Webinar | EL Esthetic Line: What are the ingredients of a great implant?

Watch Dr Henriette Lerner explaining all the features of a successful and qualitative implant.

I saw you have breathing plant systems in the pipeline and you learn a lot of systems, and probably you already have in your mind some main features that the implants need to have.
In order to make your treatment easier and more predictable in your procedures.
You probably already know that an implant has to have a high bone implant contact surface and the designs of the implants are all made in a way that increases this surface, because this is giving you a long-term stability of the surface of the osteointegration.

You can see that, in the body of the implant, implant is aggressive, which is a good thing for the sponge bone and you have in almost all systems an undersized drilling procedure, the drilling is smaller than the implant, so you have the cutting procedure, the cutting feature, which is going into the bone, which is letting the implant go to the bone and giving you almost all the bone qualities, also, in the extraction socket, a very good primary stability.
You have in the coloured part a part that is not so aggressive, why?
Because we know that the cortical bone is less vascularised, is more sensitive to forces.

The forces are transformed through the small design of the threads, or the small thread design, into smaller forces that should protect the cortical bone and avoid resorption, right?
You need to maintain that bone and the colour of the implant because what happens when you lose the bone and you take the soft tissue with it?
So, this is what you see in the whole implant restorations where nobody took care of the thickness of the bone, about the thickness of the soft tissue, and also, implant designs were different, so, you take the implant design that makes your life easier and gives you some predictability in that since we know a lot about biomechanics right now.
Also, you can see, you have a kind of concave profile of the running room of merging profiles, and you know that when you see in
the most, let’s say, advanced or modern implant systems and, in the last couple of years, implant systems implemented, there are a couple of implants that had that from the beginning on where the studies were already showing this good feature.

What is the benefit of it?
The soft tissue is, concave profile, you know from the prosthodontics,
concave profile is taking, is collecting, is attracting the soft tissue, is giving the possibility to the soft tissue to have a certain volume and height, that you can use to protect the bone underneath, as you will see, and also to have a certain height of the soft tissue, to have papillas between two adjacent implants.
So, we saw already in 2007 that there are some factors in the implant design that are influencing the resorption or preserve the peri-implant marginal bone.
So, that was one of the first studies in that region, I see that, even now, the research gate is really cited in this article very much, because it is one of the first ones that are collecting all the data.

Also, the micromotions, so the connection is an important issue, right?
And you know this Frankfurt study for sure there are two different studies, left and right, but the right picture, probably you know and you saw that micromotions are also giving bone loss, micromotions are happening when the connection is not tight enough one second early, when the microgap is very near to the bone.

So, what do we do?
We take implant systems that have a tight connection, less micromotion, or as little micromotion as possible, and less microgap, one, and moving the microgap from the bone level, that is called
platform switching design, that is probably the most familiar thing that you know from the continuing education that you did.
So, we were talking about point one, initial stability, which is given by the external design, by the thread design, platform switching design, which is avoiding micromovements and moving the microgap from the bone, and then you need a very tight connection and you can see that the most modern systems, based on studies that are showing that the Morse stable conical connection is the most stable, is implemented in the implant systems.
Avoiding micromovements and avoiding microgaps, so the conical connection seems to be smaller than a bacteria, and a concave emergence profile for aesthetic parameters.
So, if you have the choice, you choose implants that give you these advantages.
A good implant dentist, if he knows the advantages of a feature, of an implant, or the disadvantages, he’s able to choose and to use right the right system, but, if you choose implant systems that have certain features, it makes your life easier.
There are clinicians who are still uncertain, polished colour implants, in a certain way, because they know what the polished colour is doing, they know how the bone behaves, so they insert the implant a little bit deeper, then the soft tissue will come to the polished colour, so there is a strategy behind it.
That is why you always need to know the features in order to understand the advantages of an implant system and to use it accordingly.
Look at the studies of the implant, behind the implant, reliable studies, also the studies that are showing general features, because, for example, about platform switching there are 300 articles over there, so, of course you take something for platform switching.
Also, the certain studies behind the certain system to see if their features are really following those rules. So, both are needed to be followed.
So, that is why, when we use an implant system, and now we know a lot about it, but at that time, this is also a couple of years ago, we checked the properties of an implant system, first in a clinical study over 100 implants, and we evaluated the success rate, the bone loss, the particularities of the aesthetic outcome, based on surgical methods, based on some parameters that we use not only in the choice of the implant system, but also in the surgical procedure, and in the prosthetical procedure.
So, those are all studies that are cemented and checked, the reality, the clinical outcome, in real life of implant systems.