DENTSPLY Friadent News

From competence to reference

11-20-2009 | 125 laboratories were at the second annual meeting of DENTSPLY Friadent reference laboratories in 2009

While only 75 laboratories attended the first DENTSPLY Friadent reference laboratory meeting last year, one year later a total of 125 dental laboratories from all over Germany are members of the network. The qualifications for becoming a reference laboratory are not decided by factors such as size or location but exclusively by competence and experience. For practitioners the reference laboratories act as consultants to provide optimized backward planning – and they network to exchange experience to improve their qualifications even more. This requires comprehensive knowledge of materials and a solid knowledge of implant therapy and the resulting implant prosthetic concepts. Participants at the meeting were treated to a comprehensive range of information in an easily digested but also very detailed form. Internationally known lecturers presented their expertise in areas ranging from TissueCare through CAD/CAM to customized abutments.

TissueCare - long-term tissue retention
Dr. Dietmar Weng, dentist in Starnberg, described to participants the five factors for functional and esthetic long-term stability in hard tissue and soft tissue: subcrestal placement, a microstructured implant shoulder, deep platform-switching, no microgap between implant and abutment, and as a result no micromovements. DENTSPLY Friadent refers to this succinctly as TissueCare. Only where there is sufficient bone can the soft tissue remain stable over the long term. The Ankylos C/X implant system with its implant design and the new prosthetic options provides all the required conditions. Dr. Weng defined a realistic goal as not having to worry about the Tarnow rule, which requires a specific space between the fixture and the natural teeth. In the final analysis, nature shows us that bone and papillae are possible with only a 1 mm space. “Maybe the screw is the key” – we can only wait and see. During the lively discussion that followed Dr. Weng gave valuable tips from his dental practice: He prefers smaller prosthetic units, preferably not splinted, achieves excellent results with bone training, considers chewing force initiation via the tapered connection as more even that with flat connections and has already placed short implants with longer crowns with stability.

2D versus 3D diagnostics
Oral surgeon Dr. Frank Kornmann of Oppenheim compared various implantology therapy concepts based on actual case reports with consideration of late restoration or immediate restoration with conventional or virtual implant planning. His message: whatever the concept, the principle is optimized therapy. But how can we find this? First, the effective interaction of factors such as preoperative treatment management, surgical therapy phase and implantological rehabilitation are the basis of success and ensure the desired functional and esthetic long-term stability. Then whether we are dealing with single-tooth gaps, reduced dentition, edentulous maxilla or mandible and bridge supports: different classes of indications demand specific concepts. The decision for uncovered or submerged healing or an immediate restoration with immediate loading means different procedures. This is also applicable for the fixed or removable parameters. Appropriate procedures and materials with multiple options are required for solutions designed for the individual patient. The XiVE implant system and the ExpertEase computer-guided surgical planning system meets all requirements, in the opinion of the presenter.

CAD/CAM implant prosthetics
Jochen Hartmann, master dental technician at DENTSPLY Friadent, demonstrated the restoration options available to dental technicians with CAD/CAM prostheses and bridges, which were presented at the IDS for the first time. The wax-up prepared by the laboratory is scanned at the DENTSPLY CAD/CAM center. The laboratory receives a data set of a customized design proposal for the framework construction, which can be corrected or modified as desired. Then the framework is milled from titanium or cobalt chromium with industrial precision using a milling strategy customized for every case. Distortions or cavities are a thing of the past.

There are three requirements for using the system: occlusal screw retention, at least two implants and a construction at gingiva level. This enables restoration to be fabricated not only for ANKYLOS, XiVE and FRIALIT but also for all current implant systems on the market, including strongly posts placed at acute angles. The clinically proven DENTSPLY Friadent TissueCare Concept is retained in full, because the restoration is at abutment level

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Customized abutments
It has certainly been suspected for some time, but DENTSPLY Friadent only let the cat out of the bag at the reference laboratory meeting: effective immediately customized abutments are available, made of titanium and zirconium. Carsten Fischer, master dental technician in Frankfurt/Main, presented the abutment range for ANKYLOS and XiVE to the astonished participants: customized, specific, made to measure. Even the emergence profile can be shaped in any desired form, whether concave or convex. The abutments can be made of zirconium (Cercon) or titanium. Zirconium in particular is noted for excellent tissue deposition and esthetics. In the coming year "two-piece abutments" will also be available with a titanium base and retaining screw with zirconium abutment. The advantage of this is that the force resistance is transferred to a metal base. Two-piece abutments are characterized by a controlled cement gap, a more secure retention of the prosthetics.

Chivalry as contrast
Exactly what superior customer service can be was demonstrated in the evening event. The event offered a journey back into the past as a contrast to the present. Participants enjoyed an opulent mediaeval meal in the 500-year-old walls of the Klausenhof. The mood was correspondingly lighthearted.

View to the future ...
Master dental technician Rainer Struck of Berlin, master dental technician Franz-Josef Noll of Koblenz or master dental technician Rüdiger Wandtke of Lüneburg: presenting views representing most participants they found the information received at the meeting more than simply useful for their daily work. The range of customized abutments and CAD/CAM prosthetics along with the associated restoration options were found to be particularly interesting – and they are already looking forward to the surprises in dental technology at the 14th DENTSPLY Friadent World Symposium in Barcelona on March 19 - 20, 2010.