from at least one meta-analysis on the basis of high methodological quality randomized controlled trials.
Evidence obtained from at least one sufficiently large, high methodological quality randomized controlled trial.
Evidence obtained from at least one well-designed (high quality) controlled trial without randomization.
Evidence obtained from at least one well-designed quasi-experimental trial.
Evidence obtained from well-designed (high methodological quality), non-experimental descriptive trials such as comparison studies, correlation studies or case-control studies.
Evidence obtained from reports from expert committees or expert opinion or clinical experience (opinions and beliefs) of recognized authorities; descriptive studies.
Case series or one or more expert opinions.
SCIENTIFIC / CLINICAL RESEARCH
1 Jeffcoat, M.K. Safety of oral bisphosphonates:
17 Scully et al. Dental endosseous implants in
32 Hwang et al. Medical contraindications to
controlled studies on alveolar bone. The Inter- patients on bisphosphonate therapy. Implant implant therapy: Part II: Relative Contraindica- national Journal of Oral & Maxillofacial Implants. Dent. 2006; 15: 212-18.
tions. Implant Dent. 2007; Mar;16(1):13-23.
2006; 21: 349-53.
18 Fugazzoto et al. Implant placement with or
33 Hwang et al. Medical Contraindications to
2 Degidi, M., Piattelli, A. Immediately loaded
without simultaneous tooth extraction in patients Implant Therapy: part I: absolute Contraindica- bar-connected implants with an anodized surface taking oral bisphosphonates: Postoperative tions. Implant Dent. 2006; Dec;15(4):353-60.
inserted in the anterior mandible in a patient healing, early follow-up, and the incidence of treated with bisphosphonates for osteoporosis: a complications in two private practices 34 Liddelow et al. Patient-related factors for
case report with a 12-month follow-up. Clinical J Periodontol. 2007; 78: 1664-1669.
implant therapy. A critique of pertinent literature. Implant Dentistry and Related Research. 2003;
Australian Dental Journal. 2011; 56: 417-426.
19 Ruggiero et al. Osteonecrosis of the jaws
associated with the use of bisphosphonates: a 35 American Dental Association Council
3 Shin et al. Implant failure associated with oral
review of 63 cases. J Oral Maxillofac Surg. 2004;
on Scientific Affairs. Dental management of
bisphosphonate-related osteonecrosis of the jaw. 62: 527-534.
patients receiving oral bisphosphonate therapy: Journal of Periodontal & Implant Science. 2010;
Expert panel recommendations. J Am Dent Assoc. 20 Marx, R.E. Pamidronate (Aredia) and zoledro-
2006; 137: 1144-1150.
nate (Zometa) induced avascular necrosis of the 4 Ferrari et al. Fibula free flap with endosseous
jaws: a growing epidemic. J Oral Maxillofac Surg. 36 Martin et al. Characteristics of implant
Implants for reconstructing a resected mandible 2003; 61: 115-7.
failures in patients with a history of oral bispho- in bisphosphonate osteonecrosis. J Oral Maxillofac sphonate therapy. J Oral Maxillofac Surg. 2010;
Surg. 2008; 66: 999-1003.
21 Pirih et al. Case report of implant placement
in a patient with Paget's disease on bisphospho- 5 Kasai et al. The prognosis for dental implants
nate therapy. J Mich Dent Assoc. 2009; 91: 38-43.
37 Grötz et al. Zahnärztliche Betreuung von Pa-
placed in patients taking oral bisphosphonates. J tienten unter/nach BP Medikation. Gemeinsame Calif Dent Assoc. 2009; 37:39.
22 Dimopoulos MA et al. Osteonecrosis of the
wissenschaftliche Stellungnahme der DGZMK und jaw in patients with multiple myeloma treated der DGMKG. 2006.
6 Mavrokokki et al. Nature and frequency of
with bisphosphonates: evidence of increased risk bisphosphonate-associated osteonecrosis of the after treatment with zoledronic acid. Haemato- jaws in Australia. J Oral Maxillofac Surg. 2007;
logica. 2006; 91(7):968-71.
23 Torres et al. Dental Implants in a patient with
38 Javed et al. Osseointegration of dental
7 Aspenberg, P. Bisphosphonates and implants.
Paget disease under bisphosphonate treatment: a implants in patients undergoing bisphosphonate Acta Orthopaedica. 2009; 80(1): 119-123.
case report. Oral Surg Oral Med Oral Pathol Oral treatment: A literature review. J Periodontol. Radiol Endod. 2009; 107: 387-392.
2010; 81: 479-484.
8 Wang et al. Effect of long-term oral bisphos-
phonates on implant wound healing: Literature
24 Shirota et al. Bisphosphonate-related oste-
39 American Association of oral and maxil-
review and a case report. Journal of Periodontol- onecrosis of the jaw around dental implants in lofacial surgeons position paper on bisphos-
ogy. 2007; 78: 584-594.
the maxilla: report of a case. Clin Oral Implants phonate-related osteonecrosis of the jaws. J
Res. 2009; 20: 1402-1408.
Oral Maxillofac Surg. 2009; 67: 2-12.Suppl 1.
9 Bedogni et al. Oral bisphosphonate-associated
osteonecrosis of the jaw after implant surgery: A 25 Marx, R.E. [a] Oral and intravenous bisphos-
40 Zahrowski, J.J. Comment on the American
case report and a literature review. J Oral Maxil- phonate-induced osteonecrosis of the jaws: His- association of oral and maxillofacial surgeons lofac Surg. 2010; 68: 1662-1666.
tory, etiology, prevention and treatment. 1th ed. statement on bisphosphonates. J Oral Maxillofac Canada: Quintessence Publishing Co, Inc; 2007.
Surg. 2007; 65(7):1440-1.
10 Brooks et al. Osteonecrosis of the jaws as-
sociated with the use of risendronate: report of 2 26 Flichy-Fernández et al. Bisphosphonates
41 Ruggiero et al. American association of
new cases. Oral Surg Oral Med Oral Radiol endod. and dental implants: Current problems. Med Oral oral and maxillofacial surgeons position paper 2007; 103: 780-6.
Patol Oral Cir Bucal. 2009; Jul 1;14 (7): E355-60.
on bisphosphonate-related osteonecrosis of the jaws-2009 update. J Oral Maxillofac Surg. 2009;
11 Starck et al. Failure of osseointegrated
27 Marx et al. [b] Oral bisphosphonate-induced
dental implants after disphosphonate therapy for osteonecrosis: Risk factors, prediction of risk us- osteoporosis: A case report. Int J Oral Maxillofac ing serum CTX testing, prevention, and treatment. 42 Madrid et al. What impact do systemically
Implants. 1995; 10: 74-8.
J Oral Maxillofac Surg. 2007; 65: 2397-410.
administrated bisphosphonates have on oral implant therapy? A systematic review. Clin. Oral 12 Bell, B. M., Bell, R. E. Oral Bisphosphonates
28 Montoya-Carralero et al. Dental implants
Impl. Res. 2009; 20: 87-95.
and dental Implants: A retrospective study. J Oral in patients treated with oral bisphosphonates. A and Maxillofac Surg. 2008; 66: 1022-1024.
bibliographic review. Med Oral Patol Oral Cir Bu- 43 Cartsos et al. Implications of bisphosphonate
cal. 2010; Jan 1;15 (1): e65-9.
use in dentistry. Analecta Periodontologica 2009;
13 Rezka et al. Nitrogen-containing bisphospho-
nate mechanism of action. Mini Rev Med Chem. 29 Mínguez-Serra et al. Oral implants in pa-
tients receiving bisphosphonates: A review and 44 Bamias A, Kastritis E, Bamia C, et al. Os-
update. Med Oral Patol Oral Cir Bucal. 2008;
teonecrosis of the jaw in cancer after treatment 14 Grant et al. Outcomes of placing dental
Dec 1;13 (12): E755-60.
with bisphosphonates: incidence and risk factors. Implants in patients taking oral bisphosphonates: J Clin Oncol. 2005; 23:8580-7.
A review of 115 cases. J Oral and Maxillofac Surg. 30 Koka et al. Survival of dental implants in
2008; 66: 223-230.
post-menopausal bisphosphonate users. Journal 45 Grötz K.A., Piesold J.-U., Al-Nawas B.
of Prosthodontic Research. 2010; 54:108-111.
Bisphosphonat-assoziierte Kiefernekrose (BP-ONJ) 15 Albrektsson et al. The long-term efficacy
und andere Medikamenten-assoziierte Kiefernek- of currently used dental implants: A review and 31 Otto et al. Osteoporosis and bisphospho-
rosen. AWMF Online (04/2012).
proposed criteria of success. Int J Oral Maxillofac nates-related osteonecrosis of the jaw: Not just Implants. 1986; 1:11-25.
a sporadic coincidence- a multi centre study. Journal of Cranio-Maxillo-Facial Surgery. 2011;
46 Grötz K.A. Bei welchen Bisphosphonat-
16 Lazarovici et al. Bisphosphonate related
Patienten darf ich eigentlich implantieren? Ein osteonecrosis of the jaw associated with dental systematisches Review. Zeitschrift für Zahnärzt- implants. J Oral and Maxillofac Surg. 2010; 68:
liche Implantologie 2010; 26 (2): 153-61.
Fig. 44: Orthopantomogram after four months of implant healing
Fig. 45: Initial clinical situation after four months of implant
healing with immediate long-term temporary restoration
THE ESTHETIC AND FUNCTIONAL FINAL
RESTORATION OF IMPLANTS SET ACCORDING TO THE
MALÓ-PROCEDURE AND IMMEDIATELY RESTORED
Dr Ferenc Steidl, dentist Diana Mascher, Sömmerda, Bad Frankenhausen and MDT Sebastian Schuldes, M.Sc., Eisenach
In logo No. 3, the "immediate restoration in the edentulous mandible according to the Maló procedure using the CAMLOG® Guide System and Vario SR abutments" was shown. The final implant-supported restoration with a removable superstructure should distinguish itself by a tight seating with corresponding chewing function and by fulfillment of phonetic and esthetic Bar-supported restorations have proven contacts in each support zone for as the bonding base and customized themselves in implant prosthetics for stabilization of the temporomandibular accordingly.
decades. Precious metals were often joints. Functional and esthetic aspects Fabrication of the bar is CAM-assisted. used in the past due to their favorable were thus ensured during the healing The wax-up was digitalized by laser scan processing characteristics. These are time.
and then the milling strategy calculated characterized by good biocompatibility, (Figs. 51 to 53). Figure 54 shows the
but exhibit a high affinity for plaque. Fabrication of the bar and intraoral
cast with the Vario SR bases for bar This characteristic should be viewed as bonding
modified for the bonding base and the particularly problematic for bars, which bar prepared for intraoral bonding. are more difficult to clean compared to Fabrication of the cast after a closed double crowns. While searching for a impression on abutment level took into The mucosa showed no signs of suitable material, we chose zirconia. A account a gingival mask made of silicone inflammation. Insertion and removal of bar made of zirconia is tooth-colored, (Fig. 47). Tooth positioning that served the occlusally screw-retained long-term
high-strength, absolutely biocompatible as the basis for the CAD design when temporary restoration was comfortably
and has a low affinity to plaque.
fabricating the immediate restoration handled by the Vario SR abutment during was adjusted to the new cast situation the 4-month wearing time. Regular Four months of healing and wearing
(Fig. 48). The bar wax-up was created cleaning and hygiene was well controlled
time of the long-term temporary
according to the requirements of the (Figs. 55 and 56). The attached gingiva
tooth positioning with distal PRECI- on the mandibular alveolar process was VERTIX® attachments (Ceka) (Figs. 49 maintained and showed some resilience,
Figures 44 to 46 show the initial and 50).
which facilitates subsequent oral hygiene radiographic and clinical situation (Fig. 57).
after four months of implant healing To fulfill the requirement for an absolutely with immediate long-term temporary tension-free fit of the bar on the implant, An insertion tool was used to insert restoration. It was important to maintain the bar should be bonded intraorally. the customized Vario SR bases for bar. the arch relationship through occlusal The Vario SR bases for bar were used A gap-free margin fit of the Vario SR CASE STUDY
Fig. 46: Maintenance of the arch relationship
Fig. 47: Cast situation with Vario SR analogs after closed
Fig. 48: Tooth positioning for accurate analysis of the space
through occlusal contacts in each support zone for impression on the abutment level stabilization of the temporomandibular joints Fig. 49: Control of the bar wax-up using a silicone
Fig. 50: Finished bar wax-up with distal PRECI-VERTIX®
Fig. 51: The wax-up is laser-scanned and the milling
attachments (Ceka) strategy then worked out Fig. 52: The zirconia bar unprocessed
Fig. 53: The zirconia bar unprocessed
Fig. 54: Cast with the Vario SR bases for bar modified as a
bonding basis and the bar prepared for intraoral bonding
Fig. 55: Removal of the immediate restoration
Fig. 56: The temporary bridge after four months of wearing
Fig. 57: Oral situation with Vario SR abutments
time from the basal view and attached gingiva maintained CASE STUDY
Fig. 58: Insertion of the customized Vario SR
Fig. 59: The customized Vario SR bases for bar in situ
Fig. 60: Intraoral bonding of the bar to ensure the absence
bases for bar with insertion tool Fig. 64: Tertiary framework made of a cobalt-
Fig. 65: Bar matrix made of 99.9% pure gold
Fig. 66: Highly precise fit of the primary, secondary and
molybdenum-chromium alloy fabricated tertiary structure using traditional casting technology bases for bar on the Vario SR abutments An essential requirement for wear-free usual friction with bars made of a metal without pressure-sensitive change to the operation of the bar system is an alloy, adhesive and cohesive forces come attached gingiva reduces the probability absolutely smooth surface. The bonded to bear with ceramic bars with a matrix of of peri-implant inflammation (Figs. 58 zirconia bar is finalized using a turbine galvanic gold. The salivary film between
with water cooling and diamond-coated the zirconia bar and the matrix of 99.9% abrasives (Figs. 61 to 63).
pure gold ensures high cohesion together Panavia F2.0 (Kuraray) is used for with the two PRECI-VERTIX® attachments intraoral bonding of the bar. As Fabrication of the tertiary structure
distally attached to the bar and conveys adequately described in the literature, to the patient the feeling of a fixed this procedures guarantees the absence The tertiary framework was fabricated prosthesis. We see the following benefits of stress of the superstructure on the using traditional casting technology from in a zirconia galvano bar: implants and contributes significantly a cobalt-molybdenum-chromium alloy
to the long-term success of the bar (Fig. 63). The bar matrix was finished in t1BTTJWFåU
construction (Fig. 60).
the electroforming process out of 99.9% t$POTJTUFOUMZIJHIMFWFMPGSFUFOUJPO
pure gold (Figs. 64 to 66). Instead of the
Figs. 61 and 62: Bonded zirconia bar in the finished polished condition
Fig. 63: Cast situation with finished bar
Figs. 67 and 68: Veneering of the tertiary structure with high-performance polymer veneers
Fig. 69 to 72: The completed final superstructure with
polychrome gingiva design
Fig. 73: Zirconia bar in the mouth of the patient
Fig. 74: Extra-axial transmissions of force minimized by the
Fig. 75: Graceful design of the bar prosthetic base
polygonal support of the superstructure system are accommodated (Figs. 67 be removed when needed, thus providing
easy access in the event that inspections and hygiene measures are necessary.
Essential for the overall esthetics of this individually milled gold bars implant restoration was the multicolor A graceful design of the bar prosthetic design of the gingival sections. The base ensures a large range of motion for pink-colored plastic with composite was the tongue, as well as the vestibular and With high-performance polymers, in this individualized (Figs. 69 to 72).
lingual ribbons (Figs. 75 and 76). Taking
case visio.lign (Bredent), functionally into account esthetic and functional high-quality and esthetically pleasing Polygonal support of the superstructure parameters (laugh line, midline, occlusal restorations can be created in an efficient is achieved by the quadrangular plane, cuspid line), there is a natural- manner. Due to properties of this state- positioning of the implants. Extra-axial looking treatment outcome with of-the-art materials group that reduce transmissions of force are minimized and harmonious lip profile (Figs. 77 and 78).
masticatory pressure, the functional the mandibular dental arch is stabilized
conditions of the craniomandibular circularly (Figs. 73 and 74). The bar can
Fig. 76: Large range of motion for the tongue, as well
Fig. 77: A natural-looking treatment outcome
Fig. 78: Consideration of esthetic and functional
as the vestibular and lingual ribbons  Malo P, de Araújo Nobre M, Lopes A, Moss SM, Molin
GJ. A longitudinal study of the survival of All-on-4 implants in the mandible with up to 10 years of follow-up. J Am The removable bar-supported restoration  Ackermann KL, Kirsch A, Nagel R, Neuendorff G. Mit
Dent Assoc 2011;142(3):310−20.
Backward Planning zielsicher therapieren. Teil 1: Implantat- offers the patient high wear comfort prothetische Behandlungsbeispiele teamwork J Cont Dent  Kirsch A, Nagel R, Neuendorff G, Fiderschek J, Ack-
because of the secure anchorage. Due Educ 2008: 466−484.
ermann KL. Backward Planning und dreidimensionale to its low affinity to plaque, the zirconia Diagnostik, Teil 2: Schablonengeführte Implantation nach  Agliardi E, Panigatti S, Clericó M, Villa C, Maló P. Im-
CT-basierter 3D-Planung mit sofortiger Eingliederung des meets the high demands for oral hygiene mediate rehabilitation of the edentulous jaws with full fixed präfabrizierten Zahnersatzes – ein erweitertes Backward prostheses supported by four implants: interim results of and from the author's perspective, is a Planning-Konzept. teamwork J Cont Dent Educ 2008: a single cohort prospective study. Clin. Oral Impl. Res. 21, good choice for the final restoration of 2010; 459–465.
implants set according to the Paulo Maló  Randelzhofer P, Cacaci C: Verschraubte Lösung –
 Franchini I, Daverio L, Castellaneta R, Rossi MC, Testori
implantatgetragene Restauration im zahnlosen Oberkiefer. T, Tosini T. Immediate and delayed "All-on-Six" reha- teamwork J Cont Dent Educ 2011: 294−300.
bilitation of the atrophic maxilla with tilted implants. EDI Dr Ferenc Steidl:
Dentist Diana Mascher:
MDT Sebastian Schuldes, M.Sc.:
1991 to 1996, study program in dentistry at 1999 to 2003, dental technician training. 2003 1991 to 1995, dental technician training; 1998 FSU Jena. Subsequent specialist training in to 2008, study program in dentistry at FSU to 1999, qualification for master dental techni-oral surgery in Bietigheim/Bissingen, Germany Jena. January 2009, license to practice dentistry. cian. 1999 to 2000, continuing education for and at Diakonie Hospital, Schwäbisch-Hall, Salaried dentist in the joint dental practice for business administration in trade. 2006 to 2008, Germany; has been practicing implant dentistry maxillofacial surgery of Dr Steidl.
study program leading to a Master of Science, since 1997. 2001, Specialist in Oral Surgery at M.Sc. 2007, inception of S-implantat® (service LZK Baden-Württemberg, Germany. Member Practice of Dr Ferenc Steidl provider of 3D implant planning). 2009, DGZI of DGZMK, BDO, DGI, AG Oral Surgery, DGP, curriculum, 3D planning of implant dentistry MVZI. 2008, Fellow of the European Board An der Wipper 2 and prosthetics. 2011, construction of the zax- of Oral Surgery (European certification). Joint 06567 Bad Frankenhausen, Germany ocad-Dental Solutions® milling center.
dental practice for maxillofacial surgery in Tel.: +41 (0) 3634 317387Sömmerda und Bad Frankenhausen, Germany.
Dental-Labor Schuldes GmbH Johann-Sebastian-Bach-Straße 2 99817 Eisenach, GermanyTel.: +41 (0) 3691 203950 [email protected] CASE STUDY
1 Experience this publication as a video! It comes from the video compendium "Implantatprothetik VIER TEAMS – IHRE KONZEPTE UND LÖSUNGEN" (Implant-supported Restorations FOUR TEAMS – THEIR CONCEPTS AND SOLUTIONS) published this year by Quintessenz Verlag in four volumes. Volume 4 by F. Beuer, M. Stimmelmayr and J. Schweiger focuses on innovative treatment concepts for fixed prostheses on implants using CAD/CAM technology. The video compendium is available from CAMLOG as a DVD or Blu-Ray disc.
INNOVATIVE TREATMENT CONCEPTS
FOR FIXED PROSTHESIS USING
PD Dr Florian Beuer, Munich, Dr Michael Stimmelmayr, Cham, Josef Schweiger, Munich
For reasons of time, many patients want treatment in as few sittings as possible. For this purpose, implant positions can be registered, for example, right after implantation. When exposing the implant site, the final abutment is then attached. This has the additional advantage that the connective tissue attachment does not have to be detached again. The tissue can mature without disruption with potentially beneficial effects on the peri-implant situation . This proven protocol has recently been further developed using CAD/CAM technology . The final abutments can be fabricated from the biocompatible zirconia . The preparation boundaries can also be specified in the software for the temporary restoration relatively accurate at the level of the gingival margin.
Fig. 1: Preoperative panoramic imaging: In
Fig. 2: Clinical situation before implantation:
Fig. 3: A drilling template made of transparent plastic and
the first quadrant, a lateral augmentation The teeth on either side of the gap were ground at a a periodontal probe are used to mark the required implant and external sinus lift were carried out to previous sitting.
prepare the implant site.
Fig. 7: The insertion post and inserted
Fig. 8: To transfer the positions of the implants to the
Fig. 9: The screws of the insertion posts are now loosened
registration template are used to again laboratory, a composite is used to bond the template to and the registration block carefully removed from the check implant positions.
the insertion posts.
Fig. 13: The radiographic check shows the
Fig. 14: The dental technician screws the lab analogs onto the
Fig. 15: A gingival mask is fabricated over the implants in
favorable positioning of the implants in the impression posts and locks their positions with plaster. The gap the area of the alveolar ridge. Using a copy of the long-term sagittal plane.
between lab analog and insertion post is determined by the temporary restoration, the emergence profile of the planned implant crowns is then transferred to the gingival mask.
Initial situation and preparation
teeth (Fig. 1). Figure 2 shows the clinical
in the laboratory
situation before implantation.
The surgeon uses the drilling template and A 50-year-old patient was treated with In preparation for the implantation a periodontal probe to first mark implant
implants after loss of teeth 15 and 16. sitting, the dental technician creates positions on the anesthetized alveolar
The planned implants and bordering a drilling template out of transparent ridge mucosa (Fig. 3). He then exposes
teeth 14 and 17 should be fitted with plastic based on the long-term the implantation site using a crestal
single crowns. As the bone supply temporary restoration (PMMA) (see Fig. incision displaced palatally that continues
around the implant site is inadequate, a
3). In addition, a registration template into the sulci of the mesial and distal teeth lateral augmentation is first performed is milled out of PMMA molding blanks (Fig. 4). The flaps are dissected palatally
with guided bone regeneration in (Telio CAD, Ivoclar Vivadent) in the CAD/
and buccally as full flaps until visualization combination with an external sinus lift. CAM procedure from the same dataset of the alveolar ridge width. The buccal Panoramic imaging shows the condition to transfer implant positions (see Fig. 7 flap is continued into the vestibule as a after bony healing of the augmentation and 8). split flap (combined full split flap). The flap and preparation of the natural abutment can be better stretched and repositioned for a tension-free suture.
Fig. 4: The surgeon made crestal-palatal and
Fig. 5: Paralleling pins and the drilling template are used to
Fig. 6: After complete preparation of the implant bed,
intrasulcular incisions, prepared a combined full check the exact position and axial alignment of the future the first CAMLOG® SCREW-LINE implant is inserted.
split flap buccally and mobilized the flap buccally and palatally.
Fig. 10: The cover screws are inserted. With the
Fig. 11: The margins of the wound are approximated with
Fig. 12: The long-term PMMA bridge was shortened in
distal implant, the buccal orientation of a groove is horizontal backstitch sutures and sutured with single button the area of the interlink underside before it is mounted.
sutures without tension (image mirrored in the palatal portion).
4.3 mm and the distal implant with a Fabrication of the final
diameter of 5.0 mm (Figs. 6 and 7).
abutments and temporary
Registration of the implant
positions and suture
The intraorally fixed implant position is transferred via the support on the Position and alignment of the implants prepared stumps to the preoperative
are checked once more with impression cast in the laboratory. The dental
posts and registration template made technician screws the lab analogs onto
of PMMA (Fig. 7). To transfer the the impression posts and embeds them
exact positions of the implants to the in plaster (Fig. 14). Using a split silicone
Fig. 16: The technician transfers the implant positions
laboratory, a composite is used to bond index, the dental technician creates a onto the oral side of the gingival mask by perforating the template to the insertion posts gingival mask over the implants in the it from basal with a hard-metal milling cutter. Then, the emergence profile can be cut out with a scalpel (Fig. 8). After loosening the screws, area of the alveolar ridge. Using a copy
and smoothed with a staggered tooth mill.
the block is removed from the mouth of the anatomically designed PMMA
(Fig. 9). The interiors of the implants are
long-term temporary restoration, he then flushed with sterile saline and the cover transfers the emergence profile of the Marking holes are made through the screws fixed (Fig. 10).
planned implant crowns to the gingival drilling template using the 2 mm pilot mask (Fig. 15). The implant positions are
drill and expanded after removing the The margins of the wound are now projected onto the outside of the gingival
template using the surgical round drill. approximated with three horizontal mask with a round bur from the basal
A periodontal probe is used to check backstitch sutures. Monofilament suture view. The emergence profile can now be
the correct distances between implant material (size 5.0) is used. Single button cut out using a scalpel and smoothed out
positions. After completing the pilot sutures (size 6.0) follow (Fig. 11). The using a cross-cut bur (Fig. 16).
holes, the correct alignment of the basally ground temporary bridge can now
implants is checked with the drilling be cemented again (Fig. 12). The single After the emergence profiles are
template and paralleling pins inserted button sutures are removed after eight completed, appropriate scanbodies
(Fig. 5). After complete preparation of days and the backstitch sutures after 14 for CAMLOG® (Sirona) are screwed
the implant sites, the surgeon inserts two
days. Figure 13 shows the results of the onto the lab analogs in preparation
13 mm CAMLOG® SCREW-LINE implants, implantation in the X-ray image.
for scanning (Fig. 17). The scanning
the anterior implant with a diameter of process is carried out in the strip light CASE STUDY
Fig. 17: Finished emergence profiles in
Fig.18: A strip light scanner is used to transfer implant
Fig. 19: The software then works out the anatomy of the
the gingival mask with scanbodies already positions defined by the scanbodies to the CAD software. crown biogenerically from the residual teeth. The abutment screwed in for scanning.
can then be designed by reducing the crown in a manner that it supports the cusps and in the correct thickness. Fig. 23: The temporary PMMA crown on the
Fig. 24: Five months after implantation: To expose the implant
Fig. 25: A vertical relief cut follows posteriorly distal to the
abutment for the implant at position 16. The bed, a slightly curved crestal incision is made at a min. distance implant at position 16. To prevent tension on the marginal natural "biogeneric" anatomy of the crown of 4 mm from the mucogingival junction and then extended gingiva, the ligament and muscle attachments are carefully is easy to see.
mesially in the buccal sulcus of tooth 14. removed (technique according to Dr Axel Kirsch).
Fig. 29: The long-term temporary crowns are
Fig. 30: The temporary crowns are removed again three
Fig. 31: Filaments are placed around the teeth and
cemented: The removal site from which the months later. The soft tissues have healed in the meantime and abutments as in the conventional prosthetic. An impression grafts were taken can be seen in the mirrored the virtually defined preparation margin must be adapted to is taken using 2-phase silicone in the double-mix procedure. image palatally. The apically displaced the new situation using a diamond finishing bur.
The result is a very good base for the new master cast.
mucogingival junction is visible buccally.
scanner (Fig. 18), with which the The final abutments are ground and Exposure, abutment attachment
implant positions are transferred to the sintered from zirconia blanks (inCoris ZI and impression taking
planning software in three dimensions. Meso, Sirona) and bonded to CAMLOG®
In subsequent software-based steps, titanium bases CAD/CAM according to Five months after implantation,
the crowns and abutments are designed
manufacturer's instructions (Figs. 21 the implants are successfully
where the appropriate dimensions and and 22). Figure 23 shows an example osseointegrated. The mucogingival
layer thicknesses are optimally matched of a temporary PMMA crown (Telio CAD)
junction has shifted toward the alveolar biomechanically and esthetically (Fig.
on the distal abutment. The crowns have ridge as a consequence of the surgical 19). The occlusal relationship can also be
a very natural anatomical form due to intervention and must be corrected by simulated in the software via a digitalized the biogeneric design and have a highly means of a vestibuloplasty in the context silicone index or represented by scanning polished, biologically favorable surface.
of the exposure. The surgeon prepares the cast of the opposing jaw (Fig. 20).
corresponding flaps buccally and
palatally for access to the alveolar ridge
(Figs. 24 and 25). The flaps must not be
Fig. 20: The opposing dentition is calculated from
Fig. 21: The finished zirconia abutment for the implant at
Fig. 22: Bonded and polished zirconia abutments (bottom),
the digitized wax bite. The abutments show an position 15 before bonding, CAMLOG® titanium base CAD/ highly translucent temporary PMMA crowns (Telio CAD) adequate interocclusal space. For periodontal- CAM 4.3 mm and the individually milled abutment.
prophylactic reasons, the future crown margins lie at the level of the gingiva.
Fig. 26: In the next step, the implants are exposed
Fig. 27: Suturing: The buccal split flap is fixed using backstitch
Fig. 28: Two epithelialized free connective tissue grafts
using a roll flap with buccal pedicle. The buccal sutures and then adapted using single button sutures. There is are taken equilaterally from the hard palate and fixed in connective tissue can thicken and thus stabilize with a soft tissue deficit mesial and distal to abutment 15, which is the defect areas. The equigingival position of the cervical the tissue over the cover screws.
measured with a periodontal probe.
"preparation margin" can be seen palatally (image mirrored palatally).
perforated especially in the area of buccal slightly from that in the software due to implant shoulders. He then exposes the healing (Fig. 30). Figure 31 shows the
implants using roll flaps (Fig. 26). After results of the double-mix impression.
removing the cover screws, the interiors
of the implants are flushed with sterile Fabrication and insertion of the
saline and the final abutments screwed in
at a torque of 20 Ncm.
Based on the impression, the dental The flaps can now be fixed around the technician creates a new master cast, abutments using backstitch and single which is scanned by the strip light Fig. 32: The master cast is digitalized in the laboratory and
button sutures (Fig. 27). The lack of soft
scanner. He checks step by step the the final crowns designed on the screen.
tissue between the abutments is replaced preparation boundaries of the natural by free mucosal grafts from the palate and stumps and abutments and defines sewn into place (Fig. 28). The temporary
them on the screen. The biogenerically PMMA crowns are tried in and the designed crowns are then called up and function and approximal contact points using the wax-up tool, optimized in the checked. Before cementation, cotton software anatomically and functionally pellets are inserted in the screw channels, (Fig. 32). The previously scanned cast of
so that the screws can be loosened again the opposing jaw can be used again to before the final restoration if necessary. check the correct interocclusal distance
Only then are the screw channels sealed and the occlusion (Fig. 33).
with light-cured composite and the
crowns cemented temporarily (Fig. 29).
It only takes about ten minutes to shape a lithium disilicate crown in the milling An impression is taken three months later unit. Crowns made of this material do after substantial healing of the soft tissue. not shrink significantly after sintering and Fig. 33: The occlusal relationship is also easy to check
The preparation boundaries are adapted can therefore be inserted fire-polished if to the new soft tissue situation with a desired. Sintering and final firing can be rotating fine diamond bur. This differs carried out in one firing process. In the CASE STUDY
Fig. 34: After milling the final lithium
Fig. 35: For safety reasons, the fired lithium disilicate crowns
Fig. 36: The painted and sintered final lithium disilicate
disilicate crowns, the approximal (image) are also tried in the patient's mouth before finishing and crowns after finishing in the laboratory. and functional contacts are checked in function checked. It is easier to further mill the material at this The restorations were designed in a manner that supports the laboratory. This is possible because point than after sintering.
the cusps and in the correct thickness. the material is not subject to any clinically relevant shrinkage as a result of sintering.
Fig. 37: Check of the occlusion with shim
Fig. 38: After trying in the finished crowns, an index made of
Fig. 39: After fitting the final crowns using a dual-curing
stock foil. After any possible corrections, the kneading silicone can be prepared. This is used to protect the composite, the gingiva is slightly traumatized. The removal surface of the crowns must again be carefully crowns while preparing for cementation and to keep them in sites of the free mucosal grafts are already well-healed.
smoothed and polished.
the right order.
example of our patient, the sintered
crowns are first checked on the cast
before the final firing (Fig. 34) and then
in the mouth (Fig. 35) for the correct
approximal and functional contacts. Only
then is the final design carried out in the
laboratory (Fig. 36).
Before final insertion of the crowns,
the approximal (Fig. 37) and functional
contacts are checked again on the
patient. Corrected ceramic surfaces
must be carefully smoothed and
polished to prevent plaque adhesion and
biomechanical weakening. The crowns
are then fixed adhesively (Figs. 38 and Fig. 40: Lithium disilicate next to hydroxylapatite: The crowns on teeth 17 and 14 and
implants 15 and 16 blend in very nicely.
39). Figure 40 shows the esthetically and
functionally successful results.
 Wilson TG. The positive relationship between excess
cement and peri-implant disease: a prospective clinical endoscopic study. J Periodontol 2009;80:1388-1392.
 Abrahamsson I, Berglundh T, Lindhe J. The mucosal bar-
rier following abutment dis/reconnection. An experimental
 Scarano A, Piattelli M, Caputi S, Favero GA, Piattelli
study in dogs. J Clin Periodontol 1997;24:568-572.
A. Bacterial adhesion on commercially pure titanium and zirconium oxide disks: an in vivo human study. J Periodontol  Beuer F, Schweiger J. Einzelzahnkrone gemäß München-
er Implantatkonzept. Der Freie Zahnarzt 2012:78-84.
 Stimmelmayr M, Stangl M, Edelhoff D, Beuer F. Clinical
 Welander M, Abrahamsson I, Berglundh T. The mucosal
prospective study of a modified technique to extend the barrier at implant abutments of different materials. Clin Oral keratinized gingiva around implants in combination with Implants Res 2008;19:635-641.
ridge augmentation: one-year results. The International journal of oral & maxillofacial implants 2011;26:1094-1101.
 Schweiger J, Beuer F, Stimmelmayr M, Edelhoff D. Wege
zum Implantatabutment. dental dialogue 2010;11:76-90.
were saved according to the patient's of the peri-implant tissue [3,6]. This also wishes.
applies in comparison to titanium. Even The method shown is an example of the temporary restorations and final state-of-the-art, team-oriented implant Securing the final abutments at the time crowns have a positive effect on soft- prosthetics with highly developed of exposure also has potential biological tissue healing and long-term peri-implant hardware. All individual steps are advantages. The once established health due to their natural design and methodologically, technically and connective tissue attachment does not their material properties. chronologically coordinated. Only then have to be destroyed again, which bodes is this time-saving and biologically well for the prognosis of the peri-implant Not least, a careful surgical technique consistent treatment possible. The situation according to preclinical studies contributes to a highly esthetic and long-esthetic result is positive even where the . However, this hypothesis has not yet term stable result. The vestibuloplasty bar is not as high as in the front in the been confirmed in clinical studies. As a carried out in this example is a routine posterior region. Therefore, the authors result of the CAD/CAM methodology intervention used to achieve better specifically recommend this procedure for used, it was also possible to best design hygienic potential of the implant- the posterior region . The procedure the abutments with respect to the supported restorations . Finally, the can be carried out with or without emergence profile and the position of the economic aspect should be noted as the augmentation, where a 2-stage procedure subsequent crown margin ("preparation time savings and absence of healing caps is recommended for the former.
margin") . The risk of any remaining or individualized temporary abutments The starting point for this example was cement damaging peri-implant tissue is help reduce costs . Notwithstanding the desire of the patient to be treated thereby reduced . Should the position the above, the Munich implant concept in as few sittings as possible. The of the crown margin still change after the shows that proven dental know-how goes dental team took this into account by soft tissue has healed, additional finishing very well with state-of-the-art technology.
registering the three-dimensional implant can easily correct the change.
positions immediately after insertion. This allowed the team to insert the final Another plus is the use of zirconia as abutment immediately. Further sittings to the abutment material in the example replace healing caps and to transfer the shown. This material has proven very round profile of the healing caps to an favorable with respect to bacterial anatomically correct emergence profile attachment and inflammatory behavior PD Dr Florian Beuer:
Dr Michael Stimmelmayr:
Study of dentistry at Ludwig Maximilian Univer- After the state examination in dentistry at the Completed training for dental technicians after sity of Munich. 2002, conferral of doctorate. University of Regensburg, switched to Ludwig final secondary-school examinations. After ten After two years in private practice, switched Maximilian University of Munich as a research years of dental technician work in different lab- in 2002 to the Dental Prosthetics Polyclinic associate. 1992, conferral of doctorate. 1997, oratories, laboratory manager since 1999 at the (Director: Prof Dr Dr h.c. Wolfgang Gernet). specialist designation as oral surgeon and Dental Prosthetics Polyclinic in Munich. There 2007/2008, visiting scholar at the Pacific Den- senior physician at the Department of Prostho- dental management of several studies on all- tal Institute, Portland/Oregon, USA with Prof dontics. 2000, own practice in Cham with an ceramic systems; has published numerous tech- John A. Sorensen. 2009, postdoctoral lectur- emphasis on implant dentistry and specializa- nical papers on the subject of CAD/CAM and ing qualification. Work and research priorities: tion in periodontology.
advanced ceramics in dental applications. Josef metal-free restorations, implant prosthetics, Schweiger is a board member of the German CAD/CAM, digital workflow, practice-based Society for Computational Dentistry (DGCZ).
research, medical educational research. PD Flo-rian Beuer is a management board member of the German Association of Esthetic Dentistry (DGÄZ) and the Working Group for Ceramics (AG Keramik).
POSTER EXHIBITION AT THE INTERNATIONAL
CAMLOG CONGRESS 2012 NOW ONLINE
Would you like to see the ICC-2012 post-er exhibition again? Now you can conven-iently online without any stress. And while visiting the CAMLOG Founda-tion homepage, do not forget to also read the entry conditions for the CAMLOG Foundation Research Award 2012/2013.
Hehn A, Schlee M.
Ziebart T, Boddin A, Pabst A, Kulak-Özkan Y, Akoglu B, Klein MO, Al-Nawas B.
IN GOOD COMPANY – AS A MEMBER OR AUTHOR OF
CAMLOGCONNECT, THE ONLINE COMMUNITY FOR
CamlogConnect is picking up speed and now numbers more than 1750 members. The interactive Internet platform for CAMLOG users went live just one year ago! Worldwide, more and more dentists, surgeons and implantologists take advantage of the free offering of the online community for self-directed continuing education and to expand their professional network.
As international as the visitors who visit articles. Of course, we enjoy following translation of your image material. Take the Internet platform daily, so is the many more successful treatment cases advantage of this excellent opportunity to ever-growing authorship. Experienced of Dr Illaria Francini (Italy) and Dr Guido showcase your own work and to connect professionals and newcomers impressively Petrin (Germany) on CamlogConnect. with leading colleagues – or to simply be document and describe their treatment We are pleased to welcome new author inspired by ideas and examples for your successes. The international authors Dr Kimmo Karstoft from Denmark, who own daily work. include Dr Tony Regenato, a young in his debut impressively shows how he Learn, share & enjoy.
dedicated specialist from Chicago, who replaced two cuspids in an edentulous does not have his own practice, but is called mandible with CAMLOG implants. If you CAMLOG looks forward to your upon by dentists in cases of particularly want to present your own treatment cases demanding indications. Many talented using CAMLOG implants and prosthetic European capacities of implant dentistry components, please contact Dr Peter Hunt, are represented on CamlogConnect, the CamlogConnect editor in chief at too. Dr Tabuenca of Spain, who directs www.camlogconnect.com. Peter Hunt will several practices, has posted interesting take care of the technical preparation and [email protected] – ON FUTURE TECHNOLOGIES
AND THE PRINCIPLE OF HUMANITY
A forward-looking and open-minded attitude towards modern technology and a high sense of tradition and traditional values are not mutually exclusive. A clear example of this is Switzerland where the Swiss Dental Technology Congress 2012 was held in September of this year with key involvement and at the initiative of CAMLOG.
"[email protected]" was the event motto, more mobile) and dental technicians The presentation by PD Dr Florian Beuer making clear that the congress was about (CAD/CAM, skills development). After und Josef Schweiger was professionally cooperation between dentists, partners, the first speaker, Beat Kunz in his role stimulating. "The digital team workflow colleagues, employees, etc. in addition as moderator thanked the patrons of in daily practice," suggests much. Both to future technologies. "Teams" come the congress and the exhibiting firms for speakers work at Ludwig Maximilian in different sizes – common to all is that their participation and support.
University of Munich and use no less than functioning cooperation is of paramount 14(!) CAD/CAM systems in their everyday importance for the overall results of the Dental technology: Status quo
work. Individual CAD/CAM-fabricated abutments have many advantages over Occupational policy is also a topic prefabricated and cast-on abutments. Dr Alex Schär, Member of Executive in Switzerland. The "Branchenbild The variant preferred by the Munich Board at CAMLOG Biotechnologies Zahntechnik" (Dental technician industry residents is a two-part bonded abutment AG, Basel, welcomed about 200 dental profile) was very precisely and vividly consisting of a titanium base and a technicians from throughout Switzerland. portrayed by Christian Hodler, the zirconia abutment. The "academic Beat Kunz, who played an important Secretary General of VZLS (Federation discussion" around the adhesive joint is role at the first Swiss Dental Technology of Swiss Dental Laboratories). His foray of no importance for the practice. In the Congress, opened the lecture program into the industry was analytical, clear and second part of their presentation, they with the topic: "2010: Congress he was able to provide approaches to delved further into the "Munich Implant conventional-virtual – 2012: What has further development of dental technician Concept" and "digital veneering" changed?". Changes can be noted in the entrepreneurship in Switzerland. (sintered composite technology, so-called dentist (competition among themselves, CAD-on technique). marketing), patients (more decisive, The new generation of
he calls "enamels" or with implant MDT Ralph Riquier dealt with the issue reconstructions, for which he can provide of "Digital Forecasts" with a practical clear recommendations in which cases orientation and visionary at the same Dipl.-Ing. Michael Tholey ("Colors, they should be screwed in, cemented time, where it was important to him "to Firing, Chipping") and Dipl.-Ing. Bogna or used as a combination of both. His not go to far forward," but to build his Stawarczyk ("Everything a Question of credo: "You can wear anything with line of argument on the basis of facts. Material") delved deep into the world beautiful teeth," he illustrated in many The forecasts were broken down into the of materials science and were able to case examples.
material, production, CAD software and provide several practical tips for handling workflow. Each of these elements was zirconia, veneering ceramics, PMMA and The digital r-evolution
analyzed on its own. Monolithic ceramics, CAD/CAM plastic.
high-performance plastics, milling and The dental impression is a nerve-racking generative processes are keywords of the "What I show you today is handicraft, true affair for doctor and patient. "Scan or past and future. However, in the opinion handicraft," said Andreas Nolte opening impression" was thus the question for PD of the speaker, the greatest potential lies his presentation. This did the dental Dr Irena Sailer and MDT Vincent Fehmer. in the field of CAD software (interaction technician soul good and expressed his With the provocative thesis: "A new idea of software, integrity of external data) belief to the point. Esthetics can not be is ridiculed in the first phase, antagonized and the further development of process reproduced by pressing a button, but in the second phase and in the third phase, chains (networking to server portals, requires intensive expert work on and everyone was excited about it from the cloud solutions). The good news is that with the patient, empathy, thorough beginning," as they draw attention to the portals will be more controlled and analysis and planning and a trained question. However, they had to admit that regulated in the future, but it is apparent eye. The Münster resident calls this desire and reality do not always coincide that economic CAM fabrication will also "Low Tech" although he often uses a and the optical impression of individual be possible in small laboratories.
computer-assisted process in the dental quadrants work very well, but entire implementation. But they are not an end jaws are problematic. Furthermore, the in themselves, rather a means to an end. economic justification is not yet given and His brand is beautiful ceramics realized yet other limiting factors such as surface in functional restorations whether in quality of casts stereolithographically the form of non-prep veneers, which generated played a role.
Beat Krippendorf, lecturer in strategic and operational marketing, provided a fantastic end to the Swiss Dental Technology Congress 2012. His main focus is the "principle of humanity" and the belief that good relationships affect business success sustainably. According to Krippendorf, good relationships are less a question of technical competence and more a question of attitude and personality or in his own words, the "own culture". "People do not care how much you know until they know how much you care," is just one of his striking theses.
With this, an outstanding event came to a deeply inspiring and motivating end. We can already look forward with eager anticipation to the cotinuation of the Swiss Dental Technology Congress and the coming motto! HIGHER, FASTER, FARTHER!
The 35th International Dental Show will be held from 12–16 March 2013 in Cologne, Germany. With more than 110,000 show visitors and 2,000 exhibitors, this event is undisputed as the world's leading exhibition for the dental industry. IDS provides an ideal platform to learn about the latest products and trends.
Of course, CAMLOG will also be present And experience the premiere of our new So you see, a visit to the CAMLOG booth as usual in 2013 with an inviting booth communications presence live in Cologne. at IDS in Cologne this year will be well in hall 11.3. Following the positive Who knows, maybe you can be inspired worth your time. development of the CAMLOG business by it and even accept a small role? You'll trend, we have expanded our booth space be in for a surprise in any case – we You'd be well served to reserve the time to 235 m². CAMLOG is looking forward guarantee it! Without giving away too in your calendar now to visit CAMLOG in to welcoming our customers personally to much already, we can assure you at this Hall 11.3 from 12 – 16 March 2013. Booth our booth and to present a few product point that CAMLOG will be at IDS with A10-B19. We look forward to seeing you. innovations on site. Personal contact with a remarkable innovation. But we'll talk you is also clearly in the foreground at IDS about that more at a later time – in March 2013. We aim to maintain our lounge in 2013 in Cologne. comfortable surroundings as a deliberate contrast to the exhausting bustle of the show.
Slovak Academy of Sciences, Institute of Animal Biochemistry and Genetics, 900 28 Ivanka pri Dunaji, Czech and Slovak Federal Republic The assumption is introduced that there are two types of adaptive responses in central neurons in response to signicantly changed circuit activity. Morphological synaptic modications and synapse turnover are thought to be involved in both of these responses, in such a way that in the rst case they are to restore the
Diabetic foot ulcers – prevention and treatment A Coloplast quick guide Biatain® – the simple choice Diabetic foot ulcers have a considerable negative impact on The diabetic foot – a clinical challenge . 5 patients' lives, and are highly susceptible to infection that al too Pathway to clinical care and clinical evidence . 6 often leads to amputation. It is essential that diabetic foot ulcers