A new method in full mouth implant supported treatment

1. Procedure Development
On-going Treatment
Literature Review
Pilot study
Investigation
2013
Milestone 3
10/31/13
2013
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2013
11/30/13
Project End
Milestone 2
8/15/13
Milestone 1
4/30/13
1/15/13
Project Start
1/15/13 4/30/13
Legal Agreements Executed
3/30/13 4/30/13
4/15/13 6/30/13
4/15/13 6/30/13
6/30/13 10/31/13
10/15/13 Publication 12/1/13

2. Biotes/Nobel 2 piece Buser ITI 1 piece
Investigation
1965

3. All of the implants systems have similar results
NO STATISTICAL SIGNIFICANT DIFFERENCE in 10 years
Investigation

4. ● Oraltronics
/3i
/SPI
Investigation

5. The world population will grow by 150,000
people daily
for the next 40 years.
Investigation

6. Based on the existing published statistics we can INFER:
To provide world population optimal oral care the world
will need 70% more implant training programs
Investigation
Education Deficit

7. OIMC ID-SC ISC Overseas Jail
2002/OIMC 2000/ID-SC 2011/ISC 2002/Overseas 2010/Jail

8. 1200
1000
800
600
400
200
0
875
974
96
137
2
OIMC ID-SC ISC Overseas Jail
Failure
Implant No.
Patient No.
36
346
28
329
0 25
2
68
19 29
Pilot study

9. 11 years of Data collection &
Documenting all implant cases
Ehsan Charity Hospital
6/4/2012
Int. University Adoption
17/2/2008
Sharjah Jail
9/7/2011
UOS
26/4/2008
Study Circle
26/4/2011
Publication
3/6/2006
OIMC
20/10/2002
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Investigation Pilot study

10. International Publications
Investigation Pilot study

11. ISC
• Education of One Piece Implant System(OPIS) is easier as it
eliminates the teaching of the following concepts:
1. Different abutments (dimension, material)
2. Abutment screw
3. Impression
4. Treatment Planning
5. No abutment/implant interface
6. Cost effective(1/3 of the usual cost for the patient)
Pilot study

12. ISC
 Time required and absorption of
information and practical training
is minimized from 120 hours
with 8 implant placement/Res in
1 year for 20 participants to
30hrs theory with 18 hours of
practical training and 1 implant
placement/Res for 9 participants
in 1 year.
 A small group of 9 dental
students/dentist were selected
from 4 different dental schools in
UAE to participate in this study.
 A 16 chapter hand book was read
by the paragraph and all the
participants comments recorded
to update the book.
120
100
80
60
40
20
0
ISC
0 ISC
96
25
Pilot study

13. ISC
Pilot study

14. ISC (Implant Study Circle)
• Conclusion:
1. 20 % (in addition) of the population who have ideal criteria
could receive implants either in dental schools or by recent
graduates.
2. The awareness of graduating students in dental colleges
will improve by starting implantology treatment at early
stage.
3. Lab/implant cost reduction by 33% can cater part of the
80% population that did not opt for it. (aaoms.org)
4. The existing implantology education is too costly and not
sufficient to cope up with the number of graduating
dentists per year.
Pilot study
We require 1/3 of time and cost to teach Implantology

15. Success Data Timeline
Observations of pilot study
Dentist 1 1st implant in 2 months
Dentist 2 Daughter/ Invited her mother
Dentist 3
Aug 1 - Oct 9
Aug 20 - Nov 3
Aug 20 - Dec 24 13 patients 30 implants in 1 year/wide social circle
Dentist 4 6 implants and started teaching activity
Sept 2 - Nov 24
Milestone 1
Dentist 5
Oct 5 - Nov 25
Milestone 2
6 in 6 months / changed
otho residency to surgery
Milestone 3 Milestone 4 Milestone 5
2011 August September October November December 2011
Pilot study

16. The world population will grow by 150,000 people daily for
the next 40 years.
Investigation
Education Deficit
We do offer a solution

17. Based on the existing published statistics we can INFER:
20 % of total world population belong to a subgroup
That needs to be categorized and identified separately
Treatment Deficit
50 to 64 years 10.13% Edentulous
Investigation

18. Older patients with minimum bone quantity having one or
both arches edentulous seeking for fixed prostheses
represent a great challenge for the dental clinician.
Generally this group of patients:
Not working and have financial limitation,
Require a person to transport & accompany them,
Under medication requires minimal invasive procedure,
Less saliva and a removable prosthesis is uncomfortable,
Frequent follow-up visits becomes tiring.
Investigation

19. How many options?

20. 2 documented options!

21. Option 1
An ideal treatment for
a patient can be a
compromised option
for another

22. Option 2
A compromised
treatment for a patient
can be the ideal
treatment for another

23. First Miss India ( held in the year 1949) Pramila (Esther Abraham) is now 90 Years old

24. Vimto 1908 U.K
John Noel Nichols (1883 - 1966)
kellogs 1906 U.S.A
W. K. Kellogg (1860 – 1951)
Coca Cola 1888 U.S.A
John Pemberton (1831 -- 1888)
PEPSI 1890s U.S.A
Caleb Davis
Bradham (1867 —
1934)
Tang 1957 U.S.A
William A. Mitchell
(1911 - 2004)
Patchi 1974 Lebanon
Nizar Choucair
Twinkies 1930 U.S.A
James A. Dewar (1897-
1985)
Nestle 1866 Germany
Henri Nestlé (1814 - 1890)
Ferrero Rocher 1946 Italy
Pietro Ferrero
Lipton 1890
U.K
Sir Thomas
Johnstone
Lipton (1848 –
1931)
1879 Germany
Karl Benz and
Gottlieb Daimler
1952
Per Ingvar Branemark
Sweden
John Montagu, 4th
Earl of Sandwich
1718 –1792
Garrett
Morgan
1923
USA

25. 2 day visit immediate loading full arch flapless one piece fixed
restoration.
Copyright © 2012, Office Timeline, LLC. All rights reserved.
Treatment Code:
2DVILFAFOPFR
Patient
Satisfaction
Learn More
www.ID-SC.com
GET
66%
chair
time
“ORecFeFive! a 66% more profit on your
full mouth implant case”.
On-going Treatment

26. 2 day visit immediate loading full arch
flapless one piece fixed restoration.
What are dentists saying about 2DVILFAFOPFR?
Simple, easy surgery.
Professional, quick results.
Restoration the next day.
What are patients saying about 2DVILFAFOPFR?
“ “I love this! I’ve been rejected all these years by
other dentists because I have no bone left and if
they add bone the procedure takes 9 months
before I get teeth.”
“I can’t believe I’ve been using dentures all
these years! I've been missing out.”
“I like it because it's simple, intuitive and looks
great! I used it to eat hard food and I like the
result and has changed my life.”
Abstract:
Dental clinicians are confronted with an
increasing number of elderly patients who
present with insufficient bone and require
implant surgery for their oral
rehabilitation. However, there are few
guidelines on dental implant therapy in
this patient category, so that numerous
issues regarding pre- and post-operative
management remain unclear to the dental
clinician. Therefore, the aim of the present
review is to offer a critical evaluation of
the literature and to provide the clinician
with scientifically based data for implant
therapy in that category of patient with
borderline diabetic receiving medication
with partial negligence or who normally
are not good candidates to undergo
surgical procedures or whom are under
certain medications regime (eg: anti-coagulant
therapy) and cannot stop it
during surgical dental procedures.
Photos are all Copyright © 2013, OIRI, FZLC. All rights reserved.
On-going Treatment

27. 6 patients with 8 edentulous jaws (3 maxillary and 5 mandibular) have been
treated with the following protocol.
On-going Treatment

28. 6 patients with 8 edentulous jaws (3 maxillary and 5 mandibular) have been
treated with the following protocol.
-CBCT, Panoramic radiograph and articulated study casts were made.
-Patient received oral amoxicillin 1 g and mefenamic acid tablet 500 mg one hour before surgery.
Diclofinac sodium 75mg/3ml (Voltarine) IM-injection after surgery.
-Surgery was performed under aseptic protocol, patient rinsed with 0.2% chlorhexidene mouth wash.
-2% lidocaine infiltration was given from molar to molar area
-motor driven 3 mm diameter soft tissue punch locates and removes the crestal part
- #4 round slow speed round bur with 400 speed with both thumb and index finger holding the ridge to
feel the bur while its insertion 5mm deep in the 8 planned implant locations
-2mm diameter pilot drill was used in full required length of final implant with keeping an emphasis on
the parallelism of all the osteotomies
-followed by placing the one piece implants in each osteotomy to a range of 60-70 NCm torque
-the smallest implant used was 3.3x9.5 and the biggest one was 3.8x13. (sizes were: 3.3or 3.8x9.5/11/13.
-The impression was made with placing the plastic impression caps with polyether material with making
an inter occlusal record
-The implants were covered with plastic comfort caps
-The patient was provided with an ice pack for one hour post surgery and instructed to continue the
Amoxicillin 500 mg tds for 7 days and mefenamic acid 500 mg tds for 3 days and to apply clorhexidene
gel 0.5% (Elugel) and hyaluronic acid 0.2% (Gingigel) 3 times daily for 2 weeks .
-The next day a composite 14 unit bridge was cemented using glass ionomer cement
-The same procedure was performed for both arches.
On-going Treatment

29. Sequence
Diagnosis
PART I
Maintenance
PART II PART V
Surgery
PART III
Uncovery & Impression
PART IV
Restoration
Parts are Inter
related
Tx Sequence
5 Steps
On-going Treatment

30. Diagnosis
On-going Treatment

31. On-going Treatment

32. On-going Treatment

33. On-going Treatment

34. On-going Treatment

35. Commonly prescribed
post operatively
On-going Treatment

36. Uncovery & Impression
Restoration & Maintanance
On-going Treatment

37. 13 May 2014/ Loading
13 December 2014/maintenance

38. Maintenance visit after 6 months

40. 60 seconds 5 seconds
http://www.tekscan.com/occlusal-analysis-
system

41. Esthetics Phonetics Function
Do you like it’s looks?
Yes, I like every thing about it.
Does it look nice?
It is very nice, yes.
Did anyone comment on your teeth?
No, Nobody said anything.

42. Surgical phase – 8 implants in 1 hour
On-going Treatment case 2

43. On-going Treatment case 2

44. Surgical phase – 8 implant placement with surgical template in 3.5 hours
On-going Treatment case 3

45. On-going Treatment case 3

46. On-going Treatment case 3

47. On-going Treatment case 3
Sever
class III

48. On-going Treatment case 4

49. On-going Treatment case 5
On-going Treatment case 4

51. On-going Treatment case 5

53. On-going Treatment case 5
An ideal treatment for a
patient can be a
compromised option for
the same patient
A compromised
treatment for a patient
can be the ideal
treatment for the same
patient

54. On-going Treatment case 6

55. On-going Treatment case 6

56. On-going Treatment case 6

57. On-going Treatment case 6

59. Results
Presentation Title
Your company information
Publication

60. Tx Sequence
Timeline
Chair time In minutes: 315/5.25Hours
Tx planning 45
Impression/inter-occlusal registration 15
Extraction 30
Implant placement 120
Impression 15
installation 15
Occlusal adjustment 15
Follow-up By phone
Removal and fitting framework 30
Final Restoration 15
maintenance 30
Day
1 2 2 10 10 11 21 90 365
Publication

61. Publication

62. Patients on oral anticoagulants, chemotherapy,
& borderline diabetic do not stop medication.
Publication

63. minimally invasive flapless approach
Avoids bone augmentation procedure
Publication

64. to place multiple implants supported
fixed prostheses the next day visit
maximizes patient satisfaction
Esthetically, Phonetically & Functionally
Publication

65. Primary stability is the key principle in successful
treatment, immediate extraction.
Publication

66. No visibility so CT scan or bone
sounding is the key principle in
successful treatment
Publication

67. Parallelism is the key principle in
successful treatment
Publication

68. Millions of doctors with billions of
patients vs. One doctor with 6
patients
Classic vs. Modified
Publication
Lack of Data

69. Publication

70. Publication

71. Comparison
Publication

72. Publication
Discussion

73. The present study was designed to treat elderly patients with minimum bone quantity by using
narrow diameter one piece implants with immediate loading procedure.
Implant supported fixed restoration was reported to have more advantages when compared
with over denture treatment. In this respect, the placement of cross-arch multiple narrow
diameter implants shows potential for immediate loading fixed prostheses and hence
improvement in patient’s comfort, retention, chewing and speaking ability.
The main advantage of narrow diameter implant is to avoid bone augmentation procedure for
medically compromised patients.
A flapless approach has proven to be less traumatic, less time consuming, fewer complications,
faster soft tissue healing, with higher esthetic and functional acceptance. In this study, the health
benefits that patients could gain from 2 day visit implant-supported fixed prosthesis compelled
this technique against the risks of surgical treatment on medically compromised patients. 2 day
visit surgery could minimize cardiovascular stress.
The entire procedure took two hours which was convenient to provide the patients with a stable
fixed restoration in 24 hours after surgery.
The advantages of the one-piece implant include; saving chair time during placement and
restoration, the elimination of microbial influx at the abutment-fixture junction, avoiding screw
loosening and cost are preferable over two-piece implants.
Publication

74. Publication
“…the purpose of this review is to
provide rational, summarize current
available literature, and analyze
factors that influences this newly
introduced treatment method.”

75. Publication

76. M Chiapasco, C Gatti, E Rossi… - Clinical Oral Implants …, 1997 - Wiley Online Library
... Edentulous jaw; mandible; osseointegrated implants; mandibular prosthesis; long-term
effects; immediate loading. ...Waldenburg, Switzerland); Ha-Ti
screw implants (Mathys Dental Implants, Bettlach, Switzerland ... bar was fabricated
and implants were immediately loaded with an ...
DP Tarnow, S Emtiaz, A Classi - … of Oral and Maxillofacial Implants, 1997 - oralartslab.com
... The purpose of the present study was to evaluate immediate loading of threaded
cylinder implants at stage ... Germany).12 The im- plants with the lower values (better
resistance to load) and the ... A minimum of five implants were submerged and allowed to heal
without any loading. ...
C JOLIVET, K NGUYEN, C TESTON - WO Patent …, 2005 - patentscope.wipo.int
Abstract: The invention relates to an immediate-loading dental implant. The inventive
implant is characterised in that it consists of a single long piece comprising: a bone screw
anchoring part (10); an inlay-core (30) comprising elements (32) for the rotation of the ...
K Randow, L Ericsson, K Nilner… - … Oral Implants …, 1999 - Wiley Online Library
2. Abstract A clinical and radiographical study was performed to compare the out-come of
oral rehabilitation in the edentulous mandible by fixed supra-constructions connected to
implants installed according to either i) a l-stage surgical procedure and immediate ...
RA Jaffin, A Kumar, CL Berman - … of oral & maxillofacial implants, 2003 - europepmc.org
PURPOSE: The purpose of this article was to determine whether clinical success can be
achieved with immediate loading in the completely edentulous maxilla with endosseous
screw-type implants. MATERIALS AND METHODS: The study sample consisted of 34 ...
M Degidi, A Piattelli - Journal of periodontology, 2003 - Am Acad Periodontology
Background: The aim of this study was the evaluation, from a clinical point of view, of
implants subjected to immediate functional loading (IFL) and to immediate non-functional
Publication

78. “
”
Publication
After reviewing 10 articles

79. LD Campelo, JR Camara - … journal of oral & maxillofacial implants, 2001 - europepmc.org
... CONCLUSION: Flapless implant surgery is a predictable procedure if patient selection and
surgical ... and serve either as abutments or as cosmetic replacements for missing teeth. ...
your current search. Dental Implantation, Endosseous. Holding a DENTAL PROSTHESIS in ...
D Steenberghe, R Glauser, U Blombäck… - … implant dentistry …, 2005 - Wiley Online Library
Background: Based on three-dimensional implant planning software for computed
tomographic (CT) scan data, customized surgical templates and final dental prostheses
could be designed to ensure high precision transfer of the implant treatment planning to ...
A Rocci, M Martignoni, J Gottlow - Clinical implant dentistry and …, 2003 - Wiley Online Library
Background: Immediate loading of dental implants shortens the treatment time and makes it
possible to give the patient an esthetic appearance during the whole treatment period.
Purpose: The aim of the present study was to evaluate an immediate-loading treatment ...
M Degidi, A Piattelli - Journal of periodontology, 2003 - Am Acad Periodontology
... Fifty-eight implants were used to replace single missing teeth. ... AD Dominici. (2011)
Solidarizzazione elettronica su impianti a carico immediato: un caso clinico in chirurgia
flapless. ... (2009) Clinical Viability of Immediate Loading of Dental Implants. ...
W Becker, M Goldstein, BE Becker… - … implant dentistry and …, 2005 - Wiley Online Library
Background: Placement of implants with a minimally invasive flapless approach has the
potential to minimize crestal bone loss, soft tissue inflammation, and probing depth adjacent
to implants and to minimize surgical time. Purpose: The aim of this multicenter study was ...
G Cannizzaro, M Leone, M Esposito - … oral & maxillofacial implants, 2007 - ncbi.nlm.nih.gov
... Implants placed in the edentulous maxilla with a flapless procedure can
be ... Endosseous/methods*; Dental Implants*; Dental Prosthesis, Implant-
Supported; Dental Restoration Failure; ... Prospective Studies; Tooth Socket/surgery; Treatment
Outcome; Wound Healing/physiology. ...
Publication

81. “
”
Publication
After reviewing 10 articles

82. KB Tan, JE Rubenstein, JI Nicholls… - … International journal of …, 1992 - europepmc.org
... A conventional commercial laboratory one-piece casting method, using a silver-palladium
alloy, was used. ... small rotational displacements may manifest large gap appearances with
the one-screw test ... Or filter your current search. Dental Stress Analysis. Alloys that contain a
high ...
JS Hermann, DL Cochran, D Buser… - … Oral Implants …, 2001 - Wiley Online Library
... Joachim S. Hermann, FICOI, Department of Preventive Dentistry, Periodontics, and Cariology
University of Zürich Dental School Plattenstrasse ... periimplant soft tissue dimensions
dependent on varying locations of a rough/smooth implant border in one-piece implants or a ...
J Oliva, X Oliva, JD Oliva - … journal of oral & maxillofacial implants, 2007 - ncbi.nlm.nih.gov
... MATERIALS AND METHODS: One-piece zirconia dental implants (CeraRoot, Barcelona,
Spain) with 1 of 2 different roughened surfaces were designed and manufactured for
this study. Five different implant designs were manufactured. …
I Ericsson, K Randow, K Nilner… - Clinical implant dentistry …, 2000 - Wiley Online Library
... ver the years, the successful use of jawbone-anchored 0 (osseointegrated) titanium dental
implants for the ... Department of Prosthetic Dentistry and +Department ... been published by
Astrand et al,l4 and Buser et aI,l5 who reported on a number of one-piece implants (ITI)
installed …SS Porter - Dent, 2006 - biomet3i.ch ... 1.5 mm apical to the IAJ or at the first thread)
has been used as one of the ... explain in part the biologic and radiographic observation of
crestal bone loss around exposed and restored two-piece dental implants. ... 12 The
International Journal of Periodontics & Restorative Dentistry ...
P Lonca - US Patent 4,722,688, 1988 - Google Patents
... SUMMARY OF THE INVENTION A main object of the present invention is to provide a 20
complete dental procedure for installing implants of carbon carbon composite materials.
According to the invention there is provided a dental implant comprising a one-piece structure
Publication

84. “
”
Publication
After reviewing 8 articles

85. Publication
Education Deficit
Treatment Deficit

86. Publication