Dr. Nahi Jabbour Education Manager
Star Science International GmbHJupiterstrasse 57 – 418 3015 Berne / Switzerland
Tel. +41 31 941 07 31 Fax. +41 31 941 07 33
E-mail. [email protected]
Thommen Medical SPI® Dental Implant System
The SPI®System exists over 20 yearsThe SPI®System is suitable for the entire spectrum of implant indicationsThe state-of-the-art system meets the most demandig expectations: simple application and highest technical precision and QualityExcellent proven for aesthetic solutions
SPI® Implant System
The Company
TPS 1977 Ledermann
Ha-Ti 1985 Conical
ITI / Bonefit in 1998 with SLA
SPI 1998 Cylindrical NLS 1986
Interchangeable superstructures
Cemented Ball anchor
Screw retained
Development of the Swiss Precission Implant System
( Thommen Medical AG )• Improve the Design of the Implant
Length 9.5 mm – 14 mm 11-14 mm Length 8 mm – 17 mm
Development of the Swiss Precission Implant System
( Thommen Medical AG )• Improve the Design of the Implant
3.5 m 4 m 5 m 6 m 3.5 m 4.5 m 5 m4.5 m
2.7 3.5 3.5 4.253.5
4 m
45 4.2
• Research & Development• Quality• SPI®Concept• Implant Range• SPI®Implants and Implantation• Abutment Range• SPI®Abutments• Sterile packaging for SPI®Implants• Cassettes
SPI® Implant System
Research & Development
DevelopmentDevelopment locationsAdvisory Board & User groupDr. h.c. Robert Mathys Foundation (RMS)
European clinical/scientifical Advisory Board «New Developments»:
Dr. B. Merz, Technical partner, ZurichDr. K. Meyenberg, Dental Surgeon, ZurichDr. R. Minoretti, Dental Surgeon, Clinic Pyramide, ZurichHanspeter Spielmann, Dental technician, Zollikon-ZurichDr. Albino Triaca, Dental Surgeon, Clinic Pyramide, Zurich
Research & Development
European clinical/scientifical Advisory Board «New Developments»:
Dr. M. Merli, Dental Surgeon, Rimini Prof. Dr. M. Tonetti, Eastman Dental Institute for Oral Health Care Sciences, University of LondonProf. Dr. J.-R. Strub, Poliklinik für Zahnärztliche Prothetik,Albert-Ludwigs-Universität, Freiburg
Research & Development
• „Collegium Implantologicum“
Roughly 150 membersSupport in continuous educationSupport in further development of the SPI®System
Research & Development
• Research & Development• Quality• SPI®Concept• Implant Range• SPI®Implants and Implantation• Abutment Range• SPI®Abutments• Sterile packaging for SPI®Implants• Cassettes
SPI® Implant System
High quality standardThommen Medical is certified to SN EN ISO 9001, SN EN 46001 and to MDD 93/42 Annex IITherefore only CE-marked products are sold to customers All SPI® products are exclusively manufactured in Switzerland
Quality Swiss Precission Implant SPI
• Research & Development• Quality• SPI®Concept• Implant Range• SPI®Implants and Implantation• Abutment Range• SPI®Abutments• Sterile packaging for SPI®Implants• Cassettes
SPI® Implant System
IL IL
CL CL
Oss
eoin
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Oss
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CL : IL ≈ 1 : 2 CL : IL ≈ 1 : 1
Implant DesignFor two stage and single stage as well as for immediate loadingScrew type implants in different diameters and lengths
SPI® Implant System new concept
FeaturesExtreme stable implant/abutment interface connection (internal hexagonal)Identical abutments for one and two-stage procedures
SPI® Implant System
FeaturesRough implant surface (sandblasted and acid-etched)Self-cutting thread for high primary stabilitySpecial thread to enlarge the implant surface
Pure titanium = Ti, grade 4
SPI® Implant System
• Histology SPI® 8 weeks
Status report: R&DAnimal study "Next Generation Implant Surface"
• Implant types:
SPI®ELEMENT … for aesthetic indications
SPI®ONETIME … for one-stage procedures
SPI®DIRECT … for immediate loading
SPI®CONTACT … for immediate placement
SPI® CONTACT
SPI® ElementSPI®ELEMENT
for aesthetic indicationsØ 3,5 mm, L 8,0 mm 9.5 mmØ 3,5 mm, L 11,0 mm 12.5 mmØ 3,5 mm, L 14,0 mm Ø 4,2 mm, L 8,0 mm 9.5 mm Ø 4,2 mm, L 11,0 mm 12.5 mm Ø 4,2 mm, L 14,0 mmØ 5,0 mm, L 8,0 mm 9.5 mm Ø 5,0 mm, L 11,0 mm 12.5 mm Ø 5,0 mm, L 14,0 mm
3.5 mm 4.5 mm 5.00 mm
3.5 mm 4.2 mm 5.00 mm
SPI® OnetimeSPI®ONETIM
for one-stage proceduresØ 4,2 mm, L 8,0 mm Ø 4,2 mm, L 9,5 mmØ 4,2 mm, L 11,0 mmØ 4,2 mm, L 12,5 mmØ 4,2 mm, L 14,0 mm
Ø 5,0 mm, L 8,0 mm 9.5 mmØ 5,0 mm, L 11,0 mm 12.5 mmØ 5,0 mm, L 14,0 mm
5.00 mm 6.00 mm
4.2 mm 5.00 mm
SPI® Direct
SPI®DIRECT
for immediate loading
Ø 3,5 mm, L 11,0 mmØ 3,5 mm, L 14,0 mm
Ø 4,2 mm, L 11,0 mmØ 4,2 mm, L 14,0 mm
4.2 mm3.5 mm
SPI® CONTACT– Endosseous screw implant with
combined conical-cylindrical shape – For immediate or delayed
implantation in extraction alveoli– Due to the small neck height it is
suitable for sub gingival and trans gingival use
– Self-tapping thread
SPI® CONTACT• Dimensionen
– The endosseous dimension is the diameter of the cylindrical part
– The platform diameter is always one step bigger
Platform: 3.5 4.5 5.0 6.0
Enosseous: 2.7 3.5 4.2 5.0last drill Ø : 2.0 2.8 3.5 4.3
Ø 3.5 Ø 4.5 Ø 5.0 Ø 6.0
0.8 mm
1.5 mm
Ø 2.7 Ø 3.5 Ø 4.2 Ø 5.0
• Dimention – Diameter & ShoulderSPI® CONTACT
SPI® CONTACT
– Preparing the implant bed with SPI®VECTOdrill™ twist drills
– Preparing the conical implant bed with additional CONTACT profile drill • Recommended drill speed :
250 – 300 rpm
• Preparation
Cutting edge Non cutting edge(Guidance)
The sharpness is intentionally reduced!
SPI® Improved Drills
• CONTACT Profilbohrer
Bone Level
SPI® CONTACT
• CONTACT Proile Drill
Polierter Hals unter Knochenniveau
SPI® CONTACT
Contact Implant
– The cylindrical part of the implant gives an optimal primary stability • Self-cutting thread
– The conical part of the implant fills up the extraction alveoli• The bone is displaced by
the thread
Cylindrical1st primarystability
Conical2nd primary stability
Thread pitch 0.8 mm
1st primary stability:Immediate bone to implantcontact
2nd primarystability:Bone to implantcontact
Max. 300 r.p.m. for profile drill
Contact Implant (Clinical Case)By Prof. Ledermann
Contact Implant Immediate Placement (By Prof. Ledermann)
Contact Implant . Implant Preperation
(By Prof. Ledermann)
Contact Implant (By Prof. Ledermann)
Contact Implant Self Taping (By Prof. Ledermann)
Contact Implant Implant Insertion(By Prof. Ledermann)
Contact Implant X.Ray Control(By Prof. Ledermann)
Immediate loading with SPI®DIRECTSurgical Procedures
Immediate loading with SPI®DIRECTX- ray control
Immediate loading with SPI®DIRECTImpression Procedures
Immediate loading with SPI®DIRECTImpression Procedures
Immediate loading with SPI®DIRECTLab Procedures
Immediate loading with SPI®DIRECTLab Procedures
Immediate loading with SPI®DIRECTLab Procedures
Immediate loading with SPI®DIRECTLab Procedures
Immediate loading with SPI®DIRECTLab Procedures
Immediate loading with SPI®DIRECTLab Procedures
Immediate loading with SPI®DIRECTLab Procedures
Immediate loading with SPI®DIRECTLab Procedures
Immediate loading with SPI®DIRECTProsthetic Procedure
Step by Step Lab Bar Construction(By Prof. Ledermann)
Immediate loading with SPI®DIRECTLab Procedures
Immediate loading with SPI®DIRECT
Contact Implant X.Ray Control(By Prof. Ledermann)
SPI® (Screw implant by Ledermann)In 2001, Ha-Ti® was taken over by the company Thommen Medical in Waldenburg. The name was changed to SPI® (Swiss Precision Implants) and at the same time a cylindrical, self-tapping one-part Ledermann screws and two-part screws were marketed. A total of 1139 SPI® screw implants have been used for all indications, not all immediate bars. 28 required removal. The oldest surviving implant is 5 years. The success rate is 98%.
In a pilot study the clinical procedures wereevaluated and data of prosthetic complications of maintenance service were collected. 25 patients participated in the study with a total of 79 SPI implants during the time period from 2003–2004. 37 implants were located in the maxilla and 42 implants in the mandible. Two implants failed during the healing period, but no loaded implant was lost. Thus, the survival rate was 97.5% (77/79).
Studies by Prof. Mericske - Stern(University of Berne Switzerland)
44 implants supported a fixed prosthesis, including nine single crowns and33 implants were used in combination with removable partial denture. Four implants were used with ball anchor retention,29 Implants with bar support. The ELEMENT implant with the low implant shoulder allows very good esthetics.
Studies by Prof. Mericske - Stern(University of Berne Switzerland)
Studies by Prof. Mericske - Stern(University of Berne Switzerland)
Bar Reconstruction in the madible
Studies by Prof. Mericske Stern(University of Berne Switzerland)
Bar ReconstructionIn the maxilla
ImpressionWith open tray
Studies by Prof. Meriscki Stern(University of Berne Switzerland)
Single tooth replacement ( Molar 6)
Studies by Prof. Meriscki Stern(University of Berne Switzerland)
Fixed Bridge in the lower mandible
Prosthetic complications and maintenance service during the first year of function was comparable with other implant systems. Since the design of the abutment screws, healing caps and screwdriver was changed, the system has become easier in its application.the survival rate was 97.5%
Studies by Prof. Meriscki Stern(University of Berne Switzerland)
SPI® (Screw implant by Ledermann)In 2001, Ha-Ti® was taken over by the company Thommen Medical in Waldenburg. The name was changed to SPI® (Swiss Precision Implants) and at the same time a cylindrical, self-tapping one-part Ledermann screws and two-part screws were marketed. A total of 1139 SPI® screw implants have been used for all indications, not all immediate bars. 28 required removal. The oldest surviving implant is 5 years. The success rate is 98%.
Case Presentation
Agenda
• Concept• Product overview • Product details• Product range• Step-by-step procedure• Case presentation
Agenda
• Concept• Product overview • Product details• Product range• Step-by-step procedure• Case presentation
• Reasons for the new EASY abutment system– Easy– Versatile– Fast– Highly precise– Additional possibility of taking impressions
on abutment level– Large range accessory components– EASY AND SAFE HANDLING
Concept
Agenda
• Concept• Product overview • Product details• Product range• Step-by-step procedure • Case presentation
Product overview
• EASY abutments for cemented restorations
Product overview
• EASY snap on impression caps, color-coded
Ø 3.5 Ø 4.5 Ø 5.0 Ø 6.0
Product overview
• EASY protective cap for abutment
Product overview
• EASY abutment analogs
Product overview
• EASY burn-out caps with snap on retention for crowns and bridges
Agenda
• Concept• Product overview • Product details• Product range• Step-by-step procedure• Case presentation
Product details• EASY abutments for SPI®
ELEMENT, SPI® ONETIME and SPI® CONTACT
Product details• EASY abutment for cemented restoration
– Connection geometry with hexagon has not changed
– Distinct anti-rotation surface– Revolving snap on groove– 45° shoulder
Product details
• EASY abutment– 45° shoulder
0.3 mm at Ø 3.5 0.5 mm at Ø 4.5-6.0
45°
Product details• EASY abutment
– Two different cone heights
4mm6mm
Product details
• EASY abutment– Two different cone angles
4mm 6mm
9°
6°
Product details• EASY abutment
– Two different cone angles• Except for Ø 3.5
4mm 6mm
6°
6°
Product details
• EASY abutment– Three different neck shapes
emergence profile (e.p.)
0.5 mm 2.0 mm 3.0 mm
short long
Product details
• EASY abutment– Three different neck shapes, cone 4 mm and
6 mm emergence profile (e.p.)
0.5 mm 2.0 mm 3.0 mm
short long
Product details• EASY abutment, short
– For aesthetic restorations– Neck angle allows e.p. shaped
crown– Neck must not be shortened
0.05 mm
0.5 mm0.35 mm
Product details• EASY abutment, long
– Can be shortened and adapted to the gingiva• When shortened, burn-out cap has to be
adapted
1.5 mm
0.5 mm conical
cylindrical
Product details• EASY abutment, emergence profile
– Can be shortened and adapted to the gingiva
3.0 mm
4.5 mm
5.0 mm
5.0 mm
6.0 mm
Next bigger platform
• EASY impression cap for impression taking on abutment level– Color-coded -- Attached
• Bead at the inside of the cap• Groove at the abutment cone
– Anti-rotation surface at the inside of the cap– Retentive– Triangular shape of retentive anchor– Alignment of anti-rotation surface and retentive
anchor– Can be shortened up to one level
Product details
Product details• EASY protective cap
– Protects the inserted abutment– Supports the soft tissue – Cemented temporarily – Can be used as basis for
temporary restoration• Retentive anchor needed
4mm
6mm
Product details
• EASY abutment analog– Are made of stainless steel
4mm
6mm
Product details
• EASY burn-out cap for crowns and bridges– With anti-rotation surface on the inner
surface for crowns and without for bridges– Snap-on retention
4mm
6mm
Product details
• EASY burn-out cap– Irreducible strength of the cap (0.3 mm)
0.3 mm
Agenda
• Concept• Product overview • Product details• Product range• Step-by-step procedure• Case presentation
Product range
• EASY abutment, angled (20°)– As before
Product details• EASY abutment set
– Consisting of:• 1 EASY abutment• 1 abutment screw• 1 EASY impression cap• 1 EASY analog• 1 EASY burn-out cap for crown• 1 EASY burn-out cap for bridge• 1 EASY protective cap All components are also available individually.
Agenda
• Concept• Product overview • Product details • Product range• Step-by-step procedure • Case presentation
Step-by-Step Procedure
Step-by-Step Procedure• Dentist
– Step 1: Implant after successfulosseointegration• Healing cap or gingiva former is
removed • Implant platform and internal connection
are cleaned and thoroughly dried
Step-by-Step Procedure• Dentist
– Step 2: EASY abutment placement• The selected EASY abutment is
fixed to the implant with an abutment screw– 15 Ncm (3.5 mm platform) – 25 Ncm (4.5 mm to 6.0 mm
platforms)
• Dentist– Step 3: Impression cap placement
• The anti-rotation surface of the impression cap must be aligned with that of the abutment– Alignment of anti-rotation surface and
retentive anchor• The corresponding EASY impression cap is
snapped on the abutment.• Make sure no soft tissue is caught between
abutment and cap
Step-by-Step Procedure
Step-by-Step Procedure
• Dentist– Step 4: Impression taking
• No individual impression tray is needed• The impression must be taken with an
elastomer impression material; alginate or hydrocolloid is not suitable for this use
• To obtain optimal retention, it is advisable to inject impression material directly around the grooves of the impression cap
• After the impression mass has cured, the impression can be removed
Step-by-Step Procedure Dentist
– Step 5: Protective cap placement• The diameter of the cap is marked above it• Before placement the screw channel of the
abutment must be sealed with a removablematerial (wax, gutta-percha etc.)
• Temporary cement is used to fix the EASYprotective cap in place
• The protective cap protects the abutment from damage and contamination while supporting the soft tissue.
Step-by-Step Procedure
Dental Technicia– Step 6: Analog placement in the mold
• The anti-rotation surface of the impression cap must be aligned with that of the analog
• The corresponding EASY analog is inserted and snapped in to the impression cap
• The master cast is fabricated according tonormal procedures
Step-by-Step Procedure• Dental Technician
– Step 7: Burn-out cap placement• Appropriate for the prosthesis being
fabricated the EASY burn-out cap forcrowns or bridges is snapped onto theanalog
• The burn-out caps have a snap mechanism at their inner cone
Step-by-Step Procedure• Dental Technician
– Step 8: Framework modeling• As the marginal rim of the burn-out cap is
highly precise wax should not be added beyond the marginal shoulder
• The angle of the marginal shoulder allows to build up a naturally shaped crown
Step-by-Step Procedure
• Dental Technician
– Important• The burn-out cap has to be covered
completely with wax on the outside, the layer should be at least 0.2 mm
Step-by-Step Procedure• Dental Technician
– Step 9: Framework investment• The investment material must be matched to the casting alloy used (it is essential to
follow the manufacturer’s directions and recommendations)• The casting cylinder has to be put in the cold oven• Rising the temperature 3° to 4° C/min up to 250° / 300° Celsius, holding the
temperature for at least 30 minutes, then heating up to 800° CelsiusImportant: No speed preheating is possible
Step-by-Step Procedure
• Dental Technician
– Step 10: Framework preparation • After casting the retention knob at the
inner surface of the casting must beremoved with a grinding wheel beforethe framework is replaced on the analog
Step-by-Step Procedure
• Dentist
– Step 11: Final restoration placement• Before cementing the screw channel
of the abutment screw has to be sealed with a removable material
Agenda
• Concept• Product overview • Product details • Product range• Step-by-step procedure • Case presentation
SPI® EASY Temporary caps
Torque Ratchet and InstrumentsProduct features
• unique design• it is a one-part instrument (patent pending)• no dismantling for cleaning, no maintenance (oil, etc)• one-part instruments will be added in different lengths as well
Torque Ratchet and Instruments
for prosthetic, with Ncmfor surgery
Product use
Zirconia Abutmentstwo designs are planned:
• based on the SPI® EASY design• based on the milling cylinder design
Zirconia 100% compatible to the existing SPI EASY system compatible with existing abutment screw one piece design grinding possible (conventional impression taking)
SPI®ART Abutments
SPI®ART Abutments
SPI®ART Abutments
SPI®ART Abutments
SPI®ART Abutments
16 Months