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
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
Subperiosteal Implants
• 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
Subperiosteal Implants
• Case mounted with refractory model ready for design, wax-up and abutment head placement
Subperiosteal Implants
• Cast and finished implant ready for surgical placement after pacification
Subperiosteal Implants
Subperiosteal Implants
Subperiosteal Implants
Subperiosteal Implants
• 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
Subperiosteal Implants
• One month and the implant and surrounding attached ginigiva healed and ready for the finished lower prosthesis
Subperiosteal Implants
• Finished lower prosthesis with incorporated superstructure – a lab tech’s work of art
• Expected clasp life: 6 months at most
Subperiosteal Implants
Finished case, and one happy patient
• Same happy patient
• Ready for a new upper and lower prosthesis – 15 YEARS LATER
Subperiosteal Implants
Subperiosteal Implants
• Heads remodeled with horizontal groves for adaptation of the “O” attachment system
Subperiosteal Implants
• 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
Subperiosteal Implants
• 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
Subperiosteal Implants
• 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
The “O” System
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
1960’s Pin Implants
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