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.

Henriette Lerner, Uli Hauschild, Robert Sader & Shahram Ghanaati

Abstract
Guided implant surgery is considered as a safe and minimally invasive flapless procedure. However, flapless guided surgery, implant placement in post-extraction sockets and immediate loading of complete-arch fixed reconstructions without artificial gum are still not throughly evaluated. The aim of the present retrospective clinical study was to document the survival and success of complete-arch fixed reconstructions without artificial gum, obtained by means of guided surgery and immediate loading of implants placed also in fresh extraction sockets.

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.