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IRSC Follow-up Mr. Fred Senne, the guest speaker (Dentsply), kindly allowed us to give you his slides for reference. Please contact us if you have practice questions or would like to see certain topics presented at IRSC. We look forward to seeing you at the next IRSC meeting on May 9 th . The topic is: The Fixed Hybrid Denture Solution with 4-6 Implants Using the Straumann Dental Implant System presented by Brad Cates of Straumann. Chris Bishop and Savi Abey Implant Restorative Study Club (IRSC) Prosthodonticsin.com

Implant Restorative Study Club March Follow-up

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March 2013 Implant Restorative Study Club sponsored by Dentsply

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Page 1: Implant Restorative Study Club March Follow-up

IRSC Follow-up

Mr. Fred Senne, the guest speaker (Dentsply), kindly allowed us to give you his slides for reference.

Please contact us if you have practice questions or would like to see certain topics presented at IRSC.

We look forward to seeing you at the next IRSC meeting on May 9th. The topic is: The Fixed Hybrid Denture Solution with 4-6 Implants Using the Straumann Dental Implant System presented by Brad Cates of Straumann.

Chris Bishop and Savi AbeyImplant Restorative Study Club (IRSC)Prosthodonticsin.com

Page 2: Implant Restorative Study Club March Follow-up

Dentsply Contacts

Implant Restorative Study Club

Mr. Fred Senne (Regional Manager, West – Laboratory Channel) 800-531-3481 x66285 [email protected]

Clark Beal (Clinical Sales Rep) 440-7830 [email protected]

Alex Schaeffer (District Manager, Laboratory Sales) 773-469-4979 [email protected]

Page 3: Implant Restorative Study Club March Follow-up

THE NEW POWERHOUSE IN IMPLANT DENTISTRY

Page 4: Implant Restorative Study Club March Follow-up

The freedom of unlimited possibilities– patient-specific CAD/CAM abutments for all major implant systems

Page 5: Implant Restorative Study Club March Follow-up

Atlantis BioDesign Matrix™

Atlantis VAD™ (Virtual Abutment Design)

Soft-tissue Adapt™

Custom Connect™

Designed from the final tooth shape

Optimal support soft tissue sculpturing and adaptation to the finished crown

Strong and stable fit –customized connection for all major implant systems

Natural Shape™

Shape and emergence profile are based on the individual patient anatomy

Page 6: Implant Restorative Study Club March Follow-up

Atlantis VAD™ (Virtual Abutment Design) – designed from the final tooth shape

Utilizing the unique Atlantis VAD™ software, Atlantis™ Abutments are individually designed from the final tooth shape. The result is an optimized abutment solution that offers the best possible function and esthetics.

Page 7: Implant Restorative Study Club March Follow-up

• Proprietary software system designs abutments entirely in a virtual environment

• Utilizes optimized 3D scanning of casts

• Integrates technician’s specifications into design

• Automatically detects multiple features/design parameters

• Engineered designs ensurehighest level of precision

Atlantis VAD™ (Virtual Abutment Design)

Page 8: Implant Restorative Study Club March Follow-up

Designed from final tooth shape

The scanned model is transformed into a 3D image, making it possible to create the final tooth shape.

When the desired tooth shapes are decided, the abutments are designed

The final design is checked for fit and occlusal clearance before the abutments are produced

Page 9: Implant Restorative Study Club March Follow-up

Atlantis VAD™ is beyond CAD

• CAD abutment design is humans doing design aided by computers

• Atlantis VAD™ is computers doing design aided by humans

• Part of an integrated, highly optimized process

• Specialized to abutment design– Creates an optimal design to begin with based on

• Anatomy

• Engineering

• Manufacturability

– Never permits an invalid design

Page 10: Implant Restorative Study Club March Follow-up

Value of Atlantis VAD™

• Esthetics – based on the natural tooth shape

• Function – retention, anti-rotation, crown function/failure

• Mechanics – undercuts, fit, low-fracture

• Compensates for misalignments of the implant – angulations, offset

• Open for cooperation and partnerships, such as 3Shape, Dental Wings and 3M

Page 11: Implant Restorative Study Club March Follow-up

Original design

Design based on ideal values:

Result

- Thin distal core

Original

Optimal goal

Feature Original values

Shoulder 0.5 mm

Taper 2.5°

Path of insertion even

Page 12: Implant Restorative Study Club March Follow-up

Manual correction: Option 1

Result

- Reduced taper allows for tighter fit

- Optimal goal still not achieved

Original

Optimal goal

Feature Original values New values

Shoulder 0.5 mm 0.5 mm

Taper 2.5° 1.5°

Path of insertion even even

Page 13: Implant Restorative Study Club March Follow-up

Manual correction: Option 2

Result

- Increase mesial porcelain offset

- Possible conflict with path of insertion

- Optimal goal still not achieved

Original

Optimal goal

Feature Original values New values

Shoulder 0.5 mm 0.5 mm

Taper 2.5° 2.5°

Path of insertion even 3° change

Page 14: Implant Restorative Study Club March Follow-up

Manual correction: Option 3

Result

- Only 1.0 mm for porcelain

Original

Optimal goal

Feature Original values New values

Shoulder 0.5 mm 0.3 mm

Taper 2.5° 2.5°

Path of insertion even even

Page 15: Implant Restorative Study Club March Follow-up

Result- Optimal retention and fit- 1.3 mm available for porcelain- Optimal goal achieved

Feature Original values New values

Shoulder 0.5 mm 0.31 mm

Taper 2.5° 2.12°

Path of insertion even change of 0.7°

The optimized solution: Atlantis VAD™

Original

Optimal goal

Page 16: Implant Restorative Study Club March Follow-up

What Atlantis VAD™ considers

Tissue blanchingSulcus shape

Ideal base shape per tooth

Margin depth from soft tissue

Margin height from implant

Margin follows soft tissue

Margin width relative to implant

Margin smoothness

Core wall thickness

Porcelain thickness

Ideal shoulders

Occlusal reduction

Cusp and fossa positions

Core height

Core keep out zone

Core retention

Core angle limits

Core completion

Taper angle

Cusp angles

Path of insertion

Interproximal reduction

Bevel heights adjustment

Occlusal surface existence

Papilla widths

Papilla positions

Papilla smoothness

Cervical margin visibility

Emergence angle limit

Margin to counterbore distance

Crown emergence angle smoothness

Base emergence angle smoothness

Core shank interference

Cingulum undercut

Papilla undercut

Base undercutOcclusal undercut

Blank limit

Screw exposure

…and more

Page 17: Implant Restorative Study Club March Follow-up

Natural Shape™ – shape and emergence profile are based on the individual patient anatomy

The unique anatomical shape and emergence profile of the abutment nourish long-term soft tissue management and provide optimal support and retention for the final restoration.

Page 18: Implant Restorative Study Club March Follow-up

Teeth are not round

Reference:Wheeler´s Dental Anatomy, Physiology and Occlusion, Major M. Ash, Stanley Nelson

Atlantis™ Abutments are designed from the final tooth shape

Page 19: Implant Restorative Study Club March Follow-up

Atlantis™ Abutments- closest to natural prepared teeth

Atlantis™ patient-specific CAD/CAM abutments

Stock abutments

Page 20: Implant Restorative Study Club March Follow-up

Stock vs. Atlantis™ abutmentAtlantis™ Abutments- optimized function and esthetics

Stock abutmentAtlantis™ patient-specific abutment

Page 21: Implant Restorative Study Club March Follow-up

Soft-tissue Adapt™ – optimal support soft tissue sculpturing and adaptation to the finished crown

The design of each Atlantis™ Abutment takes biology, anatomy and engineering principles into consideration, providing the right conditions for soft tissue to heal and adapt to the finished crown.

Page 22: Implant Restorative Study Club March Follow-up

Design options

Contour soft tissue

Support soft tissue No tissue displacementFull anatomical dimensions

Page 23: Implant Restorative Study Club March Follow-up

Narrow healing situation No tissue displacementSupport soft tissueContour soft tissueFull anatomical dimentions

Page 24: Implant Restorative Study Club March Follow-up

Wide healing situation No tissue displacementSupport soft tissueContour soft tissueFull anatomical dimentions

Page 25: Implant Restorative Study Club March Follow-up

Soft-tissue Adapt™

Courtesy of Dr. Julian Osorio, Dr. Keith Phillips and Dr. Harold van der Burg

Page 26: Implant Restorative Study Club March Follow-up

Custom Connect™ – strong and stable fit – customized connection for all major implant systems

Atlantis™ Abutment connections and abutment screws are specifically engineered and tested for each implant interface for optimal fit, stability and a successful result.

Page 27: Implant Restorative Study Club March Follow-up

Atlantis™ patient-specific abutments forall major implant systems

• Astra Tech

• BioHorizons

• Biomet 3i

• Dentsply Friadent

• Keystone Dental

• Nobel Biocare

• Straumann

• Sybron Implant Solutions

• Zimmer DentalAll trademarks are the property of their respective owners.

Page 28: Implant Restorative Study Club March Follow-up

All interfaces are designed within the constraints of the particular implant and include:• Insertion feature for simplified handling

• Seating surface necessary to maintain tight seal and stability

• Anti-rotation features that also allow the abutment to be accurately indexed to the implant

• Each abutment screw is designed to work optimally with the specific connection and to correspond to the manufacturer’s torque driver

Atlantis™ interface design philosophy

Page 29: Implant Restorative Study Club March Follow-up

Implant interface connection typesA B C

A) Deep conical sealwith indexing feature

B) Planar or shallow cone with internal connection

C) Planar seating surface with external connection

E.g. Astra Tech, NobelActive, Straumann BoneLevel

E.g. Zimmer TSV, 3iCertain, NobelReplace, Keystone Prima

E.g. Nobel Branemark, Straumann Narrow Neck

Seal

Seal

Seal

Anti-rotationAnti-rotation

Anti-rotationInsertion

InsertionInsertion

All trademarks are the property of their respective owners.

Page 30: Implant Restorative Study Club March Follow-up

Atlantis™ quality

• Atlantis™ abutments are required to pass the same testing protocol for regulatory authority clearance as implant OEM products

• Atlantis products are subjected to extensive mechanical testing including extreme geometries (maximum angle, maximum length) in both static and fatigue loading conditions

Page 31: Implant Restorative Study Club March Follow-up

Engineering analysis on Atlantis™

interface designs• Finite Element Analysis (FEA) performed for

every interface design to optimize strength of critical regions

• Validated by mechanical testing

• Various configurations tested

• Component designs optimized via FEA & testing (wall thickness, radii, etc.)

Page 32: Implant Restorative Study Club March Follow-up

Atlantis™ interface design

• All dimensional features of an implant are first characterized in great detail

• Detailed dimensional data are analyzed using statistical methods

• Interface design variables are analyzed and designed to match or exceed functionality of the OEM connection for:

– Ease of insertion

– Anti-rotation

– Precision seal/seating surface

Page 33: Implant Restorative Study Club March Follow-up

Atlantis™ Abutments

• Consistent quality of fit, independent of implant system (higher precision of fit for some interface designs)

• Reliability of functionality equivalent to or better than OEM

• Confidence of FDA cleared product that’s backed by extensive design analysis and mechanical testing

Page 34: Implant Restorative Study Club March Follow-up

Atlantis BioDesign Matrix™

Atlantis VAD™ (Virtual Abutment Design)

Soft-tissue Adapt™

Custom Connect™

Designed from the final tooth shape

Optimal support soft tissue sculpturing and adaptation to the finished crown

Strong and stable fit –customized connection for all major implant systems

Natural Shape™

Shape and emergence profile are based on the individual patient anatomy

Page 35: Implant Restorative Study Club March Follow-up

THE NEW POWERHOUSE IN IMPLANT DENTISTRY