DBL Denti Bone Level Implant System

THE PHILOSOPHY BEHIND DENTI® BONE LEVEL IMPLANT

It has been known for long in oral endosseous implantology that a cone-shaped, varying-degree bone tissue resorption takes place around the shoulder of the implants inserted into the jaws using a two-stage surgical method within a few months after the second surgery. It is a fact proven by scientific methods that the peri-implant bone loss is primarily caused by the inflammation-inducing agents of the bacteria colonizing the micro-gap (the interface) between the implant body piece and the abutment.

We now know that a secure interface between the body piece and the abutment that inhibits bacterial colonization can be established using an implant body–abutment design that is based on a principle known as “self-locking cone” in mechanics.

The self-locking cone implant body–abutment interface must meet the following requirements:

  • the micro-gap on the interface must be no wider than 5µm
  • the abutment must not have micro-movements
  • the torque required to secure the abutment should preferably not exceed 25Ncm
  • the abutment must remain removable and replaceable if needed.

We have initiated the development of a new Denti® implant type that meets these demanding requirements in 2009. The result of this development is the Denti® BL (Bone Level) implant type. This implant is a perfect and safe choice for subcrestal (below bone level) implant placement.

PROVEN SHAPE DESIGN

The shape and surface of the Denti® two-stage Bone Level Root Form implants were designed based on theoretical considerations and long clinical experience, taking into account the most modern biomechanical principles. This implant is of universal use, that is, it covers all indications of oral implantology.

Bone Level Root Form Implant

  • a body piece design identical to the shape of the natural
  • dental root
  • excellent primary stability even in the case of lower bone quality (D3, D4)
  • the special design of the screw threads allows for immediate loading, that is, the healing of the peri-implant bone is not disturbed by the early loading of the implants
  • the threads on the neck piece facilitate quick regeneration of the peri-implant cortical bone
  • it transfers the masticatory forces evenly distributed into the bone, which prevents the early resorption of the peri-implant bone tissue
  • the esthetic shape and the inflammation-free status of the
  • peri-implant soft tissues are ensured and maintained for a long time by the use of platform switch abutments
  • because of the self-tapping design, the implant has an outstanding bone-condensing property. The implant exhibits high initial stability, and is associated with minimal peri-implant bone loss

UNIQUE THREAD DESIGN

The Denti® Bone Level implants have two different threads:

  • the thread on the apical two-third of the body piece is coarse-pitch
  • the upper third of the body piece contains microthreads
  • the conical design of the root form, its macrostructure and the special profile of its threads make it suitable for immediate functional loading, even in the case of lower bone quality
  • the special thread design on the neck piece prevents the resorption of the peri-implant bone tissue around the neck of the implant. The masticatory forces acting on the abutment are distributed evenly on the surface of the implant and transferred to the adjacent bone tissue without damaging it, and serve as physiological stimuli for the regeneration of the peri-implant bone tissue
  • the deep thread grooves and the self-tapping threads on the body piece of the implants ensure optimal primary stability even in soft bone, and facilitate and ensure osseointegration around the implant

Connection

Bacteria-free closure – micromovement-free implant–abutment connection

The self-locking cone surface is formed in the inlet of the neck piece of the Denti® Bone Level implant, and there is a hexagonal recess below it. This hexagonal design serves for the screwing-in of the body piece of the implant and the positioning of the abutment. From here a cylindrical bore starts in the apical direction, which receives the concentric skirt of the abutment. This tube-in-tube body piece–abutment design allows for the precise insertion of the abutment, and aids the damage-free elimination of the masticatory forces acting on the abutment. Below this, apically, there is the nest of the screw securing the abutment.

“TISSUE CARE CONCEPT” – TISSUE STABILITY

There are five criteria that are each required for permanently preserving the peri-implant tissues and their stability, and that have an important role in maintaining the esthetics and function of the denture retained on the implants and ensuring its long-term success.

These are the following:

  • no micro-gap between the body piece of the implant and the abutment
  • micromovement-free connection between the body piece and the abutment
  • subcrestal placement of the implant
  • wide platform switch between the implant and the abutment
  • veneer crown designed for microstructured implant shoulder (the abutment should be designed in accordance with the gingival margin so that the veneer crown can be placed following the course of the gingival margin)

The structure design of the Denti® BL implants fully meets these requirements. The optimal size and design of the angle of the internal cone and the high precision of the corresponding surface of the abutment ensure that there is no micro-gap on the interface, and that the abutment has no micro-movements. The hexagonal design below the cone facilitates the secure screwing-in of the body piece, whereas the apical cylindrical process has an important role in the optimal-direction transfer of the masticatory forces acting on the abutment. We recommend applying a torque of 25Ncm when tightening the through bolt that secures the abutment.

FOR ALL INDICATIONS

Denti® Bone Level implants are recommended for the replacement of all types of tooth losses:

  • for the replacement of single or short-span tooth losses
  • for a multi-unit fixed prosthesis for the replacement of tooth losses at the end of the   arch, or long-span or subtotal tooth losses
  • in case of total edentulousness

The position of the DBL implants, in relation to the surface of the bone, can be subcrestal, crestal or supracrestal, according to the prosthetic plan.

BL implants are of universal use: they are associated with high success rate in case of both two-stage and one-stage procedures, as well as transgingival surgical methods. Their placement is primarily recommended in esthetically important places, and in cases where the special abilities of the platform switch (preserving the peri-implant bone level and the integrity of the mucoperiosteum) are required.

The Denti® BL implant

TECHNICAL PROPERTIES

Material: Unalloyed, pure titanium (Grade 2)

THE SURFACE MICROSTRUCTURE OF DENTI BONE LEVEL IMPLANTS

In order to achieve optimal osseointegration, a microporous surface is created (using mechanical and chemical methods – sandblasting and passivation) on those parts of the Denti® Bone Level implants that are placed in the bone.

Surface design properties of Denti® titanium implants

  • microporous, passivated pure rutile surface
  • pore size: 10–25µm
  • high surface energy – rapid development of osseointegration
  • the microporous surface has increased hydrophilia
  • excellent primary stability in every type of bone tissue – there is only a small stability decrease between development of the primary and secondary stability – the secondary stability around it is achieved quickly and safely (in approximately 6 weeks).

SIZE RANGE

The best choice for every bone quality

Denti® Bone Level implants are available in 4 diameters and 4 lengths.

 
DIAMETER 3,8mm 4,3mm 4,8mm 5,3mm
LENGTH 9,5mm 9,5mm 9,5mm 9,5mm
11,5mm 11,5mm 11,5mm 11,5mm
13,5mm 13,5mm 13,5mm 13,5mm
15,5mm 15,5mm 15,5mm 15,5mm

PROSTHETIC AND LABORATORY ACCESSORIES

Denti® prosthetic components can be used for all indications:

  • all types of tooth replacement (single crowns, multi-unit bridges, telescopes, bridge prostheses and overdenture replacements)
  • diverse abutment types (universal, esthetic, shoulder, zirconium, temporary)
  • replacements secured by a screw or cementing
  • accessories made of traditional titanium or zirconium oxide base materials
  • healing abutments
  • artificial abutments with their direct and indirect advantages
  • laboratory implants
  • burnable casting tubes

The hygienic locking screw, the artificial abutments and the temporary abutment of the Denti® BL implants are made of hard plastic (PEEK). This is required in order to prevent the injury of the internal cone surface of the implant during the healing period.

INSTRUMENTS

instruments with replacement prosthetics

The surgical implant kit of the Denti® Bone Level Implant System – because of its shape design – is identical to that of the Denti® Root Form Implant System. The difference between the two instrument kits are the key for screwing in the body piece of the implant and the insertion key of the locking screw.

The surgical kit contains every instrument required for the surgical implant procedures and prosthetic procedures.

Because of their design, the instruments promote safe and trauma-free procedures.

Drills

  • are made of surgical stainless steel
  • are color coded for quick identification
  • are laser-engraved, indicating the depth and the diameter
  • can be sterilized in an autoclave
  • are available individually or in a set
  • have external cooling
  • can be used with either manual or mechanical drive

The instrument kit

  • is labeled and color-coded
  • has a deliberate, simple and user friendly drill and instrument layout
  • can be used simply and safely
  • can be resterilized several times without change in quality due to its special material

All instruments pertaining to the Denti® Bone Level Implant System are manufactured by Hager&Meisinger GmbH.

PACKAGING

The implants are packaged gamma-ray sterilised. Prosthetic components and instrumentation require autoclave sterilisation before use.

Color Code and signs

All components are featured by a colorization indicating their diameter. The purpose of color coding is to make usability easier both in surgical procedures as well as in prosthetic and laboratory stages.

The Denti® color codes are obtained by an electro-chemical reaction process without any adding of material and thus without any change of the titanium properties.