Teeth In An Hour

Editorial

As many of you know, Nobel Biocare has introduced a technique they call teeth in one hour. This technique has been widely marketed and involves producing a computer-generated surgical guide that can then be used to direct the placement of implants in an edentulous mandible or maxilla. After placement of implants and the placement of the abutments, a prefabricated bridge end is immediately placed. The technique, which combines computer-based surgical and prosthetic treatment planning associated with surgery without flap and immediate establishment of a permanent prosthesis in one sitting, seems on the surface to a major breakthrough in implant dentistry. Some of its benefits include a one-step procedure without flaps, Limited bleeding and pain after surgery, and the potential for treating fragile patients. However, there was little data to support this innovative approach. Preliminary data have shown a success rate in the range of 95%.

Recently, at the Fifth World Congress of osseointegration, which was held in Venice, Italy on February 15-17, 2007, Professor Bjorn Klinge presented a study on Nobel Biocare Teeth in an hour concept. The presentation was entitled successes and failures after computer-assisted virtual treatment planning for immediate loading of edentulous patients. It should be noted that Professor Klinge, Karolinska Institute is one of three independent MPA survey NobelDirect implant in Sweden. Professor Klinger single center data showed a complication rate of 29% to a maximum of three years of monitoring. Its data are based on the treatment of 31 arches and 175 implants. Professor Klinge was continued by saying that the rate of 71% of success is an overstatement of real success, since the current data are clinical in nature and does not include radiographic data. Therefore, the true success rate should be less than 71%. Dr. Klinge asserts that this technique remains in the exploratory phase.

I applaud Nobel Biocare visionary. However, whereas the gold standard for successful implant remains in the range of 95%, I personally have a hard time adding this technique (71% of success) to my protocol implant. It is my opinion that the acceleration of computer-aided implant protocols seem to be of clinical value. However, the practitioner must always perform a benefit / risk analysis before processing the scene. It seems that the failure rate of about 500% in an effort to expedite the processing is not something I'm comfortable.

In our practice we continue to provide immediate implant placement and immediate provisionalization fixed using an approach supported by clinical data published. In an article published in the COIR, Mr. Testori and I demonstrated a success rate of 99.38% implant over five years with immediate placement and restoration. While we continue to research combining computer-aided implant surgery and restoration, it remains part of a research protocol in our practice and should not be regarded as the standard of care until that available data are sufficient.

We must never lose sight that we are moving there are people attached to these implants.

Note: NobelGuide, teeth in one hour and NobelDirect is a registered trademark of Nobel Biocare.

Testori T, Meltzer A, Fabbro R, Troiano M, L Francetti, RL Weinstein. Immediate loading of implants OSSEOTITE occlusion in the edentulous mandible: a prospective multicenter study. Clin Oral Impl Res 2004; 15:278-284.