Pitt-EASY™ Endopore® Anatomic

Transcription

Pitt-EASY™ Endopore® Anatomic™
Sybron and Danaher Dental companies have a rich history of
providing high quality products setting the gold standard in
their respective technologies.
®
ENDOPORE
®
ENDOPORE
ENDOPORE Features & Benefits
• 3‐dimensional interlocking interface with bone • Increased surface area
• Uniform stress distribution
• Predictable and minimal crestal bone loss
• Greater surgical options with shorter implants
• Internal and External Connections, extensive prosthetic options
Internal and External Hex Connections
• Tapered, truncated cone shape
• Porous Surface
• External Hex Connections
3.5, 4.1, 5.0mm diameters
5,7,9,12 mm lengths
• Internal Hex Connections
4.1 and 5.0 mm diameters
7,9,12 mm lengths
Orthopedic Application
Porous surfaced hip implants are used since early 1970
(Developed by: Dr. R. M. Pilliar B.A.Sc., Ph.D.)
Necessary Requirements for Bone Ingrowth
• Biocompatible materials
• Limited relative movement at implant tissue interface during healing (<50µm)
• Sphere size 50‐150µm
• Pore size > 50µm
“Observations on the Effect of Movement on Bone Ingrowth into Porous
Surfaced Implants”
R.M.Pilliar Clinical Orthop Rel Res 1986; 208:108‐113
Titanium Alloy Features
• High fatigue strength (>600 MPa)
• Excellent corrosion resistance
• Biocompatible (extensive use in load‐
bearing dental and orthopedic implants)
Sintering Process
Sintered Porous Surface
• Surface Features:
–
–
–
–
–
3‐D interconnected porosity (average=100µm)
35 vol% porosity
Uniform distribution
Fine striations (thermal etching)
Sinter necks
Characteristics of Sintered Ti6Al4V
• A solid state diffusion process; consolidation of Ti6Al4V alloy powders to a bulk form with desired pore characteristics (size & vol.%)
• Sintered at 1250°C; therefore, no melting or liquid phase formation
• Strong bonding results between particles and particles‐to‐
substrate (metallic interatomic bonding)
• Sinter ‘neck’ diameter is substantial ‐ (30‐40% of particles diameters)
• Sinter ‘neck’ zone and bulk microstructural features are the same
Neck
Ti-Alloy Particle
Implant core
Neck
Neck
Ti-Alloy Particle
Human Histology
Implant in situ for 14 months
Courtesy Dr. P. Armstrong
Currently‐used Designs
Threaded screw:
Press‐fit cylinder:
Stepped cylinder:
(press fit)
Truncated cone:
(press fit)
Machined
Ti plasma‐sprayed
Acid‐etched/grit‐
blasted
Ti plasma‐sprayed
HA plasma‐prayed
Ti plasma‐sprayed
HA plasma‐sprayed
Sintered porous‐surfaced
Machined Surface
Surface Features:
• Roughness (1‐3 µm)
• Machining lines (0.1 µm width)
• Pits, gouges, transfer particles (nm‐µm)
Plasma‐sprayed Surface
Surface Features:
•
•
•
•
•
Roughness (up to 20µm)
Irregular depressions
Isolated pores (<10 vol%)
Some undercuts
Protrusion, sharp asperities
Acid‐etch Surface
Surface Features:
• Roughness (1µm)
• Etch pits, dimple‐like depression (1µm)
• Regular pattern/texture
Sintered Porous Surface
Surface Features:
•
•
•
•
•
3‐D interconnected porosity (ave=100µm)
35 vol% porosity
Uniform distribution
Fine striations (thermal etching‐nm)
Sinter necks
Surface Areas of Endopore®
Implants
Surface area of a 4.0 x 12 mm long threaded implant of Branemark design, i.e. machined: 248 mm²
Diameters
4.1 mm
4.1 mm
4.1 mm
Lengths Estimated Surface Area (mm²)
7 mm
527
9 mm 640
12 mm 781
3.5 mm
9 mm 512
5.0 mm
5.0 mm
7 mm 5 mm 638
455
•
Estimate of Available Surface
Diameter Length Geometric area
Estimated available of truncated bone area
4.1 mm
7 mm
4.1 mm 9 mm
4.1 mm 12 mm
3.5 mm 9 mm
5.0 mm 7 mm
83 mm²
99 mm²
118 mm²
80 mm²
108 mm²
~517 mm²
~630 mm²
~765 mm²
~503 mm²
~517 mm²
Stress Distribution – threaded vs. porous‐surfaced implants
Summary
Global Clinical Results
Multi‐Center Studies of the ENDOPORE® Dental Implant
Overall Clinical Results
Maxilla versus Mandible
Location and Success Rate of Implants Placed by the U.S. Study Group
Success Rate by Length Distribution by the U.S. Study Group
Place over the Mandibular Canal with as little as 4 mm of Bone
Eliminate Conventional Sinus Elevations
®
Endopore
Surgical Kit
ENDOPORE® Surgical Technique
The site is be marked with a 2.3 mm round bur at 1800 to 2000 rpm.
Use the pilot drill to the appropriate depth at a speed of 1000 `rpm with copious internal and external sterile saline irrigation.
A paralleling pin is used to determine the appropriate alignment with adjacent teeth, opposing occlusion or other implants. Pitt-EASY™ Endopore® Anatomic™
Expand the osteotomy with the appropriate sized implant bur at a drill speed of 1000 rpm with constant irrigation.
The shoulder of the cone‐shaped portion of the gauge should be flush or just below the crestal bone.
ENDOPORE® Insertion Technique
The implant is aseptically removed from the sterile package and delivered directly to the site using the attached delivery tool. The implant is pressed into the prepared site with manual pressure and the delivery tool is disconnected from the implant using a gentle rocking motion.
The implant is driven to its final position with several firm taps with the punch and mallet, resulting in a snug fit of the implant into crestal bone. The smooth coronal portion must be fully submerged in bone.
ENDOPORE® Insertion Technique
With finger pressure only, use the 0.05”
hex driver to ensure that the cover screw is tightly threaded onto the implant.
With finger pressure only, use the 0.05”
hex driver to ensure that the cover screw is tightly threaded onto the implant.
Implant Loading
The minimum initial healing period after implant placement is 10‐14 weeks in the anterior mandible and 16‐20 weeks in the maxilla and posterior mandible. This time period is dependant on bone quality.
Following the initial healing period the cover screw is removed and the clinician can proceed with the final prosthetic protocol.
Endopore® Surgical Protocol ‐
Osteotome Technique
Endopore® Osteotome Protocol
Innovation is our everyday life
A World of Implant Solutions
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Pitt-EASY™ Endopore® Anatomic

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