Doctor Peng Dong, the expert of tooth implantation in Peking University International Hospital and president of Beijing Hedu Stomatological Clinic Co., Ltd

CASE OUTLINE

Loose fixed bridge on upper anterior teeth. Carefully extract tooth 2, on the upper right side and tooth 1 on the upper left side. After the healing period, C-Tech implants will be placed in the sites of right upper tooth 2 and left upper tooth 1. After five months, an oxidized zirconia porcelain bridge will be used for the final restoration.

TREATMENT PLAN

For right upper tooth 2, the width of the alveolar bone is 7.6mm, and the height is 13.4mm. For left upper tooth 1, the width of the alveolar bone is 7.4mm, and the height is 14.5mm. C-Tech implants (Model: EL-4311) will be placed in both sites using conventional implantation with simple bone grafting. After a period of five months, the second phase of the surgery will be conducted.

TREATMENT

1. Extract venous blood for the preparation of CGF for later use.
2. Perform standard disinfection and drape the area with cloths. Administer painless local anesthesia to the upper front teeth region. Make horizontal incisions along the alveolar ridge from right upper tooth 2 to left upper tooth 1. Make incisions inside the grooves between right upper tooth 3 and left upper tooth 2. Perform a labial side vertical reduction on right upper tooth 3. Reflect the gingiva and thoroughly clean the wound, observing bone defects on the labial side of right upper tooth 2 and left upper tooth 1.
3. Precisely position the C-Tech implants (Model: EL-4311) in the locations of right upper tooth 2 and left upper tooth 1. Use tapered drills to create boreholes measuring 3.7*13mm for each implant. Implant the C-Tech implants with closure screws. Fill the bone defects and perforations on the labial side with a mixture of bone powder and CGF. Cover the gaps with membrane, and cover the alveolar ridge with another layer of membrane, followed by a layer of CGF membrane. Securely suture the area.
4. After six months, take an impression and replace the restorative abutments with Model: EL-4503F*2. Permanently fix them with adhesive fixation, and apply an oxidized zirconia porcelain bridge for long-lasting restoration.

Dott. Alexandre Minis, France

Case description:
The 55 years old female patient has a lack of prior medical history and is a non-smoker.
There is a fracture under the crown of #12 with infection and vestibular fistula for which a temporary extraction with a valplast for 3 months is performed.
On the control CBCT, low bone volume and evidence of a radiolucent vestibular image initially suggesting fenestration linked to the fistula present before the extraction, or, of the bone being formed.

Surgical dental history:
The surgery is performed using a surgical guide, designed on 3Shape Implant Studio, dentition supported guide 3D printed on a Phrozen Shuffle printer.

Magazine PIP • Practical implantology and implant prosthetics • 08 June 2022

Dentist Michael Weiland: excellent care is important to me!

In times of skilled labor bottlenecks and a fundamental lack of staff, the first thing that many lose is the services that were once seen as so essential. But the more a piece of hardware is interchangeable and discount battles want to be avoided, the more a company stands out from the customer with the many free little help.
Interview with dentist Michael Weiland and his team

pip: How did your first contact with the implant manufacturer C-Tech and Mr. Lütfü Agic come about?
Michael Weiland: I’ve known Mr. Agic for a very long time, for more than ten years, from my time in practice. Four years ago I set up my own practice, but at first I had too much to do with getting the practice up and running. At the same time, a lot was happening within our family – as it is at our age, that often happens alltogether. That’s why I didn’t deal with implantology myself at first and only provided prosthetics at first. Nevertheless, contact with Mr. Agic was never lost, especially since my basic interest continued to exist. Mr. Agic then drew my attention to the further training here at the municipal clinic with Prof. Anton Dunsche.

pip: What is particularly important to you at a training event?
Michael Weiland: Everyone is always talking about ‘take home messages’, and that’s actually what it’s all about. I would like to learn something that I can use in my practice in the relatively short term. In addition to the theory, which you can read up on or acquire through an online event, it is important to me to have the opportunity to try out and practice techniques yourself, preferably with someone at your side who can immediately give you one or two good ones can show tricks and tips. It’s about getting more security for me in my practice. The first course with Prof. Dunsche was just super organized, we learned theory, but also a lot of practice with exercises on the pig’s jaw and later the opportunity to assist Prof. Dunsche himself with surgeries.

pip: So it didn’t stop at this event?
Michael Weiland: No, after that I was given the opportunity to attend a four-day course in Palermo, Italy. They do things slightly differently there, with personal warmth and beautiful surroundings. Everything was very well organized, we even got two translators at our side, so there were no problems here either. For two days we were introduced to the C-Tech system and various surgical techniques, and we were able to use the third and fourth day very intensively for practical exercises and treatments directly on the patient. The two very experienced speakers also supervised this part and took over more complex situations myself, which I might never want to do myself in my practice, but which were exciting to watch. But I also learned an enormous number of new techniques for my areas of application and was able to practice them in such a way that I now feel safe with them. After all, I want to offer my patients the ‘state of the art’ of today’s implantology.

pip: How important is the support provided by Mr. Agic to you?
Michael Weiland: We work directly with and on people, and I personally prefer it if I too am seen as a person. Mr. Agic has never promised too much, is always available and implements my requests incredibly quickly, even if I reach him on the way. I receive all important information promptly and in Mr. Agic I have a good partner for the exchange of ideas, at the same time I never feel pressured. I sometimes think that my time is more important to Mr. Agic than his own, and I can feel that through this great service.

by Dr. Nikos MARDAS, Dr. Nikolaos Tatarakis, Dr. Christos TSAMIS

by Doctor Henriette Lerner, HL-DENTCLINIC DR. STOM. MEDIC.

Magazine PIP • Practical implantology and implant prosthetics • November 2019

Small but powerful. High-quality range with C-Tech system implants.

Full Smile, under the direction of business owner Lütfü Agic, well-known in the field of dental implantology, advises on a high-quality range with C-Tech system implants, biomaterials such as Bioteck, as well as dental and surgical instruments and tools from devemed. How can such a small unit survive in times of ever greater global players in the field of dentistry and what is the reason for a dentist to look for the partnership, asked pip and talked to Stefan Grümer, M.Sc., who runs together with colleagues a large referral practice on Theaterstrasse in Aachen.

pip: Don’t you kind of lose touch with international developments and trends with such a small partner like Full Smile?
Dr. Grümer: That may well be, regarding these international trends. Here, in the Theaterstraße in Aachen, we are a practice with an impressive range of modern services, especially in the field of restorative and aesthetic dentistry. From 3D diagnostics and computer-based functional diagnostics to laser dentistry, we use state-of-the-art and exceptionally gentle treatment methods that are comfortable for the patient. We are focusing strongly on training programs so that our range of services stays up to date with the latest state of science and research. But we do not have to follow any pseudo innovation. Much more important to us is a certain consistency with our commercial partners, because as well as between us and our patients, the cooperation between us and a medical device manufacturer is a matter of trust. It would bother me to have to adjust to a new contact person every few months, who knows neither me nor my treatment philosophy nor knows what my experiences are and what might actually enrich and interest me. Since 2013 I have been running the first university teaching practice in Germany in cooperation with the RWTH Aachen, an international academy with many foreign and extensive research projects – above all in the field of implantology and laser dentistry. Therefore, we are demanding a certain level of consulting expertise and a portfolio at eye level from our partners.

pip: What impressed you most about the C-Tech Implant System?
Dr. Grümer: As a referral practice we naturally work with different systems. Personally, I especially appreciate the C-Tech Implant System because of its system-related features. It is a fully engineered system that provides different implant diameters and lengths for all common indications – up to special designs such as one-piece mini-implants for narrow spaces, abutments or anchoring of dentures. At C-Tech we experience a very high primary stability and a very easy handling and thus a method which is absolutely suitable for everyday use. Furthermore, the aesthetic demands of our patients have increased significantly. With the EL – Esthetic Line – C-Tech offers a special design for these more demanding challenges. Refinements, like the platform switch, a generous apical threading, the morse taper connection and the concave aesthetic concept create a good stability with excellent shaping of the surrounding tissue. Despite a high prosthetic design freedom, the system is very easy to use, but the prosthetic connection is identical to the other implant diameters of the series. So you can get by with a straightforward instrumentation. I also like a whole new service of Full Smile, which I have never experienced before: As a dentist, I can search for any product via Full Smile and, if I found one, I will only pay the same list price as in the catalogue!

pip: What about service and accessibility – how can such a small company compete with companies that are quite different staffed?
Dr. Grümer: In fact, we sometimes ask ourselves the famous question of how often Mr. Agic has been cloned. He’s really frequently on the move and also visits us regularly to exchange ideas with us or to prepare ourselves for a new technique. However, we always reach someone in the office or receive a callback within a very short time – and also in such a short time our request is accepted, a delivery is initiated or a technical question is answered. In fact, with other companies I sometimes spent a lot more time in some telephone loop with automated speech before I can speak to a human being. With individual consultation, the reliable assurance of the desired delivery times and practical training, Full Smile is a professional partner for us in the field of dental implantology, periodontology and surgery.

Magazine PIP • Practical implantology and implant prosthetics • August 2018

Italian passion for German precision

When visiting the impressive manufacturing facility, with 25 CNC machines alone, you will also come across the “Mercedes” of manufacturing technology such as the Swiss Tornos, a five-axis machine, which at C-Tech is purely tasked with the manufacture of mini-implants. Currently they are the largest manufacturer in Europe for this specific type of implant. Mini-implants are popular as a minimally-invasive option for creating an immediate restoration, which is currently a highly sought-after alternative for fast and good functional care of older patients. An impressive neighbour is the Willemin Macodell (the Rolls-Royce of CNC machines), which can be fitted with 48 different CNC cutters. It can change tools in 1.4 seconds and can be used in any conceivable axis, including for the manufacture of angled mini-abutments. C-Tech was one of the first companies to move over to cooling all computer-controlled machine tools using water-miscible bio-lubricants. The plant-based oil is odour-free, improves machining and even has a wider range of applications than mineral oil products. “And even though of course we run extensive cleaning processes for the finished parts, it’s still one risk factor less”, comments Lütfü Agic with respect to the recently published independent surface study by the University of Cologne, where the C-Tech implant surfaces were tested as an example, in testing applied to very few dental implant surfaces on the dental market.

International Journal of Implant Dentistry • August 2017

Исследование состояния периимплантатных тканей и стабильности периимплантатных тканей в имплантатах, вживленных с одновременной аугментацией: анализ 3-годичного ретроспективного наблюдения недавно разработанной системы имплантата на уровне кости.

Jonas Lorenz University Hospital Frankfurt · Department of oral, maxillofacial and plastic surgery, Henriette Lerner HL DENTCLINIC, Robert A. Sader Goethe-Universität Frankfurt am Main · Center of Stomatology
and Shahram Ghanaati Goethe University of Frankfurt/Main; Universitätsmedizin der Johannes Gutenberg-Universität Mainz · Department for Oral, Craniomaxillofacial and Facial Plastic Surgery; Institute of Pathology

Целью настоящего ретроспективного анализа была оценка состояния периимплантатных тканей и документирование стабильности периимплантатных тканей в имплантатах C-Tech при одновременном вживлении с аугментацией НКР (направленная костная регенерация).

47 имплантатов, которые были вживлены одновременно с аугментацией НКР (направленная костная регенерация) с синтетическим заменителем костной ткани 20 пациентам, исследовались клинически и радиологически минимум 3 года после вживления.

Последующее наблюдение показало приживаемость имплантатов 100 % и только низкие средние значения глубины зондирования (2,7 мм) и кровотечения при зондировании (30 %). Среднее значение по шкале розовой эстетики — 10,1, максимальное значение — 14.
Очевидных костных периимплантатных дефектов обнаружено не было. Среднее значение потери кости составляло 0,55 мм.

В заключение следует отметить, что имплантаты, вживленные в сочетании с процедурой НКР (направленная костная регенерация), могут достичь долгосрочного стабильного функционирования и эстетически удовлетворительных результатов при замене отсутствующих зубов в случае атрофии альвеолярного гребня.

Ningxia Med J, Dec. 2017, Vol 39, No. 12

A one year follow up examining bone level preservation utilising platform switching implants

Jianlin Chen, Yuanjie Cao, Lili Shan, Yan Li, Li Ma, Na Wang, Xiuyu Wu Author’s
Unit: Department of Stomatology, Lingwu People’s Hospital, Ningxia

Abstract

Objective The aim of this research is to observe and evaluate the clinical application of the Esthetic Line [EL] implant system (C-Tech, Bologna, Italy). The EL implant has a surface topography created by sandblasting and acid etching (SLA) and a Morse locking conical connection.

Methods 35 patients with one or more missing teeth were selected and a total of 60 EL implants were placed using either a one stage (non-submerged) placement protocol or a two stage (submerged) protocol. Where applicable, second stage surgery was undertaken 2 ~ 4 months post implantation. Subsequent to this the EL implants were permanently restored over a period of 2 ~ 4 weeks. Clinical examination and imaging analysis were undertaken to evaluate clinical success.

Results All 60 implants osseointegrated successfully, and at the one year follow up there was a 100% retention rate and no adverse reactions in the host. Mesial and distal bone heights were recorded on the day of surgery as well as at the fitting of the permanent restoration and after the implants had been functionally loaded for 12 months. Mesial bone heights were (0. 35 ± 0. 49) mm, (0. 18 ± 0. 44) mm and (0. 25 ± 0. 36) mm respectively. Distal bone heights were (0. 20 ± 0. 42) mm, (0. 08 ± 0. 45) mm and (0. 15 ± 0. 38) mm. In the first year of implant functional load, the total absorption of the mesial bone was (- 0. 11 ± 0. 38) mm and the distance was (- 0. 07 ± 0. 31) mm; There was no significant difference in blood indexes between the preoperative and postoperative three months (P < 0. 05).

Conclusion The design of the EL implant incorporating a combination of a parallel walled section with an apical taper, a beveled shoulder, platform switching, a Morse locking conical connection combined with an SLA treated surface and a sophisticated double threaded morphological design all contribute to successful treatment.

Key words Italy; C – Tech Esthetic Line [EL] implant; implant design; surface treatment; Morse-locking.

In recent years, the evolution of implant techniques combined with developments in implant design and restorative techniques has resulted in greater acceptance of implant treatment by the majority of patients. The Stomatology department of our hospital has adopted the Esthetic Line [EL] implant system (C-Tech, Bologna, Italy) for use in our clinic. A study into the clinical results of 60 EL implants placed in 35 patients was undertaken.  

Conclusions

To sum up, the innovative design of the Esthetic Line implant with its sequential thread design, micro-threads to preserve bone at the collar, sophisticated self-cutting and double lead threading preserves bone structure and increases bone to implant contact. This is combined with a SLA surface treatment, a combination of a bevelled shoulder with a platform switching design and a Morse locking conical connection to make it safe and effective in clinical application. The limitation of this study is that the number of cases included is relatively small, only 30 implants of 35 patients were followed up for 12 months. More accurate clinical effect requires more long-term retrospective and prospective clinical observation and research on larger sample size.

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School of Dental Medicine University of Belgrade, Serbia • November 2015

Клинические результаты после горизонтальной аугментации гребня с тканевым трансплантатом костного блока.

Assoc Prof Dr Snezana Colic (School of Dental Medicine University of Belgrade, Serbia)

Целью этого исследования являлся анализ клинических результатов горизонтальной аугментации с аутологичным пересадочным костным блоком для восстановления узкой зубной дуги перед установкой имплантата. Были отобраны восемнадцать пациентов с частичной адентией, у которых недостаточная ширина кости (менее 4 мм) в местах установки имплантатов.
Один или несколько цилиндрических пересадочных костных блоков были собраны при помощи трепана с нижней челюсти и стабилизированы титановыми мини-винтами. Зафиксированные пересадочные блоки были покрыты безбелковой бычьей костной мембраной и коллагеновой мембраной. Среднее количество взятой кости составляло 3,6 мм. Один из 24 пересадочных блоков был потерян в начале периода восстановления. Пять месяцев спустя во время повторного визита для установки имплантатов ширина полученной зубной дуги была измерена. Все имплантаты были поставлены в правильные позиции и считались успешно интегрированными во время периода наблюдения. Через три месяца после установки имплантата было начато протезирование.
Среднее наблюдение после простетической нагрузки составляло 25,4 месяца.

Эта техника является надежным средством коррекции узкой зубной дуги с адентией. Плотный контакт между пересадочным костным блоком и поверхностью реципиентного ложа обеспечивает быструю и интенсивную васкуляризацию, а в последующем — остеоинтеграцию пересадочного костного блока. Добавление бычьего костного минерала и коллагеновой мембраны на пересадочный костный блок минимизирует рассасывание костных тканей во время выздоровления.
Во всех случаях все запланированные имплантаты могут быть установлены в правильных позициях.
Средняя длительность последующего наблюдения за имплантатами составляет 25,4 месяца. Зубное протезирование включало единичные коронки или мосты.
Во время периода наблюдения не был утрачен ни один имплантат. Все имплантаты были успешными как с точки зрения эстетики, так и с точки зрения функциональности.

 

References

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5. Buser, D., Dula, K., Hess, D., Hirt, H.P. & Belser, U.C. (1999) Localized ridge augmentation with autografts and barrier membranes. Periodontology 2000 19:151–163.

6. Buser, D., Ingimarsson, S., Dula, K., Lussi, A., Hirt, H. P. & Belser, U. C. (2002) Long-term stability of osseointegrated implants in aug- mented bone: a 5-year prospective study in partially edentulous patients. International Journal of Periodontics and Restorative Dentistry 22,109–117.

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(BDIZ EDI — Европейская ассоциация стоматологов-имплантологов) Исследование имплантата 2014/2015 • March 2015

Качественный и количественный элементный анализ поверхности имплантата растровым электронным микроскопом и электродиагностикой. ПРЕДВАРИТЕЛЬНЫЙ ОТЧЕТ ИССЛЕДОВАНИЯ

Prof. Dr. Dr. Joachim E. Zöller Interdisciplinary Polyclinic for Oral Surgery and Implantology Dept. for Cranio Maxillofacial and Plastic Surgery, Dr. med. dent. Dirk U. Duddeck Head of Surface Analyses, In cooperation with the European Association of Dental Implantologists BDIZ-EDI Quality & Research Committee

История вопроса и цель
Поверхность имплантатов изменяется при помощи микроструктур и увеличения поверхности с целью улучшения остеоинтеграции. Множественные исследования показали усиление адгезии и формирование остеобластной матрицы на плотных титановых поверхностях.

В 2008 г. Кельнский университет, Германия и BDIZ EDI (Европейская ассоциация стоматологов-имплантологов) вместе с ее Комитетом по качеству и научным исследованиям (www.bdizedi.org) провели сканирующее электронно-микроскопическое исследование и проанализировали поверхности 23 эноссальных титановых имплантатов разных производителей в Междисциплинарной поликлинике челюстно-лицевой хирургии и имплантологии, Отделение черепно-челюстно-лицевой и пластической хирургии, Кельнский университет(1). Протестированные имплантаты имели локализированный и/или обширный налет. В зависимости от производственного процесса было обнаружено накопление органических материалов (налет) или неорганических материалов, например: алюминия, силикона, фосфора, серы, хлора, натрия и кальция.

В 2011–2012 гг. мы проводили такое же исследование на 57 стоматологических имплантатах разных производителей. Производство имплантатов требует надлежащей системы управления качеством. И хотя некоторые производители внесли существенные изменения со времени нашего первого исследования в 2008 г., исследование в 2011–2012 гг. снова выделило несколько имплантатов с большими зонами, пораженными отложениями и некоторыми органическими загрязнениями, губительными для поверхности(2).

Европейскую ассоциацию стоматологов-имплантологов BDIZ EDI(3), в которую входят более 5500 практикующих имплантологов в Европе, на общем собрании попросили продолжать периодически проводить такие анализы и публиковать результаты в Европейском журнале стоматологов-имплантологов (European EDI Journal).

При использовании тех же материалов и методов касательно технических заданных значений это исследование позволяет сравнивать результаты предыдущих исследований.

В качестве продолжения двух исследований, упомянутых ранее, цель исследования — верифицировать улучшения в производстве и управлении качеством, а также продемонстрировать высокий уровень качества участвующих производителей и компаний.

1) Дуддек Д. У. Сравнительное исследование разных поверхностей имплантатов при помощи растрового электронного микроскопа. (Posterpresentation) 18-я ежегодная научная конференция Европейской ассоциации остеоинтеграции, 30 сентября — 3 октября 2009 г., Монако, Франция

2) Дуддек Д. У. и др. Характеристики поверхности и качество имплантатов в стерильной упаковке, Европейский журнал стоматологов-имплантологов (European EDI Journal) 2013-1

3) Европейская ассоциация стоматологов-имплантологов (BDIZ EDI) установила предварительные стандарты для квалификационной процедуры для всех имплантационных систем и ведет структурированное постоянное обучение. Основные задания Европейской ассоциации стоматологов-имплантологов BDIZ EDI — предоставлять поддержку и консультации своим членам, а также улучша