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Copy of The ANKYLOS Implant Advantage

Presentation of the Ankylos Dental Implant System
by

Dorothea Drew

on 30 April 2014

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Transcript of Copy of The ANKYLOS Implant Advantage

Distribution of Restorative Types
Distribution of Implants in the Dentition
Implant Utilization by Size
Distribution of Restorative Types
ANKYLOS Implant and Standard Abutment
Immediate Implant Placement
Let’s Define the Ideal Dental Implant
The
Biologic
Difference Between the Mechanical Connection and the ANKYLOS Cone
“A paradigm shift is an irrefutable scientific discovery that is the
What does this mean?
Paradigm Shift
The Mid-1990’s to Today
The Internal Connection
Evolution Of The Dental Implant From The 1980’s To Ankylos
History of implants
Distribution of Implants in the Dentition
BUT NOT WITH ANKYLOS
This is a treatment planning dilemma driven by the need for optimal Emergence Profile
What size Dental Implant??????
5 months Post-op, sulcus formed by temporary crown
Advantages of immediate and early temporization includes:
Maintenance of normal periodontal architecture.
Starts the maturation of peri-implant tissues.
The Standard Abutment does not have to be removed to beautifully restore this case.
Conical form of the bone preparation
causes the implant to engage un-prepared bone in the apical 1/3 of the osteotomy.

Therefore, in Type 3 and 4 bone, the Ankylos Implant is self tapping.
2. Superior Primary Stability
1. Simplified Surgical Steps
Minimizes surgical intervention
Minimizes the patient’s fears
Simple and precise technique
Atraumatic
Simple and Logical
Great tactile feel with the hand instruments
Versitile
1. Simplified Surgery
5. Maintenance Free, Retrievable Connection.
How do we achieve soft and hard tissue long term stability??????
Subcrestal Placement
Complete absence of Bacterial Micro-gap
Complete absence of Micro-movement
Abutment connection away from peri-implant tissues
3. Long term Biologic Stability
One Week Post-op
Pre-Treatment
2. Superior Primary Stability
Easy insertion
Little bone contact during 2/3 of the insertion
Excellent primary stability in soft bone
Enables Immediate Load
1. Simplified Surgical Steps
Hand wrench with central guiding pin:
Excellent visibility by getting operators hands out of the way.
Provides axial guidance for the reamer, tap and implant insertion.
Superior guidance than using a finger from the opposite hand.
1. Simplified Surgical Steps
Mechanical Connection vs Cone Connection
What’s The BIG Difference?????
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
Changing the Definition of Successful Implant Treatment
A Paradigm Shift in U.S. Implant Dentistry
2003 – FDA Approves
The Cone Connection
POINT
Threaded Implant Body
Measurable Primary Stability
One AND 2 stage protocols
Improved tactile feel assembling implant/abut.
Immediate load possibility
Internal Butt-Joint Connections
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
3. Long term Biologic Stability
Central Straining Screw requires only 15 ns Torque.

Vertical force generated by the Central Straining Screw is exponentially multiplied to horizontal force against the implant wall.

The screw is not needed after connection is complete. Hence the phrase CONTACT CONNECTION.
Absence of Microgap and Micromovement
3. Long term Biologic Stability
Standard Straight Abutment
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
2. Superior Primary Stability
Combines 2 design features:
Osteotomy design; the Conical Reamer
Progressive thread
Point:
We Got an anti-rotation element
Single tooth implants were now possible
Maintenance Issues reduced
External Hex - Point and Counterpoint
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
Single tooth replacements were not possible

Esthetics were very poor


MOST IMPORTANT: these features limited the implant market to bridges between implants or to natural teeth.
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
Therefore, The surgeon is free to optimize the implant-to-bone relationship for optimal bone support.
Surgical Advantages of ANKYLOS
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
4. Prosthetics = standard dental treatment
Every prosthetic part fits into every ANKYLOS implant.
Surgical Advantages of ANKYLOS
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
The strength of the ANKYLOS connection provides independence between implant size and the prosthetic treatment plan.
Internal Cone Connection Strength
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
Immediate Extraction/Immediate Load
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
The
Biologic
Merits of
ANKYLOS vs Mechanical Connection
No micro-movement between implant and abutment -
ANKYLOS YES
-- Mechanical NO
The BIG Difference
Cone Connection
A connection that depends on the implant/abutment contact for strength, stability, retention and anti-rotation.
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
Late 1980’s and Early 90’s
We really thought this was the answer for replacing single teeth.
The external hex

was introduced to provide the anti-rotational quality needed for single tooth replacements.
SURGICAL PROTOCOL - only 2 stage
Implant was PRESS FIT, making primary stability difficult
Implant/abutment interface was supra-crestal
NO anti-rotational element
Very high maintenance to service loosening screws and to replace the plastic IME
Limitations of the INTERPORE IMPLANT
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
Over 25-Years of Clinical Data
1985 – Design Concept Developed Dr. Nentwig & Dr. Moser
1987 – ANKYLOS Starts in Clinical Use, Germany
1996 – 2002 - VA 6-year ANKYLOS Study
2001 – DENTSPLY Intl. Purchased Degussa Dental (ANKYLOS)
The Story of ANKYLOS
3. Long term Biologic Stability
ANKYLOS = Biologic Stability and Health.
microstructured implant shoulder
no microgap
no micromovement
deep platform shift
subcrestal placement
Patient was discharged to his general dentist for temporary fabrication
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
Waxing sleeve used as a base for a custom sulcus former/crown base
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
Tri-Spade Drill Diameter
No pressure on the crestal bone
Apical Threads are in unprepared bone
Combines 2 design features:
Osteotomy design; the Conical Reamer
Progressive thread
2. Superior Primary Stability
1. Simplified Surgical Steps
Conical Reamer
Twist Drill
Round Bur
Tri-Spade Drill
Thread-Cutter
The BIG Difference
Mechanical Connection
Must be supra-crestal
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
Internal Butt-Joint Connections
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
Bone Tap
1. Simplified Surgical Steps
Great bone harvest.
F
E
D
C
B
A
1 Year Post-op
1 Week Post-op
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
Butt joint connection
The BIG Difference
Screw-retained connection
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
Any connection that depends on a central fastening screw to hold the abutment and implant together.
Mechanical Connection
External or Internal HEX
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
Diameter Driven Emergence Profile
Crestal Placement
Great advancement to replace single teeth
Restoratively integrated with Implant Diameter
Diameter of implant correlates with the dimension of the tooth to be replaced.
Internal Hex Connection - mid 1990’s
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
Internal Hex Connection - mid 1990’s
“The unique FRIADENT
implant-abutment interface technology"
The Best Connection
Cone Connection vs Mechanical Connection
Mechanical Connection
ANKYLOS Cone Connection
CLINICAL CONTRAST
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
Mid 1980’s in the US
IME – was to enable implant-to-natural tooth bridgework by reproducing the elasticity of periodontal ligament.
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
Subcrestal Placement
3. Long term Biologic Stability
Dr. Gary Brousell DDS
Oral and Maxillofacial Surgeon
2004 – January – ANKYLOS Pilot User Program Starts
2004 – September – ANKYLOS Launched to Market Place
2009 – September – ANKYLOS C/X Launch – Internal Index
2003 – FDA Approves ANKYLOS for Clinical Use - USA
IME allowed for lateral flex and vertical elasticity that would match the elastic qualities of the periodontal ligament.
Counterpoint
Still a PRESS FIT implant
Surgical Protocol-2 stage
Restorative was laborious
Abutment Screw issues
Esthetics were still poor
Peri-implantitis was expected -
Supra-crestal
Placement
Once the shift is completed, all previous understanding of a clinical scientific topic is abandoned and is supplanted by

complete undoing
of previously accepted knowledge.
new knowledge/new understanding.”
(Kuhn 1962)
Dr. Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Brousell DDS
Oral and Maxillofacial Surgeon
Connection designed for bacteria tightness -
ANKYLOS YES
-- Mechanical NO
Platform Switching by Design -
ANKYLOS YES
- Mechanical NO
Subcrestal implant placement -
ANKYLOS YES
-- Mechanical NO
Micro-roughness up to the interface -
ANKYLOS YES
-- Mechanical NO
Dr. Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Brousell DDs
Oral and Maxillofacial Surgeon
Dr. Brousell DDS
Oral and Maxillofacial Surgeon
A
B
C
D
Dr. Brousell DDS
Oral and Maxillofacial Surgeon
Versatility - can be used in all clinical situations
Dr. Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Gary Brousell
Oral and Maxillofacial Surgeon
Dr. Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Gary Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Gary Brousell
Oral and Maxillofacial Surgeon
Dr. Gary Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Gary Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Gary Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Gary Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Gary Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Gary Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Gary Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Gary Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Gary Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Gary Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Gary Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Gary Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Gary Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Gary Brousell DDS
Oral and Maxillofacial Surgeon
Dr. Gary Brousell DDS
Oral and Maxillofacial Surgeon
COUNTERPOINT
Connection at crest
Emergence Profile dependent on implant size
Second stage damaging to peri-implant biology
Butt joint difficult to manage during restorative.
Gary Brousell, D.D.S.
Oral and Maxillofacial Surgeon
Conical Reamer
The Best Connection
for Clinical Use in the USA
1. Simplified Surgery
2. Superior Primary Stability
3. Long term Bio-Mechanical Stability
4. Prosthetics = standard dental treatment
5. Maintenance Free, Retrievable Connection
offers a
maintenance free,
retrievable
connection
Dr. Brousell DDS
Oral and Maxillofacial Surgeon
The Ideal Dental Implant: It's all about the CONNECTION.
1. Simplified Surgery:
allows for subcrestal placement to enhance overall stability and aesthetics
2. Superior Primary Stability:
for a secure implant to bone connection
3. Long term Bio-Mechanical Stability: This means no bone loss.
4. Prosthetics = standard dental treatment: for the ultimate in prosthetic versatility.
Full transcript