EDI - BdiZ

ISSN 1862-2879 

Issue 1/2011 Vol. 7 

EDI Journal 

European Journal for 

Dental Implantologists 

TOPIC 

Implant abutments 

created by CAD/CAM 

»EDI News: BDIZ EDI at the International Dental Show in Cologne · Coming up: 5th BDIZ EDI 

Mediterranean Symposium · First joint congress of BDIZ EDI and DGOI · An interview with 

Professor Gerhard F. Riegl on success factors for dental offices »European Law: New EU 

Directive: More rights for patients »Clinical Science: An implant-based treatment option 

for periodontally reduced dentitions · Marginal bone loss around endosseous implants · 

Implant abutments created by CAD/CAM · Transitional implants · Reconstruction of a case 

with maxillary atrophy by means of Short Implants and individual IACs

The Exacone implant is included in the libraries 

of the most common implant planning softwares 

(SimPlant® Materialise, Implant3D Medialab, Sicat- 

Galileos Sirona) to permit an accurate treatment 

plan and offer the possibility of fabricating surgical 

guides for a computer-assisted surgery. 

MultiTech is the new abutment specifi cally created 

for CAD/CAM technology used in restorative 

implantology. Its distinctive design favours its 

capturing through dental laboratory or intra-oral 

scanners and the customizing of its emergence 

profi le and angulation. 

Thanks to the absence of a screw hole and its 

consequently high mechanical strength, the geometry 

and specifi c surface of its bonding portion, MultiTech 

allows the realization of a fully patient-customized 

abutment. MultiTech offers the option to choose 

without any restriction among the several CAD/CAM 

methods using aesthetic materials like zirconium 

oxide and lithium disilicate. 

Orthodontics and Implantology 

LEONE S.p.a �� www.leone.it

The 34rd International Dental Show (IDS) in Cologne will again 

offer many surprises in terms of products and procedures. We 

are anxious to learn whether one of the major implant manufacturers 

will dare to embark on the zirconia implant “adventure” 

at IDS. Manufacturers have long been announcing 

ceramic implants, but they have yet to present them in the 

form of products ready for the market. Their presumed excellent 

biocompatibility and aesthetic shade would make these 

implants highly desirable for use in aesthetic dentistry, provided 

they can withstand continuous functional loads and feature 

abutments that are prefabricated but customizable. 

Innovative implant surfaces and treatment concepts based 

on angulated abutments definitely deserve mention. Without 

constant innovation and ongoing improvements to medicinal 

products, we would have fewer implant systems, implant surfaces 

and bone replacement materials today. As it is, however, 

implant dentistry has a large number of highly specific surgical 

techniques and materials available for a broad range of indications. 

But treatment providers and patients alike ask questions 

about the right choice of products and, especially, product safety. 

For example, the promotion of conditioned surfaces hydroxylated 

with hydroxide ions shortly before insertion to achieve 

better primary stability and improved osseointegration during 

the healing phase begs the question of whether reliable clinical 

studies are available to show that these specially conditioned 

surfaces actually result in shortened healing times. 

Another focus at IDS 2011 will be on biotechnological strategies 

for osteogenesis. We are facing an almost endless proliferation 

of synthetic bone replacement materials today. Some 

materials serve as placeholders for natural bone formation, 

while other types of materials are designed to replace autologous 

bone grafts. How well-proven and how successful are 

products such as porcine collagen matrix “straight from the 

blister pack”, designed to replace autologous connective-tissue 

grafts in covering recessions and augmented soft tissue? 

In addition to these developments in dental materials, new 

digital devices are coming more and more into focus with 

dental practitioners – in diagnostics and therapy alike. 

Products range from three-dimensional x-ray units and 

computer-guided implant placement all the way to optical 

scanners replacing conventional impression-taking and even 

automated dental technology procedures. 

In terms of diagnostics, many companies now offer software 

for computer-assisted treatment planning based on CBCT 

images. Oral implantologists will take the opportunity to scan 

IDS for software solutions capable of processing data for as 

many popular implant systems as possible. 

CAD/CAM procedures for manufacturing implant-supported 

restorations include opto-digital processes that dispense with 

plaster casts altogether. Single-session chairside restorations 

using scanner technology could be unveiled at IDS. Automated 

processes in dental technology are supposed to reduce cost. 

The industry has promised that custom components, e.g. for 

the aesthetic zone – which now require manual fabrication – 

could be produced in this way. 

Doubtlessly, recent innovation within oral implantology has 

been driven in large part by scientific progress and by the products 

developed by the dental industry. Prompted by an everincreasing 

demand by dentists and their patients, new products, 

new processes and improved therapeutic methods have 

been brought to market for many indications – from new 

approaches to bone augmentation and novel procedures in 

laser technology to newer materials, not least the now already 

familiar zirconia. Coming from a high level of achievement and 

extremely high success rates compared with other medical procedures, 

ever better results and shorter treatment times are 

not easy to attain. There are limits to what nature will allow us 

to do. In the light of this realization, it is all the more important 

for oral implantologists to avail themselves of opportunities 

for continuing education – to keep up with technical innovations 

and new materials, for the benefit of the patients and 

their own. 

Sincerely, 

Christian Berger, Kempten/Germany 

President of BDIZ EDI 

EDI 

Editorial 

Training and 

education 

must keep up 

with progress 

3

4 EDI 

Table of Content 

EDI News 

The dental world assembles in Cologne 

Kicking off IDS 2011 8 

CAD/CAM developments at breathtaking speed 

Interview with Professor Joachim E. Zöller 10 

Meeting Point Implantology 2011 

BDIZ EDI at the International Dental Show 

in Cologne 14 

Implantology guide 16 

Implantological challenges on Portugal’s coast 

5th BDIZ EDI Mediterranean Symposium, 

10–17 June 2011 20 

Implantology and the dental team 

15th BDIZ EDI Symposium · 8th International 

Annual Congress of the DGOI 24 

PrintStar 2010 nomination for BDIZ EDI konkret 

“Academy Award” of the German printing world 30 

BDIZ EDI Administrator, Bonn office 

Career notes: Dr Dirk U. Duddeck 31 

Biomaterials under scrutiny 

20th International Expert Symposium for 

Regenerative Methods in Medicine and Dentistry 32 

Haemophilia’s little sister 

Third anniversary of the von Willebrand 

syndrome (vWS) network 34 

Finding the right patients 

An interview with Professor Gerhard F. Riegl on 

success factors for dental offices 36 

Europe Ticker 40 

European Law 

New EU Directive: More rights for patients 44 

On the legality of prior authorization requirements 

for outpatient treatment requiring the use of 

major medical devices in a different member state 48 

Clinical Science 

A new therapeutic approach 

An implant-based treatment option for 

periodontally reduced dentitions 50 

Marginal bone loss around endosseous implants 

Comparison of the bone response to dental 

implants with threaded and non-threaded necks 54 

Roads to implant abutments 

Implant abutments created by CAD/CAM 64 


Transitional implants 

A new approach to ridge restoration in cases of 

severe horizontal resorption 78 

A perfect fit 

Reconstruction of a case with maxillary atrophy 

by means of Short Implants and individual IACs 

(Integrated Abutment Crowns) 86 

Business & Events 

Innovations by Dentsply Friadent at IDS 2011 94 

An interview with Frank Bartsch, 

Trade Marketing Manager at Carestream Health 96 

An interview with Professor Daniel Buser and 

Professor Mariano Sanz on the International 

Osteology Symposium in Cannes 98 

MIS Global Conference, Cancun, Mexico, 

19 to 21 May 2011 100 

Thommen Connecting Science Workshop 

during the International Osteology Symposium 101 

TV-Wartezimmer’s market share on the rise 102 

H&H Webranking survey: Nobel Biocare’s 

website breaks top 5 103 

News and Views 

Editorial 3 

Imprint 6 

Product Reports 104 

Product News 107 

Calendar of Events/Publishers Corner 122 

Page 82: 

Inserting a 

transitional 

implant 

with a 

square tip.

© MIS Corporation. All rights Reserved. 

Explore 

360° Implantology

6 


Imprint 


European Journal for Dental Implantologists 

a BDIZ EDI publication 

published by teamwork media GmbH, Fuchstal 

Association: The European Journal for Dental Implantologists (EDI) 

is published in cooperation with BDIZ EDI. 

Publisher Board 

Members: 

Christian Berger 

Professor Joachim E. Zöller 

Dr Detlef Hildebrand, Dr Thomas Ratajczak 

Editor in Chief: Ralf Suckert, r.suckert@teamwork-media.de 

Editors: Anita Wuttke, Phone: +49 89 72069-888, wuttke@bdizedi.org 

Simone Stark, Phone: +49 8243 9692-34, s.stark@teamwork-media.de 

Scientific Board: Professor Alberico Benedicenti, Genoa Dr Marco Degidi, Bologna 

Dr Eric van Dooren, Antwerp Professor Rolf Ewers, Vienna 

Professor Antonio Felino, Porto Dr Jens Fischer, Bern 

Dr Roland Glauser, Zurich Professor Ingrid Grunert, Innsbruck 

Dr Detlef Hildebrand, Berlin Dr Axel Kirsch, Filderstadt 

Professor Ulrich Lotzmann, Marburg Professor Edward Lynch, Belfast 

Dr Konrad Meyenberg, Zurich Professor Georg Nentwig, Frankfurt 

Dr Jörg Neugebauer, Landsberg Professor Hakan Özyuvaci, Istanbul 

Professor Georgios Romanos, Rochester Luc and Patrick Rutten, MDT, Tessenderlo 

Dr Henry and Maurice Salama, Atlanta Dr Ashok Sethi, London 

Ralf Suckert, Fuchstal Professor Joachim E. Zöller, Cologne 

All case reports and scientific documentations are peer reviewed by the international editorial board 

of “teamwork – Journal of Multidisciplinary Collaboration in Restorative Dentistry“. 

Project Management 

& Advertising: 

Marianne Steinbeck, MS Media Service, Badstraße 5, D-83714 Miesbach 

Phone: +49 8025 5785, Fax: +49 8025 5583, ms@msmedia.de, www.msmedia.de 

Publishers: teamwork media Verlags GmbH, Hauptstr. 1, D-86925 Fuchstal 

Phone: +49 8243 9692-11, Fax: +49 8243 9692-22 

service@teamwork-media.de, www.teamwork-media.de 

Layout: Sigrid Eisenlauer; teamwork media GmbH 

Printing: J. Gotteswinter GmbH; Munich 

Publication Dates: March, June, September, December 

Subscription Rates: Annual subscription: Germany € 40 including shipping and VAT. All other countries € 58 including shipping. Subscription 

payments must be made in advance. Ordering: in written form only to the publisher. Cancellation deadlines: in 

written form only, eight weeks prior to end of subscription year. Subscription is governed by German law. Past issues 

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Current advertising rate list from 1/1/2011. 

ISSN 1862-2879 

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Raiffeisenbank Fuchstal BRC 733 698 54 Account No.100 416746 

Copyright and 

Publishing Rights: 

All rights reserved. The magazine and all articles and illustrations therein are protected by copyright. Any utilization 

without the prior consent of editor and publisher is inadmissible and liable to prosecution. No part of this publication 

may be produced or transmitted in any form or by any means, electronic or mechanical including by photocopy, recording, 

or information storage and retrieval system without permission in writing from the publisher. With acceptance of 

manuscripts the publisher has the right to publish, translate, permit reproduction, electronically store in databases, produce 

reprints, photocopies and microcopies. No responsibility shall be taken for unsolicited books and manuscripts. Articles 

bearing symbols other than of the editorial department or which are distinguished by the name of the authors represent 

the opinion of the afore-mentioned, and do not have to comply with the views of BDIZ EDI or teamwork media 

GmbH. Responsibility for such articles shall be borne by the author. All information, results etc. contained in this publication 

are produced by the authors with best intentions and are carefully checked by the authors and the publisher. All 

cases of liability arising from inaccurate or faulty information are excluded. Responsibility for advertisements and other 

specially labeled items shall not be borne by the editorial department. 

Copyright: teamwork media GmbH . Legal Venue: Munich


Enjoy 

The Best Cancun Has To Offer...

8 



IDS will be held in Halls 2, 3, 4, 10 and 11 this year. 

As in 2009, BDIZ EDI can be found in Hall 11.2, Aisle O, 

Stand 059 – again jointly with the legal offices of 

Ratajczak & Partners. 

The organizers – the Society for the Promotion of the 

Dental Industry (GDFI), the commercial arm of the 

Association of German Dental Manufacturers (VDDI), 

in cooperation with Koelnmesse, Cologne – expect 

approximately 1,900 exhibitors from 56 countries, 

with international exhibitors taking a 65 per cent 

share. This year, IDS will additionally utilize Hall 2 of 

the Cologne fairgrounds, for a gross exhibition area 

of 143,000 square metres or about 20 football fields. 

“Given the tremendous response on the part of our 

exhibitors, we hope to repeat the performance of 

2009, when more than 100,000 visitors attended. 

This will further consolidate and expand the position 

of IDS as a global beacon of the dental industry, not 

only with regard to the number of exhibitors, floor 

space or international attendance, but also with 

regard to the number of visitors”, as the organizers 

said in a joint statement. 

In addition to Germany, the most well-represented 

countries include Italy, the U.S., South Korea and 

Switzerland. In addition, there has been sizable 

growth in terms of international cooperation stands 

under the auspices of public or private export-promoting 

organizations or associations. Fourteen such 

cooperations have been registered so far, from 

Argentina, Australia, Brazil, Bulgaria, China, Japan, 

Israel, Italy, Pakistan, Russia, South Korea, Spain, Taiwan 

and the U.S. For 185 exhibitors this will be the 

first time they are represented in Cologne. 

One well-established feature of the IDS program is 

Speaker’s Corner in Hall 3.1, right next to the south 

entrance, where IDS exhibitors will be presenting 

Kicking off IDS 2011 

The dental world 

assembles in 

Cologne 

What is new at IDS 2011? Visitors to the International Dental Show in 

Cologne are looking forward to finding out. On 22 March 2011, the 

gates will open for the world’s largest fair for dentistry and dental 

technology. The first day is reserved for professional visitors. From 

23 to 26 March, Halls 2, 3, 4, 10 and 11 will be open to the general public. 

This year’s focus will be on endodontics and oral implantology. 

information on new products, services and procedures 

throughout the fair. Expert speakers will report 

on recent results and breakthroughs in science and 

technology. 

To make the most of their time at IDS 2011, visitors 

are recommended to plan their visit ahead of time. 

For this purpose, IDS now offers a separate app for 

iPhones, Blackberries, Android and other mobile systems 

comprising the IDS catalogue and an innovative 

navigation system for mobile devices guiding visitors 

safely through the halls and to the stands they wish 

to see. 

Arrival 

Both your trip and your stay can be easily arranged 

online ahead of time, the same is true of registration 

and ticketing at the IDS online shop. The IDS e-ticket 

not only gives you access to the IDS but doubles as 

your ticket for local transportation. The official IDS 

2011 airline is Lufthansa, offering visitors departing 

from more than 250 international 

cities in 100 countries special airfare 

rates. You may also obtain 

reduced-price train tickets on 

Deutsche Bahn to take you to IDS. 

The www.hotelzimmerbuchung.com 

website offers reservation of facilities 

for hotel rooms in Cologne 

and vicinity. For more information, 

please visit the IDS 2011 website at 

www.ids-cologne.de AWU 

IDS at a glance 

Getting started p. 8 

In depth p. 10 

The BDIZ EDI stand p. 14 

Implantology guide p. 16 

Opening hours 

23 to 26 March 2011 

Visitors: 9 am to 6 pm daily


Three Days of 360° Implantology. lantology. Explore 360° 

Implantology: A complete world ld of dental implant resources 

from MIS. An up to date range e of researches, technologies 

and knowledge. And... Enjoy oy the full spectrum of the 

luxurious Cancun fun. 

MIS offers a wide range of implants, innovative e kits and 

accessories that provide creative and simple solutions 

for the varied challenges of implant dentistry. y. 

Make it Simple 

® 

For further information please visit: 

www.mis-events.com/cancun Or visit us at the 

IDS - International Dental Show, Cologne 22-26.03.2011 

Hall 4 Level 2 Booth Number 10L/19N

10 



Interview with Professor Joachim E. Zöller 

CAD/CAM developments 

at breathtaking speed 

What expectations do implant dentists have of IDS 2011? What innovations make sense, and where would healthy scepticism 

be indicated? Professor Joachim E. Zöller, Vice President of BDIZ EDI and scientific director of its symposia, answered the 

editorial team’s questions on the future of oral implantology as seen from the perspectives of the user and the scientist. 


Professor Zöller, what innovations do you expect to 

see at IDS 2011? 

I would think that true innovation can be expected 

in the area of CAD/CAM-supported fabrication of 

implant-supported dentures, and here especially in 

digital impressions. This is where development progresses 

rapidly, and we can soon expect these procedures 

to become a standard adjunct in state-of-theart 

dentistry. We will also see some new developments 

in implant surfaces and bone replacement 

materials, but these I would not go so far as to call 

true innovations. Furthermore, I believe that we will 

be seeing the beginnings of a restructuring of the 

implant market. The roster of exhibitors has changed 

significantly since 2009. A recently published analytical 

study by Morgan Stanley on the dental implant 

market in Germany is highly interesting in this context. 

This study re-evaluates the major players and 

points out the changes that are taking place. 

There have been rumours that one of the big players 

among implant manufacturers might present a zirconia 

implant. Would not this represent a breakthrough 

for ceramic implants? 

At this point, ceramic implants have less than a five 

per cent market share, so they only play a minor role. 

The main reason is that ceramic implants – especially 

in cantilever situations – still have disadvantages 

compared to titanium. A breakthrough could occur 

if we saw significant progress in surface treatments 

and if the stability of the connection between two 

segmented ceramic implants was similar to that 

between titanium implants. 

Speaking of implant surfaces: What is your take on 

surface conditioning, where surfaces are hydroxylated 

with hydroxide ions shortly before placement to 

achieve extra stability and better osseointegration 

during the healing phase? 

Healing rates in healthy patients exceed 95 per 

cent. In other words, current hydrophilic surfaces 

based on the acid-etching technology can be considered 

very mature products. Not least for statistical 

reasons, further optimization would be possible only 

if someone invented a completely new surface offering 

very significant extra benefits. The current “innovations”, 

in my opinion, do not fit this bill. Rather, 

what we hear is mostly the industry’s sales arguments. 

As far as the healing phase is concerned, we 

are actually very familiar with the processes governing 

physiological bone healing. Thinking that we can 

cheat nature is a mistaken belief. 

But are there any reliable studies showing that shorter 

healing times can be achieved only with specially 

conditioned surfaces? 

Consolidating bone fractures will be tentatively 

stable after six weeks and functionally stable after

Cone-beam 

computed 

tomography 

(CBCT) is making 

further advances. 



eight to ten weeks. If we allow for a safety margin of 

two weeks, we have arrived at today’s healing times. 

My question is: Who is actually interested in shortened 

healing times? Does shortening the healing 

times by two to four weeks really help the patient? 

Or is this a phenomenon similar to the immediateplacement 

fad? Here, too, we have seen that this only 

works reliably in certain situations. 

Can we expect anything revolutionary at IDS regarding 

abutments and superstructures? What are you 

personally on the lookout for? 

I think we will see the trend toward custom abutments 

continue. We have already seen a lot of developments 

in this field in recent years. But here, too, 

ceramic abutments will be accepted only in the aesthetic 

zone. We continue to experience massive problems 

with these abutments in the posterior region. 

CAD/CAM procedures for manufacturing implant-supported 

restorations now include opto-digital processes 

that dispense with plaster casts altogether. Automated 

processes are supposed to reduce cost. The industry 

has promised that custom components, e.g. for the 

aesthetic zone, which now require manual fabrication, 

could be produced in this way. Single-session 

chairside restorations using scanner technology could 

be unveiled at IDS. Does that not sound promising? 

The important breakthrough for CAD/CAM procedures 

for manufacturing implant-supported restorations 

will come once intraoral digital impressions are 

ready for use in clinical practice. Here I expect digital 

images to be available in a matter of milliseconds, 

just as with present-day impression trays. Once this 

problem has been solved, and solved in a practical 

manner, I am sure that this impression technique will 

replace all conventional laboratory procedures, with 

very few exceptions. This will not only mark the end 

of all outsourcing of laboratory services to far-away 

countries – domestic laboratories, too, will have to 

completely revamp their processes in order to survive. 

11 

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12 



Just imagine: In the future you can have a scan taken 

of your adult daughter, and if she really should lose 

a tooth later on, she will simply have one milled. I 

am certain that we will see new possibilities evolve 

with tremendous speed. 

In diagnostics, the three-dimensional planning system 

hype appears to be subsiding. Although CBCT units 

have significantly come down in price, they still cost 

twice as much as conventional radiography. What circumstances, 

in your opinion, would justify the higher 

cost, extra time and the extra training needed to evaluate 

the results? 

I am sure clinical reality will provide the answer for 

that. Whether we like it or not: implantological diagnostics 

will increasingly be three-dimensional, with 

two-dimensional procedures restricted to very clearcut 

clinical situations. So CBCT will definitely not be 

reserved for particularly severe or complicated cases, 

as we thought not too long ago; time has passed us 

by. And once we have precision diagnostics available 

anyway, we will want to transfer the treatment planning 

data to the result as well. Over the long haul, 

the patients themselves will expect this. I believe 

that navigated template-guided implant insertion 

will become standard in the foreseeable future, a 

development that will be driven not least by cheap 

CAD/CAM-produced templates. 

I am sure you have been looking particularly closely at 

biotech strategies for osteogenesis. There is an almost 

endless proliferation of synthetic bone replacement 

materials. How well-proven and how successful are 

products such as porcine collagen matrix “straight 

from the blister pack” designed to replace autologous 

connective-tissue grafts in covering recessions and 

augmented soft tissue? 

It is true that “new” bone replacement materials 

are marketed at a rapid pace, but many allegedly new 

products are simply old wine in new bottles. For 

many of these materials, there has been hardly any 

clinical testing, or at least not at a higher level of evidence. 

Here the industry benefits from a tendency on 

the part of many dentists to try something “new” in 

order to chase the potential benefit rather than opting 

for well-proven products. 

When do you think that bone cultivated from bonemarrow 

stem cells will be ready for the market? 

Billions are being invested in stem cell research 

every year, all over the world. This field of research 

receives the most support. Ultimately, I believe that 

we will be seeing entirely new ways of practicing 

medicine opening up. Take diabetes mellitus or 

myocardial infarction. Here we will be able to effec- 

tively treat the causes rather than 

prescribing drugs to treat the 

symptoms. Compared to that, producing 

bone for various medical 

applications will be a minor problem. 

We will be able to generate 

bone tissue, not only complete 

with cortical and spongious bone 

but also complete with all other 

components such as blood vessels. 

This so-called tissue printing is 

the objective of massive research 

efforts. But we will probably see 

another five to ten years go by 

before we can proceed to clinical 

testing of initial applications. Even 

though stem-cell products are 

introduced every now and then, 

we are still a long way from any 

mature clinically products. 

What does the future hold for 

bone augmentation? Could laser 

technology offer new impulses? 

Industry protagonists hope to 

develop consistently porous 

moulded bodies to replace autolo- 

Bone replacement materials: 

gous grafts. They could improve 

The familiar and the new. 

the success rates in lateral-access 

augmentation procedures using bone replacement 

materials. I do not believe that bony integration of 

these moulded bodies will be good enough in the 

case of vertical augmentation. Overall, these products 

might constitute an interim solution until viable 

stem-cell products are available. 

Our last question will prompt you to take a peek at 

the future: Can we expect to see new treatment concepts 

in oral implantology? 

I think that we will see new treatment concepts 

related to CAD/CAM-produced implant-supported 

restorations. Here we will see an avalanche of new 

technologies, with considerably falling costs as a 

consequence, making laboratory products significantly 

cheaper. With regard to the surgical aspects of 

oral implantology, we would be well advised to continue 

standardizing current treatment concepts and 

their variants so that patients can be offered low-risk 

treatment and high success rates. This level of quality, 

however, will always have to have its price. 

Professor Zöller, thank you very much for this insightful 

look into the future of oral implantology. 

AWU

© Nobel Biocare Services AG, 2011. All rights reserved. Nobel Biocare, the Nobel Biocare logotype and all other trademarks are, if nothing else is stated or is evident from the context 

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14 



BDIZ EDI at the International Dental Show in Cologne 

Meeting Point Implantology 2011 

We offer high-profile continuing education and training. Our support for dentists when it comes to private-patient billing issues 

in Germany is second to none. Like a well-trained rescue dog, BDIZ EDI sniffs out what implantological clinics are missing in terms 

of education and legal and accounting advice. The main beneficiaries of these efforts are BDIZ EDI’s members, whom we would 

like to welcome to the BDIZ EDI stand at IDS 2011 in Cologne (Hall 11.2, Aisle O, Stand 059) to meet the people behind the scenes. 

At the 34th IDS, BDIZ EDI will have a joint stand with 

the legal offices of Ratajczak & Partners. As an expert in 

medical law, Dr Thomas Ratajczak has been a knowledgeable 

partner of the BDIZ EDI Board and members 

for many years and provided legal counsel. “Our 

Meeting Point Implantology is meant to assemble 

and focus all the available expertise and to demonstrate 

the support that BDIZ EDI can offer implant 

dentists”, says BDIZ EDI President Christian Berger. 

New: Implantological guideline 

“Implants without augmentation” 

In early March, the European Consensus Conference 

(EuCC) held a meeting in Cologne under the auspices 

of BDIZ EDI. The result was a new implantological 

guideline, the sixth to be issued so far. At IDS, the 

guideline, which addresses the issue of implants 

without augmentation, will be available fresh off the 

press. The other five guidelines published to date, on 

immediate loading (2006), ceramics (2007), periimplantitis 

(2008), 3-D imaging (2009) and complications 

(2010) can be downloaded from the BDIZ EDI 

website at www.bdizedi.org (change to English, 

select Professionals, choose the desired guidelines 

from the menu on the left). 

New: Testing implant surface materials 

The second qualitative and quantitative elemental 

analysis of the surfaces of more than 40 different 

makes of sterile-wrapped implants, presumably one 

of the most comprehensive worldwide, was conducted 

by BDIZ EDI jointly with the University of Cologne 

in 2010. Its findings, made possible only by the use of 

the scanning electron microscope, included improperly 

milled threads, implants with remarkably high 

levels of sandblasting residue and even implants 

with systematic organic contaminants. Significant 

improvements to a number of implants had already 

BDIZ EDI will be at Hall 11.2, Aisle O, Stand 059. 

followed the first publications of the results by BDIZ 

EDI. In a comprehensive follow-up study, numerous 

implants by other manufacturers are currently being 

examined using the same study protocol. The objective 

is to obtain an overview of the surface characteristics 

of as many implants on the market as feasible. 

For the first time, this research will also include zirconia 

implants, mini-implants and intermediate structures 

in the SEM analyses. If you are curious to find 

out how “your” implant has fared in this study, just 

visit us at the BDIZ EDI stand. 

Learn more at the BDIZ EDI stand! 

Any questions? We will be happy to provide answers. 

Of course, the BDIZ EDI Board will be present on-site: 

Presidents Christian Berger and Professor Joachim E. 

Zöller, Treasurer Dr Heimo Mangelsdorf, Secretary 

General Dr Detlef Hildebrand, Managing Director and 

Secretary Dr Stefan Liepe, as well as the Administrator 

of the BDIZ EDI Bonn office, Dr Dirk U. Duddeck. We 

will be happy to try to answer any questions you may 

have – whether on BDIZ EDI symposia, on curricula or 

on material testing procedures. 

AWU

110301_WH_AD_ELCOMED_A4_AEN_IDS:Layout 1 01.03.11 12:20 Seite 1 

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16 



Implantology guide 

Company Hall Aisle Stand 

3M Espe AG 4.2 G + J 090 + 099 

+ 091 

ACTEON Germany GmbH 10.2 N + O 060 + 069 

Advanced Technology Research ATR s.r.l. 11.2 R 051 

AESCULAP AG 10.1 C + D 020 + 029 

Alpha-Bio tec. 4.2 G 020 

ANTHOGYR 11.1 C + D 040 + 041 

Aseptico, Inc. 10.2 T 015 

Astra Tech AB 3.2 A + C 

C + E 

010 + 019 

AVINENT IMPLANT SYSTEM, S.L. 4.1 D 040 

B.T.I. Deutschland GmbH 3.2 E + F 020 + 029 

Bego Implant Systems 10.2 M + N 018 + 029 

020 + 029 

N + O 028 + 029 

Bien Air 10.1 H + J 050 + 059 

BioHorizons GmbH 4.1 A 039 

BIOMET 3i 4.2 J + G 039 + 030 

BIOTECK s.r.l. 11.1 J 017 

Bontempi Medizintechnik GmbH 4.1 C 100 

BPI Biologisch Physikalische Implantate 

GmbH & Co. KG 

4.2 K 040 

B-Productions GmbH 10.2 R 068 

bredent medical GmbH & Co. KG 11.1 B + C 010 + 019 

BTI Biotechnology Institute, S.L. 3.2 E + F 020 + 029 

BTLock s.r.l. 11.1 F 038 

C. Hafner GmbH + Co. KG Goldund 

Silberscheideanstalt 

CAMLOG Biotechnologies AG 11.3 A + B 

+ C 

10.2 R 011 

010 + 019 

018 + 019 

Carestream 10.2 T + U 040 + 041 

+ 043 

Carl Martin GmbH 10.2 N + O 020 + 021 

Carlo de Giorgi SRL. 11.2 L 049 

Champions Implants 11.1 B 008 

Clinical House Europe GmbH 2.2 D + E 010 + 011 

Curasan 4.2 L + M 038 + 039 

Degradable Solutions 10.1 J 064 

DENTATUS AB 10.1 K 050 

DENTAURUM IMPLANTS GmbH 10.1 F 014 

DENTECH CORPORATION 10.2 V 023 

Dentech Dental Instruments 

Manufacturer & Trade 

4.2 G 008 

Dentegris Deutschland GmbH 11.2 K 051 

Dentium USA 4.2 K + L 060 + 061 

DENTSPLY Friadent GmbH 11.2 K + L 018 + 019 

020 + 021 

018 + 019 

020 + 021 


DEPPELER S.A. 10.2 T 025 

DIO Corporation 4.1 A 030 

DOT GmbH 11.2 N 063 

Dr. Ihde Dental GmbH 10.2 O 059 

Dyna Dental Engineering b.v. 10.2 S + T 068 + 069 

DZR 3.2 A 015 

EQUINOX MEDICAL TECHNOLOGIES BV 10.1 B 048 

FairImplant 4.1 F 101 

Gebrüder Martin GmbH & Co. KG 4.2 G 028 

Geistlich 4.2 G 031 

General Implants GmbH 11.1 G 011 

Ghimas S.p.A. 4.1 B + C 070 + 071 

GlaxoSmithKline 11.3 K + L 020 + 029 

HADER SA 10.1 G + H 048 + 049 

Hager & Meisinger GmbH 10.1 G + H 019 + 028 

+ 029 + 

030 + 039 

Hager & Werken 4.1 A + B 070 + 079 

Hauschild & Co. KG 10.2 S + T 068 + 069 

Helmut Zepf Medizintechnik GmbH 10.1 C 041 

Henry Schein 10.2 L + M 040 + 049 

+ 048 

Heraeus Kulzer GmbH & Co KG 10.1 A + B 

+ C 

010 + 019 

010 + 019 

HI-TEC IMPLANTS LTD 3.2 F + G 028 + 029 

Hu-Friedy Mfg. Co., Inc. 10.1 D + E 040 + 041 

IDI SYSTEM (IMPLANTS DIFFUSION 

INTERNATIONAL) 

4.1 D 041 

Implant Direct 4.1 C 012 

Imtegra OHG 4.1 C 018 

Institut Straumann AG 4.2 G + K 080 + 089 

Intra-Lock International, Inc. 4.2 N 048 

J+K Chirurgische Instrumente GmbH 10.1 K 061 

Jakobi Dental Instruments 11.3 F 060 

KaVo 10.1 J + K 

H + J 

J + K 

J + K 

H + J 

Keystone 11.1 A 050 

K.S.I.-Bauer-Schraube GmbH 10.2 S 048 

Karl Hammacher GmbH 10.1 C 031 

KOHLER Medizintechnik GmbH & Co. KG 10.2 L 029 

030 + 031 

040 + 041 

010 + 019 + 

020 + 021 

028 + 029 

018 + 019 

Komet Gebr. Brasseler GmbH & Co. KG 10.2 U + V 010 + 019 

LEADER ITALIA SRL 10.2 U 019 

LEONE s.p.a. 4.1 A 068

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MATERIALISE DENTAL NV 4.2 J 019 

MECTRON S.P.A. 10.2 O + P 040 + 041 

med3D GmbH Implantology 10.2 R 011 

medentis medical GmbH 3.2 C + E 030 + 039 

Medizintechnik Gulden 11.3 B 014 

Medical Instinct 3.2 E + F 058 + 059 

MegaGen Implant Co., Ltd. 3.1 H 051 

Merz Dental GmbH 10.2 T + U 038 + 039 

Metoxit AG 4.1 B 006 

MIS 4.2 N + L 019 + 010 

MK1 Dental-Attachment GmbH 11.1 A 057 

J. Morita 10.2 R + S 040 + 049 

+ 042 

MOZO-GRAU, S.L. 4.1 D 078 

Nemris GmbH & Co. KG 4.1 B 029 

NEOSS GmbH 4.2 K + L 090 + 099 

Nobel Biocare Deutschland GmbH 10.1 D + E 010 + 019 

NOUVAG AG 11.1 F 059 

OMNIA S.p.A. 4.1 C + D 088 + 089 

Orangedental 11.2 M + N 040 + 049 

OSSTELL AB 3.2 E 070 

OSSTEM IMPLANT Co., Ltd. 4.1 A + B 010 + 019 

OT medical 3.2 F + G 030 + 039 

Otto Leibinger GmbH 4.2 G 100 

POLYDENTIA SA 10.2 R 050 

Promedia 10.2 V 029 

RESISTA Ing. Carlo Alberto Issoglio 

& C. S.R.L. 

10.2 T 049 

Resorba 3.2 A 048 

Riemser 3.2 C 040 

SAE DENTAL VERTRIEBS GmbH - 

INTERNATIONAL 

10.2 V 058 

Schlumbohm GmbH & Co. KG 10.2 U 030 

Schütz-Dental GmbH 10.1 G + H 010 + 019 

SICAT 10.2 O + P 010 + 029 

SIC invent AG 4.2 N + L 089 + 080 

Sirona Dental Systems GmbH 10.2 N + O 

+ P 

Si-tec GmbH 4.1 B 020 

Southern Implants GmbH 3.2 A 008 

steco-system-technik GmbH & Co. KG 11.1 D 008 

Stoma Dentalsysteme GmbH & Co. KG 10.2 U 011 

010 + 019 

+ 029 + 009 

Straumann GmbH 4.2 G + K 080 + 089 

Sybron Implant Solutions GmbH 10.1 J 029 

Talladium International 10.2 T 037 

T.B.R. GROUP SUDIMPLANT SA 11.2 N + O 030 + 031 

Tecnoss Dental s.r.l. 10.1 A 031 

Thommen Medical AG 4.2 N + L 091 + 090 


TRI dental 11.1 G 011 

Trinon Titanium GmbH 11.3 G 038 

Ustomed Instrumente Ulrich Storz 

GmbH & Co. KG 

10.1 A + B 048 + 049 

Wegold Edelmetalle AG 4.1 B + D 020 + 030 

+ 039 

Wieland Dental + Technik GmbH 

& Co. KG 

10.1 F + G 018 + 020 

+ 029 

W & H 10.1 C + D 018 + 019 

YDM CORPORATION 4.1 D + C 071 + 070 

ziterion GmbH 4.2 G 040 

ZL Microdent-Attachment GmbH 

& Co. KG 

10.1 P + Q 038 + 039 

Z-Systems AG 4.1 E 013 

Zimmer Dental 3.2 C + E 020 + 029 

Important addresses 


BDIZ EDI 11.2 O 059 

BZÄK/DGZMK/KZBV 11.2 O + P 050 + 059 

DAISY – Akademie und Verlag 11.2 S 009 

Deutscher Ärzte-Verlag 11.1 E + F 008 + 009 

DGOI 2.2 A 011a + 011 

DGZI 4.1 C 063 

Quintessenz Verlags-GmbH 11.2 N + O 

+ P 

008 + 009 

Spitta Verlag 11.2 P + Q 020/029 

teamwork media Verlag 11.1 F 008 

Zahnärztlicher Fachverlag/DZW 11.2 N + O 049 + 049

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20 



5th BDIZ EDI Mediterranean Symposium, 10–17 June 2011 

Implantological challenges 

on Portugal’s coast 

In 2011, as in previous years, BDIZ EDI will continue its proven concept of holding continuing education 

courses outside Germany. This year’s Mediterranean Symposium will be held in Portugal. 

If you are looking for a high-class continuing education event and a relaxing environment for 

the whole family, the 5th BDIZ EDI Mediterranean Symposium will be the right choice for you. 

Together with its Portuguese partner organization, 

the Sociedade Portuguesa de Cirurgia Oral (SPCO), 

BDIZ EDI will be holding an international congress 

at Lisbon, the Portuguese capital, followed 

by a week of lectures and workshops – and quality 

time for you to unwind together with your family 

– in the Atlantic resort of Estoril, next to larger 

Cascais. 

The all-day symposium will take place at the 

Pestana Hotel in Lisbon on Saturday, 11 June 2011. 

The topic of the 5th Mediterranean Symposium 

will be ”Clinical Challenges in Oral Implantology.” 

Simultaneous interpretation will be available for 

the presentations of the Portuguese speakers; the 

German speakers will present in English. The scientific 

program has been compiled jointly by Professor 

Jo achim E. Zöller, Cologne, and Professor Antonio 

Felino, Porto. 

The venue for the continuing-education week will 

be the Atlantic Coast, a place of spectacular beauty. 

Cascais/Estoril offers sunshine, beach life and an 

attractive coastscape, sailing and golfing opportunities 

– and the area also has a lot to offer for those 

interested in history. Many buildings go back to the 

heydays of the Portuguese seafarers. Once again 

this year, symposium attendees can learn something 

where others spend their holidays. 

Lisbon yesterday and today 

Lisbon, the Portuguese capital, has 560,000 inhabitants 

within its administrative limits (more than 

2 million overall) and is known as the City of the 

Seven Hills. From its commercial port in the bay of 

the Tejo River, Portuguese sailors set out to conquer 

the world starting in the late 15th century. The 

city has many sights worth seeing – starting with 

the Belem Tower, the widely visible defence tower 

dating back to the 16th century and certainly not 

ending with the fascinating “azulejos”, the blue tiles 

that still adorn many houses in the old city, originally 

introduced to Portugal by the Moors. 

Portugal’s Estoril coast 

An exclusive resort long frequented by the local 

nobility, Estoril is less than 30 km away from Lisbon – 

about half an hour by car. Given this short distance, it 

is probably a good idea to spend the entire time at 

the Palácio Estoril Golf & Spa, riding in to Lisbon only 

for the symposium itself. The Palácio is probably the 

most well-known and certainly the most beautiful 

hotel in town and has a five-star rating. The rooms 

with their marble bathrooms are lavishly and comfortably 

furnished. The hotel itself was built in 1930 and

Elegance and 

refinement 

in the most 

beautiful hotel 

in Estoril: The 

Palácio Estoril. 

radiates elegance and refinement. It was the refuge 

for many eminent personalities during World War II. 

Famous films were shot here as well, including a James 

Bond film, “On Her Majesty’s Secret Service”. The beach 

is only 200 m away from the hotel with its 161 rooms 

and its renowned restaurants featuring local specialties 

and international cuisine, a gourmet grill, piano 

bar, ocean water swimming pool and sun terrace. During 

World War II, Bar Estoril was a popular meeting 

point for spies. Today the place offers an atmosphere 

of classical charm and a view of the poolside gardens. 

The hotel’s own golf course, the Parcour Golf do 

Estoril, is located only 5 km northeast of the hotel. 

One of Europe’s largest casinos is within walking distance, 

with one of the most beautiful beaches, Praia 

do Tamariz, directly adjacent. 

Schedule of events 

EDI 21 

Participants and their families can enjoy a one-week 

stay in rooms with a highly exclusive ambience 

(breakfast included) at the Palácio Estoril Golf & Spa 

in Estoril or, alternatively, two nights (10 – 12 June) at 

the Real Palácio in Lisbon and then move to the 

Palácio Estoril. The arrival date is 10 June. The international 

symposium and dental exhibition will take 

place at the Pestana in Lisbon on Saturday, 11 June. 

An interactive week of continuing education begins 

at the Palácio Estoril Golf & Spa on Monday, 13 June, 

and continues through Thursday, 16 June. Friday, 

17 June, will be the day of departure. 

AWU

22 



Symposium Saturday, 11 June 2011; Pestana Hotel, Lisbon 

08:45 – 09:00 am Professor Antonio Felino, Porto 

Christian Berger, Kempten 

✁ 

Fax your registration to: 

+49 89 72069023 

or send an e-mail to: 

office-munich@bdizedi.org 

or send to 

BDIZ EDI 

Lipowskystr. 12 

81373 Munich 

Germany 

Welcoming address 

09:00 – 09:25 am Professor João Carames, Lisbon Rehabilitation of the atrophic maxilla: New strategies 

09:30 – 09:55 am Dr Nuno Braz de Oliveira, Sesimbra Management of complex cases 

10:00 – 10:25 am Dr Roque Braz de Oliveira, Sesimbra Multi-detail management of the anterior maxillary segment – clinical cases and 

science 

10:30 – 11:00 am Coffee break · Exhibition visit 

11:00 – 11:25 am Dr Ricardo Faria Almeida, Porto Immediate implants and immediate function in the aesthetic zone – new challenges 

11:30 – 11:55 am Dr Francisco Salvado, Lisbon Bone regeneration: Bone, biomaterials and tissue engineering 

12:00noon–12:25 pm Professor Hakan Özyuvaci, Istanbul Reflections on 3D imaging in oral surgery and implantology 

12:30 – 12:55 pm Professor Joachim E. Zöller, Cologne Augmentation: Different techniques and different materials – high risk, low risk 

1:00 – 2:30 pm Lunch · Exhibition visit 

2:30 – 2:55 pm Dr Detlef Hildebrand, Berlin The TEAM-BERLIN-CONCEPT: Planning and implementation of implants 

in complex cases – a team approach 

3:00 – 3:25 pm Professor Antonio Felino, Porto The importance of bone-preserving surgical techniques for subsequent 

implantation procedures – clinical practice 

3:30 – 3:55 pm Coffee break · Exhibition visit 

3:55 – 4:20 pm Dr Dirk U. Duddeck, Cologne Comparative investigation of various implant surfaces by SEM analysis – 

a surprise in the land of microns 

4:25 – 4:55 pm Professor João Carlos Ramos, Coimbra Immediate implants: From investigation to clinical practice 

5:00 – 5:30 pm Professor Antonio Felino 


Final Discussion 

Interactive education at the Palácio Estoril in Estoril: Monday, 13 June to Thursday, 16 June. 

Registration 

5th BDIZ EDI Mediterranean Symposium (11 June 2011), Pestana Hotel, Lisbon 

Continuing-education week, Palácio Estoril Golf & Spa Hotel, Estoril, 13 to 16 June 

Travel and accommodation: 

10–12 June Lisbon: Hotel Real Palácio ***** / with breakfast 

Doubles: € 78 per person per night, Singles: € 139 per person per night 

12–17 June Estoril: Hotel Palácio Estoril ***** / with breakfast 

Doubles: € 130 per person per night, Singles: €230 per person per night 

For reduced rates for children and prices for extension days, please inquire. 

Event charge 

Until 15 April € 480, after 16 April € 680 

(including the symposium and one week of interactive continuing education) 

Booking through a different travel agency or registering for the continuing-education course only 

is subject to a € 500 surcharge. 

For travel and course details please visit www.bdizedi.org (Events). 

I want to attend the 5th BDIZ EDI Mediterranean Symposium (10–17 June 2011). Please contact me. 

Surname, Firstname 

Street, Number 

Postal Code, City 

Contact, Phone, E-Mail 

Signature 

Each participant will be awarded 8 CE points per day.

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24 



Teamwork and collaboration will be the central issue 

at this congress – collaboration between the two 

organizing associations, of course, but mainly collaboration 

between the patient, dental nurses and assistants, 

dental technicians and dentists. Professor 

Joachim E. Zöller, Professor Georg-H. Nentwig, Dr Georg 

Bayer and Christian Berger have also collaborated – on 

creating the schedule of events and on selecting the 

speakers. The result is a top-notch program with international 

contributions that neither dentists nor their 

teams nor dental technicians should miss. 

The presentations during the two congress days 

include the entire range of what is important for oral 

implantologists and their teams. The congress will 

be kicked off on Friday by the Young Implantologists 

Forum and the first industry workshop session. The 

main podium for all attendees will feature Professor 

Wilfried Wagner discussing serious risks that can be 

present in the oral cavity, e.g. in osteoporosis patients, 

and the treatment providers must beware of. Dr Jörg 

Neugebauer will present information about the 

application, cost and benefits of CBCT in the dental 

practice. Marketing professional Professor Gerhard F. 

Riegl will speak about the factors that make a dental 

office or clinic a success. Dr Gerd Körner and Dr Josef 

Diemer will report on periodontal treatment prior to 

implant placement and on tooth preservation from 

the endodontist’s point of view. BDIZ EDI legal advisor 

Dr Thomas Ratajczak will inform the audience on 

issues to keep in mind when informing patients of 

available treatment alternatives. After a final discussion 

on this set of topics, a second industry workshop 

session will conclude Friday’s business. 

15th BDIZ EDI Symposium · 8th International 

Annual Congress of the DGOI 

Implantology and 

the dental team 

Two organizers, one event: All systems are go for the joint congress of BDIZ EDI and DGOI in Munich on 16/17 September 2011. 

All spotlights are highlighting “Implantology and the dental team”. The five-star Hotel Sofitel Munich Bayerpost – next to the 

central railway station – has once again been selected as the pivotal point for dentists, dental nurses and assistants, dental 

technicians, the dental industry and of course the speakers at this two-day continuing-education event. In anticipation of 

Oktoberfest, scheduled to start the same weekend, BDIZ EDI and DGOI would love to see all attendees visit the special 

pre-Oktoberfest held in the Löwenbräukeller’s Oktoberfest “marquee”. 

Oktoberfest marquee 

The evening will be rustic: In anticipation of Oktoberfest, 

scheduled to start the same weekend, BDIZ EDI 

and DGOI would love to see all attendees visit the 

Oktoberfest “marquee“ at Löwenbräukeller on centrally 

located Stigelmaierplatz. Pre-Oktoberfest means 

that we will be getting a head start by one day – 

the day before the traditional tapping of the barrel 

by Munich’s mayor. Many Oktoberfest aficionados can 

hardly wait to celebrate in the traditional manner 

and to savour the classic Oktoberfest atmosphere – 

enjoying Bavarian music and cabaret artists, and not 

least hearty food and drink. 

The implantological world 

assembles in Munich 

The entire world – it is said – will assemble in Munich 

at Oktoberfest. The implantological world, too, will 

assemble in Munich that weekend – with global 

speakers adding international flair: Speakers Dr Carl 

Misch (USA), Dr Eduardo Anitua (Spain) and Dr Maurice 

Salama (USA) will kick off Saturday’s program by 

discussing immediate vs. delayed implant placement, 

results achieved with short implants and orthodontic 

treatment before and after implant placement. 

Hard-tissue and soft-tissue aspects will be highlighted 

by Professor Joachim E. Zöller and Dr Stefan 

Reinhardt in their presentations on differential indications 

of augmentation techniques and materials and 

on new aspects in soft-tissue management, respectively. 

The presentations after lunch will once again

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Pre-Oktoberfest 

A contiguous section of seats has been reserved 

for BDIZ EDI and DGOI in the “Wiesn Marquee” at 

Löwenbräukeller on 16 September 2011. The ticket 

price of €38 p.p. includes a voucher for food and 

drink worth €16. While you may expect to see 

some guests in traditional Bavarian attire, there is 

no specific dress code. Sturdy clothing is recommended. 

address the entire team. Dr Fred Bergmann will shed 

some light on the interaction between surgical and 

prosthetic issues and discuss patient management. 

Professor Daniel Edelhoff will discuss whether CAD/ 

CAM is ready to replace conventional impressions. 

Implantologists and dental technicians alike are also 

the presumptive audience of the presentation by 

Peter Finke on potential laboratory and prosthodontic 

complications. 

Late Saturday afternoon also has something in 

store for everyone: managing complications in 

referred patients (Dr Michael Stiller), “correct” billing 

for implantological treatments (Dr Hans-Joachim 

Friday, 16 September 2011 

Scientific program 


08:00 – 10:00 am Young Implantologists Podium 

10:00 – 10:15 am Discussion 


10:30 am – 12:00 noon Workshop Session I 

12:00 noon – 1:00 pm Buffet lunch · Exhibition visit 

1:00 – 1:15 pm Welcome and introduction 

Dr Georg Bayer, President of DGOI, and 

Christian Berger, President of BDIZ EDI 

1:15 – 2:00 pm Risk factors in the oral cavity 

(HIV, bisphosphonates) 

Professor Wilfried Wagner, Mainz 

2:00 – 2:30 pm CBCT – when, which, why, how much? 

Dr Jörg Neugebauer, Landsberg am Lech 

2:30 – 3:00 pm Teamwork at the successful 

dental office 

Professor Gerhard F. Riegl, Augsburg 

3:00 – 3:15 pm Discussion 

Nickenig) and aesthetic issues to be addressed by 

dentists in the laboratory (Dr Paul Weigl). The final 

discussion, too, is something to look forward to, 

because it will almost certainly address some questions 

related to the German fee schedule, GOZ. 

With this joint congress, BDIZ EDI and DGOI wish 

to send a signal in favour of deceleration, given the 

madly spinning carousel of implantological congresses 

and events in Germany. Dentists have long 

since lost track of the multitude of dates and offerings; 

the industry, too, has been complaining about 

the excessive number of events. 

AWU 


BDIZ EDI and 

DGOI would 

love to see all 

attendees visit 

the special 

pre-Oktoberfest. 

3:45 – 4:15 pm Pre-implantological periodontics 

Dr Gerd Körner, Bielefeld 

4:15 – 4:45 pm Informing patients about treatment 

alternatives 

Dr Thomas Ratajczak, Sindelfingen 

4:45 – 5:15 pm Tooth preservation from an 

endodontist’s point of view 

Dr Josef Diemer, Meckenbeuren 

5:15 – 5:30 pm Final discussion 

Professor Georg-Hubertus Nentwig, 

Frankfurt, Professor Joachim E. Zöller, 

Cologne 

5:30 – 7:00 pm Workshop Session II 

Evening 

8:00 pm Kicking off Oktoberfest: 

Bavarian night at Löwenbräukeller 

Bavarian food and drink, music 

and comedy at the 13th “Wiesnzelt” 

marquee

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ID_OC200_D_add_EDI_2011.indd 1 24.2.2011 16:51:53

28 

✁ 



Saturday, 17 September 2011 

Scientific program 


08:30 – 08:45 am Welcome and introduction 

Professor Georg-Hubertus Nentwig, 


08:45 – 09:30 am Immediate vs. delayed implant 

placement 

Dr Carl Misch, Beverly Hills/USA 

09:30 – 10:15 am Performance of short implants – 

evidence-based? 

Dr Eduardo Anitua, Vitoria/Spain 

10:15 – 11:00 am Orthodontic treatment before and 

after implant placement 

Dr Maurice Salama, Atlanta/USA 

11:00 – 11:15 am Discussion 


11:45 am – 12:30 pm Differential indications of augmentation 

techniques and materials 

Professor Joachim E. Zöller, Cologne 

12:30 – 12:45 pm New aspects of soft-tissue 

management 

Dr Stefan Reinhardt, Münster 


Please register via fax: 

+49 8243 9692-55 

or online: www.bdiz.dgoi.teamwork-media.de 

or by mail 

teamwork media GmbH 

Hauptstraße 1 

86925 Fuchstal 

Germany 

Registration 

1:00 – 2:00 pm Lunch break · Exhibition visit 

2:00 – 2:30 pm Surgery and prosthetics as team 

players: Patient management 

Dr Fred Bergmann, Viernheim 

2:30 – 3:00 pm Will CAD/CAM replace conventional 

impressions? 

Professor Daniel Edelhoff, Munich 

3:00 – 3:30 pm Laboratory and prosthodontic 

complications and liability issues 

Peter Finke, Erlangen 



4:15 – 4:45 pm Managing complications in referred 

patients 

Dr Michael Stiller, Berlin 

4:45 – 5:15 pm “Correct” billing for implantological 

treatments 

Dr Hans-Joachim Nickenig, Cologne 

5:15 – 5:45 pm Laboratory-office teamwork: 

Aesthetics 

Dr Paul Weigl, Frankfurt 

5:45 – 6:00 pm Final discussion 

Dr Georg Bayer, Christian Berger 

Symposium 

Members of BDIZ EDI: € 350 (after 1 July: € 420) 

Non-members: € 450 (after 1 July: € 520) 

Assistant dentists: € 280 (after 1 July: € 350) 

Dental students: € 200 (after 1 July: € 270) 

Program for dental assistants 

Nurses, assistants: € 150 (after 1 July: € 180) 

Pre-Oktoberfest night: ______ tickets @ € 38 p.p. = € __________ 

(subject to availability) 

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30 



“Academy Award” of the German printing world 

PrintStar 2010 nomination 

for BDIZ EDI konkret 

Every year, the German printing industry offers its PrintStar industry awards to the top printed products and printing technologies 

in Germany. Last year, the BDIZ EDI member publication, BDIZ EDI konkret, was among the nominees for the Newspapers and 

Magazines category, placing it among Germany’s selected Top Ten. BDIZ EDI konkret is the German-language equivalent of the 

English-language EDI Journal. Both implantological journals are published by BDIZ EDI through teamwork media four times a year. 

The patron of this innovation award is Rainer Brüderle, 

German Minister for Economics and Technology. This 

is the first time that an implantological publication 

is included among the nominees. For example, the 

PrintStar 2010 competitors of BDIZ EDI konkret 

included such well-known German general-interest 

publications as Elle and Freundin by Burda and Cicero 

by Ringier. Ultimately, Elle prevailed for first prize. 

Joint runners-up were Cicero and novum – World of 

Graphic Design by the publisher of Augsburger All - 

gemeine. The third prize was awarded to Q-Querdenker-Magazin 

printed by Gotteswinter in Munich, 

which also prints BDIZ EDI konkret. 

“We are proud that BDIZ EDI konkret as a professional 

dental journal has achieved this level of visibility 

amid the enormous number of glossy magazines 

published in Germany”, said BDIZ EDI President Christian 

Berger as he reflected on the PrintStar 2010 nomination. 

He thanked the publishers, teamwork media, 

the printers, Gotteswinter, and the Assistant Editorin-Chief, 

Anita Wuttke, as representative of the entire 

editorial team. According to Berger, this shows the 

high expectations BDIZ EDI has of its member publication 

in terms of editorial content, graphic design 

and printing technology. “For BDIZ EDI konkret, this 

means a terrific boost”, agreed Ralf Suckert, the publisher 

and managing director of the teamwork media 

publishing group, Fuchstal. This nomination, he said, 

bears witness to the high level of competence in prepress 

(teamwork media) and printing (Gotteswinter). 

PrintStar, the innovation award of the German printing 

industry, is offered each year in the categories of 

printed products, marketing and technology, evaluating 

innovative implementation and overall composition. 

Considered the most highly renowned printing 

award in Germany, it is awarded by a professional 

jury that depending on the prize category in question, 

welcomes entries from print offices, agencies, 

photographic studios, publishers, prepress houses 

and posttest companies as well as print buyers with 

their corporate headquarters or branch offices in Germany, 

as well as German vocational or technical colleges 

and the international supply industry. 

AWU



Career notes: Dr Dirk U. Duddeck 

BDIZ EDI 

Administrator, 

Bonn office 

Dr Dirk U. Duddeck, dentist from Cologne, has been 

supporting BDIZ EDI in his new capacity as adminis- 

trator of the association’s Bonn office since mid-2010. 

Dr Dirk U. Duddeck 

He coordinates and optimizes administrative procedures 

in terms of quality management, serving as 

liaison between association members, the BDIZ EDI 

office and the Board of Directors. In addition, he has 

been an active member of the BDIZ EDI Qualification 

and Registration Committee. He conducted and 

supervised the joint study by BDIZ EDI and the University 

of Cologne on contamination and residue 

on sterile-wrapped implants and is currently 

engaged in conducting the follow-up study. Since 

2007, Dr Duddeck has been a research assistant at 

the Interdisciplinary Policlinic for Oral Surgery and 

Implantology and the Department of Oral and Maxillofacial 

Plastic Surgery at the University of Cologne. 

In 2009, he took on the additional responsibility as 

department head and coordinator of dental studies 

in the Dean of Studies office at the University of 

Cologne and project manager of a longitudinal curriculum 

on social and communicative competence 

for dental students (Innovationen in Lehre und Studium, 

LSK-DENT). Previously, Dr Duddeck had been program 

director and department head for a medical 

publisher; from 1999 to 2006 he had been one of the 

founding partners of a leading continuing-education 

firm and consultancy. 

AWU 

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32 



20th International Expert Symposium for Regenerative Methods 

in Medicine and Dentistry 

Biomaterials under scrutiny 

The Expert Symposium for Regenerative Methods in Medicine and Dentistry was held in 2010 – the 20th of 

these symposiums. More than 150 dentists attended the event on Fuerteventura. This time the symposium 

was held under the motto of “Implantology and biomaterials: Innovation in and beyond surgery”. 

Professor Joachim E. Zöller had once again succeeded in attracting international speakers to the Robinson 

Club Esquinzo Playa on Fuerteventura to stimulate a lively exchange of views with and among attendees. 

The – interesting yet controversial – topic selected for the anniversary symposium was that of biomaterials. 

Biomaterials have been the subject of much controversy 

among experts – and this became evident on 

Fuerteventura as well. On the one hand, faculty members 

of the University of Cologne and Dresden presented 

a number of scientific studies offering supportive 

evidence for various materials. On the other hand, 

there were vocal groups whose members critically 

remarked that not all biomaterials pushed into the 

market with the help of enormous marketing budgets 

actually meet every day clinical requirements. 

Different requirements 

The symposium also showed that the category of 

biomaterials not only includes the typical bone 

replacement materials but must also be related to 

the properties of the implants themselves, prosthetic 

components and products that safeguard therapeutic 

success in the event of inflammatory changes 

in the peri-implant tissues. 

A special effort was made at the symposium to 

present not only the various materials and products 

shown by the exhibitors on-site. Rather, speakers 

explained clinical treatment procedures related to 

the biomaterials, providing highly relevant information 

for clinical practice – an approach that was clearly 

appreciated by the participants. 

As in previous years, current developments in dentistry, 

and especially the use of digital imaging procedures, 

was given ample room on the agenda. In 

particular the possibilities afforded by digital impressions 

and the use of the relevant techniques in planning 

implant treatment and restorative procedures 

were impressively highlighted by several speakers. 

Even though the number of attendees in 2010 had 

again been higher than the year before, the cher- 

ished informal nature of the event had remained 

intact. An intensive exchange of ideas above and 

beyond the scientific program has been a focal goal 

during the past 20 years, and this approach was 

further supported by the hotel’s facilities. Attendees 

took part in the physical activities that were 

an important aspect of the social part of the symposium, 

true to the idea of “a healthy mind in a healthy 

body”. 

The dental industry, too, had been very interested 

in being present on Fuerteventura in order to intensify 

its contacts with the participants. However, this 

obvious interest was in no way detrimental to the 

event, which – being spread out over a full week – 

was certainly not dominated by consultations in a 

hectic atmosphere where one of the sides was dead 

set to “persuade” the other. Rather, there was a serious 

exchange of ideas in a relaxed atmosphere. 

The 21st Expert Symposium will be focusing on 

basic procedures and surgical techniques. It will be 

held from 27 October to 3 November 2011. 

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34 



Third anniversary of the von Willebrand syndrome (vWS) network 

Haemophilia’s little sister 

von Willebrand syndrome (vWS) or von Willebrand disease (vWD) is a mainly hereditary coagulation abnormality which, 

although relatively frequent, is not widely known and difficult to recognize. Not infrequently it is not diagnosed until a patient 

experiences acute bleeding, e.g. during dental therapy or after childbirth. The disease arises from a qualitative or quantitative 

deficiency of von Willebrand factor (vWF), the largest protein in the human body. In 2008, Network vWS was founded by 

various German associations and interest groups, including the German Haemophilia Society (Deutsche Hämophiliegesellschaft, 

DHG), the Haemophilia Special Interest Groups (Interessengemeinschaft Hämophiler, IGH), the Professional Association of 

Gynaecologists (Berufsverband der Frauenärzte, BVF) and BDIZ EDI. The network presented a synopsis of its first three years 

of activity at a press conference in Hamburg. 

“Haemophilia is well known, even though it is rare. 

von Willebrand syndrome is generally unknown 

despite the fact that it affects approximately 

800,000 men and women in Germany.” This astonishing 

fact was pointed out by Professor Reinhard 

Schneppenheim, Medical Director of the Department 

of Paediatric Haematology and Oncology at the 

Eppendorf University Hospital in Hamburg. Classic 

haemophilia – a coagulation factor VIII or IX deficiency, 

haemophilia A and B, respectively – affects 

only 6,000 men in Germany. 

Difficult to diagnose 

vWS is mostly characterized by less prominent, diffuse 

symptoms often not associated with each other 

by patients or even by many specialist physicians, as 

Professor Schneppenheim reported: “In children, vWS 

manifests itself by a pronounced tendency toward 

haematomas and nosebleeds. Type 3, the most severe 

form of the disease, may also include bleeding in the 

joints (haemarthroses) and muscles, more rarely in 

the cerebral area, as in the case of haemophilia. All 

incarnations of vWS are characterized by a tendency 

toward mucosal bleeding, e.g. following a tonsillectomy 

or polypectomy. Protracted bleeding suggesting 

vWS may also be seen during exfoliation.” 

Dr Klaus König (Steinbach), gynaecologist in private 

practice representing the Professional Association 

of Gynaecologists, reported that extended or 

very strong menstrual bleeding in women may be 

an indication of the syndrome. It is frequently not 

diagnosed since the affected women compare 

themselves with their mothers, sisters or aunts, who 

are often themselves affected by this syndrome and 

exhibit similar symptoms: “Following childbirth, 

these women often experience very strong bleeding, 

which is extremely difficult to stop.” 

Haematomas, nosebleeds, strong and extended 

menstrual bleeding, post-bleeding following dental 

treatment or surgery – these are the symptoms that 

Dr Günter Auerswald (Bremen) from the special outpatient 

Department for Thrombosis and Haemostatic 

Disorders at Bremen-Mitte hospital associates with 

vWS. All three speakers, Schneppenheim, König and 

Auerswald, admitted that the syndrome was difficult 

to diagnose. This diagnosis involves a three-level series 

of laboratory examination. There are several clinical 

centres in Germany specializing in this diagnosis. 

Treatment options 

Professor Schneppenheim described the treatment 

options as follows: If von Willebrand factor – required 

for stabilizing and transporting clotting factor VIII, 

collagen binding (in the case of injured blood vessels) 

The von Willebrand 

disease 

arises from a 

qualitative or 

quantitative 

deficiency of 

von Willebrand 

factor. The diagnosis 

involves a 

three-level series 

of laboratory 

examination.

and platelet binding – is missing, it could be re - 

placed by concentrates. Releasing the factor from 

depots within the body by administering desmopressin 

(DDAVP) is another treatment option that is 

primarily indicated for the milder type 1 of the disease, 

but also for some patients with type 2. (Editor’s 

note: DDAVP is a hormone that improves haemostasis 

by increasing plasma coagulation factor VIII and 

vWF levels.) In all cases, these patients should be 

trialled on DDAVP for effectiveness of this therapy. 

“These patients should never undergo outpatient 

surgery, but should be treated surgically only at centres 

with demonstrable experience in treating vWS”, 

said Schneppenheim. 

Free network use 

The main information platform of Network vWS, initiated 

by CSL Behring, is its website, with marketing 

assistance provided by Medical Consulting Group 

(MCG), Düsseldorf. MCG presented the results of 

the work of the past three years to representatives 

of all network associations and working groups: The 

media for the general public had achieved a print run 



of 63 million, while the media for a professional audience 

had achieved a print run of 2.5 million. Cinema 

advertisement, print advertisement, the web platform, 

press conferences, continuing-education seminars 

for physicians, self-test for potential patients, 

an atlas to support patient-physician consultations – 

all these have contributed toward informing the 

public of the syndrome and sensitizing the medical 

community. 

In a brainstorming session, the attendees – 

including BDIZ EDI President Christian Berger – discussed 

potential directions for the future activities 

of the network. They listened to suggestions for 

patient information via in-office CCTV as well as 

to demands for interactive anamnestic forms to be 

downloaded from the web. Other topics were apprehensions 

of over-diagnosis by medical labs and the 

right amount of sensitivity in preparing information 

for the public. Christian Berger pointed out that 

dentists, who meet potential vWS patients in their 

offices and at schools at a very early stage, might 

play an important part in early recognition of this 

disease. 

AWU 

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36 



An interview with Professor Gerhard F. Riegl on success factors for dental offices 

Finding the right patients 

German dentists do not always have much of a grasp on marketing. Part of the reason is their professional statute that prohibits 

advertising, but also the usual tightrope walk between ethical principles and the need to make a profit, plus the reimbursement 

principle that applies to much of Germany’s healthcare system. EDI Journal spoke with Gerhard F. Riegl, Augsburg, about factors 

that determine the success of a dental office. Riegl is professor for marketing at the Faculty of Business at the Augsburg University 

of Applied Sciences and has been following the healthcare market and its protagonists for more than 25 years. 

Professor Riegl, you have followed up your book “Dental 

Office – Centre of Excellence” with a new book entitled 

“Success Factors for Dental Offices”. What is Riegl’s 

power marketing textbook all about? 

In a few words, it is about how knowledgeable dentists 

become successful managers – and this includes 

economic success. Good dentists should not complain 

about the mediocre performance of their colleagues 

nor wait for hopeless bunglers to disappear 

from the market. Rather, they should demonstrate 

that they themselves are ready to face and outperform 

any competition in terms of knowledge, organization 

and, especially, good customer service. This 

book is a book about ideas and the future and looks 

at dentists’ public image. This public image translates 

into goodwill, something that the field as a 

whole and all dentists can benefit from. 

The next step is to create a systematic master plan 

for the dental office. The objective has been to show 

how to find the right patients for one’s own office, 

today and tomorrow; how to successfully deal with 

these patients on an interpersonal level using the 

full range of professional tools available; and how to 

achieve patient loyalty in a natural, authentic way. We 

call this dental compliance coaching. 

You have surveyed patients at 11-year intervals and 

evaluated the results at your institute. How does this 

work, and where do you get your patients from? 

Our institute performs continuous systematic 

qualitative analyses for dental customers based on 

patient research. We do not enter the dentist’s 

premises, and we do not interfere with the day-today 

workings of the office; rather, we use professional 

methods to identify individual strengths and 

chances as well as areas that need improvement. 

This evaluation gives participating dentists benchmarking 

data, i.e. anonymous comparative data relative 

to other dental offices in the same region, to 

inform dentists’ decisions, to allow them either to 

determine that they are the best or that they can 

learn from the best. We are now doing this in eleven 

European countries, from Finland to Italy, and in 

seven languages, offering certificates for dentists 

and oral implantologists. Our analyses are building 

blocks for dental quality management, which will be 

mandatory from 2011 on and contribute to patientdriven 

value at the dental office. 

Your press release states that dentists enjoy an excellent 

reputation with their patients and that the metrics 

for quality and customer satisfaction indicate 

results between good and very good. What is it exactly 

that patients appreciate? 

Dentists have certain core competencies that 

define their image in popular perception. Factor 

number one is hygiene and cleanliness at the dental 

office, followed by a friendly dental team, treatment 

quality, respectful chairside manners, patient education 

and the overall office atmosphere. 

With so much light, can there be any shadow? 

Well, 47 per cent of all dental patients are not perfectly 

satisfied with their dentist’s overall performance, 

i.e. they do not always assign the highest marks. 

According to the results of our research, patients still 

criticize their dentists’ websites (if any), inappropriate 

presentation of the price-performance ratio of the 

different treatments, waiting times, patient education 

brochures, administrative issues, dental prevention, 

cooperation of their dentists with specialists and the 

availability and timing of appointments. 

A modern adage says that you don’t change hairdressers 

and you don’t change dentists. Can you prove 

that the second part of this adage is right? 

We have found that this used to be the case, because 

40 per cent of the older patients are still seeing their 

Professor 

Gerhard F. Riegl



very first dentist. By contrast, this is the case for only 

23 per cent of the less than 30-year-olds. On average, 

patients will have been with their current dentists for 

5.7 years. But the sustainable dentistry of the future 

will require even more sustainable patient loyalty. 

To what extent do patients consult the Internet or 

advertisements in choosing their dentists? 

We must differentiate between choosing the family 

dentist and choosing an implantological specialist. 

It is true that about 25 per cent of our patients use 

the Internet as one of their sources of information 

on dental topics or issues. But only 1 per cent of the 

patients resort to the Internet for finding their family 

dentist; for younger patients, the corresponding figure 

is 2 per cent. With oral implantologists, the share 

of patients who have visited the clinic’s website to 

familiarize themselves with the treatment provider is 

11 per cent. It was found that information about dental 

offices on the web is mostly used for self-assurance, 

for identification, for confirmation of one’s own 

views or to get information about things already 

experienced in vivo – not so much for selecting or 

comparing treatment providers. 

Patients increasingly use web portals to rate their dentists. 

A single negative rating can in principle stain your 

online reputation forever. In your book you state that 

new office strategies are required, including which you 

call “exit management”. What do you mean by that? 

Looking at the so-called patient rating portals on 

the web, we see a well-known fact re-materialize: In 

principle, any dentist can treat any patient, but no 

dentist can be the best dentist for all patients. If you 

want to be a dentist who is true to principle, authentic 

and credible in your patient relations, you will 

need to have the courage to say no if necessary and 

to refuse further involvement where the psychological 

circumstances offer no path towards a satisfactory 

solution. This means that patient relationships 

that are detrimental to the dentist and office – even 

though the dentist has done nothing wrong – will 

have to be terminated diplomatically before it is too 

late. We describe behavioural strategies for severing 

ties with patients while at the same time offering 

assistance in finding a dentist who is more likely to 

meet their specific needs. 

You have done some research on the referral behaviour 

of 3,000 family dentists and found that 29 per 

cent of all dentists now perform implant procedures 

themselves, while the rest collaborate with oral and 

maxillofacial surgeons or oral implantologists; yet 

family dentists state that only 22 per cent of their 

patients choose their oral implantologist themselves. 

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How does that fit in with the image of a new generation 

of patients who use the Internet to obtain the 

information they need? 

Never before have patients had access to as much 

health information as today, and this is as true of the 

dental field as of any other. However, this multifaceted, 

heterogeneous, sometimes contradictory data 

“haze” has not resulted in faster or more autonomous 

decisions; rather, a common result is information 

overload. Experience has shown that the more 

patients know, the more they appreciate that they 

know too little. Realization of this fact results in a 

desire for counsellors, pilots, navigators – preferably 

in a face-to-face setting. We are therefore witnessing 

a trend toward recommendation marketing and wordof-mouth 

recommendations. For dental patients, the 

family dentist continues to be their by far most 

important guide. 

Even though 90 per cent of all patients in Germany are 

covered by statutory health insurance and therefore 

should not have to worry too much about the cost of 

the treatment, more and more patients need advice 

on cost and financing issues. Is this because statutory 

health insurance does not cover all treatment options, 

or do today’s patients want to be informed of the cost 

of the treatment as a matter of principle? 

The dental field has played a pioneering role when 

it comes to patients accepting responsibility for their 

own health. Only 5 per cent of the patients covered 

by statutory health insurance believe that the standard 

treatment they have coverage for is sufficient 

for their specific case. Today, dental patients require 

much more information about cost and financing 

than about issues related to the treatment itself. For 

example, 21 per cent require more information about 

co-payments for implants, 18 per cent about co-payments 

for laboratory costs, 20 per cent about instal- 

Professor Gerhard F. Riegl 

ment options, 22 per cent require assurance that 

their restorations will be fabricated by a German laboratory 

led by a master dental technician and 49 per 

cent require detailed specification about what is 

reimbursable and what is not. A full 80 per cent 

wants to discuss cost openly and up front. 

The trend would indicate that the dentist-patient 

relationship is becoming more rational. However, this 

must not result in the dentist taking on the role of a 

salesperson. Dentists should be the patients’ consultants 

and trustees, not a mere provider of services. 

Confusing the patient role defined by the standards 

of social interactions with the customer role defined 

by the standards of market interactions is not permissible. 

Patients want their dentists to treat them 

better than any customer would be treated. 

So what do the results of this study tell us about who 

is the ideal dentist for most patients? 

Our patient surveys increasingly indicate that 

patients want dentists to understand and appreciate 

them, in an atmosphere of honesty, kindness and 

friendship. Patients want to get a sense of partnership 

and security when visiting their dentists. They 

want to feel safe. Dentists capable of creating this 

type of atmosphere relieve anxiety, build confidence 

and qualify for their intended role as benevolent 

patient guides. The ideal dentist does not specialize 

in implants, dental prevention or endodontics. The 

ideal dentist specializes in people and helps patients 

behave as they always wanted to behave when it 

comes to oral hygiene and dental health. Ultimately, 

the issue is whether the dentist is capable not only of 

performing good dental treatment, but also of soothing 

and calming the patient’s soul. 

Professor Riegl, thank you very much for this insightful 

interview. AWU 

Gerhard F. Riegl, Dr rer pol, is Professor for Marketing at the Augsburg University of Applied Sciences, Faculty of Business. He is 

a university teacher in the field of international market management and the founder and Scientific Director of the Health 

Care Management Institute in Augsburg. He has been conducting research on patients and referrers for 34 years, resulting in 

pioneering publications, e.g. the German-language monograph “The Dental Office as a Centre of Excellence”, on marketing 

activities by dentists, physicians and hospitals. 

As a trailblazer of dental marketing in Germany, Riegl has overseen more than 40,000 evaluations of dentists by patients 

treated at 700 different dental offices. He is held to be one of the leading health management trainers in Germany. Riegl 

is the author and publisher of the first major dental image and marketing study; he has authored more than 300 articles 

in other publications on health care marketing and conducts national and international research projects on dental and 

health care marketing. He works with chambers of dentists, professional associations and dental working groups in Germany 

on issues related to quality management, marketing and human-research management.The German newsmagazine Focus has 

described Riegl as one of the most eminent experts on hospital management and medical quality assurance.

40 



European Parliament: PIL on the web 

In the future, patients will find comprehensive and 

intelligible information about prescription drugs on 

the web. Advertising such drugs, on the other hand, 

will continue to be prohibited, according to the European 

Parliament in Strasbourg. As reported by the 

large German daily Frankfurter Allgemeine Zeitung, 

patients and their families are supposed to receive 

basic information about the benefits and risks of 

medicinal products, as well as on alternative therapies 

and preventive methods on the websites and 

web portals of the relevant national and European 

authorities. In addition, patient information leaflets 

(PIL) will have to be made available in all official EU 

languages. The industry should be prohibited from 

actively contacting patients and be restricted to 

responding to patient requests. Detailed information 

about the medicinal products they sell, including 

price or packaging information, can be published on 

manufacturers’ websites. However, this information 

must link to the official national and European health 

portals. To prevent companies from manipulating the 

information provided such that it effectively constitutes 

advertisement, all information is supposed 

to be examined and pre-authorized by the national 

authorities and the European Medicines Agency, headquartered 

in London. 

Source: European Parliament/ 

Frankfurter Allgemeine Zeitung 

Europe-Ticker 

Czech Republic: 

Doctors threaten with exodus 

Czech hospitals have experienced a wave of physicians 

giving notice to leave their positions that may 

seriously threaten the country’s healthcare system 

and its patients. Hundreds of predominantly younger 

doctors have signed a declaration stating their intention 

to quit their jobs, responding to a call by the 

Czech Physicians’ Union that seeks to push through 

massive salary increases in this way. Under the motto 

of “Thank you, we’re leaving”, the physicians threaten 

to emigrate to Germany and other Western European 

countries, where their pay would be vastly better. 

These activities have already attracted a great 

deal of attention not only in the Czech Republic but 

also in other Central and Eastern European states, 

which also experience a mass exodus of local doctors 

and nurses. They are being courted by Western hospitals 

and healthcare institutions, which offer higher 

salaries and better work conditions. Thirty-two hospitals 

from Germany and one from Austria presented 

themselves at a job fair in Prague several weeks ago. 

The more than 5,000 Czech physicians who attended 

were offered monthly salaries of between €3,700 

and €4,500, which is roughly twice the currently prevailing 

salary level in the Czech healthcare system. 

Source: Various media 

European Parliament: 

New directive for treatment abroad 

Now even patients covered by national statutory 

health insurance can elect to be treated in hospitals 

or by specialists of their choice across the EU – at 

least if they would have to wait an unacceptably long 

time for the operation or if better specialist care for 

their specific disease is available in another member 

state. This, in short, is the content of a new EU directive 

agreed upon between the member states and 

the European Parliament following extensive and 

drawn-out negotiations. Patients seeking treatment 

in another member state will have to request prior

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42 



authorization from their health insurer; however, this 

authorization may not be arbitrarily refused. Moreover, 

they will need the financial means to advance 

the cost of treatment. Health insurance providers 

only have the obligation to reimburse patients for 

the cost incurred, and that only up to the amount 

customarily charged in the patient’s state of residence 

for comparable services. While this has little 

practical effect for patients in some countries, such 

as Germany, where reimbursement for treatment 

abroad has been the norm, in particular patients 

from Britain, Spain or the newer EU member states 

will benefit from the effects of this directive, which 

overrules existing restrictions on a national level. 

However, these liberal rulings do not cover medical 

services that are illegal in the patient’s member state 

of residence. For example, German women cannot 

expect to have pre-implantation diagnostics performed 

in Belgium and then receive reimbursement 

from their health insurer at home. You will find a 

detailed report on this directive in this issue of EDI 

Journal. 


United Kingdom: 

A health reform that is visible from space 

The British conservative-liberal government has 

brought a comprehensive health reform on its way. 

Sir David Nicholson, chief executive of the National 

Health Service (NHS), has described the proposals by 

Health Secretary Andrew Lansley as the biggest 

change management program in the world – so 

large “that you can actually see it from space”. The 

reform intends to bring the public health system into 

closer alignment with the market economy. Up to 

now, the NHS has been funded entirely by the taxpayer. 

Of the enormous healthcare budgets, 60 per 

cent are spent on the salaries of the 1.7 million NHS 

employees and 20 per cent are spent on procuring 

medicinal products. The remainder of the money 

covers the cost of new medical facilities. However, 

facilities have been seriously underfunded for many 

decades. The current inefficiency is the problem Lans- 

Photo: Panthermedia/Alexander Zschach 

ley has set out to address. Patients, physicians and 

hospitals are to be given incentives to identify the 

most economical and most beneficial treatment. 

Patients will then be able to choose their treatment 

providers, general practitioners (GPs) and specialists 

can refer patients to competing private or stateowned 

surgical clinics for treatment, and private and 

state clinics can freely compete for both staff and 

patients. GPs and specialists will be given control 

over the largest chunk, £70 million, of an overall 

healthcare budget of £100 million a year. Physicians 

are to form joint committees to decide what medical 

provider they want to use to direct the treatment of 

their patients. The more skilful they prove to be in 

doing so, the more extensive will be the amount of 

state funds allotted to them. Sceptics fear that private 

surgical centres will practice cherry-picking, performing 

only lucrative routine operations, with state 

hospitals being stuck with expensive complicated 

surgery and treatments and becoming even less efficient 

than today. The government is hoping for closures 

and mergers among dental offices and hospitals; 

this, in their view, is one of the main points of 

the reform. 


European Commission: Consultations on 

professional qualifications initiated 

The European Commission has started the public 

consultation process on the Professional Qualifications 

Directive (2005/36/EC). These consultations 

offer participants an opportunity to submit their 

views on aspects of the directive they believe could 

be simplified and made more user-friendly. Comments 

are also solicited on how professionals working 

in the European Single Market can be better integrated, 

and on a European Professional Card. 

This directive forms the basis for professionals 

unleashing the full potential of the Single Market 

when looking for a new position or seeking to extend 

their professional activities in another member state. 

In 2012, the Commission will make a legislative proposal 

on modernizing this directive. Stakeholders were 

able to submit comments until 15 March 2011. 

The Professional Qualifications Directive covers 

800 professions regulated by the member states 

that can only be exercised by holders of certain professional 

qualifications. The qualifications of a number 

of healthcare professionals, including dentists, 

are covered by the automatic recognition mechanism, 

based on the harmonization of educational 

and training requirements throughout the EU. 

Source: Various media

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European Law 

New EU Directive 

More rights for patients 

With its approval of the “Directive on the Application 

of Patients’ Rights in Cross-border Healthcare” in mid- 

January, the European Parliament has reached an 

important milestone on the road to more free movement 

and more freedom to render services. The core 

message: patients generally have the right to obtain 

health services in all member states without requiring 

prior authorization by their health insurer. In 

doing so, they have a right to reimbursement of 

their cost. This vote finally gives not only patients 

but also members of the healthcare professions as 

well as social security institutions legal clarity: in the 

future, member states must afford patients better 

support as they utilize cross-border healthcare services. 

More than a decade after the landmark decisions 

by the European Court of Justice (ECJ) in the 

Kohll and Decker cases, the principles embraced in 

these decisions have finally been codified and must 

now be implemented in national law by the member 

states. 

The principles of the Patient Rights Directive are 

not new. They can be directly derived from European 

Union contractual law, according to which limiting 

the free selection of doctors is not compatible with 

fundamental European rights. The ECJ has decided 

along these lines several times since 1998, and the 

same principles were embodied in the European 

Commission’s 2004 draft Directive on Services in the 

Internal Market. Nevertheless, EU citizens still repeatedly 

had to seek recourse from the Luxembourgbased 

court to assert their rights in their specific 

cases. Notable examples include that of Raymond 

Kohll, who was refused reimbursement for orthodontic 

treatment at a dentist in Trier, Germany by Luxembourg’s 

Caisse de Maladie. Or Nicolas Decker, a citizen 

of Luxembourg who won the right to reimbursement 

for the cost of glasses with corrective lenses 

made in Arlon, Belgium from his health insurance 

fund. Or Aikaterini Stamatelaki, who sued the Greek 

health insurer for the liberal professions, Organismos 

Asfaliseos Eleftheron Epangelmation, before the ECJ 

for reimbursement of the treatment cost incurred for 

her late husband at London Bridge Hospital, a private 

hospital in the United Kingdom. The proceedings 

dragged out for ten years before the ECJ finally ruled 

in favour of the plaintiff in 2007. 

Time and again, social security 

institutions and national health services 

have negated the freedom to perform services 

in the healthcare sector in the European internal 

market, even though the free movement of people, 

goods, services and capital is part of the European 

fundamental freedoms. Article 49 of the EG treaty 

prohibits restrictions on the provision of intra-community 

services. Restrictions are said to exist already 

if the provision of these services is made more difficult 

or less attractive or fraught with potential obstacles, 

which includes discriminatory practices in the 

general environment of the service in question. 

The ECJ has pointed out that it is not permissible 

for member states “to exclude the public health sector, 

as a sector of economic activity and from the 

point of view of freedom to provide services, from the 

application of the fundamental principle of freedom 

of movement”. The court has repeatedly stated that 

peculiarities surrounding the provision of specific 

services do not abridge the freedom to provide services 

and related principles. Nor does it matter how 

the healthcare system in the patient’s home country 

is organized. 

Reverse discrimination remains in place 

The directive now adopted obliges member states 

to refrain from requiring prior authorization before 

reimbursing patients for the cost incurred for healthcare 

services provided in another member state. If 

the cost of these services would have been paid 

for by the social security institutions in question, had 

they been provided in their own territory, patients 

must be reimbursed for them if the services were 

provided in another member state. Whether or not 

the patient’s home country adheres to the principle 

of providing benefits in kind is immaterial in this 

context. For patients covered by German statutory 

health insurance, this means that they can be treated 

in the same manner as patients covered by German 

private health insurance (which follows the 

reimbursement principle), even though they are 

(only) entitled to benefits in kind within Germany. 

Many observers have seen this as an example of 

reverse discrimination. However, reverse discrimina-


European Law 

tion is a non-topic within the context of European 

law. It is lawful for Germany to afford its residents 

covered by statutory health insurance fewer rights at 

home than abroad. A similar situation prevails with 

regard to physicians and dentists who are not accredited 

by the German health insurance system; their 

colleagues in member states outside Germany may 

legally treat patients covered by statutory health 

insurance without such authorization. It would be 

desirable for legislators to draw the right conclusions 

from the newly adopted directive. The extended 

options for applying the cost reimbursement principle 

provided by recent statutory health insurance 

legislation are a step in the right direction. 

Cost reimbursement only abroad 

In the future, patients must also be reimbursed for 

the cost of medicinal products prescribed and 

obtained in the context of healthcare-related services. 

Restrictions are only admissible if and to the 

extent that the utilization of cross-border healthcare 

services would threaten the financial balance of the 

social security systems in the member states. For 

example, the freedom to provide services could be 

restricted with regard to inpatient care if increased 

patient mobility would jeopardize the objective of 

providing a well-balanced supply of high-quality hospital 

treatment alternatives in a specific member 

state. Unfortunately, it must be expected that health 

insurers will invoke this very provision to hinder the 

increasing mobility of patients. 

The Ministers of Health had already acknowledged 

years ago that the EU is home to shared values and 

principles with regard to healthcare. These include 

universality, access to high-quality care, distribution 

fairness/equality and solidarity. For this reason, the 

member states should ensure that these shared values 

and principles are also applied to patients and 

citizens from other member states. Regardless of 

where they are from and what specific health insurance 

arrangement they have – all patients must be 

treated alike. However, this does not imply any right 

to preferential treatment. On the contrary: The freedom 

to provide services may be limited if an increase 

in demand results in longer waiting times or capacity 

bottlenecks for residents. 

Quality and safety 

The Patient Rights Directive requires member states 

to make “systematic and continuous efforts ... to 

ensure that quality and safety standards are im - 

proved”. The original plan had been to define standards 

at a European level, but the attempt failed 

because the EU has no authority to regulate the 

healthcare sector. 

EU member states will have to establish contact 

points offering information on healthcare providers. 

On request, these contact points will also provide 

information on a specific provider’s right to provide 

services or any restrictions on its practice. They are 

also tasked to educate the public on patients’ 

rights, complaint procedures and mechanisms for 

seeking remedies, for example on mediation mechanisms. 

Member states must also ensure that the 

national contact points consult with patient organizations, 

healthcare insurers and healthcare providers 

as appropriate. 

The Patient Rights Directive includes another 

important innovation: member states should ensure 

that patients from other member states receive 

information on safety and quality standards enforced 

on its territory. On request, physicians and dentists 

should provide patients with information on specific 

aspects of the healthcare services they offer and on 

the treatment options. 

Outlook 

At this point, it is still the member states, not the 

European Commission, that are competent to regulate 

health care. Nevertheless, it is obvious that the 

European institutions are beginning to extend the 

range of their activities in this field. This implies a 

threat of additional regulation and standardization. 

For this reason, the consultation process now being 

conducted by the EU Commission on the 2006 Directive 

on Professional Qualifications should be watched 

closely. This directive defines professional minimum 

standards e.g. for exercising the profession of dentist 

within the EU. It is widely feared that the standards 

will be relaxed in order to promote the mobility of 

healthcare service providers. 

Politicians in EU member states are tasked to find 

the right balance between the desirable liberalization 

within the healthcare sector and the necessary 

regulation benefiting the interests of healthcare 

providers and patients alike, a balance that considers 

the interests of all stakeholders. The new Patient 

Rights Directive provides some important stimuli in 

the right direction. 

Peter Knüpper, attorney at law 

Joint practice of Dr Rehborn 

Munich 

Germany


European Law 

On the legality of prior authorization 

requirements for outpatient treatment 

requiring the use of major medical 

devices in a different member state 

In its decision dated 5 October 2010 (C-512/08), the 

European Court of Justice in Luxemburg (ECJ) was 

called upon to decide whether statutory health 

insurers may require authorization prior to treatment 

using major medical equipment in another 

member state. 

The case 

For a change, the court was not called upon this 

time to decide on an action brought by a patient 

against a health insurer with regard to the reimbursement 

of treatment costs. Rather, the issue at 

hand was a letter of formal notice sent to the French 

Republic by the European Commission. Its specific 

complaint was that French national regulations 

require prior authorization by the statutory health 

insurer as a condition for reimbursement of the 

cost of medical treatment in another member state 

requiring the use of major medical equipment. The 

relevant article of the Public Health Code provides an 

exhaustive enumeration of the major medical equipment 

affected, namely PET scanners, magnetic resonance 

imaging apparatus, medical scanners, hyperbaric 

chambers and cyclotrons for medical use. 

According to the French rules, prior authorization is 

needed only for proposed treatments, not for cases 

where the need for the use of this equipment is 

unexpected. This means that the prior authorization 

requirement would not apply to an unforeseen treatment 

for which a need arises while the insured person 

is temporarily staying in another member state. 

According to the French Social Security Code, 

authorization may be refused only if one of the following 

conditions applies: (1) the proposed treatment 

is not one of those in respect of which the French 

rules provide for responsibility for its payment; (2) 

treatment that is identical or equally effective can be 

obtained in good time in France, taking into account 

the patient’s condition and the likely development of 

the patient’s illness. Social security institutions are 

advised that to refuse authorization, it is not sufficient 

to point out the existence of treatment alterna- 

tives in general; rather, any such refusal must be 

based on facts, for example by providing patients 

with a list of establishments capable of administering 

the treatment needed within the period required. 

Healthcare institutions in France are not free to 

purchase major medical equipment for treating 

patients under the statutory healthcare system as 

they see fit; rather, they are themselves subject to 

authorization by the competent regional healthcare 

authority to deploy such equipment. This rule 

intends to ensure an adequate regional balance in 

purchase planning and deployment. 

ECJ decision 

In earlier decisions, the ECJ had ruled that national 

health insurers are not allowed to make the reimbursement 

of costs incurred for outpatient treatment 

in other EU member states contingent on prior 

authorization. The prior authorization requirement, 

however, was deemed acceptable in the case of 

inpatient treatment, but only with regard to planned 

treatment; certainly not in the event of unforeseeable 

hospital treatment, e.g. as a result of an accident. 

The ECJ had previously justified its stance on 

treating outpatient and inpatient services differently 

by recognizing that more extensive planning needs 

and practical constraints govern the provision of in - 

patient services. Such planning requirements relate, 

on the one hand, to ensuring sufficient and permanent 

access to a balanced range of high-quality treatment 

and, on the other, to the wish to control costs. 

The court has now applied this line of arguments 

to outpatient treatment with the major medical 

equipment as mentioned, by elaborating that a 

prior authorization requirement may be acceptable 

in order to avoid, as far as possible, any waste of 

financial, technical and human resources. However, 

this authorization requirement must apply to areas 

that are subject to a general planning policy in the 

respective member state, as is the case in France 

with regard to major medical equipment. This planning 

policy must have as its objective to ensure,


European Law 

throughout the national territory, a rationalized, stable, 

balanced and accessible supply of up-to-date 

treatment, and also to avoid wastefulness wherever 

possible. Only when this is the case can the same 

line of arguments be used to require authorization 

prior to treatment using such equipment in another 

member state. 

The European Commission had argued that several 

circumstances permitted the inference that to do 

away with the prior authorization requirement in the 

sphere of treatment involving the use of major medical 

equipment would not lead to a huge exodus of 

insured persons from the French system to other 

member states and would not endanger the financial 

balance of the national social security system. 

The circumstances cited by the Commission included 

linguistic and geographic factors, the lack of information 

about the nature of treatment available in other 

member states, as well as necessary travel expenses. 

While the decision does not show that France actually 

refuted this argument, the ECJ in its decision simply 

assumes that abolishment of the prior authorization 

requirement could lead to under-use of the major 

medical equipment installed. This in turn might result 

in a disproportionate burden on the affected member 

state’s social security budget. The ECJ did not 

offer any more concrete guidance. It would thereby 

appear that the ECJ has clearly lowered the ribbon 

for member states wanting to institute such a prior 

authorization requirement by accepting as arguments 

general apprehensions without any concrete 

foundation. 

The only reservation cited by the ECJ relative to 

prior authorization requirements for outpatient 

treatment with major medical appliances is the current 

status of EU law. This reservation may have been 

introduced with a view to the impending Patients’ 

Rights Directive, adopted by the EU Parliament in 

January 2011. From 2013 on, there will be uniform 

rules governing medical treatment in EU member 

states, which may also affect the situation concerning 

prior authorization requirements for treatment 

requiring the use of major medical equipment. The 

Council’s decision is still pending, meaning that the 

wording of the directive will probably not be finalized 

before later in the year. 

Solicitor Dr Berit Jaeger 

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An implant-based treatment option for periodontally reduced dentitions 

A new therapeutic approach 

Dr Georg Bayer, Dr Frank Kistler, Dr Steffen Kistler, Stefan Adler, all Landsberg am Lech, 

and PD Dr Jörg Neugebauer, Landsberg am Lech and Cologne/Germany 

In recent years, the treatment of periodontal disease has seen developments that have resulted in various options 

for preserving the masticatory and phonetic function of compromised patients [1,6,12,13]. Patients can now select from 

a range of treatment options. Some patients are known for a critical attitude toward drug treatment, especially when 

it comes to systemic antibiotics, being afraid of adverse reactions and risks such as allergic reactions or antibiotic 

resistance. Furthermore, critical reports have been published notably with regard to the clinical results obtained in 

heavy smokers [2,6]. 

Photodynamic therapy 

Topical treatments can only be performed in patients 

willing to return periodically for recall visits and continuous 

treatment to avoid recurrence of the disease 

with progression of the vertical bone loss. Photody- 

Fig. 1 Immediate implant insertion following extraction of the 

distalmost natural abutments above the mental foramen. 

Fig. 3 Parallelized impression posts used for the fabrication of 

the screw-retained provisional restoration. 

namic therapy has yielded promising results in this 

context by effectively reducing the number of 

pathogens in the absence of systemic side effects [8]. 

If there is a need for a prosthetic restoration, however, 

Fig. 2 Connection of the angled abutments to the distal 

implants to adjust the path of insertion of the restoration. 

Fig. 4 The long-term resin provisional delivered at the end of 

the surgical treatment.



the question arises how this treatment should be 

continued. In the presence of multiple tooth loss or 

with natural distal abutments missing, conventional 

prosthetic restorations can only be implemented in 

the form of removable dentures. Especially patients 

in their forties, however, are unlikely to accept dental 

treatment of this type. Due to the extensive social 

life of this age group, they will rarely content themselves 

with a removable denture [14,15]. On the other 

hand, very extensive treatment steps may be 

required for consecutive implant placement to substitute 

for teeth that can no longer be preserved [7]. 

For one thing, the distribution of edentulous areas is 

often unfavourable, such that a relatively large number 

of implants will be required. For another, the 

need for repeated prosthetic restorations with consecutive 

implant placement may become quite 

expensive. One treatment option, therefore, is to 

remove teeth that are no longer worth preserving, 

even though they could theoretically be preserved, 

in favour of a full-arch implant-supported rehabilitation 

[4,5]. 

Angulated implant abutments allow the implementation 

of fixed restorations supported by fewer 

implants, namely four implants in the mandible or 

six in the maxilla [9]. This is precisely where photodynamic 

therapy comes in, offering ways of eliminating 

all pathogens from the infected tissue by topical 

decontamination during immediate implant placement 

[11]. This will ensure that success, and hence a 

good prognosis of immediate implant placement, 

can be achieved. Given most patients’ reluctance to 

accept a removable denture, it is recommended to 

combine the immediate placement of implants with 

an immediate restoration [3]. Angulated insertion of 

implants will allow for the establishment of wide 

anteroposterior support, which is important for 

achieving primary implant stability and for splinting 

them [10]. For immediate restoration, a temporary 

resin structure is fabricated based on a reduced setup 

extending to the second premolars directly after 

the implants have been placed. 

The final prosthesis is delivered after osseointegration 

of the implants. As the patient will be wearing a 

fixed restoration by that time, this final rehabilitation 

can be implemented with due consideration being 

given to all relevant laboratory and restorative 

aspects. Furthermore, the temporary restoration also 

offers an opportunity to increase the vertical dimension 

of occlusion to compensate for any decrease 

that may already have occurred in the area of the 

support zone due to the presence of periodontal disease 

and the absence of teeth, thus utilizing the 

period of osseointegration to adjust a new vertical 

dimension secured by stable implant anchorage. 

Dental Instruments 

Implantology Instruments 

Oralsurgery Instruments 

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Xpect more at IDS 

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Fax: +49 7771 64999-50 

www.kohler-medizintechnik.de



Fig. 6 Radiological control prior to definitive impression by 

the referring dentist. 

Options of prosthetic restoration 

Depending on the patient’s expectations, a spectrum 

of very different restorative options may be available, 

ranging from relatively simple designs including a 

non-precious metal framework to which a ceramic 

veneer is fused, all the way to sophisticated designs 

including zirconia restorations with custom veneering. 

Minimizing the number of implants for such 

rehabilitations in periodontally compromised patients 

will reduce the known risk of peri-implant disease or 

even implant loss, as fewer implants that might get 

affected will be present in the first place [16]. As the 

initial restoration following tooth extraction will be 

immediately delivered by the surgeon, the referring 

practitioner will be able to plan and deliver the final 

rehabilitation without time constraints. In this way it 

is possible to meet the expectations of patients who 

express a desire for fixed rehabilitation despite the 

presence of residual teeth likely to be lost in the 

foreseeable future. Care should be taken, however, to 

deliver an initial restoration that will offer a relatively 

good chewing comfort, thus constituting an 

Fig. 7 Lingual view following delivery of the definitive 

restoration by the referring dentist. 

improvement on the previously reduced and periodontally 

compromised dentition. With regard to the 

final prosthetic rehabilitation, an exact analysis of individual 

needs is required such that maximum patient 

satisfaction will be ensured at the end of treatment. 

As a rule, this goal is perfectly within reach, given the 

absence of any time constraints. 

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Comparison of the bone response to dental implants with threaded 

and non-threaded necks 

Marginal bone loss around 

endosseous implants 

Vitomir S. Konstantinovic, DDS, MD, MSci, PhD, Belgrade/Serbia 

The long-term survival of endosseous dental implants depends on the preservation of bone support. Bone loss may be 

reduced by the retention grooves (microthreads) or by the polished implant neck surface. The aim of this paper was to 

critically reconsider recently published papers on marginal bone loss around endosseous implants, using a MEDLINE search 

that examined treatment outcomes after insertion of dental implants with threaded and non-threaded neck designs. 

The long-term survival of endosseous dental im plants 

depends on the preservation of bone support. A loss 

of crestal bone compromises the treatment outcome 

and the patient’s oral health. In integrated crestal 

implants, the breakdown of the implant-tissue interface 

begins in the crestal region, i.e. below the mucosal 

penetration area. It has been reported that changes 

in the crestal marginal bone level occur during the 

early phase of healing [1], as an adaptation of the periimplant 

bone to occlusal loads [2] or as a long-term 

response to altered trajectories within the bone as a 

response to the increased function [3]. Moreover, 

implant designs and surface characteristics affect the 

rate of early bone loss. It has been suggested that 

bone loss may be reduced by retention grooves 

(microthreads) at the implant neck or by a polished 

implant neck surface, which prevents penetration of 

the mucosa and subsequent peri-implantitis [15]. 

The aim of this paper was to critically reconsider 

recently published papers on marginal bone loss, 

bone gain and other clinical outcomes around 

endosseous implants. Our interest was to analyze the 

studies in which dental implants with threaded and 

non-threaded necks were compared. Furthermore, 

our clinical cases, their outcomes and follow-up 

results are indicative as a contribution to the discussion 

about the impact of the dental implant neck 

design on bone response. We have decided to include 

case histories as the second part of this paper in 

order to highlight the need for further research. 

Study design 

A search of the literature was performed to identify 

studies that analyzed marginal bone loss, bone gain 

and clinical outcomes following the insertion of 

endosseous dental implants. Inclusion criteria were: 

• human studies with comparison of survival of 

dental implants with threaded and non-threaded 

neck design, 

• studies with measurements of the marginal bone 

loss, 

• studies of bone gain following dental implant 

placement, 

• studies with follow-up of implant stability, 

• studies with respectable methodological quality 

(RCT, cohort studies). 

Articles reporting case results without controls were 

excluded. Clinical cases treated by us using dental 

implants with threaded and non-threaded neck 

design were included as supplementary data information. 

It also intends to highlight the need for 

future research through carefully planned large and 

long-term comparative studies. 

A MEDLINE search was performed to identify articles 

published in the preceding five years, examining 

treatment outcomes after insertion of dental im - 

plants with threaded and non-threaded neck designs. 

Four articles met the inclusion criteria and were 

included in this report (Tab. 1 to 3). 

Interventions 

Dental implants with different neck designs were 

compared and described as follows: 

Bratu (2009) 

A prospective study of 46 patients with indications 

for two adjacent implants in the posterior mandible.

Tab. 1 

MEDLINE 

search 

summary. 

Tab. 2 

Comparative 

studies evaluating 

endosseous 

implant designs 

with or without 

microthreaded 

necks. 

Tab. 3 

Evaluation of 

articles comparing 

endosseous 

implant designs 

with and without 

micro - 

threaded necks. 

Terms Hits Reviewed 

Search dental implants OR dental implantation, endosseous [MeSH] 19.455 

Search (dental implants OR dental implantation, endosseous [MeSH]) AND 

surface properties AND comparative study, limits ENGLISH, human, literature 

containing abstracts 

319 4 

Bibliographies from existing literature 0 0 

Total primary articles reviewed 4 

Author 

(year) 

Bratu 

(2009) 

Nicke nig 

(2009) 

Piao 

(2009) 

Shin 

(2006) 

Study 

design Population 

Pro - 

spective 

cohort 

N = 46 

female: NR 

age: 23-65 

years 

RCT N = 34; 

Ni = 133 

female: NR 

age: 45.2 (25- 

55) years 

RCT N = 54; 

Ni = 135 

female: 39% 

age: 36-78 

years 

RCT N = 68 

female: NR 

age: NR 

Diagnostic 

characteristics 

Indication for placement 

of two neighbouring 

implants in 

the same quadrant of 

the posterior 

mandible 

Bilaterally edentulous 

posterior mandibles 

with indication for 

implant placement 

Indication for implant 

placement 

Indication for implant 

placement 

Implant placement 

Rough 

surface, 

with 

micro - 

threads 

N = 46; 

Ni = 46 

N = 34; 

Ni = 70 

N = 21; 

Ni = 45 

N = NR; 

Ni = 38 

Rough 

surface, 

no 

micro - 

threads 

N = 17; 

Ni = 45 

N = NR; 

Ni = 34 

Machi ned 

surface, 

no 

micro - 

threads 

N = 46; 

Ni = 46 

N = 34; 

Ni = 63 

N = 16; 

Ni = 45 

N = NR; 

Ni = 35 



Follow-up 

(%) LoE* 

12 months: 

96% 

Median 1.9 

(1.9-2.1) 

years: NR† 

12 months: 

NR† 

12 months: 

NR† 

N = Number of subjects; Ni = Number of implants; * The Level of Evidence (LoE) is based on study design and methods (very 

high, high, moderate or poor); † NR (not reported) = follow-up rate either not reported or precise follow-up rate could not be 

determined since the initial number of eligible patients or the number lost to follow-up were not provided 

Study design and methods Bratu (2009) Nickenig (2009) Piao (2009) Shin (2006) 

1. Type of study design Prospective 

cohort 

RCT† RCT RCT 

2. Statement of concealed allocation* N/A Yes Yes No 

3. Intention to treat* N/A No No No 

4. Independent or blind assessment No No No No 

5. Complete follow-up of >_ 85% Yes Yes Yes Yes 

6. Adequate sample size Yes Yes Yes Yes 

7. Controlling for possible confounding Yes Yes Yes Yes 

Level of Evidence High High High Moderate 

† RCT – randomized controlled trial; * Applies to randomized controlled trials only; N/A – not available 

High 

High 

High 

Mod - 

e rate



All patients received (a) one implant with a 1-mm polished 

neck and no retention grooves, and (b) one 

implant with a roughened surface and microthreads 

at the neck. Other implant characteristics (taper, titanium 

alloy with moderately rough surface) were the 

same for both implants. 

Nickenig (2009) 

In a split-mouth study, 34 patients with bilaterally 

edentulous posterior regions in the mandible randomly 

received implants with a machined neck on 

one side and implants with a microthreaded neck on 

the contralateral side. Subjects were followed for two 

years under functional load. 

Piao (2009) 

54 patients randomly received implants with either 

(a) a rough surface (TiUnite Brånemark MK III), (b) a 

machined surface in the coronal part and rough surface 

in the apical part of the fixture (Restore) or (c) a 

rough surface with microthreads (Hexplant Oneplant). 

Subjects were followed for one year after 

implant loading. 

Shin (2006) 

In a prospective study, 68 patients were randomized to 

receive implants with either (a) a machined neck (Ankylos), 

(b) a rough-surfaced neck (Stage 1) or (c) a roughsurfaced 

neck with microthreads (Oneplant). Subjects 

were followed for one year after implant loading. 

Implant survival 

Implant survival was 100 per cent for both polishedneck 

and microthreaded-neck implants after one 

year of function. [Bratu] 

In the other three studies the authors have not 

specified the rate of implant survival, but neither 

implant loss was reported at the final examination. 

Marginal bone loss (Figs. 1 and 2) 

The marginal bone loss as measured on digitized 

panoramic radiographs was significantly greater for 

polished-neck compared to microthreaded-neck 

implants on the day of prosthesis cementation, four 

months after implant placement (0.77 ± 0.46 mm 

vs. 0.21 ± 0.19 mm, p < 0.05), after six months (1.20 ± 

0.44 mm vs. 0.56 ± 0.23 mm, p < 0.05), and after 

twelve months in function (1.47 ± 0.40 mm vs. 0.69 ± 

0.25 mm, p < 0.05). [Bratu] 

The marginal bone loss as measured on digitized 

panoramic radiographs was significantly greater for 

machined-surface (mean, 1.1 mm; range, 0-3 mm) compared 

to rough-surface, microthreaded (mean, 0.5 mm; 

range, 0-2.1 mm) implants (p < 0.001) after a median 

of 1.9 years in function. [Nickenig] 

Marginal bone loss/gain 

2.5 

2 

1.5 

1 

0.5 

0 

-0.5 

-1 

-1.5 

-2 

Rough surface, with microthreads Rough surface, NO microthreads 

Machined-surface, NO microthreads 

12 months, n=46 

[Bratu] 

23 months, n=34 

[Nickenig] 

p

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Since multiple implants in the same subject are 

not statistically independent, either one implant 

should be chosen per patient or statistical analysis 

should account for multiple implants per patient. 

This was not the case in three studies where multiple 

implants were placed in the same patient. 

Discussion 

Since the early 90s, many clinical studies have 

been conducted on the effect of the microthread 

on crestal bone loss. This was a variation on the 

guidelines for implant design derived from the 

Brånemark system – a smooth machined surface was 

regarded as an effective design to prevent plaque 

accumulation. 

However, it was soon realized that this machined 

neck is not an effective design for the distribution of 

occlusal forces. Hansson reported in 1999 that if perfect 

interlocking between the implant and the bone 

occurs and bone prevails apically to the neck region, 

interfacial shear stresses in the neck will not depend 

on the way in which interlocking was made. Hansson 

and others found that a small thread had the additional 

advantage of increasing the axial stiffness of 

the implant and brought more reduction in the peak 

interfacial shear stress on the cortical bone. Lee et al. 

suggested in 2007 that microthreads on the coronal 

portion of the fixture might have an effect in maintaining 

the marginal bone loss against loading, 

based on a 3-year prospective study. 

All authors of the studies reviewed reported the 

least amount of bone loss in the group for the roughsurfaced 

microthreaded neck implants after one 

year of functional loading, whereas the group with 

machined-neck designs showed the greatest amount 

of bone loss. 

It still appears difficult to draw clear conclusions 

on the impact of macrodesign of the implants when 

considering microthreads on the neck. 

When bone loss rate was compared, Shin (2006) 

and Bratu (2009) reported somewhat different 

results. Shin noticed that most bone loss occurred 

early in the healing period, which agrees with the 

results of other authors. However, the implants with 

machined necks showed significant bone loss during 

every interval of the follow-up, which could be interpreted 

as progressive bone loss. Bratu noticed that 

the rate of bone loss differed between implants with 

machined necks and implants with microthreaded 

necks only during the first six months; furthermore, 

he speculated that the surface roughness determines 

the amount of early bone loss, not the 

macrodesign. Finally, all authors are cautious in their 

interpretation of the results and the exact impact of 

Marginal bone loss (mm) 

1.6 

1.4 

1.2 

1.0 

0.8 

0.6 

0.4 

0.2 

0.0 

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Fig. 3a Implant with threaded neck design before insertion. 

Fig. 4a OPG – Implants inserted at sites 14, 34 and 44 with 

threaded neck design. Implants at sites 15, 17, 35, 36, 37, 45, 46 

and 47 with polished surfaces. 

Case 1 – female, 56 years old 

The patient received a combination of machined and 

microthreaded implants (Figs. 3a and b). In Figure 4b, 

in comparison to Figure 4a, it is clearly visible that a 

larger amount of the marginal bone is lost around 

the dental implants with machined surface. 

Unlike crestal implants, basal implants (BOI, TOI, 

Diskimplant) do not cause progressive crestal bone 

loss over time along their vertical portions, and they 

do not trigger any crater-shaped areas of collapsed 

bone. An example of progressive bone loss around 

crestal implants is shown in Figure 5. There have been 

isolated reports that restorations based on basal 

implants not only arrest the bone loss brought about 

by periodontal disease but can also generate new 

bone tissue [9,10]. Over the course of the development 

of basal implant systems, some changes in the 

design took place: earlier designs (approx. 1988–1999) 

had sandblasted endosseous surfaces. During this 

period, crater-like bone loss was reported to occur in 

a considerable amount of cases. Later, the vertical 

implant portions were polished, and only the baseplates 

remained sandblasted (1999–2003). Since 2003, 

all basal implants have been supplied completely 

polished; no related complications have been reported 

since. Polished surfaces resist colonialization by 

bacteria and the accumulation of plaque. They are 

Fig. 3b View of the lateral right side of the mandible (implantation 

procedure). Site 44 – threaded neck; Sites 45, 46, 47 – 

polished neck. 

Fig. 4b OPG – Two years and eight months after insertion. 

the standard of care in the treatment of fractures 

and meet the requirements for uneventful, stable 

osseointegration [3,10]. 

Our cases with implant/restoration systems in 

heavily resorbed areas of the distal mandible sometimes 

revealed considerable new bone formation 

below and above the load-transmitting disks of basal 

implants. Bone formation is clearly driven by function 

and may be initiated by the surgical intervention and 

the interruption of the pre-existing bone trajectories. 

In implants with polished surfaces in the border area 

between the oral environment and the bone, vertical 

bone development is possible because infection has 

little chance of gaining ground. 

Fig. 5 

Progressive 

bone loss 

around crestal 

implants.

Fig. 6a OPG – Totally edentulous maxilla and mandible 

reconstructed with crestal and BOI implants using immediate 

loading protocol. 

Fig. 7a OPG – BOI implants inserted at sites 14, 17, 24, 27, 37, 

34, 44, 47. 

To clarify the causes of bone loss and to explore the 

possibility to use thinner and polished implant necks 

and transition portions, further research is required. 

Our cases of implant/restoration systems in heavily 

resorbed areas of the distal mandible sometimes 

revealed considerable new bone formation below and 

above the load-transmitting disks of BOI implants. 

Case 2 – male, 59 years old 

Clearly visible vertical bone growth at implant sites 37 

and 47, while marginal bone loss occurred around all crestal 

implants, particularly in the mandible (Figs. 6a and b). 

Case 3 – female, 48 years old 

Clearly visible vertical bone growth at all mandibular 

implant sites as well as at sites 17 and 27 (Fig. 7a). Figure 

7b shows the 5-year postoperative view. 

We have not yet developed a research plan; we are 

introducing this patient data as indicative for particular 

discussion. The results of our clinical work are 

presented to help define future research needs. 

Conclusions 

From the data analyzed in four relevant studies on 

bone loss following implant insertion, it can be con- 



Fig. 6b OPG – Two years and nine months after insertion. 

Fig.7b OPG – Four years and ten months after insertion. 

cluded that there is less bone loss around the 

implants with threaded necks. Reported differences 

were statistically significant as far as marginal bone 

loss was concerned when implants with polished 

necks were compared to implants with microthreads. 

Our cases were presented in order to support this 

conclusion, even though the small sample size precludes 

statistical analysis. Further research is needed 

to obtain proof of the amount of marginal bone loss 

in long-term function after implant insertion when 

implants with machined and microthreaded neck are 

followed up and compared. In addition, our cases of 

implant/restoration systems in heavily resorbed 

areas of the distal mandible sometimes revealed considerable 

new bone formation below and above the 

load-transmitting disks of BOI implants. 



Vitomir S. Konstantinovic, DDS, MD, MSci, PhD 

Professor of Maxillofacial Surgery and Implantology 

University of Belgrade, School of Dentistry, 

Clinic of Maxillofacial Surgery 

Dr Subotica 4 · 11000 Belgrade · Serbia 

Phone/Fax: +381 11 2685342 

v.konstantinovic@stomf.bg.ac.rs

Institute 

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Tel.: (34) 945 149 202 

Fax: (34) 945 154 909 

export@bti-implant.es

BTI of North America 

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Implant abutments created by CAD/CAM 

Roads to implant abutments 

Josef Schweiger, MDT, Professor Daniel Edelhoff, PD Dr Florian Beuer and 

Dr Michael Stimmelmayr, Munich/Germany 

The development of CAD/CAM technology in recent years has opened up many new options for customizing implant 

abutments [9,10]. Most attention has been devoted to titanium and zirconia [11]. Not getting lost in a host of new fabrication 

techniques and design principles has become increasingly difficult for today’s users. The purpose of this review is to supply 

an overview of current approaches to fabricating custom implant abutments. 

Implant abutments constitute the critical interface 

between osseointegrated implants and their prosthetic 

superstructure. They embody the sensitive 

transition from the implant through the peri-implant 

soft tissue to the oral cavity and the prosthetic 

restoration. Implant abutments therefore need to 

meet specific requirements, including high stability, 

long-term strength and resistance to chemical 

action. They need to offer excellent biocompatibility 

and the ability to customize their shape and angulation. 

The exact nature of these requirements will 

depend on the implant site along the arch. 

Customized emergence profiles and shades and 

translucencies resembling those of natural teeth are 

considered essential to the reconstruction of satisfactory 

(notably anterior) aesthetics in the presence of A1 

or A2 periodontal morphotypes [1,2]. In addition, toothcoloured 

materials in the aesthetic zone will also be 

beneficial in the event of adverse structural conditions 

giving rise to abutment exposure. Initial attempts to 

solve these exposure-related problems were sporadically 

made by layering sintered ceramics over titanium 

abutments, laying the foundation for subsequent 

delivery of all-ceramic restorations (Figs. 1 and 2). 

1 2 

Fig. 1 Build-up of a titanium abutment (Steri-Oss) with sintered 

porcelain to accommodate a glass-ceramic crown with 

a lithium-disilicate framework. 

In 1993, Prestipino and Ingber presented a densely 

sintered abutment made of alumina, to be used as an 

all-ceramic alternative to metal-based abutments 

in the anterior segment [3]. After taking a direct 

impression at implant level, cylinders of highly pure 

and densely sintered alumina ceramic cylinders were 

prepared, usually for restoration with all-ceramic 

crowns. Some of the laboratory procedures were very 

time-consuming. At the same time, the minimum 

thickness of the material could not be adequately 

controlled. Veneering ceramics fused to the surface 

were used for additive customization to establish an 

adequate emergence profile (Fig. 3). An unprecedented 

level of aesthetics and light transmission was 

achieved by combining these abutments with glassceramic 

crowns (Figs. 4 to 7). 

Soon after the introduction of alumina abutments, 

the first experimental abutments made from 

partially stabilized zirconia became available. Like 

their alumina predecessors, these zirconia abutments 

would involve a time-consuming manual 

process of customization from the prefabricated 

cylinders in the dental laboratory (Figs. 8 and 9). The 

new zirconia abutments featured both a radiopacity 

Fig. 2 Situation after delivering the glass-ceramic crown to 

the veneered abutment (technician: Volker Weber, Aachen, 

Germany).

Fig. 3 

All-ceramic 

implant abutment 

on a master 

cast with 

artificial gingiva. 

The abutment 

was made from 

highly pure and 

densely sintered 

alumina ceramic 

(Ceradapt, Nobel 

Biocare). Its 

emergence profile 

was modified 

(technician: 

Volker Weber, 

Aachen, Germany) 

with sintered 

ceramics 

(Vitaduralpha, 

Vita Zahnfabrik). 

Fig. 7 

All-ceramic 

implant restoration. 

Other than 

a mild shadow 

from the gold 

screw, light 

transmission is 

similar to a 

natural tooth. 

3 4 

5 6 

Fig. 5 Alumina abutment (Ceradapt) after connection with a 

torque driver. 

7 

8 9 

Fig. 8 Cylindrical blank of HIP zirconia (Wohlwend Innovative, 

Zurich, Switzerland) for abutments to be used with Brånemark 

implants. 

similar to metals and a reduced hardness compared 

to the alumina variant [4]. An investigation performed 

in vitro demonstrated that these zirconia 

Fig. 4 Brånemark implant (Nobel Biocare) placed at site 11. 



Fig. 6 Situation following adhesive delivery of a leucitereinforced 

crown (IPS Empress) in 1998 (technician: Andreas 

Rübben, Aachen, Germany). 

Fig. 9 Zirconia abutments after time-consuming customization 

for all-ceramic crowns. 

abutments had a fracture strength approximately 

2.5 times higher than that of their alumina counterparts 

[4].



10 12 

11 

Fig. 11 Experimental use of all-ceramic abutments (zirconia and alumina in the 

third and fourth quadrants respectively) in the posterior mandible (year: 1998). 

The highest fracture strength of metal-ceramic 

and all-ceramic crowns is, however, still observed on 

titanium abutments [5,6]. Long-term clinical investigations 

confirmed that the stability of zirconia abutments 

was higher than that of alumina abutments 

[7]. Similar findings were obtained among our own 

patients (Figs. 10 to 13). The literature reveals a beneficial 

effect on peri-implant soft-tissue conditions, as 

less bacterial adhesion was demonstrated on zirconia 

healing caps than on titanium ones [8]. 

The development of CAD/CAM technology in 

recent years has opened up many new options for 

customizing implant abutments [9,10]. Most attention 

has been devoted to titanium and zirconia [11]. 

Implant abutments have also benefited from the 

numerous improvements brought about by advanced 

manufacturing techniques. This progress has led to 

standardized fabrication routines, industrial-grade 

prefabrication of high-quality restorative materials 

and automated control of minimum layer thickness. 

Compared to manual fabrication, the processing routines 

have become more conservative and faster. Not 

getting lost in a host of new fabrication techniques 

and design principles has become increasingly difficult 

for today’s users. The purpose of this review is to 

supply an overview of current approaches to fabricating 

custom implant abutments. 

13 

Fig. 13 The implant was extensively reduced with abrasive 

instruments for correct axial inclination. Given the means 

available in laboratories at the time, minimum thickness of 

the material could not be adequately controlled. 

Fig. 10 

Experimental 

use of all-ceramic 

abutments 

(alumina and 

zirconia in the 

first and second 

quadrants 

respectively) 

in the posterior 

maxilla (year: 

1998). 

Fig. 12 

Fracture of an 

experimental 

alumina abutment 

(Ceradapt, 

Nobel Biocare) 

at site 16 following 

four years of 

clinical service.

Tab. 1 General classification of implant abutments 

Prefabricated abutments 

Customizable 

Non-customizable 

Cast-to/press-to abutments 

Cast-to HSL sleeves 

Press-to CoCr abutments (POC) 

CAD/CAM implant abutments 

Titanium 

All-ceramics (with or without bonding base) 

CoCr alloy (Wirobond Mi+, for Bego Semados) 

Classification of abutments 

A general classification of implant abutments can 

be made by fabrication techniques, distinguishing be - 

tween prefabricated abutments, castable/pressable 

abutments and CAD/CAM implant abutments (Tab. 1). 

Implant manufacturers offer prefabricated abutments 

in various sizes, shapes and angulations. Also, they 

are available as customizable and non-customizable 

versions. However, since the limits of customization 

are quickly reached with prefabricated abutments, 

users have long desired to modify the shape of abutments 

as freely as possible. An intermediary solution 

was provided in the form of HSL sleeves. These were 

designed so laboratory technicians can wax up an 

ideal geometry, which is then implemented in a precious 

metal using the lost-wax technique (Fig. 14). 

Alternatively, pressable ceramics can be used for custom 

shaping, thus yielding press-on ceramic (POC) 

abutments. Oversized customizable abutment 

blanks (e.g. Telescope Abutment, Camlog Biotechnologies, 

Basel, Switzerland) would be another 

option (Fig. 15). However, the effort that goes into processing 

these blanks is considerable. In addition, this 

type of customization involves a risk of inappropriate 

handling or damage to the material (whether titanium 

or zirconia) by overheating. Customized zirconia 

blanks should therefore be processed only under irrigation 

with copious amounts of water. To allow customization 

of titanium abutments under irrigation, 

one manufacturer (Komet, Brasseler, Lemgo, Germany) 

has developed a specialized set of cutters (original 

design by J. H. Bellmann) for use in irrigated laboratory 

14 

15 

16 



Fig. 14 Castable sleeves featuring an HSL base are currently 

the most popular approach to fabricating custom abutments. 

Figs. 15 and 16 Prefabricated customizable abutment (Telescope 

Abutment, Camlog Biotechnologies). 

turbines (Fig. 16). This system greatly improves the 

performance of material reduction while minimizing 

heat development. CAD/CAM abutments are predominantly 

fabricated from titanium and zirconia [12]. 

While titanium abutments are processed as mono - 

blocks, all-ceramic abutments may be used either 

with or without a bonding base.



17 18 

19 

1. Abutments implemented by CAD/CAM from 

titanium monoblocks 

Figures 17 and 18 illustrate this concept. Abutments 

implemented by CAD/CAM from titanium 

are offered by various manufacturers. For the time 

being, the computer-assisted manufacturing of these 

abutments can only be performed in dedicated 

milling centres (e.g. Straumann CAD/CAM, Leipzig, 

Germany; Nobel Procera, Göteborg, Sweden; Compartis 

ISUS, Hanau, Germany; Astra Atlantis, Möln - 

dal, Sweden). Manufacturers either use industrially 

prefabricated blanks of a semi-finished nature (i.e. 

with the implant-abutment interface already prefabricated 

to industrial standards) or finished abutments 

milled from a titanium block (i.e. with both 

the external shape and the interface already completed) 

for CAD/CAM implementation. Ready-made 

CAD/CAM abutments offer the advantage of not 

requiring any subsequent processing other than surface 

polishing with silicone rubber cups if required. 

This eliminates the need for expensive corrections 

and avoids the risk of damaging the material in the 

process. 

2. Abutments implemented by CAD/CAM from 

zirconia 

Zirconia CAD/CAM abutments may be fabricated with 

or without a titanium bonding base. Both variants 

have their specific advantages and disadvantages. 

3a. Ceramic abutments without a bonding base 

Like titanium abutments, those ceramic abutments 

that do not use a bonding base are also implemented 

from monoblocks by CAD/CAM (Fig. 19) [13]. They 

are also supplied as semi-finished blanks with the 

abutment-implant interface already prefabricated in 

an industrial process. The external abutment geometry 

is custom-milled from the blank, utilizing the 

design data or the wax-up that the laboratory has 

generated for this purpose. CAD/CAM ceramic abutments 

without a bonding base have both advantages 

and disadvantages. A brief summary of these follows. 

Advantages: 

• With no subsequent adjustments performed to 

the abutments, there is no risk of inflicting damage 

to the material. 

• White (i.e. tooth-coloured) abutments will offer 

aesthetic advantages for anterior implant restorations. 

• Perfect biocompatibility in the sensitive transition 

zone from implant to abutment. 

Disadvantages: 

• No conical anchorage of the abutment screws, as 

these screws have direct contact with the ceramic 

material, thus being usually anchored in a perpendicular 

channel with parallel walls to avoid tensile 

stresses inside the ceramic abutment. These con- 

Figs. 17 and 18 

Titanium 

monoblock 

abutments. 

Fig. 19 

CAD/CAM 

ceramic abutment 

(without a 

bonding base).


CAD/CAM 

ceramic abutment 

(with a 

bonding base). 

Fig. 22 

Screw designs for 

titanium monoblock 

abutments, 

all-ceramic abutments 

without a 

bonding base and allceramic 

abutments 

with a bonding base 

(left to right). 

Different screw 

designs are usually 

employed for these 

abutment types. 

20 21 

22 

nections therefore carry a higher risk of screw 

loosening than the ones used in titanium abutments. 

• Ceramic abutments will generally involve a higher 

risk of facture than titanium abutments. 

3b. Ceramic abutments with a bonding base 

All-ceramic CAD/CAM implant abutments with a 

bonding base are fabricated from presintered zirconia 

either in a dental laboratory (e.g. inLab MCXL, 

Sirona, Bensheim, Germany; Everest, KaVo, Biberach, 

Germany) [12,14] or in a milling centre (e.g. Bego Medical, 

Bremen, Germany; 3M Espe Lava, Seefeld, Germany) 

(Figs. 20 and 21). One approach is to use partially 

prefabricated “mesioblocks” of zirconia, designed 

as semi-finished blanks with the connection from 

abutment to bonding base already incorporated. 

Once the external geometry has been ground to 

shape, the abutments are densely sintered and connected 

to the bonding base. The bonding bases as 

such are industrially manufactured from titanium, 

hence offering the same fit as prefabricated titanium 

abutments. Again, a number of advantages and disadvantages 

should be considered. 

Advantages: 

• Conical anchorage of the abutment screw inside 

the titanium bonding base, which reduces the risk 

of screw loosening (Fig. 22). 



• Tightening the connection screws will not introduce 

any tensile stresses into the ceramic abutment. 

• Can be fabricated outside of milling centres 

(i.e. in laboratories and dental offices). 

• Low cost. 

Disadvantages: 

• Additional effort of bonding the ceramic abutment 

to the titanium base. 

• Risk of debonding if inappropriately executed. 

• Reduced quality management by lack of industrial 

manufacturing. 

• Increased affinity to plaque formation (due to the 

bonding gap filled with composite) in the sensitive 

transition zone from implant to abutment. 

4. Abutments implemented by CAD/CAM from CoCr 

alloy and precious metal on a titanium bonding base 

Bego additionally offers an CoCr alloy (Wirobond C+, 

Bego) as metal material for CAD/CAM bonding abutments. 

All CAD/Cast materials are also offered by this 

manufacturer. In the CAD/Cast process, resin restorations 

are fabricated in the milling centre based on 

the CAD designs generated by the laboratory technician. 

These resin restorations are then cast using the 

lost-wax technique in an industrial process of vacuum 

pressure casting. Eight different precious alloys 

and one non-precious alloy (Wiron 99, Bego) are currently 

available for this purpose.



23 24 

25 26 27 

Three strategies of implementing abutments 

by CAD/CAM 

Three different fabrication methods for CAD/CAM 

abutments can be distinguished at the present time: 

• Complete outsourcing (e.g. AstraTech Atlantis). 

• CAD in the laboratory, CAM in the milling centre 

(e.g. Straumann Wax Abutment, Straumann Cares, 

Bego Medical). 

• CAD in the laboratory, CAM in the laboratory (e.g. KaVo 

Neolink, Sirona zirconia bonding abutment) [14]. 

1. Complete outsourcing 

Examples of complete outsourcing of implant abutments 

include Astra Atlantis (Astra Tech, Mölndal, 

Sweden) and abutments supplied by the Compartis 

ISUS milling centre (DeguDent, Hanau, Germany). 

This implementation strategy will be outlined using 

the Atlantis system (Astra Tech) as an example. 

The first step after fabricating the implant model 

(Figs. 23 and 24) is to create a wax-up. The adaptation 

of prefabricated teeth has proved to be highly efficient 

for this purpose. To achieve optimal positioning of the 

teeth over the implant analogues on the cast, they can 

be waxed up to length-reduced impression posts for 

reproducible placement and removal (Figs. 25 to 27). 

The abutments are defined and ordered through a Webbased 

form (Figs. 28 and 29). A number of design features 

for the CAD/CAM abutment to be customized 

can be entered. These include parameters such as 

transmucosal profile (Fig. 30), preparation depth as 

measured from the gingival margin or implant shoulder, 

shape of the abutment preparation (chamfer or 

shoulder), any retention surfaces in the case of titanium 

abutments and any parallelism between abut- 

ments if desired (Fig. 31). With regard to mucosal shaping, 

for example, these four design options are available: 

• Mucosa will not be shaped. 

• Mucosa will be supported. 

• Mucosa will be shaped. 

• Maximum anatomical width. 

A parcel service takes care of collection and delivery. 

Delivery of titanium abutments is guaranteed within 

five days; delivery of zirconia abutments within seven 

days. Orders of more than three abutments will delay 

the shipment by one day per additional unit. 

The customized abutments are fabricated based 

on the existing wax-up in the milling centre. Astra 

Tech’s patented software solution Atlantis VAD (Virtual 

Abutment Design) permits matching the abutment 

design to the definitive external geometry of 

the restoration. The resultant design will greatly facilitate 

the subsequent task of creating the framework 

and veneer back in the laboratory. Framework errors 

are virtually ruled out by this procedure. Once the 

abutments have been designed, screenshots are sent 

by e-mail for verification (Fig. 32). In early 2010, a 

service was introduced that allows technicians to 

verify and check the CAD abutments with a 3D viewer 

(Fig. 33). The go-ahead for the actual fabrication 

process is also given by e-mail. 

A collaborative effort by 3M Espe and Astra Tech 

has resulted in a new approach based on the Lava 

Scan ST system. After scanning laboratory-fabricated 

implant models with this system, the data captured 

are transmitted directly to the milling centre. This new 

procedure enables laboratories that use Lava Scan ST 

to place orders without having to ship a model to 

Astra Tech (Figs. 34 to 36). 


Implant master 

cast with artificial 

gingiva and 

two implants 

(Astra Osseo 

Speed) at sites 35 

and 36. 

Fig. 25 

Length-reduced 

impression posts 

can be used to facilitate 

the set-up. 


The set-up can be 

performed with 

prefabricated teeth, 

which are cut back 

to fit the reduced 

impression posts.

Fig. 28 

The order is 

placed via the 

Atlantis website. 

Fig. 29 

Input form collecting 

the case 

data and design 

parameters for 

the various 

implants. 

Fig. 30 

Various design 

parameters can be 

entered for the 

custom CAD/CAM 

abutments (e.g. 

mucosal shaping). 

Fig. 31 

Several different 

abutments can be 

designed in 

parallel. 

Fig. 32 

Screenshots are 

sent by e-mail 

for verification 

of the designs. 

Fig. 33 

A 3D viewer is 

offered to verify 

the abutment 

design. 

Figs. 34 to 36 

Lava Scan ST 

(3M Espe) offers 

scanning of 

implant models 

created in the 

laboratory and 

direct transfer of 

the resultant 

data to Astra 

Tech (Mölndal, 

Sweden). 

28 29 

30 31 

32 33 

34 35 

36 


Clinical Science



37 

38 39 

Another collaborative effort by Astra Tech and Dental 

Wings (Montreal, Ontario, Canada) has been 

under way since early 2010. A similar principle as with 

the 3M Espe scanner is used as data from the Dental 

Wings 3D scanner can be directly transmitted by 

electronic means to Astra Tech’s design and milling 

centre for fabrication of Atlantis abutments. 

Atlantis abutments are available with interfaces 

for different implant systems (Astra Tech, Nobel Biocare, 

Straumann, 3i, Lifecore, Zimmer Dental, Biohorizons, 

Innova and Sterngold). They are offered as zirconia, 

titanium or GoldHue (titanium nitride-coated 

titanium) abutments (Figs. 37 to 39). 

2. CAD in the laboratory, CAM in the milling centre 

Another way of obtaining CAD/CAM abutments is 

to perform the CAD (i.e. the design) part in the laboratory 

and then to transfer the data to a milling 

centre electronically for fabrication of the customized 

abutments with industrial milling systems 

based on the data record from the laboratory. Two 

different techniques are available to generate the 

CAD record: 

• Creating a wax abutment. 

• Designing the abutment by CAD only. 

2a. Wax abutment 

This option is currently available, for instance, with 

the Straumann CAD/CAM system. The Straumann 

Wax Abutment will serve as an example to outline 

this implementation strategy. Wax-up sleeves are 

used as basis for the wax abutments (Fig. 40). These 

sleeves facilitate the task of waxing up the abutment 

geometry; in addition, they also serve as connection 

element to the scan mount in the Straumann ES-1 

Scanner (Figs. 41 to 44) [3,9]. Upon completion of 

scanning, the system will generate a CAD record of 

the wax-up. Subsequent modifications to the design 

such as smoothing of surface irregularities can be 

performed (Figs. 45 and 46). Finally, the data record is 

transferred to the Straumann milling centre (Leipzig, 

Germany) for fabrication of a monoblock (i.e. without 

a bonding base) abutment. Advanced HSC (highspeed 

cutting) systems are available at the milling 

centre for this purpose (Fig. 47). The implant-abutment 

interface being a prefabricated component, 

only the external abutment surface needs processing. 

Zirconia abutments are fabricated from a hot isostatically 

pressed (HIP) material that offers superior 

mechanical properties due to industrial-grade sintering 

(Figs. 48 to 50). 


Atlantis abutments 

are 

offered in zirconia, 

titanium or 

GoldHue (titaniumnitride-coated 

titanium).

40 

43 44 

45 47 

46 

Figs. 45 and 46 Wax abutment as CAD 

record. 

41 42 

Fig. 47 The abutments are fabricated in the milling centre. 

48 49 50 

Figs. 48 to 50 Zirconia monoblock abutment to be used with a Straumann Bone Level RC implant. 



Figs. 40 to 44 Wax-up sleeves facilitate the task of waxing up the abutment geometry; in addition, they also serve as connection 

element to the scan mount in the Straumann ES-1 scanner.



51 52 

53 54 

2b. Straumann Cares and Straumann CAD/CAM 

abutments 

This version of implementing CAD/CAM abutments 

involves a CAD record generated in the dental laboratory, 

which is then electronically transferred to the 

Straumann (Cares or CAD/CAM) milling centre. Cares 

or Straumann CAD/CAM abutments are designed with 

Cerec 3D (Figs. 51 to 55) or Etkon Visual (version 5.0 or 

later) software, respectively. CAD-based manipulation 

tools for abutments include rotation, scaling and translation. 

It is also possible to add and subtract material. 

The software ensures that predefined values for minimum 

wall thickness are respected. Sirona Cares, for 

example, outlines the minimum thickness in blue while 

the implant screw channel is displayed in red. 

The same principle of electronically transferring 

the CAD record to the milling centre once the design 

part has been completed also applies to the Straumann 

(Cares or CAD/CAM) system. The process in - 

volved corresponds to the Wax Abutment process. 

55 

3. CAD in the laboratory, CAM in the laboratory 

The third possibility is to conduct the entire fabrication 

process for custom CAD/CAM abutments in the 

dental laboratory. Titanium bonding bases are used 

for this purpose. The abutments milled from zirconia 

are bonded to these bases [14]. The blanks are custom-milled 

in a pre-sintered condition and therefore 

need to be densely sintered after milling. The following 

two solutions are available to fabricate the zirconia 

abutments: 

3a. Conventional zirconia blanks 

Here the zirconia abutment is milled from a conventional 

zirconia blank, such that the milling system 

will also take care of creating the screw canal. Examples 

include: 

• Titanium bonding bases and scan bodies by Neoss 

(Neolink) for the Everest system (Figs. 56 to 59) [15]. 

• Titanium bonding bases and scan bodies by Prowital 

(Figs. 60 to 65) [14,16]. 


CAD of a Straumann 

Cares 

abutment with 

Cerec 3D software. 

Fig. 53 

Fabrication of 

Straumann 

Cares abutments 

is centralized. 


Straumann 

Cares abutment 

in the patient’s 

mouth.


Neoss Neolink 

titanium bonding 

base and 

scan body for 

CAD with the 

KaVo Everest 

system. 


Titanium bases 

and scan bodies 

by Prowital. 


The implant 

module in 

3Shape Dental 

Designer is used 

for CAD. 

56 

58 57 

60 61 

62 

63 64 65 

57 


Clinical Science



66 67 

Fig. 66 Camlog bonding base. 

• Titanium bonding bases by Medentika (Hügels - 

heim, Germany) of the 800 series in combination 

with an add-on module (nt-IQ by NT-Trading, 

Neustadt, Germany) for 3Shape Dental Designer. 

Scan bodies and bonding bases are available for 

numerous different implant systems. 

• Titanium bonding bases by NT-Trading (Neustadt, 

Germany). Scan bodies and bonding bases are 

available for numerous different implant systems. 

• Titanium bonding bases by Camlog are complemented 

by Camlog scan bodies (introduced in 

June 2010) to be used in dental CAD systems. 

• Titanium bonding bases, scan bodies and blanks 

(inCoris ZI meso) by Sirona are available for seven 

additional implant systems. 

3b. Semi-finished zirconia blanks 

Here the zirconia abutment is fabricated from a 

semi-finished blank. For this purpose, manufacturers 

are offering partially prefabricated blanks with the 

connection geometry of the bonding base already 

incorporated. All that remains to be done is to customize 

(by grinding/milling) the external surface to 

the desired shape. The blanks are milled in a pre-sintered 

condition and therefore need to be densely sintered 

after milling. To name two examples of semifinished 

zirconia blanks: 

Fig. 67 Semi-finished blank (Sirona inCoris ZI meso) before … 

68 

Fig. 68 … and after customization on the milling machine 

(Sirona inLab MCXL). 

• Camlog bonding base with Sirona (inCoris meso) 

blank (Figs. 66 to 71). 

• Sirona bonding bases, scan bodies and (inCoris 

ZI meso) blocks are available for seven additional 

implant systems. 

Most of the manufacturers listed use an anti-rotational 

mechanism of the interface between the titanium 

base and zirconia abutment, which ensures 

that the abutment will not rotate out of position to 

avoid incorrect bonding to the titanium base (Fig. 72). 

Overly tight seating of the abutment on the bonding 

base may be caused by interferences in the area of 

the anti-rotational mechanism, which can be precisely 

removed with a diamond cutter. 

The CAD process for abutments offers customary 

manipulation tools such as scaling, rotation, translation 

and adding/reducing material. Sirona Cerec/ 

Sirona inLab introduced a CAD process for abutments 

in software revision V3.0. KaVo Everest has offered 

CAD/CAM abutments ever since version 3.x of the 

Energy software package was released. 3Shape Dental 

Designer is already capable of accommodating 

eleven different implant systems with the help of an 

add-on module (nt-IQ by NT-Trading) as well as scan 

bodies and titanium bonding bases (NT-Trading and 

Medentika). This option is supported, for instance, by

69 70 

Fig. 69 Individual components of a bonding abutment: titanium 

bonding base, abutment screw and custom-milled zirconia 

abutment. 

71 72 

Fig. 71 Bonding abutment in situ. 

the Bego CAD/CAM and 3M Espe Lava systems [15]. 

The Heraeus Cara system offers this option since 

the second half of 2010. The bonding abutment is 

designed in the laboratory (3Shape Dental Designer, 

Lava design 5.0). The data record is then transferred 

to the milling centre, where the bonding abutments 

are fabricated and shipped back to the customer. 

Bego Medical currently offers zirconia (BeCe CAD 

Zirkon+, available in five shades; BeCe CAD Zirkon XH 

offering higher strength, available in three shades), 

CoCr (Wirobond C+) and all CAD/Cast materials for 

bonding abutments. In addition, Bego also offers to 

fabricate copings that will match the bonding abutments. 

Discussion 

The success of implant-supported restorations 

depends on a number of separate factors. One of 

these factors (alongside others such as bone situation, 

implant position, implant length and oral 

hygiene) is the abutment to be used with the 

implant. In many situations, prefabricated abutments 

will run up against limitations that will bring 

about dissatisfying outcomes. This is where custom 

CAD/CAM abutments come into their own [9]. They 

can be optimized in terms of axial inclination and 

Fig. 70 Bonding abutment after bonding. 



Fig. 72 Manufacturers commonly use an anti-rotational 

mechanism between the titanium base and the zirconia. 

shape for existing situations. The most important 

clinical benefit of these abutments is their ability to 

shape the emergence profile. Used with cementable 

restorations, they eliminate any need for the tricky 

job of removing excess cement because the restorative 

margin can only be placed at (or slightly above) 

the gingival level. The effort of going into manual procedures 

remains within economically acceptable limits, 

and the materials used can be processed in a conservative 

fashion, which is not always the case with 

manual surface treatment of customizable abutment 

blanks. It is therefore not surprising that more 

and more implant manufacturers and CAD/CAM suppliers 

should join forces to provide their customers 

with the option of obtaining CAD/CAM abutments. 

These very positive developments will offer advantages 

for dentists and technicians. Most importantly, 

they will also benefit the patients. 



Josef Schweiger, MDT 

Poliklinik für Zahnärztliche Prothetik 

Klinikum der Universität München 

Goethestraße 70 . 80336 München . Germany 

zahn.labor@med.uni-muenchen.de



A new approach to ridge restoration in cases of severe horizontal resorption 

Transitional implants 

Eduardo Anitua, DDS, MD, Vitoria-Gasteiz/Spain 

The use of dental implants in the restoration of edentulous areas is standard practice today, with predictable outcomes [1]. 

Sometimes, the recipient bone will be wide, high, and dense enough for implants to be placed without any further preparation. 

In patients who have been edentulous for a long time, however, we frequently encounter severe horizontal and vertical resorp- 

tion or a combination of defects that makes additional measures unavoidable (Figs. 1 and 2). 

In the case of horizontal problems, achieving satisfactory 

revascularization and a good prognosis requires 

at least 1 mm of bone width around the implant 

vestibularly and lingually/palatally [2]. When the 

width of the alveolar ridge to be restored is smaller 

than the diameter of the implant we propose to 

insert, we can resort to specific techniques for 

expanding the ridges horizontally [1,3,4]. 

The principal techniques used for this purpose, as 

described in the literature, include: block bone grafts, 

particulate bone grafts with an absorbable or nonabsorbable 

mesh, bone substitute materials, ridge 

distraction systems and ridge expansion systems 

using expanders, osteotomes, and the split-crest 

technique using ultrasound or conventional surgery 

[1,3,5-8]. 

Evolution of the split-crest technique 

The split-crest bone expansion technique, along with 

distraction, are the only techniques used for achieving 

horizontal growth that do not rely exclusively on 

grafts. It was first described by Simion et al. [7] in 1992 

for crests in which, despite severe horizontal resorption, 

the two plates were preserved intact and presented 

with a width of at least 4-5 mm. 

The technique allows the vestibular plate to be 

separated from the lingual or palatal plate, moving 

the vestibular cortical plate of the upper or lower jaw 

so as to separate it from the medullary cavity and to 

create an intermediate gap, which is then mostly 

filled by the implants inserted. The space not taken 

up by implants can be filled with biomaterials, particulate 

bone grafts or PRGF [8,9]. The space created 

between the two cortical plates then fills with new 

bone, enlarging the alveolar ridge so that techniques 

associated with increased morbidity (that require 

larger donor areas from which bone can be collected 

for grafting) can be dispensed with [4] (Figs. 3 and 4). 

The split crest technique has made considerable 

progress since it was first used. One of the major 

advances has been the introduction of ultrasound 

surgery for performing the osteotomy, replacing the 

conventional method using discs and chisels [9-11]. 

Apart from jarring the patient with painful blows, the 

chisel method lacks precision and is difficult to control, 

especially in severely resorbed ridges with high 

bone density. Rotating or oscillating discs are less 

stressful for the patient but present significant limitations 

as regards accessibility, with possible injury to 

the lips, tongue and surrounding soft tissues [4]. 

The electronic scalpel uses an ultrasound frequency 

that makes for great precision and safety when performing 

the osteotomy – a frequency that allows it 

to cut hard tissues such as bone without damaging 

other soft tissues such as gums, blood vessels, nerves 

or sinus membranes [4,9]. 

In addition, the wide variety of specially designed 

tips means that the technique can be properly adapted 

to clinical situations involving different amounts 

of residual cortical bone. Another important point to 

emphasize is that the biological viability of ultrasound-treated 

bone is comparable to that of bone 

treated by other surgical techniques, and patients 

report less postoperative discomfort [11-13]. 

More recently, the introduction of motorized 

expanders to replace the conventional manual 

osteotomy for enlarging the implant bed has helped 

shorten surgery times and reduce the complexity of 

the technique, making it more accessible to a larger 

number of professionals (Figs. 5 and 6). 

Gradual improvements to the conventional splitting 

technique now enable us to treat ridge crests 

with a width of 3.5 mm and upward, preserving both

1 2 

f 

e 

d 

cortical plates with excellent results. The challenge 

for us now is to be able to treat ridge crests 2.5 and 

3 mm in width. 

We begin by treating these cases with a technique 

called the “two-stage split ridge”. It is a variation on 

the conventional split-ridge technique, where, after 

osseointegration, the initial implant is replaced by 

another implant with a larger diameter. 

The implant is removed completely atraumatically 

using the new BTI extractor kit with a counter-torque 

device, which ensures that the peri-implant bed is 

kept intact after the explantation. Another drilling 

c 

b 

a 



Figs. 1 and 2 Patterns of horizontal and vertical resorption in the mandible and maxilla as a consequence of tooth loss. 

Cases c and d in the mandible and b, c, and d in the maxilla look like obvious candidates for the transitional implant technique 

presented here. 

3 4 

a b c d e 

Figs. 3 and 4 Division of the ridge crest separating the vestibular and palatal cortical plates. Placement of the implants, showing 

the gap between the two plates that will be filled with new bone after a period of new bone formation. 

5 6 

Figs. 5 and 6 Using ultrasound to perform the split. Dilating the newly-formed socket by means of motorized expanders. 

procedure is then performed, and a further expansion 

step allows to place a larger-diameter implant, 

which in turn has the effect of expanding the ridge 

crest still further, while at the same time compacting 

the bone. In this way, more horizontal expansion is 

achieved than had been possible prior to the introduction 

of this new step, as seen in the clinical case 

treated in this way (Figs. 7 to 12). 

This technique has given excellent results, achieving 

an average enlargement of between 5 and 9 mm, 

depending on the measurement point (apical/coronal). 

There was just one challenge to overcome: when



Situation before Provisional implant Final implant 

7 8 9 

2,6 

2,6 

10 11 12 

Figs. 7 to 12 Images showing, from left to right, the progress of the case. The images on the left show a ridge crest marked by 

severe resorption and an average width of approximately 2.5 mm. The images in the centre show how much space is gained 

with the first split, doubling the width of the ridge crest. The images on the right show the final result after insertion of the 

second implant. We can see how the initial width has been tripled in size. 

using Tiny implants, which have a collar that opens 

out to 3.5 mm, we generally saw a vertical loss of 

1-2 mm of crestal bone in the area of the implant collar. 

We considered the possibility of using implants 

similar in design to the Tiny, but without the head, 

which had generated the bone loss by compression. 

These implants would allow us to proceed with a 

two-stage expansion with no loss in bone height. 

Moreover, these implants should have a surface 

treatment that would allow us not only to avoid the 

loss of crestal bone around the implant collar, but 

also, by exploiting the bioactive characteristics of the 

surface – coated with PRGF – to achieve vertical 

growth at this critical level. 

It was this thinking that led to the development of 

transitional implants that incorporate all these characteristics. 

They come in two lengths (8.5 and 11.5 mm) 

and two diameters (2.5 and 3 mm). They do not widen 

out at the collar and have a square implant mount 

connector, matching in size that of prosthetic screws, 

so that they can be inserted with the predesigned 

square tips using a contra-angle (Figs. 13 and 14). 

6,7 

5,6 

9,9 

10,9 

As a result, the advantage of this technique – which 

we could call the “accordion technique”, given that the 

expansion is performed in two stages – is that it 

allows us to make the two width adjustments that 

we described for the two-stage split technique, but 

without the risk of crestal bone loss seen previously. 

This reduction in diameter around the implant collar 

also gives us the option of carrying out a less pronounced 

separation of the plates at this level, which 

makes for better vascularization in the gap and, consequently, 

for a far more predictable result. 

At present, this technique lets us achieve horizontal 

growth of up to 300 per cent relative to the initial 

ridge crest, starting with crests as narrow as 2.5 mm, 

sometimes increasing to as much as 7 mm, thus 

often exceeding the results obtained with conventional 

horizontal enlargement techniques. The average 

width gain reported in different studies is equal 

to 3.6 mm, being somewhat better when using nonresorbable 

barrier membranes to cover the expansion 

site (4.2 mm) than when using resorbable membranes 

(2.9 mm) [3].

Fig. 13 

Family of 

transitional 

implants. 

Fig. 14 

Wetting a 

transitional 

implant with 

PRGF. 

13 14 

Lastly, we recommend filling the gap produced by 

the initial split and the first insertion of the transitional 

implant with activated PRGF and covering it 

with a fibrin membrane to ensure that the newly 

formed bone is of better quality and has an adequate 

blood supply. If we fill this gap with biomaterial, 

when we go back in to replace the transitional 

implant, we may find poorer-quality bone composed 

Clinical case 1 

1 2 

Fig. 1 Initial case photograph. Fig. 2 Initial X-ray. 

3 4 

Figs. 3 and 4 Image of the mandibular ridge after starting the split. 



largely of the biomaterial originally placed there, 

which would seriously compromise osseointegration 

of the second implant and satisfactory vascularization 

of the bone bed. 

The clinical cases described below illustrate the use 

of transitional implants and the results achieved. 

A list of references can be found at www.teamwork-media.de



5 6 

Fig. 5 Inserting the transitional implant with a square tip. 

8 9 

10 11 

12 13 

7 

Fig. 6 

Transitional 

implants in 

place. 

Fig. 7 

X-ray after 

surgery. 

Figs. 8 and 9 

Re-entry after 

three months; 

note the gain in 

width (6 mm). 

Fig. 10 

CAT scans for diagnostic 

purposes. Photo showing 

a residual ridge 

2.5-3 mm in width and 

the placement of new, 

wider implants. 

Fig. 11 

Implant bed after 

removal of the 

transitional implants. 

Fig. 12 

The split must 

be covered with 

autologous 

fibrin. 

Fig. 13 

Final X-ray.

Figs. 1 to 3 

Initial case 

photographs. 

Fig. 4 

Initial X-ray. 

Figs. 5 and 6 

Measuring the 

width of the 

area to be 

treated. 

Note the width, 

which varies 

between 

2 and 3 mm. 

Fig. 7 

Situation after 

performing the 

split and before 

placing the 

implant. 

Fig. 8 

Implants 

placed. 

Clinical case 2 

1 3 

2 

4 

5 6 

7 8 


Clinical Science



9 10 

11 12 

13 14 

15 16 


Eduardo Anitua Aldecoa, MD, DDS 

Calle Jose Maria Cagigal, 19 . 01007 Vitoria . Spain . eduardoanitua@eduardoanitua.com 


Photos showing 

a width of 6 mm 

around the 

transitional 

implants. 


CAT scans used 

for planning the 

handling of the 

case. 

Fig. 15 

Vestibular view 

of the implants. 

Note the 

implant heads 

remaining 

submerged 

in the ridge. 

Fig. 16 

X-ray after 

surgery.

Function, beauty and 

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Reconstruction of a case with maxillary atrophy by means of Short Implants 

and individual IACs (Integrated Abutment Crowns) 

A perfect fit 

Mauro Marincola 1 , Vincent Morgan 2 , Shadi Daher 3 , Sung-Kiang Chuang 4 and Angelo Perpetuini 5 

In the past, it was believed that osseointegrated dental implants needed to be at least 10 mm long for successful function. 

However, recent studies have shown that even shorter (< 10 mm) dental implants can perform well. Particularly, the plateau 

or fin design of dental implants with a bacterially sealed 1.5° locking-taper connection has provided for successful function 

of implants as short as 6.0 mm. Additionally, short unsplinted dental implants were associated with less crestal bone loss than 

longer splinted dental implants. This article reports on the placement and restoration of twelve ultra-short Bicon implants in 

conjunction with an internal sinus lift (by osteotome) and ridge-splitting procedures. The twelve 5.0 x 6.0 mm implants were 

aesthetically and successfully restored with single unsplinted Integrated Abutment Crowns in the severely compromised 

edentulous maxilla of a 58-year-old woman. 

In recent years, success criteria in oral implantology 

have included aspects other than the stability of the 

implant-prosthetic complex alone. 

Merely ensuring lasting bone integration of an 

implant is not all our patients need. Rather, the goal 

is a functional and aesthetic balance within the oral 

situation, consistent with the patient’s expectations. 

This can be achieved only by careful selection of the 

surgical and prosthetic techniques used. 

A physiological balance needs to be created be - 

tween the tissues at the recipient site and the implant-prosthetic 

complex – by eliminating the problems 

that have plagued oral implantology [1-4]: 

• Bacterial infiltration of the implant-abutment 

interface 

• Micro-movement at the level of the implant-abutment 

connection 

• Crestal bone resorption over time around the 

margin between the bone crest and the implant 

• Maladjustment of the gingival tissues around 

the emergence profile. 

The latest consensus statements on success criteria 

in oral implantology clearly show the need for long- 

1 Assistant Professor, University of Cartagena; private practice in Frankfurt and Rome. 

2 Clinical Director, Implant Dentistry Centre, Boston. 

3 Clinical Assistant Professor, Department of Maxillofacial Surgery, Boston University. 

4 Research Associate, Department of Biostatistics, Harvard School of Public Health, Boston. 

5 Master in Dental Technology, Rome. 

term preservation of both crestal bone structures and 

the soft tissues surrounding the restoration. 

Implants that maintain long-term stability but are 

affected by progressive bone loss with gingival irritation 

and recession can no longer be considered a 

success [5]. 

The success of an implant should be judged by 

how successfully the crestal bone level around the 

implant is preserved over time. This is critical to 

ensure a supporting base and an adequate blood 

supply to the soft tissues surrounding the emergence 

point of the abutment/crown restoration. By 

keeping the crestal bone, the periosteum and the 

connective tissue and epithelial layer healthy and 

stable, undesirable situations can be avoided. Such 

situations would include crestal bone resorption and 

the development of peri-implantitis, which have been 

extensively documented in the literature [6]. 

The clinical case presented here aims to illustrate 

how excellent results can be achieved that are 

highly attractive from an aesthetic point of view, at 

the same time ensuring the preservation of the crestal 

bone level surrounding the implant-prosthetic 

complex.

Fig. 5 

Enlargement of 

the osteotomies 

with latch 

reamers. Slow 

drilling (50 rpm 

without water 

irrigation) yields 

collectible 

autologous 

bone. 

Fig. 1 Severely atrophied maxilla with reduced vertical 

dimension in the posterior region. 

3 4 

Fig. 3 Elevating a full-thickness flap. Notice the thin bone 

layer at crest level. 

Fig. 4 Preparing for an osteotomy using a pilot drill, following 

the surgical guide and the paralleling pins. 

Clinical case 

The patient was a 58-year-old woman with a fully 

edentulous maxilla. Her medical history did not suggest 

any contraindications to implant therapy. The 

radiograph revealed severe atrophy of the maxillary 

bone, in particular in the posterior region (Fig. 1). The 

Fig. 2 Reduced frontal horizontal dimension. 



clinical intraoral examination confirmed the presence 

of a thin alveolar crest in the anterior region (Fig. 2). 

The treatment plan originally provided for anterior 

ridge expansion using a synthetic bone graft plus 

resorbable membrane and a bilateral maxillary sinus 

lift. The patient did not consent to this last treatment, 

which made the use of Bicon Short Implants 

the alternative. Only 6 mm in length, these implants 

spare the patient invasive maxillary sinus procedures. 

The use of anaesthetic without vasoconstrictor 

enabled us to collect blood from the site intrasurgically 

(by means of a 5-ml sterile syringe), which was 

useful when it came to handling the graft material 

for crestal bone remodelling. After adrenaline anaesthesia, 

a full-thickness flap was elevated along the 

entire crestal bone perimeter (Fig. 3). 

Bicon’s surgical protocol requires the use of a 2 mm 

pilot drill that cuts only at the tip and perforates the 

cortical bone at 1000 rpm using external irrigation. 

The pilot drill defines the future depth of the single 

osteotomies. A surgical stent ensures the correct 

mesiodistal and buccolingual dimensions (Fig. 4). 

The surgeon then gradually widens the pilot 

osteotomies with mechanical reamers rotating at 

just 50 rpm without irrigating the surgical site. 

These reamers are special drills that do not cut at 

the tip, avoiding perforation or undesired collapse. 

Furthermore, they gather a considerable amount of 

autologous bone, subsequently used to cover im - 

plants seated below the crest (Fig. 5).



Fig. 6 

Implant insertion 

with seating 

tip. Notice 

the subcrestal 

position of the 

Ultra Short 

Implants. 

Fig. 8 Postoperative radiograph showing the homogenous 

placement of the upper implants without invasion of the vital 

structures. Note the immediately loaded mandibular implants. 

Once the osteotomies have been prepared, surgical-grade 

titanium alloy implants (Ti 6Al 4V) 5 mm in 

diameter and 6 mm in length are inserted by means 

of a seating tip. Each individual implant is tapped 

into place (Fig. 6). The neck of each implant must be 

placed 1-2 mm below the crest to ensure the cortical 

bone ridge is maintained once osseointegration and 

loading have occurred. 

In our case, implants 11, 12, 13, 21, 22 and 23 were 

inserted into the osteotomies following crestal bone 

expansion. Bone graft material was introduced, and 

the surgical site was covered with a resorbable collagen 

membrane. For the placement of implants 16 

and 26, an internal sinus lift technique was used; it is 

less invasive for the patient and easily carried out following 

the implant system protocol. 

The harvested bone collected during the reaming of 

the osteotomies was placed over the implant shoulders 

to assure complete crestal coverage of the im - 

plants (Fig. 7). Finally, the flap was sutured using 

resorbable sutures. 

The patient was recalled at seven and 21 days. The 

gingiva healed uneventfully. The removable denture 

was delivered and relined following the first postsurgical 

visit. 

Fig. 10 The twelve two-part impression posts show the perfect 

positioning of the implants. The locking-taper connection 

between the implant connection socket and the abutment 

post uses no screws, and no index is needed. 

After four months, the implants were uncovered. 

The radiographic control revealed the subcrestal position 

of the implants, preservation of the crestal bone 

during healing and the less invasive nature of the 

twelve ultra-short implants in relation to the atrophic 

crest (Fig. 8). 

The second surgical stage involved elevating a flap 

wide enough to uncover the healing abutments protecting 

the connector socket of the implant. The healing 

plugs were taken off and the impression posts 

inserted (Figs. 9 and 10). 

Fig. 7 

The implant 

shoulders are 

completely 

covered by the 

collected autologous 

bone. 

The black 

Macron healing 

plugs are protecting 

the 

implant well. 

Fig. 9 

Inserting 

impression posts 

four months 

after healing. 

Once a small 

flap is elevated 

and the healing 

abutments are 

removed, the 

posts are 

engaged into 

the connecting 

socket.

Fig. 11 The selected abutments are placed into the stone cast and moulded. 

Sandblasting is done after protecting the abutment posts with wax. 

Using the single-stage impression technique, the 

position of the implants was transferred from the 

oral cavity to the laboratory cast using elastomeric 

material. After applying the gingival material to the 

impression and pouring the impression in class IV 

stone, the lab employed the Integrated Abutment 

Crown (IAC) technique by selecting the abutments to 

be drilled. The crowns were modelled onto the prepared 

abutment surface, and chemical bonding of 

latest-generation polyceramic materials took place 

on the abutment itself (Integrated Abutment Crown). 

With no need for cementing, invasion of the biological 

space by non-biocompatible components was 

avoided and the gap between the aesthetic material 

and the prosthetic abutment was eliminated. 

The proper abutment selection for restoring Bicon 

implants depends on the respective tooth position. 

As the abutment post is inserted into the connector 

socket of the implant, a hemispherical base starting 

2 mm from the implant shoulder forms the emergence 

profile that maintains the soft-tissue margin. 

The diameters of the abutments are 6.5 mm for 



molars, 3.5 mm for lower incisals, 4 mm for upper lateral 

incisors and 5 mm for canines, premolars and 

upper central incisors. 

The standard abutments are solid and have no 

fastening screws and can therefore be reduced as 

appropriate. 

In the case on hand, the gingival contour was 

marked with a felt-tip pen. The crown margin had to 

be placed 1-2 mm below the gingival contour, creating 

an individual crown/gingival anatomy for each 

IAC. The abutments required a rounded shape with 

no sharp edges, with a basal shoulder. It is vitally 

important that the hemispherical base is never modified 

and that the gingival tissues are kept in close 

contact with the titanium. 

During the sandblasting procedure and while 

primer agent and opaque paste were applied, the 

integrity of the abutment post was protected by 

placing it in a wax base (Fig. 11). 

Sandblasting was performed using aluminium 

oxide (50 μm), and the surface was cleaned with 95% 

ethanol in an ultrasonic bath for five minutes. The 

abutments were connected to metal implant analogues 

and treated with a layer of primer that wets 

the entire surface. Pre-opaque and opaque material 

of the chosen shade was then built up in layers and 

light-cured. The opaque dentine that replaces the 

metal frame had to support the following layers that 

determine stability and colour. The opaque dentine 

made up about 40 per cent of the final volume. Its 

layer thickness of 2 to 5 mm enabled the polyceramic 

material to spread across the surface of the abutments. 

The cervical materials, dentines, enamels and 

intensives used belonged to cervical group A and 

incisal group D on the Vita shade guide. These had to 

be built up such as to give the restoration a natural 

aesthetic look. The IAC crowns were finished using 

a silicon polishing wheel that removed any excess 

material between the abutment and polymer material, 

ensuring a perfect marginal seal. The advantage 

of this technique is that it avoids errors arising from 

fusion and cementation (Fig. 12). 

Fig. 12 Polyceramic material is chemically bonded onto the titanium abutments (IAC). The single crown/abutment restorations 

show custom emergence profiles.



Fig. 13 Template for inserting single crowns. Note the green 

implant analogues with the sloping shoulder, the 3-mm 

posts reducing the required space at crest level and the 

custom emergence profile of the IACs. 

Fig. 15 Control one year after insertion of the upper IACs. 

Fig. 17 Extraoral view of the smile line. 

The advantages of using latest-generation poly - 

ceramic materials are linked to their high elasticity, 

resistance to traction and above all to light-curing, 

which prevents oxidation of the post, keeping its 

integrity and preserving the locking-taper connection. 

The abutment/crown units produced are characterized 

by individual emergence profiles and perfect 

adaptation of the polyceramic material to the 

titanium abutment at the marginal gap level. All 

crowns produced in this way were placed on the cast, 

and an oral repositioning stent and a taping jig were 

produced (Fig. 13). 

As each Integrated Abutment Crown was completed, 

it was inserted with its post fitting the into the 

connector socket of the implant and activated by 

pressing onto the crown itself (Fig. 14). 

The custom emergence profiles of each crown 

ensured that the surrounding gum was shaped such 

as to produce a natural and healthy-looking gingival 

contour (Figs. 15 to 18). 

Fig. 14 Insertion of an Integrated Abutment Crown (IAC). 

The screwless connection without index allows the post to 

be inserted into the connecting socket with simple rotational 

movements and is then tapped into position. 

Fig. 16 Note the long-term preservation of the gingival contour. 

Fig. 18 Control ten months after insertion of the lower IACs. 

Materials and methods 

Bicon dental implants were used for the reconstruction 

of the case, combined with Ceramage poly - 

ceramic materials (Shofu Inc., Kyoto, Japan) for the 

restoration. 

Bicon implants stand out on account of their special 

macrostructure that is characterized by a rootshaped 

design with wide fins called plateaus, by a 

sloping shoulder and by a connecting socket that 

accommodates the abutment post by means of a 

locking-taper connection [7]. 

The plateaus are of particular importance for biomechanical 

performance, allowing Short Implants 

with a wide diameter to be used in any position in the 

oral cavity. They are inserted into the osteotomy, prepared 

using atraumatic drills rotating at 50 rpm, using 

mechanical pressure. The countless microretentions 

created by the fin edges on the walls of the osteotomy 

ensure primary stability of the implant. Further-



more, the wide spaces between the plateaus avoid 

vertical compression of the bone walls and rapidly 

collect the coagulated blood, allowing rapid bone formation 

without the classic macrophage and osteoclast 

processes of bone resorption. Well-defined bone 

is formed, with Haversian canals and blood vessels 

that enable continuous bone remodelling around the 

implant/bone interface. This ensures implant stability 

in any situation involving biomechanical stimulus [8]. 

The sloping shoulder is vitally important for preserving 

crestal bone after implant osseointegration 

and for implant function. The Bicon implant design 

offers platform switching with a neck that converges 

from the widest diameter of the first plateau to 2 

or 3 mm towards the crestal zone (converting crest 

module). In the case presented here we used 5 mm 

diameter implants, but the space required at the crestal 

level is only 3 mm. This ensures bone augmentation 

above the neck, not least because, during the 

first surgical stage, the implant is positioned at least 

1 mm below the crest. This allows structures such 

as the crestal bone, periosteum and epithelium to 

grow around the hemispherical base of the abutment, 

and to give sufficient space for papilla maintenance 

and/or growth. 

Another factor important for long-term crestal 

bone stability is the bacterial seal at the implantabutment 

interface. If crestal bone maintenance and 

the formation of papillae can only be achieved by an 

implant placed in a subcrestal position and platformswitching 

at the level of the implant neck, it is also 

true that this situation can only be achieved if the 

gap is hermetically sealed against bacterial infiltration. 

Without this feature, the placement of a subcrestal 

implant without a bacterial seal would result in 

a rapid spread of pathogens around vital structures 

such as the crestal bone, periosteum and epithelium. 

The result would be bone resorption to well below 

the original crestal bone level. 

Bicon’s locking taper is indispensable for ensuring 

maintenance of the crestal bone level around an 

implant with a convergent sloping shoulder placed 

subcrestally [9]. 

The locking taper is an extremely precise connection 

formed by contact welding of two surfaces of 

the same material brought into close contact. In this 

way, the oxidation layers that have formed on the 

abutment post and on the implant connector surface 

are removed [10, 11]. 

The prosthetic components (one-piece titanium 

abutments made from the same surgical-grade titanium 

alloy as the implants) ensure maximum mechanical 

resistance and optimum biocompatibility. The subgingival 

hemispheric geometry is ideal for ensuring 

the stability of the peri-implant connective tissues. 

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The abutments are connected to the implant well by 

a post 2 or 3 mm in diameter. Implants 3.5 and 4 mm in 

diameter are suitable for 2-mm posts, while 4.5, 5 or 

6 mm diameter implants match abutments with 3-mm 

posts. Abutments with 2- and 3-mm posts have diameters 

or emergence profiles of 3.5/4.0/5.0/6.5 mm, suitable 

for recreating natural anatomical gum shapes. 

Abutment diameters are therefore independent of 

implant diameters. Each implant may host four different 

abutment emergence profiles. The different 

emergence profiles start from the 2- or 3-mm posts, 

placed at the crestal level. 

The geometry of the abutments provides for platform 

switching even at a prosthetic level, which is 

of vital importance for the connecting tissue and 

epithelial layer. 

The supraperiosteal space involved in the shift 

from the connecting-post diameter (2-3 mm) to the 

diameter of the abutment hemisphere (5-6.5 mm) 

allows thicker and more dense connecting tissue to 

form, resulting in optimal preservation of the papilla. 

In the case described here, all abutments had 3-mm 

posts, as they had to connect to the 3-mm connector 

sockets of the 5.0 x 6.0 mm implants. Heights, inclinations 

and hemisphere diameters are selected in 

the laboratory in accordance with the positions of 

the implants and the mesiodistal space available. 

The space created by the bone distraction in the 

anterior zone is filled with Pure Phase Beta-Tricalcium 

Phosphate (SynthoGraft). This completely synthetic 

bone grafting material eliminates the uncertainty 

and the risks associated with materials derived from 

humans or animals. SynthoGraft has a unique structure 

(two variants: 50-500 μm and 500-1000 μm), 

which ensures stability during handling, while its 

microporosity allows rapid vascularization with subsequent 

resorption and replacement with autologous 

bone [12]. 

The material used for IAC preparation is Ceramage, 

a microceramic composite system containing 73 per 

cent of microfine ceramic filler particles – Progressive 

Finely Structured (PFS) filler and nanohybrid fillers – 

supported by a polymer matrix. This strengthens the 

homogenous structure and makes the material similar 

to a ceramic material, to be used both for posterior 

and anterior restorations with metal or metal-free 

frameworks. 

Discussion 

This case highlights the predictability of Short Implants 

and, in particular, Ultra Short Implants. Both 

have been widely described in the literature [13-15] 

and numerous long-term studies have demonstrated 

their suitability over time [16, 17]. 

The 6.0-mm length used is classified as an ultrashort 

implant. Its unique geometry gives the implant 

a bone stability capable of supporting a crown/ 

implant ratio that can be above the 4 : 1 ratio [18]. This 

concept overturns the classic demand for a crown/ 

im plant ratio of 1 : 1. According to what we know 

today about the importance of implant design for 

the function of the crown/implant complex [19-22], 

the contact area (BIC) of the implant surface with the 

recipient bone is a decisive factor, as are the diameter 

and the macrogeometry of the fixture – not necessarily 

its length [23-25]. 

Conclusion 

Modern oral implantology must rely on exact biomechanical 

and histomorphological criteria to 

obtain long-term results satisfactory to clinicians 

and patients [26]. 

Recent studies underscore the importance of 

improving implant macrostructures, particularly 

around the implant neck [27]. The crestal bone needs 

space to support the surrounding structures. Only 

then can the gingival architecture and papillae be 

maintained in the long term [28]. Simple platform 

switching at the abutment level is no guarantee of 

space, while platform switching at the implant neck 

level is crucial. The implant used in our clinical case 

has fulfilled both criteria for over 25 years (Fig. 19). 

The Integrated Abutment Crown (IAC) technique 

further improves the condition of the soft tissues, 

eliminating the need for cementation and avoiding 

any misfits between the border of the crown and 

the preparation of the abutment. Furthermore, the 

custom emergence profile ensures proper gingival 

anatomy [29,30]. 



Professor Mauro Marincola 

Studio Dentistico Camardent 

Via dei Gracchi 285 . 00192 Roma . Italy 

Phone: +39 06 3215056 

mauromarincola@unicartagena.edu.co 

Fig. 19 

Radiological 

control at 

24 months 

showing the 

preserved crest 

around the platform-switched 

implant shoulder 

and the hemispherical 

base of 

the abutment.

Sie kennen den 

richtigen Zeitpunkt. 

Ermittlung des optimalen 

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Frühzeitige Warnungen durch 

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vom Zeitpunkt der Implantation bis zur endgültigen 

Versorgung verfolgen. Vor allem die Behandlung von 

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Einfache und schnelle Messung 

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bar. Osstell ISQ ist das einzige objektive Qualitätssicherungssytem, 

das Sie rechtzeitig warnt, wenn Implantate 

nicht wie erwartet osseointegrieren. Objektive ISQ-Werte 

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und Baden-Württemberg am 27. und 28. Mai 2011 in Ulm.



Innovations by Dentsply Friadent at IDS 2011 

Detailed solutions 

“from root to crown” 

At IDS 2011, Dentsply Friadent will present a number of additions to its range of implant products. In the following statement, 

Marketing Director Birgit Dillmann is talking about these new solutions that blend in perfectly with the company’s overall 

concept and further reduce chairside treatment times, thus increasing patient satisfaction. 

For Dentsply Friadent, providing complete solutions 

“from root to crown” means providing users with a 

comprehensive product portfolio for every step of 

their dental implant procedures. Beginning with precisely 

timed digital planning and a stable base for 

implantation to the implantation itself and right up 

to the aesthetic completion of the treatment – 

Dentsply Friadent offers detailed implant solutions 

for every individual case. 

At the same time, we strive to develop all our treatment 

concepts towards TissueCare, because the only 

secure basis of effective treatment is the stability of 

hard and soft tissues over the long term. 

We are very pleased to present new solutions at the 

upcoming IDS that blend in perfectly with our overall 

concept. Next to enhancing our implant brands with 

new components first and foremost, these include 

our digitally manufactured restorations, which stand 

for precision and for simplifying daily routines in your 

practice. With our now commonly organized central 

Compartis Scanning and Design Service for custom 

abutments and CAD/CAM superstructures, you can 

order individual implant prosthetics for your patients 

even faster and get competent advice at any time. 

Apropos of digital solutions: our Guided Surgery 

System will help you shorten chairside treatment 

times and increase patient satisfaction. Because with 

ExpertEase, the temporary denture can already be 

fabricated before the template-guided implant 

placement so that the denture can be incorporated 

directly, without delay. 

Digital solutions – for many practitioners they have 

become indispensable, so they are an important part 

of our portfolio. As a solution supplier and a partner 

of your successful practice, however, we provide you 

with much more: Our individual implant systems, for 

outstanding primary stability in all bone qualities 

and enduring tissue stability. Our prosthetic concepts, 

for aesthetics and perfect functionality. And 

ultimately, we will help you become a brand in your 

region – with our stepps customer program, a comprehensive 

program for marketing and office/laboratory 

management. 

We would be delighted to tell you more about all 

this and show you the full range of our offering. 

Come and meet us at IDS – we are looking forward to 

seeing you! 

Birgit Dillmann



An interview with Frank Bartsch, Trade Marketing Manager at Carestream Health 

“Innovation is our focus 

at the IDS 2011“ 

In the run-up to IDS 2011, EDI Journal talked to Frank 

Bartsch, Trade Marketing Manager at Carestream 

Health, about the new business division Carestream 

Dental and the forthcoming product launches of the 

company at the IDS. 

What can visitors to the IDS expect from Carestream? 

Plenty, of that you can be sure! In Cologne, we will 

be presenting a number of surprises in the field of 

X-ray imaging. We have also increased our floor space 

considerably compared to IDS 2009, and we have 

added some attractive features. For example, our visitors 

can look forward to our “Innovation Room” that 

showcases our highlighted exhibits in detail. 

The focus of our presentation will of course be on 

the 9000 series imaging range. In late 2007, this 

range established a new class in X-ray imaging, which 

has lost nothing in terms of cutting-edge technology 

and fascination. In 2009 we had already updated 

the 9000 3D model by adding the Stitching Function. 

Now we have extended the product range and will 

present the CS 9300, the market leader’s “big brother” 

in focus-field imaging. The CS 9300 not only combines 

panorama and 3D technology, but also offers a 

number of innovative features, such as free choice of 

viewing field (5 x 5 cm up to 17 x 13,5 cm) – “Flexy-Fieldof-View” 

– with excellent resolution, simple-to-use 

software and imaging details second to none. 

And what about the cost? 

The CS 9300 model offers an excellent price/performance 

ratio. Model calculations have shown that the 

investment pays off already after a short time based 

on average use. Together with our business partners 

we have arranged for attractive financing packages 

that will facilitate economical use from the outset. 

As the only single-source manufacturer worldwide for 

the entire product range from films to 3D imaging, you 

can provide customized solutions for all X-ray imaging 

requirements. What can smaller dental practices expect? 

Here we are looking primarily at two models we 

are very proud of. The CS 7600 is an innovative intra- 

oral scanner that defines new benchmarks in terms 

of speed, efficiency and product features. To mention 

just one of the benefits: images are available within 

five seconds. And the CS 1600 intraoral camera sets 

new standards in the detection of caries. This addition 

to our highly successful 1500 camera allows the 

detection of caries at a very early stage by employing 

the patented FIRE technology. 

Another interesting aspect is your recently created new 

business division, Carestream Dental. What can you tell 

us about this? 

This development reflects the growing importance 

of the dental business. We intend to focus more heavily 

on this field in the future and to align our service 

with the specific needs of our customers. Therefore we 

decided to split the Carestream Health brand into a 

Carestream Dental and a Carestream Medical division. 

Can you give us a glimpse of the future? 

The name Carestream already stands for a wealth 

of innovation and first-class products with excellent 

price/performance ratios. This will continue to be the 

case in the future. We want to ensure that our customers 

benefit from our X-ray imaging expertise over 

the long term. We provide unbeatable imaging 

results allowing for optimum diagnostics and efficient 

treatment planning, which in turn result in considerable 

time savings and high levels of efficiency. 

This is true today – and it will be true tomorrow! 

Mr. Bartsch, thank you for this interview. SIS

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An interview with Professor Daniel Buser and Professor Mariano Sanz 

on the International Osteology Symposium in Cannes 

Risk factors and complications 

in regeneration 

The next International Osteology Symposium is being held from 14–16 April 2011 in Cannes. What will the symposium be offering 

to practitioners and scientists? The international chairmen of the symposium, Professors Mariano Sanz and Daniel Buser, 

respond to questions in an interview. 

Another International Osteology Symposium is now 

being held after four years. What are the main topics 

of interest? 

Professor Buser: We have chosen the main topics 

“Clinical Excellence, Risk Factors and Complications” 

for the symposium. Nowadays bone regeneration 

is the standard of care in implant dentistry. In uncritical 

cases implant surgeons can treat small to midsize 

defects such as apical fenestration or crestal 

dehiscence defects with high predictability to 

achieve successful outcomes. It is very important, 

that the clinician can correctly assess risk factors 

and integrate them into treatment planning in more 

complex cases. 

Professor Sanz: Our patients not only want functional 

results, they also want beautiful smiles. The 

right proportions between beautiful teeth and gums 

is what makes a nice smile and that is precisely what 

our patients are looking forward to. We therefore 

need to balance the importance of risk factors and 

complications with techniques aimed to achieve aesthetic 

results. This is the reason why the field of softtissue 

management has gained an important impetus 

in the last few years, both in implantology and 

periodontology. At Osteology in Cannes we will be 

discussing new therapeutic approaches, new biomaterials 

and improved surgical techniques to augment 

both hard and soft tissues, both around teeth and 

dental implants, in order to rebuild what oral diseases 

have destroyed. 

Just to get back to the topic of complications: What 

significance does the topic now have in regenerative 

procedures? 

Professor Buser: As the number of inserted im - 

plants has significantly increased in the past ten years, 

the number of complications such as peri-implantitis 

also rises. Therefore, a section of the programme in 

Cannes deals exclusively with the topic of periimplantitis. 

Well-known experts will be reporting on 

the prevalence, risk factors and pathogenesis of the 

disease. They will demonstrate what surgical and 

non-surgical therapies are indicated for what cases 

and they will show when regenerative treatments 

promise success. 

Professor Sanz: Besides the occurrence of periimplant 

infections and complications, we will discuss 

other multiple sources of complications and most 

importantly, how to diagnose and how to treat them. 

Complex therapeutic procedures, such as soft tissue 

augmentation, guided bone regeneration or sinus 

floor augmentation will be discussed in the context 

of the treatment of complicated cases. Special 

emphasis will be placed in how to prevent complications 

and how to achieve the best possible outcomes. 

Professor Daniel 

Buser (left) and 

Professor Mariano 

Sanz will be chairing 

the International 

Osteology 

Symposium 

in Cannes.

The Osteology symposia are well-known for their high 

scientific standard. Is Osteology in Cannes sufficiently 

practice-oriented? 

Professor Sanz: Absolutely! The motto of the Osteology 

Foundation is “Linking Science with Practice”, 

and we consistently make this happen in our symposia. 

Science provides the basis for new therapeutic 

concepts, but the wide usage of these concepts in 

practice cannot be widespread until this treatment 

option or product has been sufficiently tested and 

backed up by scientific data. The presentation of 

new scientific data has, therefore, always taken an 

important place at the Osteology symposia programmes. 

We strongly believe that only well 

informed practitioners would be able to provide 

optimum treatments for their patients. But we do 

not overlook the practical applications of current 

therapies. On the pre-congress day there is a large 

selection of practical hands-on courses and theoretical 

workshops. In this Osteology Symposium we 

have also organized an interactive clinical forum in 

which top-class experts and the audience will be 

discussing exciting complex cases. 

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What else is on the programme in Cannes? 

Professor Buser: The programme embraces a broad 

selection of indications in implantology and periodontology. 

We will be discussing whether new findings 

cast doubt upon well established treatment 

concepts, and what new therapies and products 

could be reliably used in daily practice in the future. 

As ever at the Osteology symposia, we not only 

offer participants a top-class, exciting scientific programme, 

but also an exceptional atmosphere and a 

fascinating social programme. Osteology in Cannes is 

making another guest appearance on one of Europe’s 

most beautiful coasts. This guarantees inspiring days 

at the congress. Our colleagues should not miss that 

highlight in 2011! 

Thank you very much for this interview. 

Dr Birgit Wenz, Lucerne 

More information 

Osteology Foundation 

www.osteology-cannes.org 

Brilliant in Any Language 

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The 1st MIS Global Conference is an exclusive international 

event in the Osseointegration world in 2011, 

where science and clinical expertise meet on the 

background of warm white powdery beaches and 

turquoise clear waters. 

During the conference’s three exciting days, participants 

are expected to broaden their horizons 

and enhance their knowledge in implant dentistry 

through lectures by highly qualified and respected 

first class opinion leaders and pioneering researchers 

MIS Global Conference, 

Cancun, Mexico, 19 to 21 May 2011 

360° Implantology 

The first MIS Global Conference entitled „360° Implantology” will be 

held in the magnificent Hilton Cancun Golf & Spa Resort in Mexico 

from 19 to 21 May 2011. 360° Implantology represents MIS’s vision 

based on a deep understanding of all professionals’ needs in implant 

dentistry that will be presented in an exceptional, elegant and 

sophisticated event organization. 

and practitioners that will present the latest innovations 

and advances in the field along with a wide 

range of compelling topics. MIS’s latest virtual guided 

implant system M-Guide, an innovative new MIS 

implant system, and the innovative graft material 

Bond Bone are just a few of the advances that will be 

presented during the conference. Participants can 

also extend their knowledge and experience by 

attending a variety of influential and beneficial workshops 

and hands-on sessions. 


MIS Implants Technologies Ltd 

www.mis-implants.com/cancun



Thommen Connecting Science Workshop 

during the International Osteology Symposium 

in Cannes 

Risk factor bone 

Under the topic of “Risk factor bone” Thommen Medical will hold an 

exclusive Connecting Science Workshop Session taking place on 14 April 

2011, 9:00 am – 12:30 pm, during the course of the Osteology Symposium 

in Cannes. The participants can expect an outstanding scientific program 

with excellent speakers and interactive round panel discussions. The mod- 

erator of the program will be Dr Ueli Grunder from Zurich, Switzerland. 

The workshop will focus on different 

aspects related to weak bone 

quality: meaning either insufficient 

bone volume or bone types 

III or IV. 

Dr Michaela Kneissel from the 

Novartis Institute of Biomedical 

Research will focus on the biologic 

background of maxillofacial 

bone regeneration and the underlying 

mechanisms in different 

bone types. Furthermore, various 

clinical aspects of diseases affecting 

bone regeneration and comedication 

will be addressed. 

Professor Markus Huerzeler will 

present current approaches in 

socket preservation in the aesthetic 

zone and some new preservation 

techniques for the buccal wall. 

PD Dr Dr Dennis Rohner from 

the Cranio-Maxillofacial Center in 

Aarau will summarize the treatment 

options for patients with 

poor bone quality, underlying diseases 

or otherwise disturbed 

bone regeneration. The role and 

function of a superhydrophilic 

implant surface (Inicell) will be 

demonstrated and data from a 

clinical study on reduced healing 

time in patients with bone quality 

III and IV presented. Future 

developments in implant surface 

modifications and co-medication 

will be addressed by Dr Michaela 

Kneissel. Based on a newly developed 

ostoporotic rat model, several 

new approaches will be presented. 

Additional 

program highlight 

Thommen Medical will welcome 

all Osteology participants to a further 

Thommen Session that takes 

place within the official Osteology 

Implant Forum on Thursday, 

14 April 2011 at 1:00 pm. Here Dr Konrad 

Meyenberg, Switzerland, will 

hold an exclusive lecture on the 

topic “Smart Design – the basis for 

biological, technical and esthetic 

success”. 


and registration 

Thommen Medical AG 

Hauptstrasse 26d 

4437 Waldenburg 

Switzerland 


www.thommenmedical.com/events 

3D Composites 

Natural Shading & Shaping 

By Ulf Krueger-Janson 

Dentist Ulf Krueger-Janson is considered one of the 

foremost global experts on functional and aesthetic 

chairside composite techniques. 

His new book fi rst invites the reader to train his or her 

senses to consciously take in and to reproduce shapes, 

contours, but also the shades of various teeth. Once 

the senses have become working, the implementation 

phase follows. The book contains practical instructions 

for an uncomplicated build-up as well as tips and 

tricks for the correct handling of appropriate materials 

and tools. Finally, the reader will have a chance to 

follow the author and his techniques as exemplifi e d 

by selected patient cases, organized by the different 

restoration types and locations. 

The book comprises eight chapters with easy-to-follow 

didactics, a stunning layout and brilliant illustrations. A 

book that inspires, teaches and motivates – a “must 

have” for every ambitious practitioner. 

€ 178 

(including VAT) 

264 pages, approx. 1300 illustrations 

ISBN: 978-3-932599-29-3 

REF 9028 

Visit our bookshop or order via 

Phone +49 8243 9692-16 

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NEW 

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European market leader in medical 

B2C communication celebrates its 5,000th installation 

TV-Wartezimmer’s 

market share on the rise 

Today’s health-conscious and responsible patients expect comprehensive information on illnesses, alternative treatment methods, 

prevention options and healing prospects. They are willing to invest in their personal health and well-being. This makes it 

essential for doctors and clinics to communicate their profiles, services and qualifications in an efficient and sophisticated 

manner. Patients want this information and are eager to learn how useful investments into their own health can be – 

for example in terms of prevention efforts. 

Efficient contemporary communication platforms for 

offices and clinics are on their way ahead. “Only innovative 

solutions that focus on the doctors’ specific 

needs will prevail”, says Markus Spamer, founder and 

CEO of TV-Wartezimmer. The 5,000 systems his company 

has sold bear witness to the truth of his statement. 

“TV-Wartezimmer has proven to be of multiple 

benefit in medical waiting areas.” Patients are 

informed and entertained by attractive content, while 

at the same time TV-Wartezimmer fills an important 

purpose for doctors by providing patients with relevant 

medical information, ahead of treatment. 

Markus Spamer founded TV-Wartezimmer in 2003 

after learning that many professionals have problems 

communicating with their customers in a way 

that makes them act on the message they were 

supposed to receive. Since then, TV-Wartezimmer has 

established itself as the European market leader in 

audio-visual doctor-patient communication solutions. 

Total revenue for 2009 was 7.5 million euros, and the 

company employs 40 people at its headquarters in 

Freising near Munich. More than 100 sales and service 

partners complement the company’s team. 

TV-Wartezimmer does not focus on healthcare topics 

alone. It includes such diverse matters as wildlife 

and travel documentaries, news, regional weather 

forecasts, gossip news, comic strips and much more, 

all which is continuously updated, some of it at hourly 

intervals. But the core of TV-Wartezimmer is the wide 

range of films, offered for free use, that show all the 

additional services, therapies or prevention programs 

that a practice can offer. Each topic presents itself 

in a contemporary, three-dimensional look and uses 

a language that explains even complex procedures in 

terms the medical layperson can understand. 

TV-Wartezimmer’s production 

company, which has won multiple 

international awards, has produced 

more than 400 films of 

this kind so far – in HD quality. 

TV-Wartezimmer’s customers purchase 

a comprehensive user license 

to these films that includes their 

use on websites or iPad offerings. The company 

provides continuous content updates, personalized 

customer support, the complete hardware including 

42-inch state-of-the-art displays and a free installation 

service. The license fee, payable monthly, covers 

all these and further features. There are no hidden 

fees or additional costs. “This is one of the reasons 

why we lead the market today”, says Markus Spamer. 

“Our understanding of good service is that all product 

features should always be included.” 

The company itself is enthusiastic about its product 

– and so are its customers: When TV-Wartezimmer 

asked for letters of reference, the company was 

overwhelmed by the flood of responses. About 200 of 

them were published in a book presented at MEDICA, 

the world’s largest medical fair, in 2010. With such 

great support, TV-Wartezimmer looks optimistically 

into the future and plans to expand to additional 

European countries. 


TV-Wartezimmer 

Raiffeisenstraße 31 

85356 Freising 

Germany 

info@TV-Wartezimmer.de 

www.TV-Wartezimmer.de

H&H Webranking survey 

Nobel Biocare’s corporate website has been ranked 

the fifth best website in Switzerland by Hallvarsson & 

Hallvarsson. It is thus hot on the heels of the top 4 

websites of Swisscom, UBS, CS, and Georg Fischer. 

Nobel Biocare was able to improve its position from 

last year’s sixth place. 

The H&H Webranking survey is the most in-depth 

analysis of online financial and corporate communication 

in Europe. It represents a useful instrument 

not only for measuring the effectiveness of a company’s 

online communication but also to compare it 

with competitors on a national and international 

level. H&H conducts an analysis of corporate web- 



Nobel Biocare’s website breaks top 5 

According to the annual Hallvarsson & Hallvarsson (H&H) study, Nobel Biocare’s corporate website ranks fifth 

among 48 Swiss companies, moving up one position from last year’s sixth place. 

Cologne, 22-26.03.2011 

Visit us! 

Hall 4.1 Stand C088- D089 

sites in English through an evaluation protocol composed 

of 127 criteria. The results are based on questionnaire 

feedback from 571 analysts, journalists and 

investors throughout Europe. 

The Nobel Biocare corporate website recently also 

ranked fourth best website in the webranking car- 

ried out by Bilanz, a leading Swiss 

business magazine. The corporate 

website was launched in January 

2009 and has been continuously 

enhanced since, as part of a series 

of initiatives to improve Nobel Bio - 

care’s online presence. 

www.omniaspa.eu 


Nobel Biocare Management AG 

P.O. Box 

8058 Zurich-Airport 

Switzerland 


Since our beginnings, we have always been focused on 

quality and innovation toward the battle against 

cross - contamination and infections. 

In the last 20 years, we have ensured safety and protection to you and your patients, 

with advanced and reliable products. Tools that represent the ideal solution for who is 

operating in dentistry, implantology/oral surgery and general surgery. 

With Omnia sure to be safe. 

OMNIA S.p.A. 

Via F. Delnevo, 190 - 43036 Fidenza (PR) Italy - Tel. +39 0524 527453 - Fax +39 0524 525230 

VAT IT 01711860344 - R.E.A. PR 173685 - Company capital € 200.000,00 

by


Product Reports 

Alpha-Bio’s Graft by Alpha-Bio Tec 

Safety and reliability in dental 

bone and tissue regeneration 

Alpha-Bio Tec has launched a new line of bone and tissue regeneration products – Alpha-Bio’s Graft. 

It offers simple, safe and reliable solutions for a wide range of clinical indications. 

Alpha-Bio’s Graft product line offers a variety of highquality 

bone and tissue regeneration products to suit 

all dental requirements and indications – from the 

simplest extraction socket filling to the most complicated 

bone augmentation. It includes Natural Bovine 

Bone, Synthetic Resorbable Bone, Collagen Membrane 

and Collagen Fleece. Alpha-Bio’s Graft products 

were developed in order to provide simple, easy to 

handle bone and tissue regeneration products that 

are highly reliable and yield outstanding, predictable 

results. During the regeneration process, each product 

in the Alpha-Bio’s Graft line becomes an integral 

part of the newly forming bone framework. All products 

have been extensively clinically tested. They 

are produced under cleanroom conditions and with 

accordance to the highest quality and safety standards. 

Alpha-Bio’s Graft products are CE-marked in 

accordance with the Council Directive 93/42/EEC and 

Amendment 2007/47/EC. 

Alpha-Bio’s Graft Natural Bovine Bone 

Alpha-Bio’s Graft Natural Bovine Bone is a highly reliable 

and dimensionally stable, purified grafting 

material. The mineral composition, three dimensional 

structure and the physico-chemical and biological 

properties of natural bovine bone are very similar to 

those of human bone. The special manufacturing 

process involves high-temperature heating. The 

process removes all organic components and eliminates 

all potential immunological reactions, making 

Alpha-Bio’s Graft Natural Bovine Bone 100 per cent 

BSE-safe and 100 per cent protein-free. The product 

fulfils all requirements of the Annex II.4 of the Directive 

93/42/EEC and the Directive 2003/32/EC. 

Alpha-Bio’s Graft Synthetic Resorbable Bone 

Alpha-Bio’s Graft Synthetic Resorbable Bone is an 

innovative, safe, reliable and fully synthetic bone 

graft substitute with improved controlled resorption 

properties and pleasing handling characteristics. The 

homogenous composition of 60 per cent hydroxyapatite 

(HA) and 40 per cent beta-tricalcium phosphate 

(ß-TCP) results in two mineral phases of activity: it 

supports the formation of new vital bone and maintains 

the volume and mechanical stability. 

Alpha-Bio’s Graft Collagen Membrane 

Alpha-Bio’s Graft Collagen Membrane provides a 

long-lasting adequate barrier function. Due to a special 

production process, the superior properties of the 

native pericardium are preserved, allowing to maintain 

the characteristics of this natural tissue. 

Alpha-Bio’s Graft Collagen Fleece 

Alpha-Bio’s Graft Collagen Fleece is pH-neutral, wetstable, 

haemostyptic and made out of native collagen. 

The potent haemostatic effect of collagen is wellknown 

and induced by the adhesion of platelets to 

the collagen fibrils. As a consequence, platelets aggregate 

and release coagulation factors by degranulation. 

This initiates the coagulation cascade resulting 

in haemostasis. 


Alpha-Bio Tec Ltd. 

7 Hatnufa St. · P.O.B 3936 

Petach Tikva 49510 · Israel 

Phone: +972 3 9291055 

info@alpha-bio.net · www.alpha-bio.net 

The product information produced here editorially is based on information 

provided by the manufacturer and has not been checked by the editor 

for its accuracy.

Join the Thommen 

Connecting Science TM 

Workshop during the 

Osteology in Cannes 

Topic: Risk factor bone 

Date: April 14, 2011, 09.00–12.30 

Language: English 

Price: Euro 130 

Speakers: 

Dr. Ueli Grunder, Prof. Markus Hürzeler, Dr. Michaela Kneissel, PD Dr. Dr. Dennis Rohner 

Program 

09.00 Introduction Dr. Ueli Grunder, Switzerland (Moderator) 

09.15 Maxillofacial bone regeneration Dr. Michaela Kneissel, USA 

09.45 Clinical experience with extraction sockets in the aesthetic zone: 

how can we preserve the volume? Prof. Markus Hürzeler, Germany 

10.45 Weak bone: which options do we have? PD Dr. Dr. Dennis Rohner, 

Switzerland 

11.15 Implant healing in the osteoporotic rat model Dr. Michaela Kneissel, 

Cambridge, USA 

11.45 Panel discussion Dr. Ueli Grunder, Dr. Michaela Kneissel, Prof. Markus 

Hürzeler, PD Dr. Dr. Dennis Rohner 

12.30 End of session 

SWISS PRECISION AND INNOVATION. 

www.thommenmedical.com 

Register now online at www.osteology-cannes.org 

or get more information on 

www.thommenmedical.com/events 


,


Product Reports 

Immediate Smile by Materialise Dental 

Top-notch backward planning 

When dealing with edentulous patients, it is paramount to start at the end-point by ruling out any anatomical, 

functional and esthetical surprises during implant surgery. SimPlant reveals all details about a patient’s bone 

and soft tissue – crucial information when engaging in restorative-driven planning. Thanks to SimPlant and the 

Immediate Smile model, an accurate restoration can be made well in advance – seeing patients leave surgery 

with a carefully prepared new smile is the fruitful result of thinking and acting ahead. 

The Immediate Smile model plays a pioneering role 

on the market, in that it enhances communication 

with the dental lab by delivering all the necessary 

tools to fabricate a fixed restoration prior to surgery – 

a bone model, silicone soft tissue and copy of the 

scan prosthesis. This is interdisciplinary dentistry at 

its best. 

The bone model represents the patient’s bone 

anatomy and contains implant sites that correspond 

with the SimPlant 3D plan. The implant sites are 

adapted to the dimensions of the implant analogs. A 

clever time- and money-saving fixation system even 

allows for easy recuperation of implant analogs. 

A lifelike silicone soft tissue, which is perforated 

at the implant positions, represents the patient’s 

soft tissue, helping the lab take into account the realistic 

soft tissue thickness during fabrication of the 

restoration. 

A prosthesis duplicate is a copy of the scan prosthesis 

that fits perfectly onto the bone model allowing 

for accurate articulation. It also enables the lab 

to fabricate the restoration the way the clinician 

planned it. At the time of surgery, the restoration is 

then relined in the patient’s mouth to ensure a passive 

fit onto the implants. 

As a result, reverse planning has never been more 

efficient for all parties engaged in implant treatment 

and avoids cumbersome procedures. Clinicians don’t 

need to use a guide to fabricate a model, because this 

increases the risk of damaging the guide. Also, they 

can follow the same routine procedures as with all 

standard guided surgery procedures, and implant 

holders are not required. 

Immediate Smile makes clinicians’ businesses 

stand out. It’s a marketing tool which can be used 

to attract patients when other implant dentists do 

not follow a strategy of thinking ahead in terms of 

adopting new technology and bringing esthetics into 

the equation. 

Patients are given an accurate, predictable, esthetic 

and cost-efficient outcome. They won’t even have 

to think about taking days off at work or worry about 

time- and money-guzzling follow-up appointments 

and the drag to get there every time and on time. 

Overall, an Immediate Smile procedure enhances 

treatment acceptability because patients know they 

will have new teeth in no time. 

The Immediate Smile model is compatible with all 

SAFE SurgiGuide kits available on the market: Antho - 

gyr Guiding System (Anthogyr), Facilitate (AstraTech), 

Navigator (Biomet 3i), ExpertEase (Dentsply Friadent), 

Straumann Guided Surgery Kit (Straumann), Nobel- 

Guide (Nobel Biocare), Camlog Guide System (Camlog), 

and Zimmer Guided Surgery Instrumentation 

(Zimmer Dental). 


Materialise Dental NV – Headquarters 

Technologielaan 15 

3001 Leuven . Belgium 

Phone: +32 16 396620 

simplant@materialise.be 

www.materialisedental.com 

The product information produced here editorially is based on information 

provided by the manufacturer and has not been checked by the editor 

for its accuracy.


Product News 

Degradable Solutions 

calc-i-oss crystal 

Product: 

calc-i-oss crystal 

Indication: 

Bone replacement 

Distribution: 

Degradable Solutions AG 

Wagistrasse 23 . 8952 Schlieren . Switzerland 

Phone: +41 43 433-6260 

dental@degradable.ch . www.degradable.ch 

IDS 2011 will see the first presentation worldwide of 

the biphasic calc-i-oss crystal by Degradable Solutions, 

a product consisting of 100% synthetic bone replacement 

particles (60% HA, 40% pure-phase ß-TCP) 

exhibiting a rotund, interconnected and highly porous 

shape. calc-i-oss crystal is the logical complement of 

easy-graft crystal. It is especially useful in large defects, 

which can be filled with calc-i-oss crystal first, then 

covered with easy-graft crystal. In the same manner, 

autologous bone or bone morphogenetic proteins (BMP) 

may also be introduced into the region to be augmented 

and a stable coverage of the defect is ensured. 

easy-graft crystal and easy-graft classic are good examples 

of successful product maintenance. Its special 

handling continues to win over more and more supporters, 

enjoying numerous well-documented examples 

of long-term success. In contact with blood, the 

material will take only a few minutes to solidify into a 

porous body that has the same shape as the defect, 

which will often render membrane coverage unnecessary. 

The difference between easy-graft classic and 

easy-graft crystal is in their chemical composition, 

making them suitable for different indications. “Classic” 

easy-graft consists mainly of ß-TCP. It is fully resorbed 

by the body and replaced by bone. By contrast, 

easy-graft crystal is only partially resorbed. It consists 

of coated biphasic calcium phosphate (40% ß-TCP, 

60% HA). The hydroxyapatite fraction remains integrated 

in the bone, ensuring sustained volume stability. 

Dental Bone Bone & 

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Product News 

Omnia Circular scalpel 

Aseptico Elite 

The Elite all-in-one motor system from Aseptico 

(model AEU-7000L-70V) is indicated for a number of 

dental specialties, including implant, endo, restoration, 

and oral surgery. Features include: 

• A powerful, 40K rpm, autoclavable micromotor 

with LED illumination at any speed. Unlike conventional 

fiber optic bulbs, the integrated LED 

provides tens of thousands of operating hours. 

• An advanced dynamometer calibration system 

that automatically detects the properties of individual 

implant or endo reduction handpieces for 

highly accurate speed, torque, and efficiency 

results at the time of treatment. This means that 

almost every brand of new or existing reduction 

handpiece from 16:1 – 32:1 (implant) and 4:1 – 16:1 

(endo) can be used. 

• Torque control is adjustable up to 60 Ncm, 

ensuring compatibility with every implant system 

in the market. 

• Endo functionality that exceeds any competing 

hybrid system (on-board file library, torque in 

g-cm, auto-stop-reverse, etc.). 

• Twelve programmable preset buttons 

(six implant/six endo) are available for saving 

preferred ratio, speed, torque, irrigation, motor 

direction settings, and even display names. 

• Upgradable software ensures longevity of the 

device. 

The circular scalpel or soft-tissue 

punch is used to precisely incise 

the mucosal rim around the 

implant. Omnia offers scalpels 

with three different diameters 

(Ø 4.1, Ø 5.2 and Ø 6.2) for easier 

adaptation to major implants 

brands. 

Since the incision is limited to 

the dimensions of the implant 

cap, the disposable circular scalpel 

causes less mucosal trauma than 

traditional scalpels. 

The Elite performs the complete 

implant procedure using a 20:1 

reduction contra angle, such as 

the new AHP-85MBFO-CX Mont 

Blanc Fiber Optic Handpiece with 

Depth Control. The micromotor is 

also compatible with most brands 

of lighted and non-lighted handpieces 

(such as the AHP-85MB-X 

or AHP-85MB-CX Mont Blanc and 

the AHP-85P-I Impulsion). The 

Elite may also be used with 8:1 

endo, 1:1 standard, 1:2, and 1:5 

increaser handpieces for a multitude 

of dental applications. 

Product: 

Circular scalpel 

Indication: 

Dental implantology, oral surgery 

and maxillofacial surgery 

Distribution: 

Omnia S.p.A 

Via F. Delnevo 190 

43036 Fidenza (PR) · Italy 

Phone: +39 0524 527453 

info@omniaspa.eu 

www.omniaspa.eu 

Product: 

Elite 

Indication: 

LED motor system 

Distribution: 

Aseptico 

P.O. Box 1548 

Woodinville, WA 98072 

USA 

Phone: +1 425 487-3157 

info@aseptico.com 

www.aseptico.com

It’s Time for a ReThink: 

High Quality at factory-direct Prices 

Zimmer © Dental * 

Implant: from €100 

In times of financial constraints - 

look for innovation with the best value! 

Implant Direct sets new standards with high-quality implants with low prices 

and value added All-in-One Packaging for only 115 Euro per implant, including 

the corresponding prosthetic components. Besides the unique Spectra System, 

we offer compatible implant systems to Nobel BiocareTM , Str aumann and Zimmer © 

Dental. Make a decision today and choose a path of smart solutions and 

considerably more profit. 

*Registered trademarks of Straumann, Zimmer © Dental and Nobel Biocare TM 

Spectra-System 

Six application-specific implants 

All-in-One O e Package: ac age € 1155 

Hexagon Tri-Lobe Octagon 

Nobel Biocare TM * 

RePlant Line 

RePlus Line 

ReActive Line 

All-in-One Package: from € 115 

All-in-One Package: includes implant, abutment, cover screw, healing collar, comfort cap and transfer 

Straumann * 

SwishPlant Line 

All-in-One Package: € 145 

Innovation with the best value 

Hall 4.1 

Stand E018�F019 

and Hall 10.1 

Stand J029 

Visit us! 

Tollfree Infoline: 00800 4030 4030 

www.implantdirect.eu 

Europe’s No. 1 Online Provider for Dental Implants 

��


Product News 

Leader Italia Tixos Nano 

The Tixos family of implants has received two new 

members, based on the familiar and much-appreciated 

Nano micro-implants. Leader Italia’s two new 

implants, the Tixos Nano 2 and the Tixos Nano OVD, 

owe their advantages to further optimization of the 

production process and a number of changes to the 

implant design – without in any way compromising 

the benefits of the high-quality Tixos surface. 

The new products differ from Tixos Nano implants 

in that their neck is shorter. Moreover, the Normo ball 

of the OVD implants is not nitride-treated. 

The Tixos Nano 2 and the Nano OVD feature the 

new Tixos laser-microfused titanium surface: An 

isoelastic surface is created around a very compact 

core, replicating the spongy structure of natural bone 

by micro- and macro-cavities of well-defined size and 

shape interconnected by micro-pores. The structure 

is highly mimetic, accelerating bone healing and 

osseointegration, as demonstrated by in-vitro and 

in-vivo human studies*. 

*References available on www.leaderitalia.it. 

The new Saturno Pivoting O-Ring Attachment from 

Zest Anchors makes restoring overdentures using 

O-rings much simpler and more predictable. This 

innovative new overdenture attachment features a 

race that pivots 15 degrees in any direction inside 

the denture cap while securely holding the O-ring. 

These attachments compensate for divergent im - 

plant angles by creating an aligned fit that is forgiving 

and patient friendly. Extensive laboratory 

testing has demonstrated that the Saturno O-Ring 

Attachment outperforms traditional O-rings during 

insertion and removal at 15 degrees of divergence. 

Saturno is available for standard and mini implant 

applications. A new, patented O-Ring Insertion Tool 

that makes replacing O-rings quick and efficient is 

also offered by Zest Anchors. 

Product: 

Tixos Nano 

Indication: 

Micro-implant with shorter 

transmucosal segment 

Distribution: 

Leader Italia Srl 

Via Aquileja 49 

20092 Cinisello Balsamo (MI) 

Italy 

Phone: +39 02 618651 

export@leaderitalia.it 

www.leaderitalia.it 

Zest Anchors 

Saturno Pivoting O-Ring Attachment 

Product: 

Zest Saturno Pivoting O-Ring 

Attachment 

Indication: 

Restoration of overdentures 

using O-rings 

Distribution: 

Zest Anchors, LLC 

2061 Wineridge Place 

Escondido, CA 92029 

USA 

Phone: +1 760 743-7744 

www.zestanchors.com

Europe 

Bulgaria 

Croatia 

France 

Georgia 

Germany 

Italy 

+359 285 910 24 

+38 549 372 605 

+33 545 839 452 

+99 532 9100 00 

+49 6196 777 550 

+39 185 788 7863 

Lithuania 

Norway 

Poland 

Portugal 

Russia 

Serbia 

+370 521 530 62 

+47 229 991 41 

+48 22 6581444 

+351 968 205 696 

+7 496 739 9925 

+381 112 763 639 

Slovakia 

Spain 

Sweden 

Turkey 

United Kingdom 

+421 527 722 924 

+34 934 239 294 

+46 8 732 6170 

+90 216 418 5100 

+44 773 915 6413 

Africa 

OSSTEM Germany GmbH Mergenthalerallee 25, 65760 Eschborn, Germany 

europe@osstem.com www.sinuskit.com 

Middle East 

Iran +98 218 861 0256 

Pakistan +92 321 2422365 

Saudi Arabia +966 128 130 08 

Syria +963 114 416 714 

Egypt +202 3304 3554


112 

Product News 

Leone Exacone implant system 

Patient’s restorative needs are increasing daily. Dental 

professionals are called upon to meet these needs. 

With new digital technologies making ever stronger 

inroads on the world of dentistry, the products used in 

these technologies have gone from “nice to have” to 

“impossible to do without”. 

The Exacone implant with its screwless Morse taper 

connection simplifies and improves the application of 

most recent technologies. With this implant, high-resolution 

digital impressions no longer have to depend 

on special accessories such as scanning abutments, 

but can be taken directly on the abutments themselves. 

Regardless of whether an intraoral scanner or a 

laboratory scanner is used. 

The system’s prosthetic advantages are further enhanced 

by CAD/CAM techniques, as the absence of the 

screw access channel greatly simplifies the design and 

fabrication of frameworks. In particular the MultiTech 

abutments have been designed to more readily respond 

to the requirements of CAD/CAM technology, 

which favours their use in custom solutions. 

Aesculap will be presenting its new instruments for 

the tunnelling technique at this year’s IDS in Cologne. 

The tunnelling instruments are characterized by discshaped 

working ends offering considerable extra freedom 

of movement in frontal and lateral subperiosteal 

preparations using the tunnelling technique in connective-tissue 

graft procedures. 

Strategically sharpened at the edges, these instruments 

facilitate not only the tunnelling technique 

but also sulcular preparation as used in the envelope 

technique. The design and curvature of the working 

Exacone implants are included in 

the libraries of most common implant 

treatment planning systems, 

facilitating computer-assisted management 

of implant therapy at 

every step from implant placement 

to prosthetic restorations. 

The Exacone system is perfectly in 

tune with today’s high-tech equipment, 

ready to contribute its share 

to dentistry’s digital revolution. 

ends greatly simplify preparation 

tasks even on convex surfaces. In 

this manner, application of the 

tunnelling technique is simplified 

for users, allowing them to 

achieve significantly improved results. 

Aesculap’s new tunnelling instruments 

will be available in a 

straight (DX310R) and an angled 

(DX311R) version. 

Product: 

Exacone implant system 

Indication: 

Dental implantology 

Distribution: 

Leone S.p.A. 

Via P. a Quaracchi, 50 

50019 Sesto Fiorentino (Fi) 

Italy 

Phone: +39 055 3044-1 

info@leone.it 

www.leone.it 

Aesculap New tunnelling instruments 

Products: 

Tunnelling instruments 

Indication: 

Dental periodontology and 

implantology 

Distribution: 

Aesculap AG 

Am Aesculap-Platz 

78532 Tuttlingen 

Germany 

Phone: +49 7461 95-0 

dental@aesculap.de 

www.aesculap-dental.com

· Universal connection 

· Anatomic design 

· Compatible 

High Definition 

Every single feature defines a Masterpiece 

Are you interested in becoming our distributor? 

Contact us. 

HEADQUARTERS 

· Non-traumatic apex 

· RBM Surface treatment 

· Triple-thread Design 

Visit us at IDS 2011 

34 th International Dental Show 

Cologne, 22-26.3.2011 

Stand D78. Hall 4.1 

· 11º Morse taper connection 

· Platform switching 

· Microthreads 

· 45º implant shoulder 

· Immediate loading 

· RBM Surface treatment 

C/ Santiago López González, 7 · 47197 Valladolid · Spain · Tel. +34 983 211 312 

Fax +34 983 304 021 · info@mozo-grau.com · www.mozo-grau.com 

CHILE CHINA COLOMBIA POLAND PORTUGAL SPAIN TAIWAN VENEZUELA


Product News 

Dentaurum Implants tioLogic pOsition 

Modern 3D imaging technologies such as DVT and 

CT give users a better view of existing jaw structures 

and bone conditions before surgical procedures, 

allowing them to determine the implant positions 

and to select the right protocols. 

The tioLogic pOsition navigation system has been 

designed to work with imaging processes and 3D 

planning software for guided preparation, followed by 

placement of tioLogic implants. If the indication al- 

lows it, tioLogic implants can be restored 

immediately with previously 

fabricated restorations. 

The tioLogic pOsition system includes 

specially designed instruments 

and accessory components 

for preparing the bone site and for 

implant placement. The sleeves of 

the tioLogic pOsition system are 

made of titanium and ensure accurate 

guidance of the drills. The bone 

is atraumatically prepared to the 

specified implant length while 

gradually widening the diameter. 

Working with the tioLogic pOsition 

has been designed to be simple 

and safe for users with the inclusion 

of many special details 

such as the ability to adjust the 

handle of the internal sleeves in 

three dimensions for work in restricted 

spaces or the silicone ring 

that fixes the internal sleeves in 

position during the procedure. 

Alpha-Bio Tec Alpha Universe 

MultiUnit abutment system 

Alpha-Bio Tec has launched the Alpha Universe Multi- 

Unit angular abutment system for use with tilted 

implants. It is simple and easy to use and consists 

of two parts: The base (UniBase), available in a range 

of angles and heights, and the cover (UniCover), available 

in a range of designs according to the desired 

restoration option. The MultiUnit body is supplied 

connected to a patent pending, flexible plastic handle, 

which enables precise base placement, even in 

hard-to-reach places. The specially designed base and 

cover are screwed together in order to provide extra 

strength and stability, assuring a long-term solution. 

Alpha Universe is compatible with the standard 

Alpha-Bio Tec tools and prosthetic parts to reduce 

inventory and to simplify the restoration process. 

The UniBase is available in 17° and 30° angles, and 1.5 

and 2.5 mm heights. The UniBase kit contains the base, 

connected to the flexible handle and two UniScrews – 

a blue screw for the physician and 

a silver screw for the lab. 

The range of UniCovers enables 

a wide range of restoration options 

– screw retained, bar retained, 

ball retained and cement 

retained. UniCovers are also available 

in a range of heights for optimal 

aesthetics. 

Product: 

tioLogic pOsition 

Indication: 

Guided implant placement 

Distribution: 

Dentaurum Implants GmbH 

Turnstr. 31 

75228 Ispringen 

Germany 

Phone: +49 7231 803-560 

info@dentaurum-implants.de 

www.dentaurum-implants.de 

Product: 

Alpha Universe MultiUnit 

abutment system 

Indication: 

Angular abutment system 

Distribution: 

Alpha-Bio Tec Ltd. 

7 Hatnufa St. · P.O.B 3936 

Petach Tikva 49510 

Israel 

Phone: +972 3 9291055 

info@alpha-bio.net 

www.alpha-bio.net

Malta 2011 

International Anniversary Congress 

Innovation through cooperation – your partner on the way to success 

September 22 - 25, 2011 

Register now ! 

Dentaurum Implants GmbH 

· Dentauru m Im plants G m bH · 

Prof. Dr. Ahmed Barakat · University Cairo · Egypt n Prof. Dr. Tobias M. Böckers · University Ulm · Germany 

Prof. Dr. Christoph Bourauel · University Bonn · Germany n Prof. Dr. Marzena Dominiak · University Wroclaw · Poland 

Prof. Dr. Dr. Wilfried Engelke · University Göttingen · Germany n Dr. James Galea · Malta 

Prof. Dr. Tomas Gedrange · University Greifswald · Germany n Dr. Friedhelm Heinemann · Germany 

Dr. Joachim Hoffmann · Germany n Dr. Peter Keller · Germany n Dr. Alireza Keshvad · Iran 

ZT Björn Koller · Germany n Dr. Stephan Kressin · Germany n Dr. Friedemann Petschelt · Germany 

Dr. Umberto Pratella · Italy n Dr. Hatem W. Al Rashdan · Jordan n ZT Germano Rossi · Italy 

Prof. Dr. Klaus Roth · University Hamburg · Germany n Dr. Enzo de Santis · Italy n Dr. Daniel Schulz · Germany 

Dr. Sigmar Schnutenhaus · Germany n Dr. Manfred Sontheimer · Germany 

Turnstraße 31 · 75228 Ispringen · Germany · Phone + 49 72 31 / 803 - 0 · Fax + 49 72 31 / 803 - 295 

www.dentaurum-implants.de · E-Mail: info@dentaurum-implants.de 

DE_0211_Anzeige_Malta_Implants_EN_210x297mm.indd 1 03.02.2011 15:10:58 Uhr


Product News 

Mozo-Grau 

17° Angled Tapered Multi-Unit Abutment 

Mozo-Grau, manufacturer of the MG InHex and 

MG Osseous dental implant systems, now offers 

an option for screw-retained restorations on angled 

tapered abutments developed by Mozo-Grau’s engineering 

department. 

This new abutment has been designed for screwretained 

restorations with a screw angle of 17° in relation 

to the implant insertion axis. This feature is very 

useful in difficult situations or in multi-implant protocol 

cases, such as the “All-on-4” technique that entails 

angled insertion on the implants placed at the distalmost 

positions. 

The multi-unit solution will shortly be complemented 

by abutments with other angulations. 

Implant Direct Sybron has added two very interesting 

lines of regenerative products to its product offering 

– Bioresorb Macro Pore grafting material and 

Cytoplast membranes and sutures. 

Bioresorb Macro Pore is an osteoconductive, purephase 

ß-tricalcium phosphate (99%) bone-grafting 

material developed via a patented process that creates 

a highly porous structure very similar to human 

bone. The combination of interconnecting micro- and 

macroporous structures gives this material its definitive 

advantage by allowing vascularization and the 

introduction of cells into and through the particle. This 

in turn results in new bone deposits within the parti- 

cles themselves rather than just on 

the particle surface, as can be the 

case with less porous materials. 

The Cytoplast line of membranes 

gives clinicians the choice 

between a resorbable membrane 

made of highly purified type 1 collagen 

or a non-resorbable membrane 

made of d-PTFE if primary 

closure of the grafting site cannot 

be achieved. For cases with a defect 

affecting one or more walls or 

where head space at the grafting 

site needs to be maintained, premium 

non-resorbable membranes 

with titanium reinforcements are 

available in various shapes and 

sizes. 

Both products are indicated for 

treating most osseous defects and 

result in highly predictable bone 

formation. You can learn more 

about the products at IDS 2011. 

Visit the two Implant Direct Sy - 

bron booths in Hall 4.1, Stand F18/ 

E19 and Hall 10.1, Stand J29. 

Product: 

17° Angled Tapered Multi-Unit 

Abutment 

Indication: 

Free-standing implants, 

overdenture treatment 

Distribution: 

Mozo-Grau 

Santiago González López 7 

47197 Valladolid 

Spain 

Phone: +34 983 211-312 

sales@mozo-grau.com 

www.mozo-grau.com 

Implant Direct Sybron Extended product range 

Products: 

Bioresorb Macro Pore grafting 

material; Cytoplast membranes 

and sutures 

Indication: 

Treatment of osseous defects 

Distribution: 

Implant Direct Europe AG 

Hardturmstrasse 161 

8005 Zürich 

Switzerland 

Phone: 00800 40304030 

info@implantdirect.eu 

www.implantdirect.eu

Anteriores – 

Natural and Beautiful Teeth 

by Jan Hajto 

Picture Gallery 

This book aims to be highly visual and inspiring. A selection of naturally beautiful anterior teeth 

is presented in the form of a coloured atlas. The cases are systematically arranged according to 

gender and an approximate classifi cation of the regularity of the dentition. 

This collection will become indispensable as your manual for the aesthetic planning and production 

of anterior restorations or as an aid to communication between dentist, patient and dental 

technician. 

Implant Retained Single Tooth Restorations 

by Roberto Bellini 

The production of single tooth crowns in the 

anterior tooth or lateral tooth area has always 

posed a special challenge to the technical and 

creative competence of a dental technician. In 

this reference book are more brilliant pictures 

than explanatory text because the author 

consciously tried to use the medium ‘picture’ 

as a prime information transfer. 

103 pages, 254 pictures 

ISBN: 978-3-932599-09-5 

REF 9009 € 24,80 

270 pages, 950 illustrations 

ISBN: 978-3-932599-19-4 

Crown – Bridge & Implants 

by Luc & Patrick Rutten 

REF 9019 € 153,- 

The authors show in this book the way to a 

perfect red and white aesthetic by using about 

1,300 excellent pictures and a cross section 

out of their daily work in the laboratory. An 

essential schoolbook for the prosthetic and 

implant logical dentist and dental technician. 

296 pages, 1300 pictures 

ISBN: 978-3-932599-17-0 

REF 9021 € 149,-


Product News 

Nobel Biocare Replace Select TC 

Replace Select TC is a two-piece implant with a 3 mm 

high, extended machined collar, which enables platform 

access at tissue level. Simultaneously, its colorcoded 

internal tri-channel connection facilitates 

accurate and quick restorative component identification 

and placement. 

The body of Replace Select TC is derived from Brånemark 

System MK III implants, making it well-suited 

for all bone types and one-stage treatment protocols. 

Zimmer Dental Inc. is studying ways in which Trabecular 

Metal Technology can be applied to the dental 

market. Manufactured at Zimmer’s TMT facility in 

Parsippany, NJ, USA, Trabecular Metal Material has 

been used in the company’s cutting-edge ortho pae - 

dic devices for more than a decade. 

Trabecular Metal Material will be presented at IDS 

2011. It is a three-dimensional, highly biocompatible 

material – not an implant surface or coating – with a 

structure, function, and flexibility comparable to cancellous 

bone. Made from tantalum, element number 73 

in the periodic table, Trabecular Metal Material is fabricated 

utilizing a proprietary vapor deposition process. 

A glimpse inside Trabecular Metal Material reveals 

its uniform, three-dimensional cellular architecture 

with up to 80 percent porosity and a surface area 

exhibiting a consistent, nanotextured topography. 

While conventional textured or coated implant surfaces 

achieve bone-to-implant contact, or on-growth, 

Trabecular Metal Material’s open and interconnected 

network of pores is designed for both on-growth 

and in-growth, or osseoincorporation. This means 

that bone has the potential to not only grow into the 

pores and around the struts, but also to interconnect. 

In a retrospective study with an 

average three year follow-up, Replace 

implants with 3 mm collars 

demonstrated a cumulative survival 

rate of 99.2 per cent. 

To facilitate immediate temporization 

using existing dentures 

and to prevent soft tissue overgrowth, 

a new healing screw was 

developed for Replace Select TC. 

Two different screws are available 

to accommodate soft tissue thickness 

and facilitate intraoperative 

flexibility: 1 mm and 3 mm height 

variants. Final prosthetics can be 

attached to Replace Select TC using 

any Nobel Biocare overdenture 

solution: Locator Abutment, 

Ball Abutment, Gold Abutment Bar/ 

Gold Coping Bar and NobelProcera 

Implant Bar Overdenture. 

While other manufacturers 

have attempted to mimic the 

properties of Trabecular Metal 

Technology through sintered 

bead and other conventional 

porous coatings and materials, 

the end products have differed 

significantly. The cancellous-like 

structure, interconnected porosity 

and in-growth potential are a 

special combination of attributes 

that contribute to the osteoconductive 

properties of Trabecular 

Metal Material. 

Product: 

Replace Select TC 

Indication: 

Two-piece dental implant 

Distribution: 

Nobel Biocare Management AG 

P.O. Box 

8058 Zurich-Airport 

Switzerland 

Phone: +41 43 2114200 

info@nobelbiocare.com 


Zimmer Dental Trabecular Metal Material 

Product: 

Trabecular Metal Material 

Indication: 


Distribution: 

Zimmer Dental Inc. 

USA 

Phone Germany: +49 761 15647-0 

Phone Spain: +34 93 84605-43 

Phone France: +33 1 451235-66 

Phone Italy: +39 043 85555-73 

Phone Israel: +972 3 612-4242 

www.zimmerdental.com


Product News


Product News 

mectron Bone expanders 

At IDS 2011, mectron will be presenting its bone 

expanders, indicated mainly for splitting the atrophic 

alveolar ridge and for the lateral bone-condensation 

technique. These bone expanders were developed 

in scientific collaboration with Dr Rosario 

Sentineri. They are available in three different diame - 

ters (2.5 mm/3.5 mm/4.5 mm) and two lengths 

(11.5 mm/15 mm) to suit different anatomical situations. 

All of them can be used with either an implantology 

micromotor or a manual ratchet with dedicated 

adapters. 

mectron will be showing various exciting new 

products at its IDS Cologne booth (Hall 10.2, Stand 

The Locator Attachment for overdentures from Zest 

Anchors is designed with the primary benefits of 

ease of insertion and removal, customizable levels of 

retention, low vertical profile and durability. The most 

critical design feature is its innovative ability to pivot, 

which increases the attachment’s resiliency and tolerance 

for the high mastication forces an attachment 

must withstand. This patented pivoting feature also 

allows the attachment to compensate for implant 

divergence. Today, Locator has become the overdenture 

attachment that is embraced by clinicians 

worldwide. It is currently available for over 350 different 

implants produced by more than 70 manufactur- 

Kohler Paralleling guide 

O40/P41). Visitors can enjoy the 

new products while sipping a free 

tasty espresso or two. 

ers, meaning almost any implant 

platform has a compatible Locator 

Attachment to fit. 

The paralleling guide is used for 

aligning two or four interforaminal 

implants in the edentulous 

mandible with the median plane. A 

hole is drilled in the middle of the 

mandible using a pilot drill, which 

is easily aligned with the median 

plane. The distance from the middle 

can be accurately transferred 

to the opposite side by swivelling 

the fitted paralleling guide. 

Products: 

Bone expanders 

Indication: 


Distribution: 

mectron s.p.a. 

via Loreto 15A 

16042 Carasco (GE) · Italy 

Phone: +39 0185 35361 

mectron@mectron.com 

www.mectron.com 

Zest Anchors Locator Implant Attachment 

Product: 

Zest Locator Implant Attachment 

Indication: 

Overdenture attachment 

Distribution: 

Zest Anchors, LLC 

2061 Wineridge Place 

Escondido, CA 92029 

USA 

Phone: +1 760 743-7744 

www.zestanchors.com 

Product: 

Paralleling guide according to 

Dr Schäfer, Germany 

Indication: 


Distribution: 

Kohler Medizintechnik GmbH & Co. KG 

Bodenseeallee 14-16 

78333 Stockach · Germany 

Phone: +49 7771 64999-0 

info@kohler-medizintechnik.de 

www.kohler-medizintechnik.de

Hi Tec Implants 

Logic plus implant system 

Product: 

Logic plus implant system 

Indication: 


Distribution: 

Hi Tec Implants 

P.O. Box 2022 

Herzliya 

Israel 

Phone: +972 9 9587775 

sales@hitec-implants.com 

www.hitec-implants.com 

Trinon GIP implant 

Product: 

GIP implant 

Indication: 

Ultra-short 

hollow-cylinder implant 

Distribution: 

Trinon Titanium GmbH 

Augartenstraße 1 

76137 Karlsruhe 

Germany 

Phone: +49 721 932700 

trinon@trinon.com 

www.trinon.com 

The Logic plus implant system by 

Hi Tec Implants was developed 

with the vision of providing the 

ultimate range of products for all 

needs and requirements, covering 

all clinical indications – for maximum 

simplicity, using only one 

prosthetic system for all implant 

diameters. The implant system 

features platform switching to preserve 

crestal bone. The prosthetic 

system is extensive and covers: 

• A universal abutment system 

for screw-retained bridges, 

including angulated universal 

abutments for posterior cantilever 

situations and full-arch 

rehabilitations. 

• A modular abutment system, 

snap-ons, zirconia and castgold 

abutments and a large 

selection of titanium abutments. 

The GIP implant by Trinon is an 

ultra-short hollow-cylinder im - 

plant 7 mm in diameter and 4 to 

7 mm in length. Like other Q-Im - 

plants by Trinon, the GIP implant 

features the Osteo thread and 

SLA surface treatment both on 

the inner and on the outer surfaces. 

Its hollow-cylinder shape 

greatly increases the available 


Product News 

The Logic plus system includes the X-6 implant system, 

extra short implants with diameters of 4.30 mm, 5.0 mm 

and 6.0 mm and a special thread design for cases of 

extremely minimal bone height. 

contact surface for osseointegration – a GIP implant 

5 mm in length has the same surface area as a 

tapered Q-Implant 4.5 mm in diameter and 12 mm in 

length. 

Patients with a preference for a fixed rehabilitation 

supported by implants often cannot receive 

their treatment of choice due to an insufficient 

bone supply. Some of these patients have benefitted 

from the advent of angulated implants. With ultrashort 

implants now available, dentists and patients 

now have additional treatment options at their disposal 

– the GIP implant has a diameter of 7 mm 

and an inside diameter of 5 mm is an excellent 

choice. Rotational stability of the implant is ensured 

by the stable bone connection afforded by the internal 

cylinder and the four longitudinal cuts 2 mm 

below the implant shoulder. A platform-switching 

effect is established by the micro-groove design of 

the wide shoulder. Clinical experiences over the past 

five years have proven ultra-short implants to be a 

safe alternative to bone augmentation.


Calendar of Events 

CALENDAR OF EVENTS 

2011 Event Location Date Details/Registration 

March 34th International Dental Show 

(IDS) 2011 

Cologne, Germany 22–26 March 2011 Koelnmesse GmbH 

Phone: +49 180 577-3577 

www.ids-cologne.de 

April Forum Dental Mediterraneo Barcelona, Spain 7–9 April 2011 Puntex 

Phone: +34 937 964-507 

www.puntex.es/fdm/index.php 

Scandefa 2011 Copenhagen, Denmark 7–9 April 2011 Bella Center 

www.scandefa.dk 

International Osteology 

Symposium 2011 

May 360° Implantology – MIS Global 

Conference 2011 

June 5th BDIZ EDI Mediterranean 

Symposium 

July Advanced Certificate Course in Sinus 

Grafting and Bone Augmentation 

with Hands-on Cadaver Surgery 

September FDI Annual World Dental Congress 

2011 

Joint congress of BDIZ EDI and 

DGOI 

October EAO Annual Scientific Congress 

2011 

EDI – Information for authors 

EDI – the interdisciplinary journal for prosthetic dental implantology is 

aimed at dentists (and technicians) interested in prosthetics implantology. 

All contributions submitted should be focused on this aspect in content 

and form. Suggested contributions may include: 

. Case studies 

. Original scientific research 

. Overviews 

Manuscript submission 

Submissions should include the following: 

. two hard copies of the manuscript 

. a disk copy of the manuscript 

. a complete set of illustrations 

Original articles will be considered for publication only on the condition 

that they have not been published elsewhere in part or in whole and are 

not simultaneously under consideration elsewhere. 

Manuscripts 

Pages should be numbered consecutively, starting with the cover page. 

The cover page should include the title of the manuscript and the name 

and degree for all authors. Also included should be the full postal address, 

telephone number, fax number, and electronic mail address of the contact 

author. The second page should contain an abstract that summarizes the 

article in approximately 100 words. 

Manuscripts can be organized in a manner that best fits the specific goals 

of the article, but should always include an introductory section, the body 

of the article and a conclusion. 

Figures and tables 

Each article should contain a minimum of 20 and a maximum of 50 origi - 

nal color slides (35 mm) or digital photos, except in unusual circumstances. 

The slides will be returned to the author after publication. Slides 

should be numbered on the mount in the sequential numerical order in 

which they appear in the text (Fig. 1, Fig. 2, etc.). 

Editors office: teamwork media GmbH, Hauptstr. 1, 86925 Fuchstal/Germany 

Phone: +49 8243 9692-0, Fax: +49 8243 9692-22, service@teamwork-media.de 

Cannes, France 14–16 April 2011 Osteology Foundation 

Phone: +377 97 973555 


Cancun, Mexico 19–21 May 2011 MIS 

service@mis-implants.com 

www.mis-implants.com 

Cascais, Portugal 10–17 June 2011 BDIZ EDI 

office@bdizedi.org 

www.bdizedi.org 

London, England 7–9 July 2011 Dr Koray Feran 

Phone: +44 207 224-1488 

anai@korayferan.co.uk 

Mexico City, Mexico 14–17 September 2011 FDI World Dental Federation 

info@fdiworldental.org 

www.fdiworldental.org 

Munich, Germany 16–17 September 2011 BDIZ EDI 

office@bdizedi.org 

www.bdizedi.org 

Athens, Greece 13–15 October 2011 Colloquium 

Phone: +33 1 4464-1515 

www.eao.org 

Radiographs, charts, graphs, and drawn figures are also accepted. 

Figure legends should be brief one or two-line descriptions of each figure, 

typed on a separate sheet following the references. Legends should be 

numbered in the same numerical order as the figures. 

Tables should be typed on separate sheets and numbered consecutively, 

according to citation in the text. The title of the table and its caption 

should be on the same sheet as the table itself. 

References 

Each article should contain a minimum of ten and a maximum of 30 references, 

except in unusual circumstances. Citations in the body of the text 

should be made in numerical order. The reference list should be typed on 

a separate sheet and should provide complete bibliographical information 

in the format exemplified below: 

[1] Albrektsson, T.: A multicenter report on osseointegrated oral implants. 

J Prosthet Dent 1988; 60, 75-82. 

[2] Hildebrand, H. F., Veron, Chr., Martin, P.: Nickel, chromium, cobalt dental 

alloys and allergic reactions: an overview. Biomaterials 10, 545-548, (1989). 

[3] Johanson, B., Lucas, L., Lemons, J.: Corrosion of copper, nickel and gold 

dental alloys: an in vitro and in vivo study. J Biomed Mater Res 23, 349, 

(1989). 

Review process 

Manuscripts will be reviewed by three members of the editorial board. 

Authors are not informed of the identity of the reviewers and reviewers 

are not provided with the identity of the author. The review cycle will be 

completed within 60 days. Publication is expected within nine months. 

Page charges and reprints 

There are no page charges. The publisher will cover all costs of production 

and provide the primary author with five free copies of the journal issue 

in which the article appears.

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EDI - BdiZ

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