Interview: “Are your workflows perio-friendly and efficient?”
AMSTERDAM, Netherlands: In an interview, CAMLOG Biotechnologies Brand Manager Dr Annika Meyer talked about the characteristics of a perio-friendly and efficient workflow. Meyer, who studied dentistry at the Humboldt-Universität in Berlin and previously worked in dental education and product management for several international dental businesses, also touched on implant products manufactured by the innovative Swiss company that aim to make that workflow possible.
Dr Meyer, it seems you are always up to date when it comes to significant trends in implantology regarding clinical research. From your point of view, what can you tell us about the emerging trends in implantology?
For me, as a scientifically oriented clinician, flashy claims from implant manufacturers trying to set trends with colourful pictures are not at all interesting. What is important and attractive to me is getting clinical data, clinical results, on the most significant developments affecting the treatment outcomes for our patients. Can we see a clinical benefit? If so, under what conditions? Now, faster than ever before, we are able to collect more data from completed clinical trials. This allows us to implement the acquired knowledge for decisive developments in implantology.
Why is implementing the acquired knowledge for decisive developments in implantology important?
Today, we are even more capable than before of establishing consensus on the benefits of particular workflows and developments. This gives clinicians the necessary guidelines.
So what are the decisive developments of the past that have made implant treatment workflows perio-friendly?
Developments in CAD/CAM technology are progressing very rapidly. We tend to forget that providing a custom-made abutment with an individual emergence profile was a time-consuming and expensive way to obtain a perio-friendly restoration. Now, perio-friendly structures are easy to achieve with individual abutments from DEDICAM. With DEDICAM abutments, an individual emergence profile allows the clinician to define the optimal position of the cervical margins—be it for aesthetic reasons or for easier removal of excess cement for proper cementation margins.
For many of those attending EuroPerio9, the advantages of individual CAD/CAM abutments are well known. Nowadays, such abutments can be an integral part of the general dentist’s offering without any further investment—making this process perio-friendly and efficient.
The lab designs the individual abutment and the dentist receives the ready-to-use titanium abutment within two days. In some countries, even a scan and design service is available, facilitating the work of the dental technician too.
What other developments do you consider perio-friendly?
Well, I almost daren’t say it, because implants that have this attribute have been described as old-fashioned, but machined necks on implants are definitely gaining a resurgent importance regarding perio-friendly products.
What are the clinical advantages of CAMLOG implants with machined necks and platform shifting?
CAMLOG products with machined necks have been included in several in vivo studies and international clinical studies. The data showed less bacterial adhesion on machined implant surfaces. This indicates that the reported risk of peri-implant microbial adhesion and tissue inflammation can be reduced by using implants with a machined collar.
The CAMLOG Implant System is available with two different machined collar heights and an option for platform shifting for the implants with 0.4 mm machined necks. CAMLOG implants are available with different machined collar heights. If one places the implants correctly—the Oral Reconstruction Foundation (formerly the CAMLOG Foundation) provides a consensus report containing guidelines—then one has a clinically proven advantage.
Is platform shifting an option?
Yes, the CAMLOG Implant System with the Promote plus surface (0.4 mm machined surface) does have the option to perform platform shifting. The clinician can decide whether platform shifting is suitable for the specific clinical situation, offering him or her a certain level of flexibility and the safety of the machined collar. The CONELOG Implant System offers integrated platform shifting and surface roughness up to the platform, a concept that has also proven to be perio-friendly, as it leads to stable soft-tissue levels and less crestal bone loss.
What are the trends regarding efficiency?
Everything that allows for transmucosal healing makes the surgery easier to perform. Randomised clinical studies have shown that the disassembly and reconnection of the abutment might have an influence on changes in bone level, with a subsequent negative effect on the soft tissue around implants.
In several studies, transmucosal and submerged healing were compared and no superiority of one or the other healing method was found. Therefore, depending on the indication, several advantages can be seen using transmucosal healing (i.e. it is time-efficient and therefore cost-effective for the surgeon, and it addresses the patients’ desire for less surgery and a shorter treatment time).
A good example is the iSy Implant System. As the pre-mounted implant base remains on the implant right from the beginning, one works on abutment level from the start. The implant and superstructure can integrate and the soft tissue can stabilise during the healing process.
Another factor that drives efficiency is a reduced number of instruments in an implant system. The iSy Implant System has achieved this objective, not only with the lean drilling surgical protocol but above all with the use of multifunctional abutments. The multifunctional cap can be used intra-orally as an impression post, and in the lab, it has the additional function of a scan post. As we like to say here at CAMLOG Biotechnologies, digital dentistry made iSy. It’s designed as a system to optimise access to individualised CAD/CAM restoration. The clinician can choose to work chairside or with a lab or use an external CAD/CAM service provider.
Editorial note: The interview was provided by CAMLOG Biotechnologies.