MIS Magazine 5

MC-MMAG5 Rev.1

3D OR NOT 2B PAGE 8

4th Quarter, 2013

INTERNATIONAL MAGAZINE

THE CANNES EXPERIENCE PAGE 22

PAGE 33

NEXT GENERATION REGENERATIVE SOLUTIONS

®

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Idan KleifeldCEO, MIS Implants Technologies Ltd.

© 2013 MIS Corporation. All rights reserved.

Greetings! Synergy between knowledge, products and procedures is fundamental to the MIS vision. The articles, interviews and product reviews in this issue of the MNews clearly represent that vision, and also bring to light our continued investment in technology as a precondition for growth and innovation. For all those who attended our Global Conference in Cannes, France this June, (and there were a lot of you), the MNews offers a recap of the event; characterized by a high academic level, networking, recreation and fun. Product articles include the MGUIDE MORE; increased diagnostic accuracy in our virtual dental implant planning and guided implantology system, the expanded 4BONE brand; now an entire family of regenerative biomaterial solutions, the C1 Narrow implant and many more exciting products. Our MIS distributor showcase reveals what traits are common to successful business people and explores the history and ongoing global educational programs of the Esparza Training Center network in South America. In addition you’ll find an in-depth interview with a highly respected KOL and pioneer in immediate loading and placement of implants; giving you a glimpse of his vision for the future, plus many more articles we’re sure you’ll find useful and enjoyable. MIS is committed to the continued expansion of our product range, bettering the processes by

which they are developed and produced; increasing our services and the choices and flexibility in treatment options we can offer our customers. To make it simple, we strive to boost quality, efficiency and profitability for our customers worldwide.

Happy reading!

04 Ride to success 08 3D or not 2B 13 New in

the MIS portfolio of products 16 Meet MIS distributor

superstars 22 The Cannes experience 27 A vision

for the future 33 Next generation regenerative solutions

38 Winners of MIS clinical case competition 42

It’s a great app 46 Upcoming events

INTERACTIVE PRINT

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EVENT

4 MNEWS 4th Quarter, 2013

MIS-Implants Technologies Ltd. embodies a deep commitment to creating innovative yet simple solutions and products aimed at improving dental implantology. MIS also promotes professional and social events on a global scale to encourage networking, knowledge sharing and moral-building. Such was the MIS Day in Portugal.

The event took place in two picturesque port cities: Lisbon and Oporto. MIS presented international speakers on a variety of implantology topics, including general advice to help doctors achieve their professional and personal goals. Featured speakers were Moshe Goldstein DMD, specialist in periodontology, and Federico

Hernandez-Alfaro MD. DDS. PhD. Feboms, specializing in Oral and Maxillofacial Surgery. Subjects included “Oral Implants in Potentially Problematic Sites-Surgical Options for Optimal Restorative Results” and “Reconstructive surgery in oral implantology - What have we learned?”.

What made the MIS DAY really special was the inclusion of speakers from one of the most prestigious and inventive automotive brands, Porsche. The pairing up of MIS-Implants with Porsche for this event was a big surprise, however, not really that surprising when you consider what they have in common; both sharing core principles of quality, accuracy, innovative

A SURPRISE PARTNERSHIP: MIS IMPLANTS & PORSCHE

RIDE TO SUCCESS... MAKE IT SIMPLE



design and attention to safety. Porsche representatives presented a fascinating insight into this iconic automotive brand, resulting in an important knowledge exchange and some truly unforgettable moments.

The idea for this special joint event was inspired by MIS and heartily welcomed by the automobile giant Porsche. The purpose was to not only provide a scientific overview for dental implantology professionals, but to provide a platform for interactive socializing and the fostering of an atmosphere of cooperation and friendship amongst all participants. As explained by Ms. Cristina Antas da Cunha, Director of Marketing and Sales at MIS Portugal: “We wanted to create a unique event that was different and stimulating, especially in light of the many challenges facing the dental implants industry today. An event that encourages energetic, creative thinking as a way of problem solving; showing doctors the positive and enthusiastic reaction to difficult situations and how to do the best with the resources at hand. We succeeded through innovative and motivating activities, and with the aid of internationally recognized speakers.”

The concept of quality and simplicity through advanced engineering are highly prized at MIS. Mr. Doron Peretz, Senior VP of Marketing and Product Development at MIS Implants Technologies explains. “As with many well-known brands in all fields, our approach at MIS revolves around the design of a simpler solution, in this case implant systems. A good example of MIS simplicity, quality and safety, is the C1 implant, with its conical connection and dual stability mechanism. It provides primary stability in the collar of the implant and secondary stability in the apical part of the

implant, along wi th other components that provide a s i m p l e solution used with CAD/CAM

based titanium t o z i r c o n i a

interfaces.”

Mr. Peretz c o n t i n u e s .

“With a view towards reducing

the investment in quality and service,

MIS has introduced surgical kits that are

simpler to use, assisting den t i s t s w i th c l in ica l

procedures. What if in the future you have the proper drill for each

implant, always sharp, clean and safe? The dentist’s success rate increases

dramatically. Even if it takes a few more years to accomplish, this concept depends on simplifying the surgical procedure (not the implant itself), from packaging, drilling, suture, graft, etc., including all the appropriate safety and quality testing.”

Sharing a unique perspective on Implantology that he created and developed at the School of Dental Medicine at the Hadassah-Hebrew University Medical Center, in Jerusalem, Dr. Moshe Goldstein, President of Europerio 2012, contributed to the event from a scientific perspective. “Function, comfort and aesthetics are our daily goals, and are achieved based on a step-by-step treatment plan for every kind of implant case, from the simple to the complex.” This was exactly what Dr. Goldstein presented in his informative lecture and personal surgery videos. Dr. Goldstein understands the importance of keeping up with updates in the development of graft or regenerative materials, guided surgery techniques, CAD/CAM, and other restorative components newly developed in the industry.

In Oporto, Federico Hernandez-Alfaro MD. DDS. PhD., President of the Department of Oral and Maxillofacial Surgery at the Medical Center of Teknon, Spain, and Head of the Program of Dental Implantology at the International University, lectured about developments in reconstructive surgery, implant dentistry and the learning process that led us to present day levels of expertise. Participants in Oporto also attended a lecture by Dr. Nachum Samet, VP of R&D at MIS Implants. Dr. Samet focused on Implant Osteotomy, Stability, factors that have been largely achieved with MIS Implants Technologies: The SEVEN implant internal connection and the C1 conical connection. He focused on the meaning behind the MIS motto: Make it Simple, first discussed by Mr. Doron Peretz in Lisbon. “The simplicity of the surgical procedure is built-in to the C1 implant, whose standard package includes the ability for immediate loading, and a specially designed final drill for better clinical outcomes.”

Over 400 implant professionals participated in the MIS Day event - the first of a series, highlighting scientific research, cultural experiences, sporting events and numerous other activities designed to educate, update, motivate and surprise. The MIS Day event in Portugal also made us realize how much unites MIS Implants with Porsche. It was a stunning success enjoyed by all, owing to the efforts of organizers and participants alike, and is sure to be repeated in the coming years.

Function, comfort and aesthetics are our daily goals, and are achieved based on a step-by-step treatment plan for every kind of implant case, from the simple to the complex.

‘‘ ‘‘


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For more information about MIS MGUIDE, please see: http://www.mis-implants.com/Products/Virtual-Implant-Planning.aspx

OR

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T 2B

...3D

Mr. Liron MosheMIS MGUIDE MOREProduct Manager


The MGUIDE MORE is an advanced virtual implant planning and guided implantology system that has been developed by MIS to accurately transform DICOM data into 2D and 3D images that depict real cases in a virtual environment; enabling real-time 2D and 3D visualization for perfect implant planning. The MGUIDE system is a timesaving measuring and diagnostic tool featuring user friendly software, and incorporates the production of a fully validated drilling template for a minimally invasive surgery when indicated, assuring accurate guided implantation with predictable prosthetic outcomes.

The MGUIDE MORE offers flexible prosthetic-driven planning that can be done either by the clinician, using our simplified state-of-the-art MGUIDE software, or through our worldwide network of MCENTER facilities. Available in over 20 countries and five languages, the MCENTERS are full-service technical support and guidance facilities. Implantology professionals using the MGUIDE software become members of an important online information hub that connects all software users; doctors, dental laboratories, periodontists, prosthodontists and the MCENTER. MGUIDE software users can share cases, take part in demonstrations, initiate discussions or consultations. They can also use a remote access feature that allows direct connection to another member’s computer to share in the MGUIDE planning process.

How does the MGUIDE process begin? First a single patient Cone Beam CT scan is done. The DICOM data is then uploaded for a 3D clinical evaluation. Next comes the implant planning and template design stage. Integration of a scanned wax-up and stone models enable virtual top-down planning as well as the template design. Then the stereo-lithographic templates are produced. These open wire-frame templates are made using advanced 3D printing technologies to ensure optimum fit. Now the guided surgery can be performed. Restoration can be done via immediate provisional prosthetic solutions that have been produced in advance using MGUIDE prosthetic tools available for laboratory technicians.

There are many clear advantages to the open wire-frame design of the MGUIDE MORE templates. It allows an open field of view during surgery, where anesthesia and irrigation are accessible from all angles without removing the template. Raised flap surgery can also be more easily performed. The template is constructed from a strong, durable biocompatible material and the 3D CAD/CAM design ensures the highest level of accuracy. The lightweight template design is an added benefit for patient comfort as well.

The MGUIDE MORE surgical kit not only enhances accuracy and safety for a worry-free guided procedure, it also simplifies the implantology process by eliminating the need for traditional guidance keys. Specially designed sleeves and drills stop at the precise position and depth planned, freeing-up hands and saving valuable time.

Many guided implantology systems today still require conventional techniques, often compromising on efficiency or accuracy. The MGUIDE MORE is different. It has been specially engineered to enable doctors and clinicians to deliver a more accurate and streamlined minimally invasive implant placement and restoration procedure, resulting in less chair time and fewer patient appointments.

MGUIDE Surgical Kits for the SEVEN implant and 3D printed surgical template


MIS CONTINUES TO INTRODUCE NEW PRODUCTS AND EXPAND EXISTING PRODUCT LINES WITH THE AIM OF MAKING DENTAL IMPLANTOLOGY PROCESSES SAFER, EASIER AND SIMPLER. WE HAVE A GENUINE COMMITMENT TO INTRODUCING NEW SOLUTIONS AND TECHNOLOGIES PERFECTLY MATCHED TO THE NEEDS OF IMPLANT PROFESSIONALS WORLDWIDE.

NEW IN THE MIS PORTFOLIO OF PRODUCTS


The Ti-Base abutments are MIS Titanium base units for CAD/CAM systems allowing the production of custom ceramic abutments for a wide range of individualized solutions and greater compatibility to specific site requirements. Two categories of Titanium Base abutments are available; for single unit restorations – with an anti-rotational mechanism and a full implant-abutment connection, and for multiple-unit restorations – without an anti-rotation mechanism and with a shortened implant-abutment connection. Both come in Standard, Narrow and Wide diameter sizes.

Ti-BASE: Titanium base connecting customized abutments to MIS implants

The C1 implant system is the result of an extensive research and development process that offers a unique combination of surgical and restorative benefits. The C1 Narrow has a 3.30mm diameter and comes in lengths of 10mm, 11.50mm, 13mm and 16mm. The narrow platform is suitable for use on narrow ridges and between closely spaced teeth or implants. The C1 Narrow features a unique conical connection, with a 4-position anti-rotational index. This enables thicker walls at the neck area, resulting in a 3.3mm implant that is equivalent mechanically to 3.75 internal hex implants. The new implant also incorporates the MIS dual stability mechanism (DSM) by design. When placed in full bone, the single-use final drill (supplied with each implant) creates an osteotomy that generates mild compression at the coronal third of the implant, ensuring high initial stability, while allowing rapid osseointegration in the apical third. This advanced technology combines the benefits of high primary mechanical stability with an accelerated osseointegration, achieving rapid biological stability.

The C1 Narrow: Implant and prosthetic components

The new zirconia abutments are biocompatible, customizable and have superior strength characteristics. They combine the esthetic benefit of zirconia, with the accuracy, strength and long-term stability of a titanium-to-titanium connection between the implant and the abutment. The zirconia abutments are constructed for incisors (interior esthetic zone) and for pre-molars (posterior zone). The titanium base comes in a non-reflective gold finish for best esthetic results. Two titanium-zirconia abutment options are available: Non-cemented and Pre-cemented. Pre-cemented zirconia abutments come as a ready-to-use single units, manufactured from an anatomically designed zirconia component that is pre-cemented to a titanium base. Modification can be made by reduction only. Single unit pre-cemented abutments are available in pre-designed shapes for incisors and premolars.

Zirconia abutments

OT EQUATOR: Overdenture solutions

The OT Equators are low-profile overdenture and removable denture attachments that offer a variety of retentive solutions. With a functional height of 1.7mm, and a 2.5 diameter engagement area, it is ideal in cases of space limitations. Each abutment is supplied with a metal housing and five retentive nylon inserts; allowing for a wide range of retentive options. OT Equators are available for all MIS connection types and platform sizes, and in gingival heights of between 1-5mm. The OT Equators are the smallest attachment system on the market, and are made under license at MIS to ensure optimum accuracy at the implant-abutment connection. The titanium-nitride coating offers exceptional resistance to wear and ensures long-term continuous functionality.



Claudia P. Esparza, DDS, MBA and Samy Akerman, DDS, operating MIS Implants S.A.S in Colombia, Venezuela, Ecuador and Mexico.

MEET MIS DISTRIBUTOR SUPERSTARS

UNDER THE POTLIGHT

MIS is very proud of the high level of dedication and professionalism that all our business partners, distributors and sales reps provide to our customers. With a world-class distributor network in almost 70 locations spanning

5 continents, it wasn’t an easy task to select a single outstanding candidate to showcase for the current issue of the MNEWS.

Ms. Claudia P. Esparza and Mr. Samy Akerman


What Characteristics Make Up a Superstar?

A competitive nature is common to most successful business people, regardless of their area of expertise or cultural background. Whether in games, sports, or deal making, these people truly want to win; and are prepared to make greater sacrifices, work harder and learn every complexity of their industry in order to do it.

Typically, effective sales and marketing people are optimistic and upbeat. They have their down days, sure, yet they consistently bring a positive outlook to the table. Enthusiasm is not only refreshing, it’s contagious. Business may be serious and demanding but a positive attitude always helps in building profitable relationships.

Good sales and marketing people are also good teachers. They understand the importance of investing time in making their customers more knowledgeable and informed about products, processes and technologies. They desire to bring real value to their business relationships by building a strong professional reputation through rock-solid knowledge sharing.

MIS Implants S.A.S Partners Claudia and Samy are Pleased to Tell Their Story:

Dentistry Became Our Passion...

Since I was a kid, explains Claudia, I was attracted to social services, and later developed a deeper interest in health sciences. At university, although I liked medicine, I studied dentistry; which has become my passion. As much as I have loved practicing dentistry over the years, I have been steadily moving from the clinical field into the management and educational arena, which I find very rewarding. Each and every day is filled with wonderful experiences and professional achievements. Samy on the other hand, says that he first wanted to be a doctor. But before graduating from university realized he really didn’t want to spend his life inside of a hospital. It was at that point he decided to go into dentistry; continuing in the medical field without being confined to a hospital. Now, he enjoys the best of both worlds.

Motivated with MIS from the Start...

In 2003, when we first began, the field of implant dentistry in our country was very weak. Amongst an economically disadvantaged population, there was little demand for treatments. A few dental implant companies did exist, however most were unable to offer an appropriate infrastructure, logistics or reliable service. Also, there were very few trained clinicians capable of providing predictable treatments. We were motivated to become a distributor with MIS from the start; providing a great product and excellent service.

Furthermore, we were immediately inspired after our first meeting with Mr. Doron Peretz, Senior VP Marketing and Product Development. He is such a friendly, smart and confident man, who offered great encouragement in our efforts to start the business. Then, after getting to know the rest of the people at MIS, we knew without a doubt, we were in the right place at the right time. Alongside MIS, we have grown both personally and professionally, and are confident that the future holds many shared opportunities for us.

Steadily Branching Out for 10 Years...

We’ve been in business since 2003, starting here in Colombia, and steadily branching out in South America to include Venezuela and Ecuador, so we have been in the Latin American market for ten years. We now also operate in Mexico. We have over 100 staff members in our regional offices and another 100 affiliates working for us. The owners are: In Colombia and Ecuador; partners Claudia Esparza, Sammy Akerman and Morris Benisty. In Venezuela, our associates are Adriana, Veronica and Juan Carlos Tejeira; and in Mexico we have joined with Dr. Samuel Bukrinsky and Dr. Edgar Hernandez.

Unfair Competition & Other Challenges...

Latin America generally has a lower income population compared with the US or Europe, and dental implants and treatments anywhere in the world are not cheap. Product pricing is a critical issue for us. In order to sell more and grow our business, we not only need to keep prices competitive, we must also make it very clear

to dentists that we can provide them with substantial added value: Quality, customer support and educational strategies.

Competition is a challenge, like with most businesses in any industry. There’s a famous saying: “Imitation is the sincerest form of flattery”. There are companies out there telling customers that they are MIS but selling cheaper implants. MIS has earned a good name, that’s why these competitors want to capitalize on it, or even spread false rumors to discredit us. We need to maintain excellent marketing exposure to neutralize these kinds of tactics. We also face competition from the world’s largest implant company, who has a strong market presence, especially locally though their lecture circuits etc.

The Keys to Our Success...

Our Company has grown step-by-step, based on principles of integrity and customer satisfaction. We promote open communication with our sales staff, such as frequent departmental meetings to discuss difficulties and challenges. It takes time to get to know our market and the customers. We encourage a creative outlook and a commitment to building strong personal relationships. We tell our team: it’s not a matter of making a sale, the key to success is in developing loyalty and trust; creating a true partnership with our customers. If you provide excellence in both product training and service, then everything else seems to fall into place more easily - making it simple. Through our independent academic organization, Esparza Enclosed, we work with a passion teaching dentists the most advanced techniques in diagnosis, treatment planning and surgical and prosthodontic procedures.

Although there’s no magic formula for success, we have made great progress through an important mixture of ’good sense’ practices to achieve our business goals which include: Having a great product with a good ‘quality to price’ ratio, investment in aggressive marketing campaigns, maintaining a broad and comprehensive stock to give customers great service, providing top-class education and practical training to dentists in alliance with our distribution business, cultivating personal relationships with university leaders, dental clinics and public organizations, sponsoring of our annual event; which has become one of the largest dental implant industry events in Colombia, and last but not least – hard work!


Esparza Enclosed offices & training center

Esparza Enclosed Education…

Esparza Enclosed is a Training Center in Implant Dentistry and Dental Continuing Education. It is a Foundation offering clinical courses that provide good quality treatment to low income patients free of charge. We began in Colombia in 2006. Our first facility was a small rebuilt house, where we first introduced the advantages of the MIS system. There were only a few commercial implant brands at that time and MIS was new in Colombia. We knew from the beginning that MIS offered an excellent product and it became a priority to teach dentists how to use it properly

in order to provide predictable treatment for edentulous patients. We started with lectures and hands-on treatments with real patients, which was the most effective method of training.

Today, there exists a strong synergy between Esparza Enclosed and MIS Implants that allows us to function as an independent network linking scientific and clinical experts in the field of oral implantology. We develop research projects and all sorts of activities to expand knowledge of implant dentistry to achieve wellness for the patient. As an independent academic organization, EE aims for information exchange and contact between its members, their training centers and the dental industry.

Over 800 dentists visit our facilities annually for training in implant dentistry including; surgical and prosthodontic techniques, orthodontics, esthetic dentistry, facial esthetics, photography and more. We currently run nine modern, well-equipped Training Centers in Colombia, two in Venezuela, one in Ecuador and another in Mexico. We have an excellent team of lecturers; most are university professors. Our Institute is a reference center in Implant Dentistry Education worldwide, training dentists from Latin America, Poland, Canada, Germany, Australia, Israel, Turkey and other countries as well.

Continuing to Grow for the Future…

In countries where we have an established distribution network, MIS is very well positioned. Customers readily identify and associate our products with excellent service and scientific support. When we first started these conditions did not exist. Today, the amount of visitors to our facilities and the invitations we receive to take part in global, regional and local conferences, has demonstrated to the Latin American market that we are well-respected contenders. The strength of the MIS brand; our experience, expertise and dedication to quality really does speak for itself. The plan for the next five years is to continue growing in the market, overcoming the challenges related to unfair practices by competitors, developing more diverse leadership strategies, opening additional offices in Colombia, Ecuador, and Venezuela, and of course, providing even better service, education and support to our customers.

Claudia Recalls a Proud Personal Moment…

We are not only hard-working business people; we are also parents, sometimes striving to overcome the challenges of balancing parenthood with a successful career. However there are certain moments that occur in life that joyfully combine the two. The day we bought our new office, we placed a large dental implant replica in the front garden of the building; a perfect advertisement clearly visible from the street. My eldest daughter told me that in the morning when her school bus passed by our office, she proudly announced to all her friends: “That big implant you see there, that belongs to my family!” The recognition I received from my daughter was the best of all, and we are truly very proud of everything we have accomplished.

20 MNEWS 3rd Quarter, 2013

Ms. Claudia P. Esparza and Mr. Samy Akerman



The conference theme, 360 Degrees Implantology: From Science to Practice - How to Make It Simple, revolved around internationally recognized opinion leaders

sharing practical experience, new research and best business practices. “This was no ordinary conference,” explains Mr. Idan Kleifeld, MIS Implants CEO. “Throughout the

world, more doctors and patients than ever before are using and benefiting from dental implants. This has resulted in an urgent need for doctors and implant professionals not

ENERGY AND ENTHUSIASM FUELED THE 2nd MIS IMPLANTS GLOBAL CONFERENCE THAT HOSTED ABOUT 2000 PARTICIPANTS FROM OVER 60 COUNTRIES DURING AN EXCITING 3-DAY EVENT IN CANNES, FRANCE.

THE CANNES EXPERIENCE!

only to understand emerging technologies and techniques in theory, but to gain real practical knowledge of the latest implant products, tools and procedures.”

Idan continues, “MIS is unique in the industry by consistently providing a direct response to the needs of dental implant professionals. We bring to market top quality products and procedures engineered for design simplicity and efficiency; designed specifically to benefit doctors, laboratories, dental practices, and of course their patients.”

“First and foremost we are a business about people,” says Mr. Doron Peretz, MIS Implants Senior VP of Marketing and Product Development. “The entire MIS team is dedicated to the values built-in to every part of our work process - quality, service and innovation. We are proud to be world leaders

in a business that’s doing something good for people and we are committed to doing it right! Integrity, quality and hard work are the keys to building something great, as our recent MIS Global Conference proved, and it was a great success for everyone involved. “

The MIS Global Conference made the most of this world renowned venue for the Cannes Film festival by celebrating in style, with a red-carpet grand opening fit for the stars. It featured the unveiling of the beautifully designed new MIS video about the inspiration, innovation and motivation that brought to market some of the world’s best-selling implants. In addition, the MIS dental implants exhibit attracted a large crowd eager to engage with staff to learn more about MIS implant systems, prosthetics, accessories and bone grafting materials.

The conference fulfilled a dual purpose; not only boosting the market image of MIS as one of the largest global implant manufacturers, but also offering conference goers a marvelous vacation experience by organizing an unforgettable line-up of top-class entertainments. The exciting ‘Tour De MIS’ Charity Bike Ride kicked-off the conference, with a 50km and 70km route along the picturesque coastline of southern France in support of ‘Operation Smile’, a charity that specializes in the facial and dental reconstruction for children worldwide. The closing party was a stunning night out at the famous Gotha club in Cannes.




Paul A. Schnitman, DDS, MSD

27 MNEWS 4th Quarter, 201327 MNEWS 4th Quarter, 2013

A VISION FOR THE FUTURE

When did you start using dental implants?

In the late 60’s and early 70’s introductory courses on dental implants were starting to become available. In 1971, as a young dentist working in Connecticut, I became very excited by the idea of replacing teeth with implants instead of just fitting dentures. I saw an advertisement for a course being given at The Brookdale Hospital Medical Center in Brooklyn New York by Dr. A. Norman Cranin, a pioneer in implant dentistry. After I completed the course, Dr. Cranin invited me to be the first resident in the new Advanced Education Training Program for Implant Surgery and Prosthodontics that he was establishing – a collaboration between New York University and the Brookdale Hospital Medical Center. I accepted with great enthusiasm, and moved with my wife Phyllis to New York to become the first university trained implantologist.

MIS interview with Paul A. Schnitman,

DDS, MSD

FROM A PIONEER IN IMMEDIATE LOADING IMPLANTS


It was there, my work with implants began in earnest. Prior to the advent of root-form endosseous implants, most implants were either blade endosseous implants, in that the shape of the metal piece placed within the bone resembled a flat blade, or subperiosteal implants, in which a framework was constructed to lie upon the bone of the jaws. We started with research on dogs, testing blade implants with different loading conditions, because in those years implants were being placed in patients and restored between 2-4 weeks with unpredictable results. Many implants failed due to infection.

You are pioneer in immediate loading implants. How did you come up with that idea, when everyone else was following standard protocols?

I was passionate about dental implants being a superior solution, and was expanding on the idea of using different implant designs and loading conditions ever since my Masters Thesis in my implantology training program: submerging, neck-exposed with no abutment, neck-exposed with an abutment, and a bridge immediately placed on the implant at insertion (with the objective of identifying the relationship to loading).

However, moving forward at that time was a challenge. Academia held dental implants in little esteem, and although it was a popular idea with dentists because it could greatly

improve their patient’s quality of life by virtue of eliminating the need for a removable prostheses, still, results were unpredictable. Infection often set in early on, or after 4-5 years. Implant removal was difficult and associated with significant bone destruction with few options at that time for grafting and reconstruction. This was a disappointment to me; however I became even more determined to help solve these problems. I sought a place to do high level research and discussed my hopes with Dr. Paul Goldhaber, Dean of Harvard School of Dental Medicine. He in turn hooked me up with Dr. Leonard Shulman, who was the Principle Investigator of two NIH grants involved in basic clinical

research to discover the effect of surface design on implant acceptability in baboons, and a clinical trial in patients of the then new “space-age” carbon implant.

Clinical research takes years, and the dental implant industry was forging ahead quicker than our ability to answer research questions. For me it became clear that in order to make headway, we would need one of the then new NIH Consensus Development Conferences that dealt with the reality that the clinical application was outstripping science. We were awarded an NIH Consensus Development Conference grant which became known as the Harvard Conference on the Benefits and Risks of Dental

Implants, and the results of participants, clinicians, researchers, and academicians for the day were encouraging; 75% success rate for 5 years. As a result of this experience, I conducted a large NIH clinical trial; around the same time the Branemark implant with its 2 stage protocol was being introduced in Toronto Canada in 1982, with 90% and higher success rates. With results like these, it became clear we could anticipate dental implant surgery becoming a routine procedure.

So how did I start to immediate load 2-stage implants? My practice in the mid eighties was primarily full arch reconstructions for failing dentitions, and my patients didn’t want to wear dentures for an extended healing period. I knew from my early loading research with dogs and my clinical experience with blade implants that any implant we put into bone would stay stable for at least thee months. Armed with that knowledge, I started to place three implants to support a complete denture while submerging the 5 required implants adjacent to the immediately loaded implants. I fully expected the immediately loaded

implants to fail, however that would only be after the 5 submerged adjacent implants had osseintegrated. Well, to my surprise they didn’t fail and that was the beginning of immediate loading of 2-staged implants.

It was during this period I began to understand that in order to bring dental implant surgery into the mainstream we needed to create a standardized infrastructure for the training and education of implant practitioners, and not simply in order to refine basic research; which is time-consuming, costly and complex. Another factor was the patients themselves, who were eager to become recipients of implant technology, yet understandably, didn’t want to wait for long-delayed clinical results. With this vision for the future, I was given the opportunity to chair the world’s first ever university-based department of Implant Dentistry; embodying a full spectrum of formalized implant teaching, research and patient care.

What do you see as being the most important emerging technology in implant dentistry today?

The first digital treatment planning and guided surgery software was introduced in 2005. It was revolutionary; less invasive, quicker, and offered more precise placement. Precision placement was the really groundbreaking issue; elevating our success rates from free-hand placement of 88% up to 100% success rates with a virtual implant planning and guided system – and zero failed implants.

I think that virtual implant planning and guided implant surgery and restoration is the future, and should be taught to everyone in the field, not just veteran doctors. Within 5-10 years virtual planning and guided implant surgery will be the norm. It’s a big plus for the patient; however it will take a bit more time to overcome some of the obstacles to doctors; such as more prep time, new training for support staff, interfacing between lab and clinic, and the learning curve for new techniques, equipment and software. Virtual implant planning and guided implant surgery is already easier and more economical than it was just a few short years ago and its evolving quickly. For the future I see this technology being used to create 3D virtual teeth and restorations (also to combine with implants), eliminating the need for impressions or waxing crowns, speeding up the procedure and cutting down on patient visits.

Clinical research takes years, and the dental implant industry was forging ahead quicker than our ability to answer research questions...’’‘‘

MIS stands for Make It Simple. How do you think dental implantology can become simpler?

In my mind, we must make it simple for the doctor by developing standardized treatment guidelines. In this way the doctor can more readily identify the most efficient and cost effective course of action for routine cases

that will produce the best results. Then to create similar guidelines suited to more complex cases.

More advanced technology isn’t the only answer. In order to keep success rates high and achieve predictable results, we must provide doctors with quality, standardized education and training. Most implant companies focus solely on product development. However it’s equally as important to design more streamlined procedures as well. The goal would be to identify and categorize different types of cases, also defining complexity levels and extenuating conditions, and then providing the recommended options for effective and efficient procedures/treatments.

Another practical consideration in making it simpler is to reduce delay times for implant placement and loading. This is advantageous for both patients and doctors. Today, early or immediate loading following implant placement and immediate implant placement into the fresh extraction site with immediate loading, has become more widely accepted. It is popular due to reduced overall treatment

time, less trauma, a decrease in hard and soft tissue resorption, an increase in patient acceptance and better aesthetic results. Yet there are still no standard protocols in place for these procedures. According to the traditional protocols, 3-4 months of healing is required for the consolidation of an extraction socket. Add to this the 3-4 month osseointegration period and prosthetic treatment times and patients are often waiting up to 1 year for tooth replacement.

What are some of the challenges affecting the future of implant dentistry?

There’s not really that much new in the industry aside from improved techniques and materials to work with. We need to overcome the problems inherent with the increased usage of implants. With increased usage, there will be a greater need for retreatment. “Of paramount importance today is the standardization of dental implant protocols.” The most effective tool in tooth replacement will be the refinement and maturation of the education process – that’s really the key. We need to create an industry-approved, standardized curriculum and accepted treatment protocols for oral implantology, that takes into consideration the mouth as an organ approach; not merely focusing on an isolated implant procedure to fill a space, often amongst other questionable teeth.

Please tell us about the MIS Fellowship at HSDM. Why is it important? What are the future goals and plans of the MIS Fellowship?

The Harvard School of Dental Medicine (HSDM) now has an Implantology Fellowship sponsored by MIS Implants Technologies Ltd. The Fellowship provides for students who have a strong commitment to academics, with high quality training based on rigorous science from researchers and clinicians that will enable future implant practitioners to adopt new techniques and procedures that have already been validated. The Fellowship is an important step in creating evidence-based research for further development of streamlined protocols that will eventually make implants more affordable to a wider population. For the future, these clinical studies will help us find ways to standardize dental implant protocols and will be a critical step in evaluating new products and technologies. Candidates for the MIS Fellowship are identified by their potential to provide future leadership in implant dentistry.

The Harvard School of Dental Medicine (HSDM) is grateful for the confidence that MIS Implants Technologies has placed in the School by funding the MIS Implantology Fellowship. These funds have allowed the inaugural recipient to complete specialty training in both prosthodontics and periodontics in May 2013, providing a platform to contribute to the dental implant community and to become one of its future leaders.

The fellowship has made possible for the recipient to gain experience in making research presentations at the annual sessions of AO 2011 and 2012, 2013, AADR 2012, AAID 2012, and ACP 2012. Further, the MIS Fellow has become exposed to clinical trial research techniques through participation in the development of the MIS randomized controlled clinical trial protocol and IRB. We expect to launch that study in the third quarter of 2013. The first MIS Fellow’s work has raised the profile of the program, and the HSDM community is well aware of MIS as a socially responsible implant company advancing implant dentistry at the highest levels.

Now that the first Fellow has completed the program, it is appropriate to discuss the future of the Fellowship at HSDM. Since much has been learned about implant training during this inaugural fellowship, I believe that it would benefit both the field and MIS, if the Fellowship were to be continued for at least another year. During this time we will refine


SUCCESS RATES WITH FREE-HAND VS. GUIDED IMPLANT PLACEMENT

Paul A. Schnitman, DDS, MSD

Introducing the MGUIDE MORE, an advanced virtual dental implant planning and guided implantology system enabling real-time 2D and 3D visualization for perfect implant planning. Features include user friendly software, the production of an advanced open wire-frame template for accurate guided implantation with predictable prosthetic outcomes, special tool kit that eliminates the need for guidance keys, and support from our worldwide network of MCENTERS. Learn more at : www.mis-implants.com

WHEN VIRTUAL BECOMES REALITY

MAKE IT SIMPLE

© MIS Corporation. All Rights Reserved.

NEW!

®

SCAN THIS PAGEWITH LAYAR APP


the goals and objectives of the program in our efforts to determine the optimum training methods for academic implant clinical scholars and to provide a model for the future. Currently, university-based advanced education in Implant dentistry is provided in several ways: Dedicated implant programs providing both surgical and restorative components, oral and maxillofacial and periodontal programs providing the surgical training, and prosthodontic programs providing the restorative elements. During the first MIS Fellowship we looked at adding a periodontal program to a graduating prosthodontist. Now we would like to explore a new concept - the addition of full-blown implant surgery into a prosthodontics program in our quest to develop exceptional implant training in less time.

We are excited about the potential of this Fellowship and if it can be continued, we have already identified a qualified advanced

graduate resident who perfectly embodies the spirit and scholarship of the MIS Fellowship with a commitment to a full time future in academic implant dentistry. The student will complete the advanced graduate program in periodontology in 2014, and is a DDS with a PhD in immunology. The student will then be poised to become a leader in implant dentistry with a research interest in the study of peri-implantitis and implant clinical trials research as well as academic curriculum design. Becoming an MIS Fellow will allow this candidate to assist in the development of the pilot program to add in-depth implant surgery to the HSDM Advanced Graduate Prosthodontic Program.

‘‘ I think that virtual implant planning and guided implant surgery and restoration is the future, and should be taught to everyone in the field...

‘‘Paul A. Schnitman, DDS, MSD, limits his private practice to Implant Dentistry and is on the faculty at Harvard School of Dental Medicine. He is a Diplomate of the American Board of Oral Implantology/Implant Dentistry, Fellow of the Academy of Osseointegration and is a Fellow and a past President of the American Academy of Implant Dentistry and the American Board of Oral Implantology/Implant Dentistry. He is

founder and former Chairman of the Department of Implant Dentistry at the Harvard School of Dental Medicine. He has published widely, and lectures nationally and internationally on the subject of dental implants.

Introducing the MGUIDE MORE, an advanced virtual dental implant planning and guided implantology system enabling real-time 2D and 3D visualization for perfect implant planning. Features include user friendly software, the production of an advanced open wire-frame template for accurate guided implantation with predictable prosthetic outcomes, special tool kit that eliminates the need for guidance keys, and support from our worldwide network of MCENTERS. Learn more at : www.mis-implants.com

WHEN VIRTUAL BECOMES REALITY

MAKE IT SIMPLE

© MIS Corporation. All Rights Reserved.

NEW!

®


31 MNEWS 4th Quarter, 201331 MNEWS 4th Quarter, 2011

Ms. Mindy SpielmanMIS Biomaterials Product Manager


MIS has broadened our product portfolio to include the expanded 4BONE line; a total biomaterials solution package consisting of bovine, porcine and synthetic based products.

Bone grafting is necessary in cases where there is a lack of adequate maxillary or mandibular bone. Sufficient bone is needed in three dimensions to securely integrate with the implant. Improved bone height—which is very difficult to achieve—is particularly important to assure ample anchorage of the implant’s root-like shape because it has to support the mechanical stress of chewing, just like a natural tooth.

Bone grafting typically involves small minimally invasive interventions that can be managed quite easily in a dental clinic. While bone grafting in the past may have involved harvesting and using large quantities of the patient’s own bone (autogenous grafts), today however, one of the popular options available are xenografts, processed bone harvested from animals (i.e., cows). These grafts are generally comprised only of the mineral content of natural

bone, and have been sterilized with all organic material removed.

Using bovine bone as a graft material has become commonplace in most oral surgical offices today and has been a tried and proven technique for many years. A simplified explanation for the success of this form of grafting is that a bovine bone graft is placed to act as a “biological placeholder.” Initially, it mechanically prevents the collapse of the surrounding tissues, whether that is bone or soft tissue. Then, through a process called “guided bone regeneration,” the human body is fooled biochemically to recognize the graft as natural bone and over time resorbs and replaces it with the patient’s own native bone.

Flexibility is a key feature of the new 4BONE

product range. 4BONE products can be mixed together in various configurations to achieve more flexible treatment solutions, i.e. resorption time and types of bone matrix required. Products are packed in varying weights and volumes, for simple and easy delivery directly to the surgical site.

MIS ANNOUNCES THE EXPANSION OF ITS REGENERATIVE SOLUTIONS PRODUCT LINE: 4BONE®

NEXT GENERATION REGENERATIVE SOLUTIONS


MIS regenerative products also mix readily with other biomaterial brands.

MIS best serves our customers by providing a wide range of quality bone grafting materials, membranes and accessories to answer almost any clinical scenario. Quality equipment and design control processes assure high standards of sterilization and safety for all 4BONE products; making it safer and making it simple.

The new 4BONE series now includes the following products:

4BONE® XBM - Bovine Bone Matrix

XBM is an anorganic bovine bone mineral matrix for use in bone regeneration procedures, and recommended for use as a bone void filler or augmentation material in periodontal defects and dental implant procedures.

It is produced by removal of all organic components from bovine bone, leaving the natural mineral component for use as an osteoconductive material for bone regeneration. Due to its natural structure, 4BONE XBM is physically and chemically comparable to the mineralized matrix of human bone. The trabecular architecture

with interconnecting macro and micro pores, allows for the

optimal ingrowth of new vascularity and bone at the graft site and maximizes the potential for

angiogenesis.

4BONE® BCH - Synthetic Bone Substitute

BCH is a fully synthetic bioactive bone substitute composed of chemical synthesis of 60% HA and 40% ß-TCP. It is recommended for use as a bone augmentation material in dental implant procedures and periodontal defects.

With its interconnected micro and macro porosity and osteoconductive properties, BCH attracts osteogenic cells and promotes the diffusion of biological fluids, providing a guaranteed homogenous distribution and diffusion

of the two phases. BCH has optimized morphology and resorption properties to provide flexibility and a predictable healing process for a wide range of bone regeneration procedures.

BONDBONE® - Bonding Graft Material

BONDBONE® is an innovative synthetic bone grafting material composed of biphasic calcium sulfate. Due to it novel engineering process, BONDBONE has excellent handling properties. The initial pliable paste is fast setting and is not affected by the presence of blood and saliva.

This resorbable, osteoconductive bone grafting material takes the best qualities of hemihydrate and dehydrate calcium sulfate and combines them into one unique product. When combined with other augmentation products, it acts as a binder to improve graft stability and to increase volume and effectiveness of the bone graft. BONDBONE can be used by itself as a highly effective material for socket preservation procedures and the augmentation of small defects.

4BONE® RCB - Resorbable Conforming Barrier Membrane

RCB is engineered from highly purified Type I bovine collagen. It is a fully resorbable and adaptable cell occlusive barrier used in guided tissue regeneration and guided bone regeneration procedures in the areas of dental implants, bone defects and ridge augmentation.

Upon hydration, the barrier membrane easily adapts and adheres to all surgical sites and promotes healing of bone and soft tissue. RCB can be easily trimmed and does not deform or adhere to itself or instruments when hydrated. The optimal mechanical properties and high tensile strength of RCB allows for easy placement and adaptability in ridge augmentation procedures, due to its ability to naturally conform to the site where it is placed.

4BONE® RSB - Resorbable Collagen Barrier Membrane

RSB is a bioresorbable, cell occlusive membrane engineered from highly purified bovine collagen. It is indicated for use as a barrier membrane in guided tissue regeneration and guided bone regeneration procedures in the area of dental implants, bone defects and ridge augmentations.

Due to its optimal initial rigidity and defined stability, the RSB Membrane is the product of choice to prevent soft tissue ingrowth during healing in defects that lack bony wall support. Its semi-permeable properties permit the exchange of essential nutrients for healing, while the porosity qualities effectively hinder epithelial down growth; preventing gingiva connective tissue cell migration into the treated site. Optimal resorption time allows for sustained function during the healing process.

4BONE® PLUG and TAPE- Wound Dressings

4BONE PLUG and TAPE products are used following oral surgical procedures to control bleeding, stabilize blood clots and aid in wound healing. They are engineered from highly purified cross-linked type I bovine collagen with an optimal structure and thickness to allow the absorption of both fluid and blood at the defect site.

These sterile dental wound dressings are engineered from bovine Type I collagen. They protect the oral wound bed and controlling bleeding due the hemostatic properties of collagen fibers. Both the PLUG and TAPE are fully resorbed within 10-14 days.

RCM

RCB

BOND BONE®

XBM

PLUG

TAPE

RSB

®

BCH


Starting a new tradition, MIS has established a Clinical Case Competition to acknowledge outstanding young clinicians. The aim of the competition is to promote clinical excellence in dental implantology, and to open up the stage to young clinicians. Four recipients received awards on the topic of immediate placement and loading in the esthetic zone. The winning cases were presented at the 2nd MIS Global Meeting in Cannes, France.

WINNERS OF THE MIS CLINICAL CASE COMPETITION

COMPETITIONSR&D

*To see complete clinical cases visit our site: www.mis-implants.com

Dr. Paolo Cardelli“Immediate post-extraction implant with immediate provisional and simultaneous buccal ridge augmentation with composite graft.”

First Prize:

Dr. Joile Alvarez Cantoni“The combined use of MIS dental implants and BONDBONE, for immediate procedures in the esthetic zone.”

Second Prize:

Dr. Emilio Mateo Dr. James R. Collins“Minimally invasive surgery for post-extraction immediate implant C1 MIS with 4BONE graft and immediate

loading in the aesthetic zone.”

“Implant placement in the esthetic zone. Surgical and prosthetic management. Clinical case report.”

Third Prize shared:

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INTRODUCING THE -

MIS PRESENTATION APPLICATION

IT’S A GREAT APP!

The MIS TABCASE gives you the ability to show great looking, ready-made interactive presentations for offline viewing on IPads. It’s the new must-have tool for sales, demos, training and

general information pertaining to implant dentistry and support products and technologies. We offer an extensive collection of high quality presentations on a range of subjects.

Check out our collection regularly for new presentations.

APPLICATION

2013


OCTOBER

SEPTEMBER

UPCOMING EVENTS

All rights reserved. No part of this publication may be reproduced, transcribed, stored in an electronic retrieval system, translated into any language or computer language, or be transmitted in any form whatsoever, without the prior written consent of the publisher.

AAP

28 September, 2013Philadelphia, USA

Annual Congregation of Association of Hungarian Dentists

6 September, 2013Hungary

MIS Club Exclusive Club Event for MIS Users

3 October, 2013 Hungary, Budapest

AAOMS Annual Meeting

7-10 October, 2013 Orlando, FL, USA

AAID Southern/Northeast District Meeting

23-26 October, 2013 Phoenix JW Marriott, USA

DENTAL WORLD 2013 International Dental Exhibition and Conference

17 October, 2013 Budapest, Hungary

Congreso de la Asociacion Odontologica Argentina

28 October, 2013 Hotel Sheraton Buenos Aires, Argentina

ADA

31 October, 2013 New Orleans, LA, USAEAO

17-19 October, 2013 Dublin, Irland

DECEMBER

NOVEMBER

SEPTEMBER

Taipei Academy of Oral Implantology

2 November, 2013 Taipei, Taiwan

The fifth Prosthodontics Professional Committee

12-14 November, 2013 Wuhan, China

DIA Melbourne Campus(2 days/16 CEU)Basic Implantology

23-24 November, 2013 DIA Melbourne Campus

ADF Annual International Conference and Trade Exhibition 27-30 November, 2013 Paris, France

SECIB Sociedad de Cirugía Bucal 28-30 November, 2013 Madrid, Spain

GNYDM 29 November, 2013 Javits Center, New York City, USA

TAO 14-16 December, 2013 Taipei, Taiwan

THE FUTURE IS NOW! MAKE IT SIMPLEWe are pleased to invite you to join us in “Preparing for the Future of Implant Dentistry”, the theme for the 22nd Annual Scientific Congress of the EAO, to be held in Dublin, Ireland, October, 17th to 19th 2013. Learn about MIS Implants - visit our site: mis-implants.com.

Booth #G10To learn more about our innovative

products, please visit us at:

MAKE IT S I M P LE

Dublin, Ireland.

© MIS Corporation. All rights reserved.


Documents

MIS Magazine 5