Neoss Newsletter November 2013

Dear ,

In this issue you will find two case reports by Dr. Ilhan Uzel who shares Congenitally Missing Laterals and 45 year old male patient with a failed tooth supported fixed partial denture. Check them out below.

Neoss announces the renewal of a distribution relationship with Osstell in the USA. Osstell and resonance frequency analysis has been shown to be the definitive measurement of implant stability. Osstell's efficacy has been documented in over 500 publications.
Click here for more info.

Neoss custom titanium abutments are now available through your laboratory from CMC - Custom Milling Center of Denver, CO (in addition to Glidewell Dental Laboratories). To ensure the highest quality fit, CMC mills these abutments from Neoss blanks, with pre-milled Neoss connections, and are supplied to you with Neoss Crystaloc screws.

As an ADA CERP Recognized Provider we recently renewed for another 4 years. As CE providers we are are committed to providing you the best education possible with the intent of avoiding it becoming commercial in nature. Our course evaluation form is one important feedback tool where we can measure what the lecture delivered, another important tool is our annual education survey.

Speaking of the Annual Education Survey, it's time for this years survey. We would love it if you would take about 5 minutes and fill it out by clicking here. All responses submitted by November 24th will be entered into a drawing for a "Neoss pros kit". An e-mail will be sent out announcing the winner on December 6th. If, for any reason you do not get a confirmation of your survey being submitted after completing it, simply e-mail Marketing and say "I completed the survey" in the subject line and your name. Thank you.
CLICK HERE to get started.

We have simplified the design of our newsletter into a mobile friendly version to accommodate more platforms. Our logo has changed slightly as you can see, and you will continue to see changes on our website and literature in the coming year.

Please send an e-mail to Marketing if you would like to see a specific topic featured, if you have a case that you would like to share with the subscribers, or a testimonial.
Thank you for reading.

Wishing you all a wonderful weekend.

Sincerely,

Pia Jansson

Activity Director, Neoss, Inc.

News Items

New Prepable Wide Emergence Molar Abutment

Through its wider design, this abutment gives the restoring doctor a wider emergence profile option compared to other Neoss Prepable abutments. It can ONLY be seated on ProActive Tapered Implants Ø5.0 and Ø5.5 mm. It comes in a sterilized package with a specific cover screw and healing abutment for this abutment.

Article 31317, Prepable Ti Abutment 2 mm 0° - Wide Emergence
wide molar

Neoss Implant Mounts for NobelGuide® System

These fixture mounts, available in both Ø5.0 and Ø6.0 mm, allow guided surgery placement of Neoss implants when using the NobelGuide^® system.

Articles 51148 & 51152, Neoss Implant Mounts

US Activities

Here are some of the exhibits that we are attending in the coming months. Please stop by our booth if you are attending.

EXHIBITS

GNYAP - 12/6-7/13 - New York

AO - 3/6-8/13 - Seattle, WA - Booth# 927

EDUCATION
Please contact your local Neoss representative for information on local educational activities.

Testimonial

I just started placing implants 9 months ago, and I chose Neoss because a colleague said that the local rep, Jim, would be very helpful. Indeed he was--coming in for the surgeries, helping me get to know the system, and always being helpful over the phone. What I didn't expect was how great the system is. It's very simple, and yet comprehensive.

The web site is also great at explaining all of the components and their use. I've done 24 implants so far in my first year, and they were all placed very easily. They also integrate predictably. Restoration is also very simple. I scan the Neoss abutments with my CEREC and make beautiful crowns in one visit. I'd recommend Neoss for anyone, especially someone starting with their first system. And the VALUE?!! OMG--can't be beat.

- Dr. Eric Prouty, Costa Mesa, CA

Case Reports

Two Neoss Cases by Mehmet Ilhan Uzel, D.M.D., D.Sc.

Case1 - Congenitally Missing Laterals

by Mehmet Ilhan Uzel, D.M.D., D.Sc

Fig. 1, 2 - 25 year old female patient with congenitally missing maxillary lateral incisors: The patient underwent orthodontic treatment upon initial implant consultation in order to create adequate space for implant placements and to obtain symmetry for optimal esthetics to replace congenitally missing teeth #7 and #10.However, following the orthodontic treatment the patient changed her mind and decided to get two Maryland restorations (6-x-8 and 9-x-11) as she thought that the treatment would be less invasive. Within the following two years the patient had multiple problems with Maryland restorations' retention sincethey had to be re-cemented multiple times as they could not bear occlusal forces.

Uzel_case1_1_2

Fig. 3 - Eventually, the patient decided to pursue the ideal treatment with dental implants. Clinical and radiographic evaluation revealed adequate space for two 3.5x11mm Neoss implants. The ridge at #7 and 10 sites was defective buccolingually even though the dimensions were adequate at soft tissue level; this was more pronounced at #10 site. Thus, the implants were inclined palatally to compensate for the minor ridge defects. Both implants were placed with primary stability and submerged for six months.

Fig. 4 - Following uncovering, PEEK abutments were placed for both implants, then prepared and temporized with temporary crowns. The patient requested to maintain her initial esthetic appearance as much as possible that was with altered passive eruption. She was informed that it was going to be assessed following the soft tissue healing since the ridge would determine the soft tissue profile.

Uzel_case1_3_4

Fig. 5- Following the initial healing, soft tissue had to be recontoured to obtain an optimal esthetic result. An esthetic crown lengthening procedure was performed in the maxillary anterior sextant in a minimally invasive fashion.

Fig. 5

Fig. 6 - Approximately, four months later final PFM crowns were fabricated to patient's satisfaction. The waiting period for completion was essential especially for a case like this with thick gingival profile, since the connective tissue and collagen fibers must be allowed to reorganize for the best possible esthetic result.

Fig. 6

Fig. 7 - A natural esthetic appearance and smile was established
(Restored by Dr. Everod A. Coleman).

Fig. 7

Case 2 - 45 year old male patient with a failed tooth supported fixed partial denture

by Mehmet Ilhan Uzel, D.M.D., D.Sc

Fig. 1 - Our patient presented with a PFM fixed partial denture from tooth #4 to tooth #12 that was fabricated 10 years ago. Uzel_case2_1

Fig. 2 - He presented with significant recurrent decay for most of the abutment teeth with periapical lesions around teeth #2, 8, 9 and 13.

Fig. 2

Fig. 3, 4 -Upon clinical, radiographic and CAT scan evaluation teeth #2, 5, 7, 8, 9, 10 and 12 were deemed hopeless. In addition, CAT scan evaluation revealed adequate dimensions of bone presence for both apicocoronal and buccolingual dimensions. Especially the presence of buccal plate at immediate implant placement sites was critical for our treatment plan.

Fig. 3

Fig.4

Fig. 5, 6 - Strategically important teeth with good prognosis were kept, such as teeth #3, 4, 11 and 13, 14. All the hopeless teeth, #2, 5, 6, 8, 9, 10, 12 were extracted atraumatically and the sockets were debrided free of granulation tissue under high magnification. In addition, the first phase of surgical treatment plan was consisted of immediate implant placements at tooth #5 and 6, as well as #10 and 11 sites with guided bone regeneration (GBR).

Fig. 5

Fig. 6

Fig. 7, 8 - Four implants (4x13mm and 4.5x13mm Neoss) were placed with primary stability to replace teeth #5, 6, 10 and 11 and guided bone regeneration was performed with immediate implant placements. Freeze-dried bone allograft (FDBA) and resorbable bovine cross-linked collagen membranes were used. CAT scan evaluation revealed a large periapical lesion for tooth #12 that caused a large perforation on the buccal plate. Therefore, #12 was extracted, and guided bone regeneration was performed with the same regenerative materials. Implant #12 was placed six months later. Also a crown lengthening procedure for tooth #13 was performed.

Fig. 7

Fig. 8

Fig. 9 - Simple interrupted as well as horizontal mattress suspension sutures (4/0 Vicryl) were used to achieve primary closure that is critical for a desirable result following a GBR procedure with immediate implant placements.

Fig. 9

Fig. 10 - A laboratory processed metal reinforced acrylic temporary fixed partial denture was provided to the patient for aesthetics and adequate function. Subsequently, an implant was placed at tooth 12 position.

Fig. 10

Fig. 11- Complete bone regeneration was observed during implant uncovering six months after implant placements, some of the implants were completely submerged and some of the new bone had to be profiled. The buccal flap was apically positioned in order to create an adequate width of keratinized tissue around the final implant supported fixed partial denture; 5-6-x-x-9-10.

Fig. 11

Fig. 12 - Open trey technique was used for the impressions in order to fabricate custom abutments.

Fig. 12

Fig. 13 - The custom abutments were tried in.

Fig. 13

Fig. 14 - The final PFM fixed partial denture was fabricated from implant # 5 and 6 to implant #9 and 10, as well as PFM single crowns for teeth #3, 11 and 13 and implant #12.

Fig. 14

The restorations were completed three years ago, periodontal recall and maintenance has been done every three months with yearly radiographic evaluations (Restored by Dr. Jay Lackman).