SECTION 3 – INDUSTRY NEWS AND RESEARCH Q: I have an implant with cracked internal hex. What is the best way to remove it? Should I use a trephine-drill (where can I get one ?) or can I unscrew an integrated implant without too much bone damage? A: In
1990, we began offering the Screw-Vent implant in both commercially pure
titanium and titanium alloy. Six years later, we widened the neck of the
small-diameter Screw-Vent from 3.5mmD to 3.7mmD, which required the incorporation
of a countersink section at the top of each length-specific drill. Core-Vent/Paragon
has also have offered wide-diameter, internally threaded implants with
4.5mmD necks since 1986. To date, we have not received a single fracture
report with these wide-diameter implants. To maximize strength, Paragon
has offered all diameters of the Screw-Vent implant only in titanium alloy
since 1997. The following guidelines are provided in Paragon's product
warranty:
In the rare cases where fracture
does occur, we have a removal tool available. Visit our product page to
view and order our Removal Tool for Broken Screw-type Implants [IRT]:
Q:
I attended a course given by the guys of BioHorizons. They say that
they have found that the initial crestal resorption during the first
year in dental implants is related to the design of the neck of the
implant. I asked what role bacteria plays in that phenomenon, and they
said NONE. I am not very convinced with that answer. What do you think
about the presence of bacteria in the implant-abutment interface or
design of the neck of the implant as the cause of initial crestal bone
resorption?
Q:
I am sorry to bother you with a personal e-mail like this but I need
some help. I am treatment planning a large restorative case with Advent
implants. Basically the patient is edentulous in the mandible and I
will be restoring her with a hybrid prosthesis using 6 implants. I looked
through your CD ROM but it does not discuss this type of restoration.
I plan on using Advent as a one-stage procedure with an interim denture
while she heals. What abutment is best, in your opinion, to restore
this type of case? I have done cases like this with Lifecore and Astra
but I want to use Paragon products now. Thanks for any information.
Q:
I tried using the Tapered Screw-Vent for a sinus elevation procedure,
but could not completely seat the implant, even with a mallet. Since
then, I have used the Micro-Vent implant, then the Micro-Vent2 implant
for many years and have been very happy with it. Recently someone mentioned
that the Micro-Vent2 is going to be discontinued. Is this true?
Q:
I read about the Tapered SwissPlus on your website newsletter (#7),
and I can agree on many points. However, at this time, I am not ready
to make a wholesale switch from ITI to anything else because they work
better than anything else I have used. Further, the prosthetic problems
are resolvable using a little ingenuity.
Q: Sargon may be compacting bone when dentists first expand the pods. However, if the implant/bone interface turns into fibrous tissue, as happens when osseointegration is not achieved, the amount of bone lost could be highly variable, depending on the load and the time the nonintegrated implant was left in function. Just how fast IS the downgrowth of fibrous tissue? Could membranes help? A: I don't think that fibrous tissue necessarily has to grow downward. Bone is calcified fibrous tissue that forms in definite patterns, depending on stress and probably chemical messengers. I think fibrous tissue may occur through stresses, micromovements, etc., that break down the bone. In turn, the bone is "repaired" by replacement with fibrous scar tissue. If that is the case, a membrane probably wouldn't work. I agree completely that downgrowth of soft tissue is not the issue. Let’s get down to basics. Osseointegration is dependent on the following three factors: 1. Avoid overheating when preparing bone. 2. Achieve initial stability. This can be accomplished with a self-tapping thread or, better yet, a tapered, self-tapping implant, screwed into a straight hole for bone expansion. You don't need expanding pods to accomplish this. 3. Avoid premature loading. The variables of bone density, initial stability, surface roughness, force and direction of initial loading of the implant affects osseointegration success if the implant is not submerged. This is especially true if the implant is immediately loaded. I think that initial stability and, therefore, the likelihood of success with immediate loading, can be more predictably and effectively achieved with a rough surface (better yet HA surface) on a self-tapping tapered implant, than with expanding pods. If the Sargon idea is that the pods allow you to read the bone and you should only immediately load if the bone is so dense that the pods can't expand, one can determine the density of the bone for immediate loading based on the resistance to drilling or self-tapping. The Sargon claim of being able to expand the pods to get a second chance at osseointegration is a false claim. The likelihood of achieving success the first time is probably greater if the surface is rougher, the design of the implant allows self-tapping, and especially if the bone is expanded. Sargon has a smooth machined surface and is not self-tapping. One can always just replace the failed implant with a wider one if osseointegration is lost on an immediately loaded solid implant, and then wait for non-loaded healing. With Sargon, one is going to have to remove the crown to expand the pods and then leave it off to avoid further loading. This is just as much a nuisance as replacing the implant, especially if the better surface and self-tapping design can increase the initial stability and, therefore, the likelihood of integration in the first place.
Q: No major company has copied the Sargon concept. Are there better ways to achieve the goal of immediate load, without the concerns of long-term complications from a weakened molly bolt design? A: The following study confirms that Straumann can not claim earlier loading with SLA compared to TPS. There was no statistical difference between the attachment strength of these two surfaces. The slide of this study is on the CD-ROM under TPS vs. SLA, along with two other studies that show similar results. Buser D, Nydegger T, Oxland T, Cochran DL, Schenk RK, Hirt HP, Snetivy D, Nolte LP: Interface shear strength of titanium implants with a sandblasted and acid-etched surface: A biomechanical study in the maxilla of miniature pigs. Journal of Biomedical Materials Research 1991;25:889–902: "The purpose of the present study was to evaluate the interface shear strength of unloaded titanium implants with a sandblasted and acid-etched (SLA) surface in the maxilla of miniature pigs. The two best-documented surfaces in implant dentistry, the machined and the titanium plasma-sprayed (TPS) surfaces served as controls. After 4, 8, and 12 weeks of healing, removal torque testing was performed to evaluate the interface shear strength of each implant type. The results revealed statistically significant differences between the machined and the two rough titanium surfaces (p <. 00001). The machined surface demonstrated mean removal torque values (RTV) between 0.13 and 0.26 Nm, whereas the RTV of the two rough surfaces ranged between 1.14 and 1.56 Nm. At 4 weeks of healing, the SLA implants yielded a higher mean RTV than the TPS implants (1.39 vs. 1.14 Nm) without reaching statistical significance. At 8 and 12 weeks of healing, the two rough surfaces showed similar mean RTVs. The implant position also had a significant influence on removal torque for each implant type primarily owing to differences in density in the per implant bone structure. It can be concluded that the interface shear strength of titanium implants is significantly influenced by their surface characteristics, since the machined titanium surface demonstrated significantly lower RTV in the maxilla of miniature pigs compared with the TPS and SLA surfaces."
Q: It has been reported that, for implants to become osseointegrated, they must heal in the absence of functional loads for 4 to 6 months. However, more and more implant companies have developed systems that promise to address the patient’s demand for uninterrupted or immediate function and esthetics following initial implant placement. How successful have these systems been and what information is available to substantiate these claims? A: The TPS screw implant sold by Straumann in the 1980s was used with 4 implants in the symphysis, splinted and loaded immediately. Babbush and Kent published on several thousand implants restored this way. It is rapidly becoming accepted methodology again to immediately load implants that are splinted across the midline in edentulous jaws. Schnitman published a 10-year study of Branemark implants immediately loaded. Here he loaded 3 and buried 5 in a number of jaws with the idea that the 3 immediately loaded would fail but provide transitional support. He achieved very high success with both the early and late loaded implants. Tom Balshi and Bill Becker also published on immediate loading in lower full-arch cases. Dr. Dennis Tarnow of NYU published on immediate loading in both arches. I am presently funding an immediate loading study of one-piece, one-stage ADVENT implants at New York University and University of Pittsburgh. The protocol calls for the placement of 4 implants in the symphysis, two of which are blasted and two are HA coated. Immediately upon suturing, a gold collar, shaped like the collar of a standard two-piece abutment, will be attached to the top of the implant. These gold collars are then joined in the mouth with gold dolder bars cut to length and attached with autopolymerizing acrylic. The assembly is then removed, soldered and returned for attachment to the implants within 24 hours. An overdenture will then be attached. This splints the one-stage implants for greater stability, saves the cost of transfers, analogs and the inaccuracy of indirect fabrication of bars. If you wanted to make a screw-retained temporary bridge to splint the implants immediately, a titanium sleeve could be attached to the top of each implant and the provisional prosthesis could be fabricated by using an omnivac shell made from the patient's old denture. The provisional prosthesis could then be relieved to accommodate the titanium, and relined directly in the mouth to incorporate the sleeves. A better way may be to do a transfer impression immediately upon inserting the implants and fabricate the temporary bridge indirectly. I know a number of dentists who use this method for unilateral bridges in the lower jaw where bone quality is good, but there is very little documentation to support this concept yet. I believe it will prove to be reliable with at least 3 implants splinted and kept out of full occlusion. The key to immediate loading is good quality bone and/or splinting around the arch. Q: How can Paragon advocate preparing abutments directly in the patient's mouth? Eriksson et al. (J Prosthet Dent 1983;5[1]) documented that a temperature rise of 10 degrees C for one minute in bone is sufficient to cause tissue injury. The extreme heat generated by the cutting procedure can cause irreversible tissue damage and threaten osseointegration. A: Paragon has advocated intraoral abutment preparation without incident since 1981, provided an intermittent cutting technique with diamond burs under copious irrigation is utilized. A pilot thermographic analysis conducted by McCullagh et al. (Pract Period Aesthetic Dent 1998;10[9]) found that non-irrigated, high-speed preparation of five different abutment types with a medium-grit diamond burs in 60-second durations produced temperature increases that ranged from 13.2 to 31.3 degrees C. In contrast, Gross et al. (Int J Oral Maxillofac Implants 1995;10[2]:207-212) compared heat generation at the implant surface during abutment preparation with tungsten carbide and diamond burs in a high-speed, turbine handpiece with standard turbine coolant. Cutting in 15-second increments reduced heat generation by 75% compared to continuous cutting for 30 seconds. During periods of continuous cutting for 30 seconds, tungsten carbide burs caused a mean temperature increase of 2 degrees C (maximum = 4.7 degrees C), versus 1 degree C (maximum = less than 2 degrees) for diamond burs caused a mean temperature increase. Gross et al. conclude that abutment reduction with medium-grit diamond burs using intermittent pressure and normal turbine coolant is unlikely to cause an interface-temperature increase sufficient to cause irreversible bone damage and compromise osseointegration.
Q: The biological width seems to be an important factor in implant dentistry. What is your opinion on this subject? A: I don't believe that "biological width" is a factor in implant dentistry. Dr. Dennis Tarnow, who is the greatest proponent of this concept, observed bone loss around two-stage Branemark® implants and surmised that several millimeters of bone loss was inevitable below the junction of the implant and the abutment. This theory excluded the more likely scenario that stress under the wider 4mmD neck of the 3.7mmD Branemark implant was a source of stress concentration that resulted in bone loss. This is what Branemark's 1977 textbook concluded (Branemark P-I, Hansson BO, Adell R, et al. Osseointegrated Implants in the Treatment of the Edentulous Jaw. Experience from a 10-year Period. Stockholm, Sweden: Almqvust & Wiskell International, 1977:110). Another possibility is that the countersinking needed to place this implant also contributed to the bone loss. With the countersink drill separate from the final sizing drill, two possibilities exist. One is that, during seating, the implant bottoms out on the base of the countersink, rather than at the bottom of the socket. This could compress the base of the countersink, leading to bone loss. Another is that the implant bottoms out in the socket, leaving a space between the neck of the implant and the base of the countersink. This could also contribute to bone loss. Today, Paragon makes length-specific drills with built-in countersinks for its external hex Taper-Lock implants. This drill design helps ensure that the implant bottoms in the socket and on the countersink at the same time. Another possibility for the bone loss associated with the Branemark implant is the imprecise fit between the implants and abutments (Dellow AG, Driessen CH, Nel HJC: Int J Prosthodont 1997;10:216-221). This has resulted in microbial leakage through the implant-abutment interface with subsequent bacterial colonization of internal surfaces of the implants (Persson LG et al., Clin Oral Impl Res 1996;7:90-95; Quirynen M et al., Clin Oral Impl Res 1994;5:239-244; Koka S et al., J Prosthet Dent 1993;70:141-144). It also allows rotational wobble between mated Branemark implants and abutments. Binon, for example, documented 6.7 degrees of abutment rotation with the Branemark System (Binon PP, Int J Prosthodont 1995;8(2):162-178). Lateral forces will cause tipping with the abutment joint cyclically opening and closing, causing percolation of bacteria from the junction. This undoubtedly would contribute to bone moving away from this junction. THAT IS NOT TO SAY THAT ALL TWO-PIECE IMPLANT SYSTEMS HAVE THESE SAME LIMITATIONS. Paragon's friction-fit abutments and internal hex with lead-in bevel eliminate all tipping and rotational movements (Binon PP, Postgraduate Dent1996;3(1):3-13). The "Biological Width" theory is thus most likely based on a false premise from observations made on the Branemark System. Bone loss is inevitable if the ridge is thin, and is of little consequence if it is only a few millimeters in height. If it were the junction between mating parts that was causing the bone loss, why does Staumann's one-stage ITI® implant that has the supragingival junction still experience bone loss? Some have suggested that a two-stage implant with a polished collar would provide better tissue health if the collar were left above the tissue. However, this would position the threads of the implant at the crest of the ridge. Exposed threads can't be a good thing, especially in an HA- or TPS-coated implant. Soft tissue health certainly has been demonstrated with smooth titanium healing collars and abutments. I believe that, regardless of whether a two-piece implant is selected for a two-stage procedure or to position the margin as far subgingival as possible for esthetics, the top of the implant should be placed level with the crest of the ridge. Furthermore, the implant's surfaces should be designed with a 1mm smooth machined (not polished) neck to accommodate for the 1 mm of bone loss that most likely will occur just from the surgical insult to the bone. Below this relatively smooth neck region, a medium-rough surface should be placed to retard bone recession. If one wants a rougher coated surface on the implant, it should be separated from the 1 mm smooth neck by a 2 mm, medium-rough blasted zone. Paragon offers such a design, which is called the Dual Transition™ Selective Surface™. When a one-stage procedure is desired, the implant should be designed to accomplish this with a 2-3 mm long neck that projects above the endosseous portion of the implant, as in the ITI, AdVent™ and SwissPlus™ implants. In the maxillary anterior esthetic zone, the use of a two-stage implant in conjunction with a healing collar for a one-stage surgical protocol is acceptable. It is even advisable to do so if the tissue is less than 3mm thick. A secure, friction-fit internal connection (Tapered Screw-Vent) would eliminate concerns about microleakage caused by micromovements. Steri-Oss' Replace Select™ implant, which claims to be usable as a one- or two-stage implant, requires leaving the implant body extending 2 mm above the crest of the ridge, which brings the rough coating and threads to the crest of the bone where they will be easily exposed to the soft tissue with a minimal amount of bone recession. Steri-Oss' ads show this implant used one-stage, but with a healing collar attached to maintain the opening through the soft tissue. A true one-stage implant should be able to accomplish this without the need to purchase extra parts. Q: I was once an big user of Core-Vent/Paragon products, but dropped away during the Dentsply era. I am extremely interested in your new product line after reading a copy of your new AdVent™ and Screw-Vent® Implant Systems catalog. How is the new Paragon System selling here in Canada? A: Many former Dentsply customers are now Paragon customers, due to the superior technology and precision engineering of the system. What is it going to take to convince you to start using the best implant system in the world? If you are only willing to accept external hex implants, then check out the advantages our Taper-Lock™ at: ../Brochures/Ext_Hex_Lock/cover.html In the U.S., this implant lists for $125, compared to $248 for Steri-Oss and $292 for Branemark. The Taper-Lock's preparable straight abutment is now only $55. If you want implant dentistry to be more profitable and easier for your referring dentists, simply attach the abutment for them! If you have to buy the abutments, maybe the cost would be more important to you than it apparently is now. Because of the friction-fit connection created by our tapered external hex, the Taper-Lock comes with a 5-year guarantee of no loose screws under cemented bridges. This is a significant factor, if you are going to attach the abutment. Taper-Lock also features triple lead threads that make seating three-times faster and with 12% less torque! You have probably switched from Steri-Oss' Replace® to Replace Select®, because Nobel Biocare and Steri-Oss are finally going to give you "what every dentist wants ... an internal connection," as their journal advertisements state. The underlying implication to their ad is that, for the time you have been using the Replace external hex implant, they have been giving you what you don't want...an external hex implant! Paragon is vigorously pursuing its legal rights to stop Nobelbiocare/Steri-Oss from selling the internal connection and we believe that we will be successful within this year. For your dentists who want the ITI® system, our SwissPlus™ blows it away in both surgical and prosthetic advantages, while selling for about 60% less than the ITI. Review the technological advantages of the SwissPlus at: ../marat/octaplusnew.htm If you want a better one-stage implant, the AdVent™ is your answer. SteriOss doesn't even have a true one-stage implant. They tell you to add a healing collar to their Replace Select implant. Read about the technological advantages of the AdVent system and a view a case study at:../TechnologyPages/finalpages/AdventIntro.htm If you want a tapered two-stage implant, then our new Tapered Screw-Vent® is the ultimate choice. It offers the option of expansion/compression in soft bone, because it is inserted into a socket prepared with an undersized straight drill. For dense bone, straight Step Drills ensure thread engagement by the tapered apex. For more information about the technological advantages of the Tapered Screw-Vent and to view a single tooth case inserted by Dr. Louis Clarizio, visit our website at: ../TechnologyPages/finalpages/Screwventinro.htm Dr. Clarizio did place some Replace Select implants that Nobelbiocare/Steri-Oss gave him. However, he has now come back completely to Paragon, because our many product advantages help him make far more money in his practice than any company could give him in products or honorariums. If you want a direct comparison between the features (advantages) of the Tapered Screw-Vent to the Steri-Oss Replace Select implant, this is provided at: ../company/DrNiznickOnsec4.htm#sterioss Q: Does anybody know about the Paragon Implant System? Is it good? A: Paragon Implant Company employs approximately 250 people, maintains corporate offices in the U.S., Canada, Germany and Israel, and has distributors in 30 other countries. All of Paragon’s products are manufactured by its affiliate, Core-Vent Bio-Engineering. For more detailed information on Paragon’s products, visit our award-winning website ../index.html. Paragon has led the industry not only in innovative implant product, but also in using web technology and interactive computer programs to provide state-of-the-art education and customer service. While online, be sure to order Paragon’s free CD-ROM that contains an implant education program with over 800 computer-animated slides. It also includes an interactive treatment planning, ordering and inventory control program designed to facilitate communication between members of the implant team. To answer your question, however, I will briefly outline the developmental history of the Core-Vent/Paragon product line. EARLY YEARS Core-Vent Corporation was started in 1982 to market the two-piece, hollow-basket, Core-Vent® implant. The original design featured a Hex-Hole; that accepted a variety of cemented posts. Due to its reasonable price, which was substantially lower than the Branemark® System at the time, and easily accessible education programs, the Core-Vent implant became the most widely used root-form implant in the world by 1986. Other systems were also first introduced around that time. The IMZ® System, for example, which is still marketed, but essentially defunct. The Calcitek® System, as another example, coated the implant to its top, and the abutment fit against it. Unfortunately, the resulting soft tissue problems contributed to giving HA a bad reputation. A third example is the Steri-Oss® System, which was first introduced as the Denar® System. The initial implant design was a screw that accepted cemented abutments, and featured a 4mm long smooth neck. SPECTRA-SYSTEM® EVOLUTION PERIOD: 1986-1990 In 1986, Core-Vent broke the tradition of one design for each implant company by introducing a second design targeted at the Branemark business. This was the Screw-Vent® implant, which featured the same thread design (0.6 mm pitch) and made from the same material (weak Grade 1 commercially pure titanium). In time, that choice of metal proved not to be a good idea. The Screw-Vent did bring two innovations to the industry. The first was its self-tapping design: vertical cutting groove and threads to the apex. The second was a unique internal Hex-Thread® connection (US Patent # 4,960,381). Core-Vent Corporation added three other implant designs over the next three years. The Micro-Vent® (1987) was the first small-diameter (3.25mmD), root-form implant and the first HA-coated screw implant. This implant featured a unique design (ledges on body with apical threads) and a unique surgical protocol (push-in for ease of insertion, with final thread-in for stability). The Swede-Vent® implant (1987) was the first real Branemark clone. Finally, the Bio-Vent® HA-coated cylinder featured vertical grooves and apical vents to alleviate hydraulic resistance to full seating. In 1990, to make some sense of this array of hardware, Core-Vent introduced the Spectra-System concept of designating different implants for different locations of the jaw. Soon afterwards, the V.A. clinical study that evaluated 2800 of these implants at 32 U.S. government Veterans Affairs Hospitals began. The V.A. study primarily proved that HA-coated implants achieved and maintained significantly higher success than acid-etched implants, and overcame limitations of soft bone, surgeon's inexperience and even smoking. Approximately 700 Micro-Vents were included in the study, of which 97.5% achieved 3-5 year success. The crystallinity of the HA used in this study was not as low as the HA applied to the implants in the late 1980's, and not as high as the HA used by Paragon today. Review the V.A, study results at: ../research/studies/study2_pt01-1.html and ../research/studies/study2_pt01-1.html DENTSPLY PERIOD: 1991-1997 For the 6-year period from April 1, 1991, to May 31, 1997, Dentsply International distributed the products still manufactured by Core-Vent Bio-Engineering. In 1994, the external hex of Core-Vent’s Swede-Vent® implant was redesigned to incorporate a patented 1.5-degree taper (U.S. Pat. #5,433,606). The name was changed to Swede-Vent TL (Taper-Lock), and provided a very stable friction-fit connection when used with Swede-Vent abutments. The Swede-Vent TL was still only available in 4.0mmD with a Branemark®-compatible platform (4.1mmD/0.7mm-high hex). In 1996, the Screw-Vent’s strength was improved by increasing the neck diameter from 3.5mmD to 3.7mmD, which necessitated design of length-specific drills with built-in countersinks. Maximum strength was further ensured by eliminating the use of Grade 4 CP Ti in favor of titanium alloy, which had been offered as an option since 1990. The diameter options of the Screw-Vent were increased to include a 3.3mmD (still with a 3.7mmD neck) and a 4.7mmD body. This Screw-Vent line was further expanded during this time to include Healing Collar Packaging for one-stage surgery. Together, these Screw-Vent Implants were called the Paragon System. The word "paragon" means "the standard by which all others are judged." CORE-VENT CHANGES ITS NAME TO PARAGON: 1997 When Core-Vent regained distribution of its product lines in 1997, the company changed its name to Paragon Implant Company. This may have led to some confusion between the name of the company and the name given to the one-stage Screw-Vent implants packaged with healing collars. From April 1997 through the end of 1999, Core-Vent/Paragon introduced several new product changes. Among these, the Micro-Vent was tapered and reintroduced as the Micro-Vent2® and a 5.7mmD implant was added to this line. Paragon also introduced the Complete® Implant, a one-stage, one-piece implant with a platform compatible with the Branemark Standard Abutment. Its 3mmL neck extension could be used as the abutment for screw-retained restorations, or adapters (abutments) could be added similar to 2-piece implants. After 1997, the Swede-Vent TL implant line was expanded to include 3.3mmD and 4.7mmD options, all with the same platform as the 3.7mmD implant. In 1999, Paragon's triple lead threads were also added for three-times faster insertion and 12% less torque than single-thread implants. The material was also changed to work-hardened Grade 4 commercially pure titanium that withstood 421 lbs of compressive load at 30 degrees and 22.1 in-lbs of torque. The increased strength of its hex, coupled with Paragon’s Selective Surface® process of leaving HA-coated or SBM-blasted implants with an uncoated, machined apical end (US. Pat #5,571,017), made self-tapping insertion possible in all qualities of bone. The fixture mount that comes preattached to the implant was also redesigned in 1999 to serve as a transfer and temporary abutment. By 1999, the advantages of the Complete Implant and the Screw-Vent implant with Healing Collar packaging, both one-stage implants, were combined into the AdVent, which replaced these designs. The AdVent Implant offers several significant improvements: 1. The platform changed to a 3.0mmD internal hex with greater prosthetic versatility. It can accept a ZAAG Attachment (Zest Co.) for overdenture retention, and also accepts a full range of prosthetic abutments compatible with Paragon’s two-stage internal hex implants. 2. The body was tapered. In soft bone, the socket is prepared with straight drills for compression of the bone or expansion of narrow ridges. In dense bone, step drills allow self-tapping insertion of the implant. 3. The threads changed from a single-thread design to triple lead threads that reduce insertion time. 4. The Advent is packaged with a 2mmL Implant Extender that provides greater versatility in projecting the implant through the soft tissue for one-stage healing. PARAGON IMPLANT COMPANY --- 2000 With the start of the 21st century, Paragon introduced the Tapered Screw-Vent®, which adopted the body design and surgical protocol of the AdVent implant and the Dual Transition® Selective Surface™ of the Micro-Vent2™ implant. The Tapered Screw-Vent is packaged for two-stage insertion with color-coded fixture mounts designed for use as transfers. This implant is destined to replace the tapered Micro-Vent2 and the standard Screw-Vent, as it combines the best features of both with the added advantages of triple lead threads. It will undoubtedly also replace the Bio-Vent® cylinder implant, because it is as easy to insert, provides added initial stability and is packaged with a Fixture Mount/Transfer that facilitates stage-one impressions. As dental professionals start to load implants earlier, and as more implants are placed immediately in extraction sockets, the design advantages of the Tapered Screw-Vent compared to the straight, non-threaded Bio-Vent become even more obvious. Paragon Implants have been classified into three categories on our "click-to-chart" Interactive Case Planning and Product Selection Guide available free on Paragon’s CD-ROM: Implants 2000 - Paragon's Premium Line of Implants consists of the Tapered Screw-Vent and AdVent implants. Spectra-System: This line consists of the old Screw-Vent, tapered Micro-Vent2 and Bio-Vent implants. 1. Implants 2000: Paragon's Premium Line of Implants consists of the Tapered Screw-Vent and AdVent implants. 2. Spectra-System: This line consists of the old Screw-Vent, tapered Micro-Vent2 and Bio-Vent implants. 3. Economy Implants with industry-compatible platforms:
IN CONCLUSION In reference to the comment that Paragon implants are very good, as are 3 to 4 others, one needs to define what features are important in a system, and then look for the system that offers the greatest number of these advantages. In evolving the AdVent and Tapered Screw-Vent into what is, in my opinion, the paragon of implant systems, here is what I considered important: 1. Surgical Simplicity
While the comment that Paragon is very good, as are 3 to 4 others, not all implants and implant companies are created equal. It takes the discerning dentist to differentiate between competing product claims... and a discerning manufacturer to try to differentiate its product through features and benefits rather than through its marketing and hired opinion leaders.
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