CHAPTER 11 Root Form Implant Surgery: Proprietary II
The BioHorizons implant system consists of six styles of titanium alloy implants. These implants, which are threaded (reverse buttress threads), have either resorbable blast texturing (RBT) or a hydroxyapatite (HA) surface coating. The Tapered Internal design also has the proprietary Laser-Lok microchannels. The microchannels are a series of 8- and 12-μm grooves engineered onto the collar of the Internal implants, which come with an abutment and its retaining screw and a healing cover screw. The other implants have a polished collar. All of the implants have a lifetime unconditional restoration-to-implant warranty (Fig. 11-1, A).
FIGURE 11-1. A, BioHorizons implants. These implants are made of a titanium alloy and have resorbable blast texturizing (RBT) threads (reverse buttress threads) with the proprietary Laser-Lok microchannels. B-E, The osteotomy method follows classic techniques using drills of increasing diameter.
(Courtesy BioHorizons Implant System, Birmingham, Ala.)
The Overdenture implant is an affordable device for patients whose ridges are too narrow for wider, two-piece systems. The Overdenture’s one-piece, titanium alloy construction provides maximum strength, and its 3-mm diameter allows placement in narrow ridges. These implants are placed using a single-stage protocol, with options for either flap or flapless surgery. Each implant is packaged with the complete attachment system, with options for three levels of retention.
The External implant features the 3inOne prepable titanium abutment and a 1-mm high external hex. The modified-square threads provide greater bone to implant contact and reverse torque values than V-thread designs. The series is available in four diameters (3.5, 4, 5, and 6 mm) and four lengths in each diameter size (9, 10.5, 12, and 15 mm).
The Tapered Internal implant has the proprietary Laser-Lok microchannels and reverse buttress threads on an anatomically tapered implant body. The Tapered Internal Implant also has the 3inOne prepable titanium abutment, with the same 1.5-mm deep internal hex connection as the Internal and Single-stage implants. The Tapered Internal implant is available in three diameters (3.8, 4.6, and 5.8 mm) and five lengths (7.5, 9, 10.5, 12, and 15 mm).
For the Single-stage implant, the same surgical kit is used as for the Internal (two-stage) implant. The Single-stage also has the same internal hex connection. This allows the clinician to choose the implant design best suited to a particular case. The Single-stage implant is available in four diameters (3.5, 4, 5, and 6 mm) and five lengths (7, 9, 10.5, 12, and 15 mm).
The Internal implant has the 3inOne prepable titanium abutment, a 1.5-mm deep internal hex connection, and the modified-square thread design. The Internal implant is available in four diameters (3.5, 4, 5, and 6 mm) and five lengths (7, 9, 10.5, 12, and 15 mm).
The One-piece 3.0 implant has an integrated crown and bridge abutment. It is specifically indicated for replacement of maxillary laterals and mandibular incisors. This implant allows the dental surgeon to treat spaces that cannot be handled with conventional two-piece implants. The prepable gold-colored titanium nitride coating on the abutment portion also improves soft tissue esthetics. The surgical protocol follows steps similar to those of the other implant lines.
Since 1985, Bicon implants have been promoted as the short implant of choice for the anatomically challenged areas where there is non-optimal alveolar height present in proximity to the inferior alveolar canal or the maxillary sinus. Implants are available with a grit blasted acid etched surface known as Inegra-Ti or with a calcium phosphate treatment (HA) known as Integra-CP.
In accordance with the manufacturer’s instructions for using a Bicon implant, initial cortical perforation is made with a 2.0-mm pilot drill with external irrigation to a depth 2.0 – 3.0-mm deeper than chosen implant (when practical) (Figure 11-2, A). Widening of the osteotomy is performed with sequentially larger reamers beginning with a 2.5-mm diameter and ending with the diameter of the intended implant (Figure 11-2, B). Reamers have horizontal markings at 6.0, 8.0, 11 and 14 mm, whereas older reamers may have different markings. It is imperative that the depth indicators on the latch reamers are known before surgery. No assumptions should be made about the height of the first marking on any latch reamer. If there is any doubt about the markings on any drill or reamer, take a measurement before using the reamer. Bone may be harvested from within the flutes of the reamers as no irrigation is utilized.
The Star/Vent implant is a single-stage, one-piece, titanium plasma spray (TPS) screw implant that allows immediate loading. It is available in diameters of 3.3 and 4 mm and lengths of 8, 11, 14, and 17 mm.
The Star/Vent implant has the StarLock internal hex screw and a press-fit cylinder in non-coated, restorable blast media–surface roughening treatment (RBM), TPS, or HA coated. Abutments are straight or 15 or 25 degrees. The implants are available in various diameters (3.3, 3.8, 4, 5, and 6 mm) and lengths (8, 10, 11, 13, 14, and 15 mm).
The external hex system in screw and press-fit cylinder shapes also is available. The different surfaces include RBM, surface roughening for noncoated implants, HA, and TPS. The HA and TPS coatings are available in all sizes.
MIS has a wide range of implants that allow reconstruction of a single tooth, screw-retained or cemented fixed bridges, and overdentures. These implants are made of biocompatible, medical grade titanium, and their surface is dual roughed by sand-blasting and acid-etching procedures. The product line ranges from root form implants to temporary provisionals to orthodontic anchorage.
The screw-type root form lines (i.e., BioCom, Seven, and Mistral) have an internal connection. Placement of these implants follows the generic surgical protocol for root form implants using either the flap or flapless approach. The osteotomy is created in incrementally increasing diameters of 0.5 to 1 mm until the ideal shape and size have been created. The implant then is either hand or engine driven to the full depth. A healing cover screw or an abutment is inserted on top of />