Short implant history2 15-10

transcript

May 3, 2023

The ISI Complete and TSI Immediate Load Dental Implant System

OCO Biomedical presents OCO Biomedical presents the the next generation of endosseous next generation of endosseous implants:implants:Dual StabilizationDual Stabilization

The 117 Year History of Dental The 117 Year History of Dental Implants in The USAImplants in The USA

33 Year History of OCO 33 Year History of OCO Biomedical Biomedical

( formerly O Company, Inc until 2000)( formerly O Company, Inc until 2000)

Presented byPresented byDavid D. D’Alise, DDSDavid D. D’Alise, DDS

May 3, 2023

1891 1892

First U.S. Patents

• First really successful dental implant: GREENFIELD – 1909

• Documented cases lasting 5 to 7 years

• Root form• Dovetail interface• First two-stage dental

implant

First Successful Implant

The Greenfield Implant was used and further developed from 1909 until the late 30s and early 40s. First constructed of platinum and later Vitalium ( chrome cobalt) by work carried on by Moses and Alvin Strock. Note: Greenfield later opened up the apex and with a trephine bur created a bone pedestal onto which the implant was tapped creating and immediate load root form implant.

• This patent covers the general form of all of today’s root form dental implants

• First two-stage threaded root form dental implant

1938 – Adams

• After WWII, the beginning of the space age provided us with new metals such as chrome, cobalt & titanium

• These Metals were first used as impeller blades in jet engines

• Then later found to be biocompatible• Prior to WWII, the so called noble metals were used

with dental implants such as gold, platinum & silver • These metals were not biocompatible, and were

limiting the life of early dental implants

Implant Metals

Subperiosteal Implants

One of the first Subperiosteal Implants placed by Gershkoff and Goldberg

Pre - Op

Bone Models

Subperiosteal Implant cast with chromecobalt surgical metal

Subperiosteal Implant –bottom or bone side of the implant.

Surgically denuding the mandible

Subperiosteal Implant in place after 5 years

Subperiosteal Implant design evolve over the years. 1960 - 1969

• Typical sub case in the late 60’s and early 70’s

Subperiosteal Implants – One of my first cases -1968

Subperiosteal Implants – entire top, buccal and lingual exposed disecting around mental nuro-vascular bundle

• Taking a bone impression using ortho acrylic forming a tray on the bone and the final wash with surgident impression material

Subperiosteal Implants, First stage

Bone Impression

• Fabrication and placement of the subperiosteal implant had to take place within 48 hours

• Or a second surgical procedure was done 6 weeks later

• With a bone to opposing bite registration, the Models were mounted on a Guiletti articulator for accurate design and head-abutment placement of the subperiosteal implant

• Case mounted with refractory model ready for design, wax-up and abutment head placement

• Cast and finished implant ready for surgical placement after pacification

• The denture, which was made during the 6 week waiting period, is relieved and lined with a soft denture liner.

• The super structure being fabricated, now will be incorporated in the next few weeks

• One month and the implant and surrounding attached ginigiva healed and ready for the finished lower prosthesis

• Finished lower prosthesis with incorporated superstructure – a lab tech’s work of art

• Expected clasp life: 6 months at most

Finished case, and one happy patient

• Same happy patient

• Ready for a new upper and lower prosthesis – 15 YEARS LATER

• Heads remodeled with horizontal groves for adaptation of the “O” attachment system

• 1973 – the “O” ring attachment system is born using prefabricated components first for subperiosteal implants, and then for a variety of situations

• Essentially attaching any removable prosthesis to implanted or natural roots

• “O” Company, Inc. is born

The Original “O” Company, Inc.

The “O” Ring attachment system is the most widely used for attaching overdentures than any other and used with virtually every dental system implant world wide

• Catscan – CAD generated model comparing it to and actual resorbed maxilla above

The Original “O” Company

• CAT scan generated model used in constructing upper HA coated sub

• Upper CAT scan HA coated sub & lower

• Conventionally placed sub 10 years prior

• Note the change in abutment design more like today’s male attachments allowing more inter-maxillary space for prosthetic design

• Lower conventional “O” system over-denture

• Upper “D’Alise removable-fixed prosthesis” using a C&B like framework with “O” system female attachments and covered with composite, light cured C&B material

• When inserted, feels like and resembles fixed bridgework

The “O” System

• CAT scan generated model of the mandible to construct a tripodial subperiosteal implant with an “O” Company PS bar system.

• HA coated

The PS bar system for extremely resorbed mandibles allowing tripodial sub design

The Original “O” Company

19561948 – First of the Expansion Bolt Type Implants such as the Sargon

• One-piece immediate load with screw on abutment for periodic crown removal

Linkow’s Patented Vent-Plant Hollowed Bodied Rootform Implant

1968 1.5 to 2.0mm pins

1960’s Pin Implants: Forerunner of Today's Small Diameter Transitional or Mini Implants

• Used to stabilize anterior teeth with extreme bone loss

1960’s Pin Implants

Upper Cuspid Stabilized with 3 Tripoded Pins

Threaded Pin Implants

• Stabilized anterior teeth with threaded titanium pins

Threaded Pin Implants

• Osteotomy was prepared freehand with a #8 round hi-speed surgical bur

• Tattoo discoloration appeared above the crown

Vitreous Carbon Implants

• Carbon : very biocompatible

• But worked only with 2 of these 4 implants!

• Which 2?

Vitreous Carbon Implants

1969 – Lenny Linkow: Creator of the Blade Implant

1971 – Roberts Brothers,Ramus Blade & Frame

Immediate Load Implants

• Carbon coated• Various surface patterns

Coined Pure Titanium & Titanium Alloy• First generation titanium blades by

Implant Research, Inc.

• As with root forms, there were opinions & preferences as to blade design• But, unlike root forms, blades could be bent, cut and shaped to fit almost any

anatomic situation

Open Vent

Closed Vent

Vent Under Abutment PostVents Not Under Abutment Posts

HA Coated Upper

Blade Implants

Pre ISI Immediate Load Implants

Upper Mix of Blades, Cylinders and ISI Immediate load Implants

30 Years of OCO Biomedical (“O” company”) of Varied O-Ball Attachments

Upper and Lower Precision AttachedProsthesis

Once Again, An Historical Mix of 35 Years, 5 Generations of Successful Implants Supporting Teeth

In The Same Patient

• In the early 80’s, Dr. Branamark takes a large marketing campaign to the universities and the oral surgeons and “legitimizes” dental implants in the USA with a two-stage, threaded implant (design circa 1938)

• Calcitec, IMZ, Sustain and others introduce coated cylinders to the implant academies and AMOS

• As a result of effective marketing by these companies, the two-stage dental implant became the “Standard of Care”

• Since the OCO Biomedical ISI implant system was introduced in 2002, the buzzword is once again is “immediate load”

Immediate Load/Fuction: The Next Generation Lead by OCO Biomedical

The introduction of the 2 stage osseous integrated implant changed ImplantDentistry until the reintroduction of the immediate load, one stage implant.“ How do you restore a bolt?” The lab became biomedical engineers.Cost of implants gadgets, and special lab fees have made it almost impossible toTreat with the current standard of care for a missing tooth!

Different platforms

Direct or Indirect ?

Cone beam X-ray

Mini Implants

What next?

So Define the New “Standard of Care”?

• Implant and crown vs. fixed bridge• Direct technique vs. flap and 2 stage• 3-6 month 2 stage waiting for osseous integration vs. immediate load

Can we provide our patients with the “Standard of Care”

in this present economy

Short implant history2 15-10

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