Extraction and immediate implant placement - Courtesy ROOTS
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From: Liviu Steier
Sent: Tuesday, April 13, 2010 12:17 AM
Subject: [roots] Case of the day
Patient flew in and out today accompanied by his own dentist
for extraction and immediate implant placement.
- Dr.med.dent. Liviu Steier
And what Implant could that be? An Alpha Bio or a Noble activ?
- Dr Sanjay Jamdade
who cares the brand? it looks like perfect treatment to me. - Sergiu
Dr Sergiu obviously it is perfect there is no argument about it.
But the macrogeometry and microgeometry of the implant obviously
play an important role. That is an established fact of implant
dentistry. Hence you SHOULD care what the brand is.
I ask you Dr Sergiu would bone healing around an implant with
sharp threads. with blunt threads, deep threads and shallow
threads, Implant with machined surface, rough surface
all be identical? - Dr Sanjay Jamdade
Dr Sanjay, your point is highly appreciated.
Having placed couple of thousands of implants since 1989 and
having had the chance to review quite a high number of them
over the decades beside reviewing the literature evidence
different questions had to be answered before deciding what
system to choose and how to be best treatment plan.
I shared my case with you and shared multiple other cases
with this forum and proved my point. I wonder if you could
do the very same to prove the evidence of your point,
but ...I can understand if you do not have any and just prefer
to play "devils advocate" for the sake of the theory...
I had a great teacher in Germany I would love to quote:
"Don t tell me - show me!"
Respectfully, L. Steier
Sanjay, All differences you mentioned have anything to
do about final outcome in first 6 to 9 motnhs. After implant
is successfully osseointegrated there is no any study, as far
as I am informed, which can show us a statistically significant
differeneces in results. The "hollow cylinder with vents"
implant of Straumann sold in the past may be is the only
exclusion with its high percentage of late failures due to
See some pictures attached of over 30 years loaded Tramonte
implant and also of 8 and 13 years loaded SDV 1 implant
(which I developed back in 1990). A 30 years result of
blade implant is also attached with endo failing next to it :-).
It's ALL about correct implant treatment planning and NOT
because of particular implant design after first year of
successful loading. - Valeri Stefanov
Sanjay, I can not speak on behalf of Liviu, but with my post
I just wanted to teach you something I've come to through many
years of personal experience and accumulated knowledge
by placing implants, designing implants and at certain point
by manufacturing the system I developed myself. The discussion
you are now trying to start on ROOTS is imho not appropriate
for this endo forum, although some of endodontists have already
started placing implants, too. We have had these discussions
on another on-line list for many years - IMPLANTLOGY list
founded by Dr.John Cliff back in 1996.
What is good within first 6 months post implant insertion imho
- thin body and large sdv threads in case you want to do delayed
immedaite loading ( I do not like real immediate loading myself
and I do not practice it ). If you will do it in a classic way
Bicon implant system approach is fine and same is valid for all
other classic implant systems with thick body and low height threads.
There is an implant which allows you to practice both approaches
depending on the circumstances in each clinical case using
ONE design implant only ( see attached photo of ARDS implant -
made in Israel ). Another important thing - rough
is better than smooth. At least at this stage how exactly the
roughness will be created does not matter too much. TPS and HA
coatings are worse than SLA, SXLA, RBM and etc similar
surfaces which are not coatings.
I am attaching the PPT of my lecture I had on Experts Podium
during a DGZI / ICOI Congress held in Budapest in 2002
(8 years ago). If you have questions about some of the electron
microscopies I'll be glad to explain in details, since Power
Point presentation is not a lecture itself. In advance I can
tell you that resorbtion of HA coating - both low crystalinity
and high crystalinity can be seen even only 3 months after
insertion without any loading of implants ! Hope you will enjoy
the presentation. - Valeri
Power point presentation