Rights to changes reserved X.J6731.03/2017 Manufacturer of iSyÂŽ products: ALTATEC GmbH, Maybachstr. 5, 71299 Wimsheim, Germany 29.08.2017 08:40:31
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October - December 2017
CONTENTS
SURGICAL SALES SPECIALISTS Books........................................ 31 Courses................................ 14-15
NSW MARK SORENSEN 0408 405 556
STUART WHITELEY 0426 176 202
Detection.............................. 16-17 Digital Implantology........... 20 – 30 Implantology............................. 8-9 Komet....................................... 19
QLD
Laser Lok Technology.................. 3
CHRIS TAPP 0410 422 120
SHARON CLARK 0401 723 317
Surgical Instruments.................. 13 Surgical Units.................... 10 – 12 Sutures...................................... 18
SA
VIC SUE FORRESTER 0420 990 150
WA
NZ
MYNKA ANDERSON 0422 234 648
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JANIE WALTON 0419 835 898
KIM BELL 64 21 712 758
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LASER LOK TECHNOLOGY
Laser-Lok Technology Laser-Lok overview Laser-Lok microchannels are a proprietary dental implant surface treatment developed from over 25 years of research initiated to create the optimal implant surface. Through this research, the unique Laser-Lok surface has been shown to elicit a biologic response that includes the inhibition of epithelial downgrowth and the attachment of connective tissue. This physical attachment produces a biologic seal around the implant that protects and maintains crestal bone health. The Laser-Lok phenomenon has been shown in post-op studies to be more effective than other implant designs in reducing bone loss.
SEM image at 30X showing the Laser-Lok zone on a BioHorizons implant.
The uniformity of the Laser-Lok microstructure and nanostructure is evident using extreme magnification.
Unique surface characteristics Laser-Lok microchannels are a series of cell-sized circumferential channels that are precisely created using proprietary laser ablation technology. This technology produces extremely consistent microchannels that are optimally sized to attach and organise both osteoblasts and fibroblasts. The Laser-Lok microstructure also includes a repeating nanostructure that maximises surface area and enables cell pseudopodia and collagen microfibrils to interdigitate with the Laser-Lok surface.
Histology of a Laser-Lok abutment on an RBT implant with a machined collar showing exceptional bone growth at 3 months.
Colourised SEM of a dental implant harvested at 6 months with connective tissue physically attached and interdigitated to the Laser-Lok surface.
Colourised SEM of Laser-Lok microchannels showing superior osseointegration.
Colourised histology of a fully lased implant thread at 3 months showing complete bone attachment.
Different than other surface treatments Virtually all dental implant surfaces on the market are grit-blasted and/or acid-etched. These manufacturing methods create random surfaces that vary from point to point on the implant and alter cell reaction depending on where each cell comes in contact with the surface. While random surfaces have shown higher osseointegration than machined surfaces, only the Laser-Lok surface has been shown using light microscopy, polarised light microscopy and scanning electron microscopy to also be effective for soft tissue attachment.
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IMPLANTOLOGY
tapered short
NEW
limited space The new Tapered Short implant is a solution for areas of limited space, where preserving anatomical landmarks is critical.
platform switching 15 degree bevel increases lateral threads.
Laser-LokÂŽ zone creates a connective tissue seal, maintaining crestal bone and reducing probing depths.
threadform Deep aggressive buttress threads provide primary stability and compressive bone loading.
cutting flutes
helical cutting flutes increase surface contact2 and are self tapping.
restorative ease 45° conical internal hex connection is color-coded for quick identification and component matching.
shop online at www.biohorizons.com
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* Histologic images are courtesy of Myron Nevins, DDS
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IMPLANTOLOGY
product information & ordering Tapered Short Implants and Instruments
Tapered Short Implants and Instruments BioHorizons Tapered Short implants offer a solution for casesShort Implants and Instruments Tapered with limited vertical bone height, potentially expediting treatment by eliminating the need for bone grafting. Tapered Short Implants and Instruments body features diameteran aggressive 4.6mm 5.8mm The Tapered Short implant design thread profile and tapered body for primary stability, even in prosthetic 3.5mm 4.5mm connection compromised situations. A platform-switched, dual-affinity, Laser-Lok surface offers crestal bone maintenance TSL4606 and soft 6.0mm length TSL5806 body diameter 4.6mm 5.8mm tissue attachment for flexible placement. prosthetic 7.5mm length TSL4607 TSL5807 3.5mm body diameter 4.5mm 4.6mm
5.8mm
connection
6.0mm length
TSL4606
7.5mm length
TSL4607
prosthetic TSL5806 3.5mm connection body diameter 4.6mm
4.5mm 5.8mm TSL5806 4.5mm TSL5807 TSL5806
TSL5807
TSL4606 3.5mm TSL4607 • 25% more surface area compared to Tapered StarterInternal Drill TDS32HD TSL4606 Intermediate Drill 6.0mm TDS37HD • dual-affinity Laser-Lok surface for crestal4.6 bone maintenance andlength soft tissue attachment length threadTSL4607 4.6body Final Drill TDS41HD • primary stability from anatomically tapered and deep7.5mm aggressive profile
features:
6.0mm length prosthetic connection 7.5mm length
TSL5807
ed Short Implants and Instruments ered Short Implants and Instruments TDS47HD TDS32HD
5.8 Intermediate Drill Drill • conical internal hex for a rigid connectionStarter and stable restoration
TDS54HD TDS37HD
5.8 Intermediate Final Drill 4.6 Drill
TDS41HD
4.6 Final Drill
TDS47HD
5.8 Intermediate Drill
TDS54HD
5.8 Final Drill
TYGIDH
HD Implant-level Driver, Handpiece*
SAVE
TDS32HD
Starter Drill
TDS37HD
4.6 Intermediate Drill
TDS41HD TDS32HD TDS47HD TDS37HD
4.6 Final Drill Starter Drill
TDS54HD TDS41HD
10%
5.8 Intermediate Drill 4.6 5.8 Final Drill 4.6
HD Implant-level Driver, Ratchet* 5.8 Intermediate Drill TYGIDR TDS47HDLaser-Lok body diameter 4.6mm 5.8mm body diameter 4.6mm 5.8mm zone 5.8 Final Drill TDS54HD prosthetic prosthetic implant 3.5mm 4.5mm HD Implant-level Driver, Handpiece* TYGIDH 3.5mm 4.5mm connection length connection body diameter 4.6mm 5.8mm HD Implant-level Driver, Ratchet* TYGIDR TSL5806 6.0mm length TSL4606 HD Implant-level Driver, Handpiece* 6.0mm length prosthetic TSL4606 TSL5806 TYGIDH
3.5mm
7.5mm length TSL4607 7.5mm lengthconnection TSL4607 DB12 Laser-Lok zone 1.8mm
4.5mm TSL5807 TSL5807 Bur Block 1.8mm
TYGIDR TYGIDH
Autoclavable bur block used to store up to 12 instruments.
apical diameter
3.7mm
platform switch
0.5mm
4.9mm 0.6mm
DB12
TYGIDR
HD Implant-level Driver, Ratchet* HD Implant-level Driver, Handpiece* prosthetic connection platform HD Implant-level Driver, Ratchet* switch
Bur Block
6.0mm length TSL4606 TSL5806 Starter DrillDrill TDS32HD Starter TDS32HD Autoclavable bur block used to store up to 12 instruments. Block diameter DB12 BioHorizons® and Laser-Lok® are registered trademarks of BioHorizons. Not all products are available in all Bur countries. ©BioHorizons. body All Rights Reserved. 4.64.6 Intermediate Drill TDS37HD 7.5mm length TSL4607 TSL5807 Intermediate Drill TDS37HD Refer to the Tapered Short Catalog & Manual (L02027) for a complete description and instructions on the use of the surgical instruments. Autoclavable bur block used to store up to 12 instruments. Final DrillDrill TDS41HD *Tapered Short implants can only be placed using these HD drivers. 4.6 Final TDS41HD 4.6 Bur Block DB12 Intermediate DrillDrill TDS47HD Intermediate TDS47HD 5.85.8 Final Drill Autoclavable bur block used©BioHorizons. to store upAll toRights 12 instruments. BioHorizons® and are available in all countries. Reserved. TDS54HD 5.8 Final DrillLaser-Lok® are registered trademarks of BioHorizons. Not all products TDS54HD 5.8
Refer to the Tapered Short Catalog & Manual (L02027) for a complete description and instructions on the use of the surgical instruments. For more information, contact your local Territory *Tapered Short implants can only be placed using these HD drivers. Manager or call Customer Care: 1.888.246.8338 BioHorizons® and Laser-Lok® are registered trademarks of BioHorizons. Not all products are available in all coun shop online at www.biohorizons.com 24/7Short at store.biohorizons.com Refer Order to the Tapered Catalog & Manual (L02027) for a complete description and instructions on the use of *Tapered Short implants can only be placed using these HD drivers.
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BioHorizons® and Laser-Lok® are registered trademarks of BioHorizons. Not all products are available in all coun For more information, contact your local Territory
Refer to the Tapered Short Catalog & Manual (L02027) for a complete description and instructions on the use of HDHD Implant-level Driver, Handpiece* TYGIDH Manager or call Customer Care: 1.888.246.8338 Implant-level Driver, Handpiece* TYGIDH SPMP16288 *Tapered Short implants can only be placed using these HD drivers. REV B MAR 2017
TYGIDR TYGIDR
HDHD Implant-level Driver, Ratchet* Implant-level Driver, Ratchet*
Orders
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Order 24/7 at store.biohorizons.com For more information, contact your local Territor Manager or call Customer Care: 1.888.246.833 5 6 5 8 8 2 2 Order 24/7 at store.biohorizons.co
IMPLANTOLOGY
the BioHorizons guided surgery kit The BioHorizons guided surgery kit offers the precision and predictability of guided implant placement with a streamlined, single kit design. All components are color-coded to avoid the complexity seen with other systems while offering our customers predictable implant placement for optimal esthetic outcomes.
surgical guide flexibility open architecture design for fabrication of surgical guides
ease of use master cylinders and instruments are colorcoded to ensure proper component usage
guided implant depth control implant is placed to planned depth using a surgical guide created from a virtual treatment plan
8 online x BioHorizons Implants shop at store.biohorizons.com
2 1 x Guided Surgery Kit 1 x 3Shape Implant Studio Planner for BioHorizons (10 Saves)
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$6495
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IMPLANTOLOGY
R-Tx LocatorLocator R-Tx
introducing
ng g
®
Locator R-Tx ®
®
Locator R-Tx is a better, simpler and strongerall-in-one system that packaging
NEW
Locator R-Tx is a better, simpler and stronger system that relies on theassame restorative techniques as the original relies on the same techniques the original Locator R-Tx is arestorative better, simpler and stronger system that Each Now with the housing cap, spacer andAssembly includes: (1) Abutment, (1) Locator. Now available with Locator. the housing cap,available spacer and relies on the same restorative techniques as the original Housing with Black retentive inserts for a convenient all in one package.Denture Attachment retentive inserts for a convenient all in one package. all-in-one packaging
Locator. Now available with the housing cap, spacer and retentive inserts for a convenient all in one package. delivered and torqued with an .050” (1.25mm) hex driver
Processing Insert, (4) Nylon Retention Inserts, Each Assembly includes: (1) Abutme and (1) Block-out Spacer.
Denture Attachment Housing with B Processing Insert, (4) Nylon Retentio and (1) Block-out Spacer.
delivered and torqued with an .050” (1.25mm) hex driver
delivered and torqued with an dual retentive surfaces and narrower .050” (1.25mm) hexfordriver coronal geometry easier seating
3.0 platf
dual retentive surfaces and narrower coronal geometry for easier seating
0.5mm cuff height
dual retentive surfaces and narrower coronal geometry for easier seating
more wear resistant Titanium Carbon Nitride coating and pink anodization for improved esthetics
1mm cuff height
0.5mm cu TP3L
2mm cuff height
1mm cuf
2mm cuf
TP3L
3mm cuf
more wear resistant Titanium Carbon Nitride coating and pink anodization for improved esthetics
TP3L
4mm cuff height
4mm cuf
5mm cuff height
TP3L
5mm cuf
6mm cuff height
enhanced design pivots to 30° per implant – eliminating the need for pre-angled abutments
TP3L 6mm cuf
Locator R-Tx Components
Locator R-Tx Components LRTX-G enhanced design pivots
Zero Retention Insert LRTX-G to 30° per implant –
Zero Retention Insert Replacement (4pack)
Replacement (4pack)
eliminating the need for LRTX-B pre-angled abutments enhanced design pivots
ncludes: (1) Abutment, (1) ment Housing with Black t, (4) Nylon Retention Inserts, utBioHorizons. Spacer.Not all products are available in all countries.
to 30° per implant – LRTX-B eliminating the need for pre-angled abutments LRTX-P
For more information, contact your local Territory Manager or call Customer Care: 1.888.246.8338
3.0mm
3.5mm
4.5mm platform
0.5mm cuff height
not available
PYLRTX0
PGLRTX0
1mm cuff height
TP3LRTX1
PYLRTX1
PGLRTX1
2mm cuff height
TP3LRTX2
3mm cuff height
TP3LRTX3
Horizons® is a registered trademark of BioHorizons.platform Not all products are available in all countries. platform ioHorizons. All Rights Reserved.
5.7mm platform LRTX-C not available
Horizons. Not all products are available inFor all countries. more information, contact your local Territory Manager
or callPYLRTX2 Customer Care: 1.888.246.8338 PGLRTX2
PBLRTX2 LRTX-BS
PGLRTX3
PBLRTX3
For more information, contact your local Territory Manager TP3LRTX4 PYLRTX4 4mm cuff height or call Customer Care: 1.888.246.8338
PGLRTX4
PBLRTX4 LRTX-DC
16207 REV A JUN 2016
5mm cuff height
TP3LRTX5
PYLRTX5
PGLRTX5
PBLRTX5
6mm cuff height
TP3LRTX6
PYLRTX6
PGLRTX6
PBLRTX6
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Low Retention Insert Replacement (4pack)
Low Retention Insert Replacement (4pack) LRTX-P
Medium Retention Insert Replacement (4pack)
Medium Retention Insert Replacement (4pack) High Retention Insert LRTX-C
Replacement (4pack)
High Retention Insert Replacement (4pack) LRTX-BS
PBLRTX1
PYLRTX3
mponents
TP3L
3mm cuff height
more wear resistant Titanium Carbon Nitride coating and pink anodization for improved esthetics
ging
not av
LRTX-DC Block-Out Spacer Replacement (20pack)
Block-Out Spacer Replacement (20pack)
Denture Attachment Processing Assembly (4pack)
Denture Attachment Processing Assembly (4pack)
LRTX-TL
Lo In
SPMP16207 REV A JUN 2016
LRTX-TL
Locator R-Tx Insertion/Removal Too
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I M P L A N T This O LisOiSyG 7Y iSy comes complete with everything an implant case needs. Enclosed with the implants and its pre-mounted implant base, the all-in sets contain a single patient form drill, a gingiva former, and two multifunctional caps. A cover cap is also included. But you only need this if submerged healing proves necessary.
NE&W Exclusive
All-in-Set of 1
All-in-Set of 4
1 Implant with pre-mounted implant base 1 Cover cap 1 Gingiva former 2 Multifunctional caps 1 Single patient form drill
4 Implants with pre-mounted implant base 4 Cover caps 4 Gingiva formers 8 Multifunctional caps 1 Single patient form drill
Components of the single implant set:
iSy Implant with pre-mounted implant base
Single patient form drill
Cover cap
2 Multifunctional caps (Impression taking, scanning, temporary restoration and bite registration)
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KaVo SURGmatic instruments – For S U Rall G Iyour C A L applications. UNITS
KaVo SURGmatic S201 XL/XC
KaVo Surgery Portfolio KaVo Surgery Portfolio
KaVo SURGmatic instruments – RTsurg KaVo LUX EXPERTsurg –applications. Put yourself LUX – Put For all your KaVo SURGmatic instruments – sion into relax. precision For allthe your applications. to relax. KaVo Surgery Portfolio
KaVo KaVo SURGmatic SURGmatic instruments instruments offer offer good good speed speed and and torque: torque: from from smoothing smoothing the the alveolar alveolar ridge ridge to to fixing fixing implants, implants, micro-surgery, micro-surgery, ENT, ENT, retrograde retrograde apicectomy, apicectomy, bone bone splitting splitting and and much much more. more.
NEW! NEW! With With hexagon hexagon clamping clamping system system to to extend extend the the working working life life (compatible (compatible with with standard standard burs burs and and screw-in screw-in tools). tools).
One touch auto-calibration
• Reduction • Reduction of of forces forces on on torque torque transmission transmission segment segment • Less of and • Ensures accurate torque • Less wearing wearing of tools tools and instruments instruments • Less tools • Less jammed jammed tools process • Automatic
make sure you e side.
anks to one gical motor and
KaVo SURGmatic instruments offer good speed and torque: from smoothing the alveolar ridge to fixing implants, micro-surgery, retrograde apicectomy, splitting The KaVo EXPERTsurg LUX isENT,designed to makebone sure youand much more. and your patients are always on the safe side. KaVo SURGmatic instruments offer goodto extend the working life NEW! With hexagon clamping system speed and torque: smoothing the (compatible withfrom standard burs and • Operate safely with high precision thanks onescrew-in tools). alveolar ridge to fixing implants,to micro-surgery, • Reduction forces on torque transmission ENT, retrogradeofapicectomy, bone splitting and segment of the world’s lightest and smallest surgical motor and
• Rely on high the instrument
• External media • External rinsing rinsing with with media connector attached to the the head head connector attached to KaVo SURGmatic
• Hexagon clamping for • Hexagon clamping system system for S201 XL/XC extended working life • Reduction ratio 20:1 • Optimized head gearing and • Detachable ball bearing head and shank KaVo for easySURGmatic cleaning • 55 Ncm max. torque S201 XL/XC • EXPERTgrip for improved grip and hygiene • Reduction ratio 20:1 • Small head head with internal • Detachable and shank rinsing for easysystem cleaning • External rinsing with media • EXPERTgrip for improved grip connector and hygieneattached to the head
• Optimized head with gearing and • External rinsing media ball bearing connector attached to the head • 55 Ncm max. torque • Hexagon clamping system for extended working life
much more. • Less wearing of tools and instruments • Symbolic references and color display
NEW! With hexagon clamping to extend working • Less jammed tools • Accurate display ofsystem adjusted max. the torque andlife motor speed (compatible burs and screw-in performance withwith 80standard Ncm torque at tools).
m torque at
yourself
• Hexagon system for • Small headclamping with internal extended working life rinsing system
Intuitive user interface
auto-calibration
• Reduction • Reduction ratio ratio 20:1 20:1 • Detachable shank • Detachable head head and and shank for for easy easy cleaning cleaning • EXPERTgrip for improved grip • EXPERTgrip for improved grip and and hygiene hygiene • Small • Small head head with with internal internal rinsing rinsing system system
• Reduction of forces on torque transmission segment
KaVo SURGmatic S201 L/C • Reduction ratio ratio 20:1 20:1 • Reduction • Detachable head head and and shank shank • Detachable for easy easy cleaning cleaning for
KaVo SURGma S11 L/C
• EXPERTgrip for for improved improved grip grip • EXPERTgrip and hygiene hygiene and
• Handpiece transmiss transmis • Handpiece
• Small head head with with internal internal • Small rinsing system • External rinsing with media connector attached to the head KaVo SURGmatic
• 55 Ncm max. torque S201 L/C
• EXPERTgrip for for impr impr • EXPERTgrip hygiene and hygiene
One touc
• For use use with with handpie handpi • Ensures acc with standard standard length lengt with
• With external external spray spray • With
• Automatic
• Reduction ratio 20:1
Ncm max. max. torque torqu • 5,5 Ncm
• Detachable head and shank KaVo for easySURGmatic cleaning
KaVo SURGma S11 L/C
S201 L/Cfor improved grip • EXPERTgrip and hygieneratio 20:1 • Reduction
• Handpiece transmissi
• Small head with • Detachable headinternal and shank rinsing for easysystem cleaning
• EXPERTgrip for impro KaVo SURGma and hygiene
• External rinsing with media • EXPERTgrip for improved grip connector attached to the head and hygiene • 55 Ncm max.with torque • Small head internal rinsing system
S11useL/C • For with handpie with standard length • Handpiece transmis
Intuitive
• With externalfor spray • EXPERTgrip impr andNcm hygiene • 5,5 max. torque
• Optimized head gearing and ball bearing
• External rinsing with media connector attached to the head
• 55 Ncm max. torque
• 55 Ncm max. torque
• For use with handpi • Symbolic re with standard lengt
• Accurate di • With external spray
• Less wearing of tools and instruments
and easy hygiene • Save time with intuitive• Less programming jammed tools and easy hygiene
• 5,5 Ncm max. torqu
Hygienic design • Smooth surface, easy to clean
t yourself
• Thermodisinfectable and sterilizable motor and motor tube
Hygienic
• Smooth sur
• Thermodisin and motor
German Design Award 2015 • Prestigious prize dedicated to discovering, presenting and recognising unique design trends internationally
8
One touch auto-calibration
9
• The prize is awarded to top-class products and projects in the field of product and communication design
• Ensures accurate torque • Automatic process
German 8
• Prestigious recognising
9
8
• The prize is field of prod
Intuitive user interface
9
• Symbolic references and color display • Accurate display of adjusted max. torque and motor speed
SAVE
5
$5726 Hygienic design • Smooth surface, easy to clean
EXPERTsurg LUX only $5253 includes FREE Contra-Angle Handpiece S201XL or S201L
• Thermodisinfectable and sterilizable motor and motor tube
4
5
4
5
German Design Award 2015 • Prestigious prize dedicated to discovering, presenting and recognising unique design trends internationally • The prize is awarded to top-class products and projects in the field of product and communication design
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SURGICAL UNITS
I AM I AM POWERF POWERFULLY RESPON RESPONSIVE $11,888 Dynamic power responsiveness S5-F50102 for superior osseous surgery Dynamic power responsiveness for superior osseous surgery
• Immediate pow maximum effic technology) • Immediate power responsiveness for procedu • Faster maximum efficiency & safety (D.P.S.I. handpiece hou technology) • Broaden your c • Faster procedures with CUBE LEDtips for many s • Increase patien handpiece housing 6 ceramic rings healin • Broaden your clinical scope with superior exclusive
tips for many surgical applications • Increase patient case acceptance with superior healing outcomes
Dyna Powe Syste Insid
Dynamic Power System Inside
ACTEON® Australia/New Zealand Suite 119, 30-40 Harcourt Parade, ROSEBERY, NSW 2018 Tel. 1300 ACTEON (22 83 66) info@acteongroup.com www.acteongroup.com
Orders
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SURGICAL UNITS
AIRFLOW Prophylaxis Master
THE GAME CHANGER Introducing the NEW AIRFLOW Prophylaxis Master from EMS - the latest innovation from the world’s No.1 prophylaxis provider. Benefits: • Heated water system= increased patient comfort • Improved powder consumption rate 30% PLUS powder reduction • Easier to operate & clean • No more clogging- simpler to maintain • Wireless foot pedal- eliminates trip hazard • Treat more patients - allows for 10-20% more treatment time
NEW
EMS-FT229-1B
$12,250
NEW Night Cleaner u Long term solution to cover one month cleaning.
Tabitha Acret The new AIRFLOW Prophylaxis Master is a game changer in not only implant maintenance but in overall patient care. No other machine heats the water (to 40 degrees!) in both the PIEZON scaler and AIRFLOW to offer a positively ‘warm’ experience. It maximises patient comfort with some patients describing it as ‘spa-like’; increasing clinician satisfaction. Once you have used the AIRFLOW Prophylaxis Master you won’t be able to work without one.
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SURGICAL INSTRUMENTS
DIRECTA Luxators Luxator LX Mechanical Periotome
Luxator LX Mechanical Periotome Kit
$1659.87 DR-5064-43
Setting a new standard for trauma free extraction, the Luxator LX mechanical periotome offers improved safety, precision and access. • Optimal access • Vertical reciprocating tip
• Atraumatic extractions • Self-directing tip
SAVE
10%
Luxator Periotome
on Directa Luxators
• Ergonomic design • Atraumatic extraction • Maximum tactility • Wide range of sizes and shapes
Dual Edge Periotome Luxator • Dual edge • Safer insertion • Ideal for fractured teeth • Perfect starter in difficult cases
Orders
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COURSES
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COURSES
Orders
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CALM
DETECTION
™
Movement artefact correction
Without Planmeca CALM™
With Planmeca CALM™
New Planmeca CALM™ algorithm for patient movement correction • Cancels the effects of patient movement • Excellent when imaging more lively patients • Can be applied before and after image capturing NOW AVAILABLE FOR ALL PLANMECA 3D IMAGING UNITS!
For more info speak to your Equipment Specialist or contact: www.henryschein.com.au | equipment@henryschein.com.au
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DETECTION
Implant Planning from the Crown Down with
IMPLANT SELECTION AND PLACEMENT
CROWN DESIGN
ABUTMENT DESIGN
OP300 Maxio 3D
Precision and confidence are key elements to successful implant planning and treatment. Doctors must have the tools that provide them with knowledge of the patient’s anatomy and confidence in their ability to offer implants as a solution for their edentulous cases. Many implantologists find cone beam imaging and powerful 3D software essential for successful implant planning and treatment. The ORTHOPANTOMOGRAPH OP300 from Instrumentarium Dental™ combined with Invivo5 software from Anatomage are an incredible combination for doctors performing implant procedures. These tools allow complete control in implant planning from the crown down. IMPLANT SELECTION AND PLACEMENT
CROWN DESIGN
ABUTMENT DESIGN
There is so much more to know about OP300 Maxio. Contact your Equipment Specialist or enquire on the details below www.henryschein.com.au | equipment@henryschein.com.au
Orders
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* Use UseMonosyn Monosyn*
SUTURES Synthetic absorbable Sutures - The surgeon´s choice. If you use FREE
If you use Chromic Catgut
Sample Plain Catgut s on request!
If you use Plain Catgut
If you use Chromic Catgut Use Monosyn*
Need Needaafaster faster absorption absorptionrate? rate? Use Use ® Monosyn Monosyn® Quick Quick
If you useUse Monosyn* Chromic Catgut
Need a faster For further information contact Customer Service on For further information contact Customer Service on absorption rate? 1800 1800251 251705 705or orcustomerservice.au@bbraun.com customerservice.au@bbraun.com
se Monosyn* MONOSYN QUICK MONOSYN Need a faster Properties Properties rate? after 6-7 days Use® • Retention of 50% knot tensile strength after 14 days • Retention of 50 absorption % knot tensile strength Monosyn Quick • Complete mass absorption after 56 days • Complete massAustralia absorption to Vista 90 days B. Braun Pty Ltdin| 60 Bella NSW 2153
B. Braun Australia Pty Ltd | Bella Vista NSW 2153 Tel Tel1800 1800251 251705 705 || Fax Fax1800 1800628 628045 045 || www.bbraun.com.au www.bbraun.com.au
Advantages • Short-term absorption profile • High knot pull tensile strength • Superior handling features ®
Need a faster sorption rate?
Use Monosyn Quick
Advantages • Superior initial knot tensile strength • Ideal degradation profile for soft tissues • Smooth tissue passage • Excellent knot security • Quick mass absorption
For further information contact Customer Service on 1800 251 705 or customerservice.au@bbraun.com
SAFIL
UseSAFIL QUICK ® onosynProperties Quick
Properties • Retention of 50% knot tensile strength after 18 days • Complete mass absorption in 60 to 90 days
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Advantages • Excellent handling properties • Good knot security
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instrument H379, taking care not to damage
• For reprocessing, use an anti-corrosive
the implant shoulder. The instrument has a
disinfecting and cleaning agent
total length of 30 mm which enables it to
(for example Komet DC1).
KOMET
reach all areas with ease, even in cases of non-removable superstructures. 4. The required very fine surface is created
3
6
Surgical Burs
with an ultrafine instrument of identical
shape. We advise against proper polishing of the surface, for example with silicone polishers, because of the residues this
Set 4656
would leave behind (silicon film, particles).
Bur block 9989 and 1 rotary instrument of each reference.
5. The clean titanium surface after treatment. The photo shows that the connection
Specialty Kit for Periimplantitis
for the implant abutment is still intact. Any titanium chips have been removed with a sterile K-4656 nylon brush beforehand. $250
H 269 H 269
H 267 H 267
6. Closure of the wound. Control and
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removal of the stitches after 7 days.
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© 07/2016 · 417410V1
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DENTAL SURGERY DENTAL SURGERY
Knochenfräser Knochenfräser Bone Bone cuttercutter
Surgery | Tungsten carbide
Chirurgie | Hartmetall
PRAXIS
5 · Export: 5 5 5 5 5 5 5 5 / Lemgo Komet Dental · Gebr. Brasseler GmbH & Co. KG · Postfach 160 · 32631 Telefon +49 (0) 5261 701-0 · Telefax +49 (0) 5261 701-329 · export@kometdental.de · www.kometdental.de Größe · Size
Ø ¹⁄₁₀ mm
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D I G I TA L I M P L A N T O L O G Y
Simplification of implantology Using BioHorizons implants, BioHorizons digital library, 3 Shape Implant Studio There are two types of dental implant treatment workflows: the traditional analogue treatment modality and the digital implant workflow. Full and proper treatment planning protocols are the foundation of any fixed restorations of the arch supported by dental implants. The generally include the following protocols:
1. Articulated study models from diagnostic impressions.
2. Diagnostic wax-ups, intraoral wax-ups or diagnostic appliance fabricated to evaluate aesthetics and phonetics.
3. Radiographs including periapicals and CBCT scans must be taken to evaluate osseous support for dental implants.
4. Fabrication of a radiographic and surgical guide Analogue systems have traditionally relied on conventional impression techniques utilised to create a plaster model from which all subsequent procedures from the diagnostic wax-up to the prosthesis is manually fabricated by the ceramist. The utilisation of a full digital workflow eliminates the disadvantages and difficulties commonly associated with conventional analogue techniques. Some of these common limitations
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include:
treatment planning and surgical workflows in short has the following benefits:
1. The discomfort commonly associated with the impression procedure.
2. The potential for distortion of
predictable workflow in implant treatment planning and guided surgery. 3. Provides better angulation and accuracy of placement of single and multiple implants. 4. The prosthetic design process is much simpler and easier.
3. Potential of damage to the dental cast.
4. Delay due to logistics of sending lab work between the dental practice and the laboratory. These disadvantages of the analogue system do not occur in the full digital workflow where the impression is taken with an oral scanner and the design of the prosthesis is done on CAD software. The data from the digital impression is also simply sent over the Internet, significantly reducing the time needed to manufacture the wax-ups and prosthesis. One of the main advantages of the full digital workflow is the ability and the simplicity in accurately diagnosing and virtually planning the implant position using the digital scan and CBCT data. This in turn, allows the fabrication of an accurate surgical implant guide that allows the surgical protocol in the placement of the implant fixtures to be accomplished in a simplified and predictable manner. Full digital workflows in implant
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visits for the procedure.
2. Provides for a simplified and
the impression material and inaccuracies of subsequent steps in the manufacturing process.
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1. Reduced the number of patient
The following case report presents a fully digital workflow from the treatment planning to the guided surgery phase in the provision of an immediate implant retained fixed provisional bridge. There are many advantages of a fixed provisional over a removable provisional that includes;
• stability of the prosthesis and • • • •
associated implants aesthetics less interference of speech patterns better mastication and comfort for the patient most importantly minimise soft tissue complications associated around the peri-implant site
Patient feedback about the provisional will also be an important step in helping guide the final prosthesis towards an ideal aesthetic and functional outcome.
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D I G I TA L I M P L A N T O L O G Y
About the author Dr. Anthony Mak Dr. Anthony Mak obtained his Bachelor of Dental Surgery from Sydney University and then went to complete his Post Graduate Diploma in Clinical Dentistry (Oral Implants). He graduated with multiple awards and since then has worked with some of Sydney’s most renowned practitioners. His interests lie in dental technologies and advances in materials and techniques. He has a unique understanding in CAD/CAM Digital dentistry and currently runs two practices in metropolitan Sydney focusing on comprehensive and implant dentistry. Anthony has a through understanding of direct vs indirect dental restorations and has lectured locally at various study clubs.
Case information A patient in his early 80s presented with the chief complaint of recurrent pain, discomfort and swelling from his lower dentition. An examination revealed moderate to advanced bone loss of her remaining mandibular teeth. Peri-apical radiolucencies associated with chronic apical periodontitis were also diagnosed on the lower anterior segment. His lower dentition at the time of presentation was restored with fixed crown and bridge prosthesis with implant fixtures on the 37 and 47 site, placed 20 years prior. The implant fixtures were abutments for fixed bridges that were linked to natural teeth abutments. The patient’s health history was unremarkable. The patient requested for his lower dentition to be rehabilitated with the use of dental implants due to his good perception of longevity stemming from his past treatment experience. It was the patient’s brief and request that the procedure be simple and not time consuming due to several factors. These factors included:
In treatment planning the case, the following criteria were established with the goal of delivering a fixed implant retained provisional bridge.
1. To deliver the complete treatment process in 3 appointments with the appointments being:
i. The consultation and treatment planning phase utilising intraoral scanning with the 3-Shape scanner, BioHorizons’s Digital Library, 3-Shape implant Studio and a CBCT from Instrumentarium Maxio OP
ii. Extraction of all lower natural teeth and immediate placement of implant fixtures utilising a fully guided surgical placement protocol. An intra-oral scan will then be completed utilising implant scan markers to allow the fabrication of the provisional prosthesis.
iii. Delivery of a fixed provisional implant retained bridge.
2. To deliver the planned treatment utilising a full digital protocol without the use of conventional impression techniques.
3. For implant surgery to be fully guided keeping the surgical procedure simple, accurate with minimal trauma and discomfort.
Treatment description
1. His struggle to keep his mouth open for long periods of time.
2. Difficulty in tolerating
conventional impression techniques. 3. His perceived age and health status.
Full Consent from Patient and daughter.
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D I G I TA L I M P L A N T O L O G Y
Appointment 1 - The Consultation and Treatment Planning The Pre-Operative presentation Failing lower dentition that was heavily restored with metal ceramic crowns on the anterior segment, and implant to teeth bridge on the posterior segment.
The Pre-Operative Scan Intra-Oral scanning of the full arch. Virtual extractions and BioHorizons implant fixture planning on 3-Shape Implant Studio using the BioHorizons digital library.
Virtual extractions for digital implant planning The teeth was virtually extracted on the implant planning software, leaving behind the 47 and 37 implant prosthesis. These crowns will act as reference points, stability anchors for the implant surgical guide. By maintaining the distal abutment implant prosthesis, we will also maintain the occlusion and VDO.
Distal implants left in situ. Still very well integrated and good to maintain occlusion and VDO. Also will be using the abutment crowns as locators for the surgical implant guide as they will give ideal stability.
Implant Planning - Four BioHorizons Tapered Internal Implants with a guide-pin to maintain stability of 3D printed surgical guide
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D I G I TA L I M P L A N T O L O G Y
Then a 3D surgical guide was designed. We used the distal abutment teeth and a guide pin in the anterior mandible to create trapezoidal stability of the surgical guide in the mouth during surgery. Stability of the guide is extremely important in immediate extraction of full arch cases.
Placing the guide pin/osteotomy in immediate extraction cases can sometimes be less accurate as the guide can rock on the soft tissue area where the extractions just took place. To avoid this from occurring, a simple 3D guide was designed to place the guide pin osteotomy when the teeth where still present. Hence, once the teeth were extracted, the implant surgical guide was easily referenced and fitted without any loss of accuracy. This was achieved by using the distal implant prosthesis and the anterior guide pin osteotomy that was already placed with the 1st guide pin 3D guide. This is easily accomplished with 3Shape Implant Studio. The problem with immediate extractions and guided surgery is that there are no reference points for the surgical guide to sit after the extractions. Using soft tissue and opposing occlusions is less than ideal and not as accurate as it should be. The beauty of having a guide-pin surgical guide is we were able to place the guide pin osteotomy prior to extraction of the teeth. Hence this guide was using the hard tissue of the existing teeth prior to extractions occurring. Having the guide holes, we were able to accurately locate our second implant surgical guide once all the extractions and full clearance had occurred.
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D I G I TA L I M P L A N T O L O G Y
Appointment 2 – The surgical appointment Sectioning of long span bridge prior to extraction of all remaining teeth.
Implant surgical guide in place after full clearance and osseous crestal reduction.
Immediately after surgery. BioHorizons snap on digital markers were placed and a 3 shape IOS scan was performed immediately after surgery and soft tissue closure had taken place. I find this option more accurate than planning the prosthesis at the same time as implant planning. There are tolerances that may affect passive fit in multiple implant cases.
IOS scan after implant surgery. Having the ability to scan the occlusion and the scan markers in a three dimensional spatial environment allows this workflow to be much more accurate and time saving when compared to the analog workflow.
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D I G I TA L I M P L A N T O L O G Y
The Laboratory component – Brad Grobler Oral Dynamics
Super imposing the pre-operative scan for fabrication of the temporary bridge. Allows an exact copy of what the patient had prior to extractions. With the ability of the previous picture where we were able to scan the occlusion, the digital workflow allows for an effortless prosthetic portion of the whole treatment process
Brad to design and mill an immediate temporary bridge on non-engaging temporary cylinders. PMMA framework with pink composite and stains
Digital mock up of the prosthesis. The beginning of the CAD design by ceramist Bradley Grobler. You can see on this picture that he was able to incorporate all the information/data on one screen making the prosthetic design also very simple.
Virtual articulation to ensure there were no lateral or excursive interferences.
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D I G I TA L I M P L A N T O L O G Y Checking the occlusion on the virtual articulator.
The wonders of digital implant dentistry! With good planning and use of technology, we were able to achieve a direct to fixture prosthesis. No multi- unit abutments were required to achieve perfect prosthetic screw access channels.
BioHorizons implant library - digital metal analogs or 3D printed analogs. BioHorizons have a complete digital library that allows simplicity in the digital workflow to work synergistically with their implant system. Having both option for implant model fabrication allows for easy logistics in the ability to cover most scenarios.
Milled temporary bridge on nonengaging temporary cylinders. Pink composite and GC Optiglaze were used to create an aesthetic provisional bridge.
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D I G I TA L I M P L A N T O L O G Y
3D printed models. The model on the left have the implant connection printed in the 3D model. The model on the right have metal digital implant analogs inserted into the model. Both techniques readily available on the BioHorizons digital library.
Fitting surface showing non-engaging temporary cyclinders.
Passive fit of the temporary bridge on the digital printed model.
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D I G I TA L I M P L A N T O L O G Y
Appointment 3 – Fitting the temporary prosthesis One week post surgery. Guided surgery allows for a much more minimally invasive approach leading to much better healing and better morbidity for the patient.
One week post surgery – temporary bridge fitted and in situ.
OPG showing implant angulation and placement.
Periapical xrays to confirm fit of temporary bridge.
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D I G I TA L I M P L A N T O L O G Y
Final image of the temporary bridge in the patient’s mouth. Start to finish in 3 appointments. Conclusion
• Facilitates accurate and safe planning of implant placement and critical anatomical landmarks such as nerves, sinuses and adjacent teeth can be identified and avoided through safety zones set up in the planning software.
It should be noted that the software utilised in the delivery of this case (the BioHorizons digital Library and 3Shape Trios, 3Shape Implant studio and Dental Designer) has allowed the following aspects of the implant workflow to be achieved. • Allows the clinician to accurately assess bone volume, bone density and restorative space. • Allows the location of the prosthesis to be merged from a digital wax-up (or in this case the patient’s pre-operative dental setup) and pre-operative scan for prosthetically driven implant planning.
• Allow the fabrication of a highly accurate surgical guide or stent. Compared to free-handed surgery, computer generated surgical guides significantly reduces the chance for a positional errors at the time of implant placement. (Di GIacomo et al J Periodontol. 2005)
The case presented illustrates how advances in digital technologies can provide clinicians with the tools for diagnosis, treatment planning, placement and restoration of dental implants in a truly transformative way. Simplification of clinical protocols, increased accuracy over conventional analogue techniques and improved patient comfort and outcomes are compelling reasons as the benefits of a full digital workflow in the provision of implant retained restorations.
• Digitally designed and fabricated provisional restorations can be manufactured before or immediately post-surgical procedure for immediate temporisation.
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D I G I TA L I M P L A N T O L O G Y
3Shape Implantology Digitalize your implant workflow
Grow your practice with TRIOS and Implant Studio Scan, plan, deliver – predictable implant treatment and in-house production of surgical guides in step-by-step digital workflows.
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BOOKS ITI Treatment Guide, Volume 9: Implant Therapy in the Geriatric Patient Daniel Wismeijer, Stephen Chen and Daniel Buser, (editors) People now live longer and have higher expectations for health and quality of life than they did in previous generations, and demographic shifts have occurred in recent decades leaving more older people than younger. These shifts have brought new demands to implant dentistry and practitioners, who now see elderly patients routinely in practice. Because of their age, these patients are subject to certain limitations and often require special dental care, especially patients in ailing condition. This volume addresses the situation and needs of the elderly patient, from systemic changes and physical and mental limitations to considerations of quality of life. Twelve clinical cases demonstrate solutions for various clinical situations, including treatment of an Alzheimer patient, rehabilitation of a patient with osteoarthritis, treatment sequencing for full-arch removable dental prostheses, flapless guided surgery for bar-supported overdentures, and minimally invasive treatment of a patient in her 90s with severe peri-implantitis, among others. Q-5120827
312 pp; 500 illus
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Surgical Design for Dental Reconstruction with Implants: A New Paradigm Martin Chin This book presents a novel strategy to improve the outcome of maxillofacial reconstruction by combining evolving principles of neurophysiology and tissue engineering with an integrated surgical and laboratory technique. The objective of this book is to bridge the gap between the routine practice of maxillofacial surgery and theoretical laboratory science. The early chapters set down clear, specific treatment-planning principles that should be considered in every surgical design to optimize healing. Subsequent chapters detail the laboratory and surgical techniques that make precise skeletal movements predictable. This methodology is validated with comprehensively illustrated clinical examples, including long-term follow-up. This integrated approach to reconstructive therapy offers the potential to solve clinical problems that are known to be resistant to conventional treatments. Guided by this book, the reader will be able to exploit emerging biotechnical discoveries to establish a working model that can be applied to real problems affecting real patients. Q-5120802
256 pp; 700 illus
$263.74
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Oral and Maxillofacial Surgery Review: A Study Guide Din Lam & Daniel Laskin This comprehensive text, prepared by experts in their field, provides a quick and effective way for both residents and busy clinicians to review important information and published literature in dentoalveolar surgery and implantology, anesthesiology, medicine, pathology, orthognathic surgery, craniofacial and reconstructive surgery, cosmetic surgery, and TMJ disorders and facial pain, as well as to gain new knowledge in these areas. The content is organized in bullet-point format and complemented by numerous illustrations, tables, and algorithms, making the material easy to remember. This is an excellent resource for board preparation as well as recertification. Q-5120796
440 pp; (softcover); 187 illus
$129.74
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