MLV144 REV C Laser-Lok Microchannels Overview

7/28/2019 MLV144 REV C Laser-Lok Microchannels Overview

http://slidepdf.com/reader/full/mlv144-rev-c-laser-lok-microchannels-overview 1/42

presented by name







Laser-Lok® microchannelsesthetics enhanced by technology

• only surface shown using human histology to

attract a physical, connective tissue attachment1

• superior crestal bone maintenance when

compared to traditional implants2

Innovation

1Based on human histology published in IJPRD, vol 28, no 2, 2008 compared to a pubmed search in

June 2009 on other systems.

2Based on a 3yr study published in Implant Dentistry, vol 18, no 1, 2009 compared to the 1.5-2mm of bone loss commonly reported with traditional implants.



VIP 2.1interactive 2D and 3D

treatment planning software- intuitive, user-friendly interface

- self-processing DICOM converter

- improved case predictability

and confidence

Innovation



3inOne abutmentcomes packaged with every bone-level implant

1) implant mount

2) impression coping

3) esthetic, gold-hued abutment

Innovation



Service

over 70 countries served

• one hundred direct reps• fifty-eight distributors

• seven direct markets

- US, Spain, Canada, UK,

Germany, Australia, Chile



Spain

AustraliaChile

Canada

Germany

United Kingdom

Over 70 countries served

Worldwide distribution network

United States

Service

Argentina

Bulgaria

China

Colombia

Costa Rica

Ecuador

Egypt

El Salvador

France

Ireland

Portugal ItalyGreece

RomaniaUkraine

PolandLithuania

Latvia

Russia

Turkey

Hungary

Mexico

Morocco

Peru

South Africa

Nigeria

Saudi Arabia

United Arab Emirates

IsraelLebanon Iran

India

Serbia

Taiwan

Japan

Thailand

Korea

Malaysia

Indonesia

Jordan

Kazakhstan

KuwaitLibya

Pakistan

Philippines

Hong Kong

New Zealand

Netherlands

Austria

Belgium

Luxembourg

FinlandIceland

DenmarkNorway

Sweden

Czech Republic

Malta

Slovenia

Slovakia

Estonia

Cyprus

Liechtenstein

Yemen

Singapore

Vietnam

Switzerland





biologic width around natural teeth

3mm avg. dimension

1mm

Sulcus

1mm

Epithelial

Attachment

1mm

Connective

Tissue



implants get close but are not

quite there

tissue level

at the time

of placement

bone level

at the time

of placement

microgap



typical bone loss

1-2mm commonly accepted



laser-lok more uniform than

other surfaces

SLA

Anodic oxidation(TiUnite)

*Resonance frequency measurements in vivo and related surface properties of magnesium-incorproated,micropatterned and magnesium-incorporated TiUnite, Osseotite, SLA and TiOblast implants. Sul YT, Jönsson J,

Yoon GS, Johansson C. Clin Oral Implants Res. 2009 Oct;20(10):1146-55.

blast textured

acid-etched

Laser-Lokmicrochannels

uniformmicro/nano

structure8-12 micron channels

all random surfaces0.72-1.34 microns avg. surface roughness *



laser-lok is cell-sized unlike

microthreads

NobelBiocare Astra BioHorizons

30X magnification

courtesy of Jack Ricci PhD (NYU)



300x magnification

~250µm

~200µm

16-24µm

cells respond to the

surface treatment

NobelBiocare

Astra

BioHorizons

courtesy of Jack Ricci PhD (NYU)



laser-lok encourages an optimal &

consistent cell response

ostoeblasts assume a flattened

fibroblastic morphology and spread

ostoeblasts perceive a smooth surface

ostoeblasts are unable to flatten and

spread and anchor to the surface

on a mixed topography the behavior

reflects the average of the morphologies

Boyan and Schwartz, chapter 21, Bone Engineering, 2000.





human histology shows epithelial

downgrowth inhibited

courtesy of Myron Nevins, DDS



polarized light shows functionally-oriented

collagen fibers

bone

functionally-oriented

collagen fibers

Laser-Lok

implant

images courtesy of Myron Nevins, DDS

natural

tooth

IJPRD 1998 18;321-331

how attached? Sharpey fibers in cementum



SEM’s show a physical

connective tissue attachment

scanning electron microscopy courtesy of Myron Nevins, DDS



prospective, controlled study

published

• two identical implants

- one with Laser-Lok

- one without Laser-Lok- placed in pairs

• four investigators

• 15 patients

• 20 pairs of implants

Clinical evaluation of laser microtexturing for soft tissue and bone attachment to dental

implants. GE Pecora, R Ceccarelli, M. Bonelli, H. Alexander, JL Ricci. Implant Dentistry, Vol

18(1). Feb 2009. pp.57-66.

OE

ES

EA

CT

CB



prospective, controlled study

protocol

• single stage, temporary out of occlusion

• restored at 4 months post-op

• none lost to follow-up• evaluated every other month from 1 to 37 months

- crestal bone loss

- probing depth

- plaque index- sulcular bleeding index

Clinical evaluation of laser microtexturing for soft tissue and bone attachment to dental

implants. GE Pecora, R Ceccarelli, M. Bonelli, H. Alexander, JL Ricci. Implant Dentistry, Vol

18(1). Feb 2009. pp.57-66.



improved crestal bone

maintenance

0.0

0.5

1.0

1.5

2.0

2.5

1 3 5 7 9 11 13 15 17 19 21 23 25 29 33 37

months

m m

control Laser-Lok

laser-lok

benefit

1.94mm

0.59mm

P<0.005 after month 5



shorter sulcus depth

0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

1 3 5 7 9 11 13 15 17 19 21 23 25 29 33 37

time (months)

m m

control Laser-Lok

laser-lokbenefit

3.60mm

2.30mm

P<0.005 for all time periods



-0.10

0.00

0.10

0.20

0.30

0.40

0.50

0.60

1 3 5 7 9 11 13 15 17 19 21 23 25 29 33 37

time (in months)

control Laser-Lok

laser-lok showed no increased bleeding

results not significantly different except months 21 and 37 where laser-lok was superior



pre-op at placement

6 months post-op4 months post-op2 months post-op

L C

L C

L C

sample study case



a controlled study of the bone retention qualities of

the Laser-Lok® dental implant

• 12 mos. overdenture model

• 60 implants- 30 Laser-Lok (15 loaded)

- 30 Nobel (15 loaded)• unloaded bone loss

- 0.29 vs 0.55mm (p=0.01)

• loaded bone loss- 0.42 vs 1.13mm (p<0.001)

• plaque & bleeding similar

• submitted for publication

Spyros Botos, DDS, MSD / Hoda Yousef, DMD, MS /

Barry Zweig, DMD / Saul Weiner, DDS. New JerseyDental School, Newark, NJ, USA



marginal tissue response to different

implant neck design

• canine model

• implants placed

in healed ridges

• harvested at 8 & 12 weeks

Marginal tissue response to different implant neck design.

HE Bae, BDS, MDS, MK Chung, DDS, PhD, IH Cha, DDS, PhD, DH Han, DDS, PhD.J Korean Acad Prosthodont 2008 Vol 46 No 6.

@ 12 weeks machined micro-thread Laser-Lok

bone-implant contact (%) 30.5 22.6 41.0

marginal bone loss (mm) 1.63 0.56 0.26

@ 8 weeks machined micro-thread Laser-Lok

bone-implant contact (%) 22.3 21.8 35.5

marginal bone loss (mm) 1.61 0.79 0.4



Dr. Shapoff’s retrospective study

• 41 patients / mean age 62 yrs

• 50 laser-lok implants

• 41 implants up to

2yrs post-restoration- crestal bone change:

0.44 ± 0.10mm

• 30 implants up to3yrs post-restoration

- crestal bone change:0.46 ± 0.12mm

• accepted to IJPRD0.00

0.10

0.20

0.30

0.40

0.50

0.60

0.70

2 yr 3 yr

C r e s t a l B o n e L o s s ( m m )

the mean crestal bone level change (mm)

during two different time frames

(courtesy of Cary Shapoff, DDS)

l l k hi f t i t ti



6 weeks

0

20

40

60

80

100

grit blasted

(titanium alloy)

grit blasted

(cp titanium)

microgrooved

% b

o n e i n - g r o

w t h

laser-lok achieves faster osseointegration

and higher bone in-growth*

*Osseointegration onmetallic implant surfaces:effects of microgeometryand growth factor

treatment. Frenkel SR,Simon J, Alexander H,Dennis M, Ricci JL. JBiomed Res.2002:63(6):706-13.



case review



Stuart Froum, DDS

New York University

pre-op 2 ½ years post-op

at placement

C Sh ff DDS



Cary Shapoff, DDS

Fairfield, CT

bone on collar at two years

C Sh ff DDS



Cary Shapoff, DDS

Fairfield, CT

• Male, 68, non-smoker

• failed endo-fracture

• immediate extraction placement

• 3mm gap (facial-palatal)

• freeze-dried bone,enamel matrix derivative,connective tissue graft

• 2nd stage surgery 3½ mo

t l di



one year post-loading

1 year second stage

courtesy of Cary Shapoff, DDS

C Sh ff DDS



Cary Shapoff, DDS,

Fairfield, CT

• female, high lip line• esthetic zone

6 months crestal bone

retention

at 8 years

8 years

note high bone

level on 1mm

prototype collar



bi ti l ti hi



preserve the bone

courtesy of Myron Nevins, DDS

a symbiotic relationship

preserve the tissue

l l k i il bl



laser-lok is available on

internal, single-stage, tapered internal





thank you

shop online at www.biohorizons.com



Documents

MLV144 REV C Laser-Lok Microchannels Overview