Overview
The Neoss Implant System provides a simple, easy to use means of anchorage for a single crown, bridge or denture thereby satisfying a wide range of aesthetic and functional requirements.
Simple implant installation and flexibility in prosthetic solutions provides optimal aesthetic restorations for a wide range of clinical variables.
Implant Design
The Neoss Implant is based on extensive research and development, the outcome of which is a state-of-the-art system, rationalised by design.
The implant has a patented design, geometry and surface that impart specific features and benefits to the system.
It may be used as a one or two-stage implant and is manufactured from Commercially Pure Titanium Grade IV with a subtractive surface. The implant system fulfils all clinical indications with a compact and rational range of implant components and instruments.
The Neoss Implant System incorporates TCF geometry combining both Thread Cutting and Thread Forming (TCF) features. This feature results in optimised stability in all bone qualities by a combination of thread cutting and compression thereby optimising stability in poor bone quality and minimising over compression in dense bone.
Thread cutting is provided by primary cutting faces at the apex of the implant. This ‘self tapping’ feature carries out the major part of the thread preparation process. Large bone clearance chambers preventing clogging and over compression are optimised to provide maximal bone to implant contact. Threads extending to the most apical portion of the implant achieve optimal stability of the implant along its length.
The implant is ‘double threaded’ and is designed with a positive tolerance to achieve compression and increase stability in poor quality bone.
In order to optimise stability and allow seating whilst minimizing over compression, a secondary cutting face (TCF design) engages and cuts dense bone areas compensating for the positive tolerance. This extends along the major threaded part of the body.
These features ensure that optimal stability is achieved using a single design of implant in all bone qualities. There is a unique relationship between the preparation site, instruments and the geometric features of the Neoss implant and the TCF design.
Neoss System Surfaces
Bimodal - The Neoss Bimodal implant has an altered surface. This surface has been subjected to a multistage blasting and cleaning process during production. The result of this process is a ‘bimodal’ surface which exhibits a coarse level of surface roughness over the threaded body of the implant to optimize bone interlocking and stress distribution. A superimposed fine level of surface roughness over the entire implant including the cutting faces and the flange. This ‘ultra clean’ surface is produced by a combination of cleaning and packaging methods.
ProActive - The Neoss ProActive implant is a commercially pure titanium implant with an altered surface. This surface has been subjected to a multistage blasting, etching, cleaning and chemical treatment. The result of this is an implant which exhibits a relatively coarse level of roughness over the threaded part of the implant and a reduced roughness over the flange of the implant. The surface is ultraclean and is produced by a combination of cleaning and packaging methods. A unique surface treatment enables the implant to achieve an ultra high level of wettability using a technique called Electrowetting. In combination, these features demonstrate an accelerated and increased strength of osseointegration in vivo in comparison to blasted and machined implants.
Instrumentation
The rationalised design of the Neoss Implant System enables implant placement and restoration to be carried out using the minimum number of components and instruments.
The Neoss implant is supplied in a kit as a ‘sterile blister pack’ containing the Implant, Cover Screw, Healing Abutments and Screw.
The Healing abutments are made from PEEK. The 5.0mm healing abutment engages the internal connection of the implant and the 2.7mm healing abutment is non-engaging.
The Neoss Implant System inserter engages the internal connection of the implant in a ‘no touch’ delivery method direct from the glass vial. The tip of the inserter also engages the cover screw to facilitate placement.
There is only ONE screwdriver connection in the Neoss System assortment which is used for all screws – Access Abutment components, Cover Screws, Provisional Screws, Impression Coping Screws, Laboratory and Neoss Gold Abutment Screws.
The torque ratchet is designed for the controlled manual insertion of implants and tightening abutment screws under a defined torque.
Titanium Healing Abutments are available in heights 2, 4, 6, 8 & 10mm.
The impression coping is designed for open tray or closed tray impression and is packaged with the implant replica.
Neoss' drill stop solution satisfies all clinical needs and provides improved safety, control and efficiency.
Indications
Dental implants from Neoss Limited are used as the means of anchorage between crowns, bridges or dentures and the surrounding bone in the upper or lower jaws. Such prostheses may range from replacement of a single tooth to an entire arch of bridgework and cement or screw retained restorations.
The Neoss Implants – Neoss Implant System are also intended for immediate placement and function on single tooth and/or multiple tooth applications recognizing sufficient bone stability and appropriate occlusal loading, to restore chewing function. Multiple tooth applications may be splinted with a bar.
Insufficient size or numbers of implants to support biomechanical loads or undesirable positioning of implants can lead to mechanical failures including fatigue fracture of implant fixtures, abutments or abutment screws.
Such an example is a narrow diameter implant in combination with large angulated abutments in the posterior region. Implant placement and prosthetic design must accommodate individual patient conditions such as bruxism or unfavorable jaw relationships to reduce the risk of overload or fatigue failure, and treatment is contraindicated if adequate accommodation cannot be accomplished.
Please consult appropriate surgical and restorative manuals and textbooks for information on treatment planning and medical evaluation. Dental implants need to be selected so that they provide an optimal connection and stability with the surrounding bone.
Neoss dental implants are contraindicated where bone of insufficient quality or quantity is available to produce adequate stability and support.
The design and construction of the abutment and prosthesis by the technician should incorporate appropriate retentive features for the prosthesis and should optimize the angulation between the implant fixtures and prosthesis such that applied loads are directed down the long axis of the implant.
Failure to achieve this can lead to excessive bending force and fatigue failure of the implant components.
Clinical Technique
Proper planning before surgery and correct preparation of the implant site ensures efficient and accurate installation. It is also expected that clinicians working with the Neoss Implant System have a good understanding of the principles of implant surgery and the restorative phase.
The position of the implant sites are determined and can be marked on the bone with a round bur, lance drill or the 2.2mm twist drill. Incremental site preparation is carried out as recommended. The ideal distance between each implant is 3.5–4.0mm which gives a minimum centre to centre distance of 7.0mm.
Pre-operative clinical and radiographic evaluations, together with the established overview of the jaw morphology play important roles in clinical decisions.
In partially edentulous situations the position of the fixtures and their relationship to the remaining dentition must be considered.
All preparation of the bone tissue is carried out under profuse irrigation with saline using an intermittent drilling technique. This prevents overheating of the bone and creates a pumping effect for efficient removal of bone debris.
After careful preparation of the surgical site the Neoss implant is inserted by means of the Implant Inserter. This is placed into the implant and manually rotated to engage the internal connection design of the implant. To ensure proper carrying capacity the inserter is then lightly pushed into the implant before being lifted out of the vial.
The machine installation of the implant is carried out at low speed – recommended maximum of 20 rpm. Torque control can be used – a maximum of 45 Ncm is recommended.
For a one stage surgical procedure the implant is commonly inserted so that the flange is positioned above the alveolar crest.
For a two stage surgical procedure the implant is commonly inserted so that the flange is level with the alveolar crest.
The Neoss System implant may be loaded at anytime – immediately, 6-8 weeks or after such time as the clinician deems appropriate based on their experience and the abovementioned criteria.
Aesthetic Solutions
Developing a natural soft tissue emergence profile during healing and/or provisionalisation is vital to ensure an aesthetic and functional outcome. Neoss Anatomical Healing Abutments are made from PEEK and have been designed in cooperation with world leading clinicians.
Neoss Anatomical Healing Abutments offer a selection of anatomical shapes ranging from lateral incisors to molars, which can be further customised to meet individual treatment demands. The component can serve both as a healing abutment and/or a provisional abutment.
Neoss Anatomical Healing Abutment features:
A range of anatomical shapes – Neoss Anatomical Healing Abutments create improved soft tissue architecture for virtually all clinical situations.
Flexibility and ease of use – Pre-made anatomical shapes reduce appointment and laboratory time. Components can be modified if necessary depending on the clinical situation. Supplied sterile with screw.
Multi-functional – Ideal for most cases as a healing or provisional abutment including early and immediate loading cases.
Cost-effective
Osstell
Osstell was invented in 1992 by Neil Meredith and Peter Cawley at Imperial College, London. It can be very difficult for a clinician to assess the healing and osseointegration of a dental implant. This can be important to assess at risk implants at placement, help determine healing periods and loading times and monitor the performance of implants over time. A range of methods have been investigated including measurement of cutting resistance during insertion and tapping with a mirror handle. However none of these experimental methods offer quantitive, reproducible and sensitive measurements.
Resonance Frequency Analysis (the principle on which Osstell is based) provides a highly accurate non-invasive clinical method to measure implant stability. The technique uses a simple ‘smartpeg’ to attach to an implant or abutment and a measurement is made by holding a probe near to the peg. The Implant Stability Quotient or ISQ value in the range 0-100 gives a value of the Primary Stability of an implant at placement or Secondary Stability which indicates the changes due to bone formation and osseointegration. In combination with a clinical evaluation, Osstell can be used to indicate the suitability of an implant for loading and identify potential problems at the earliest stage thereby minimising failures. Osstell is becoming the standard of care for the clinical assessment of implants in many countries.
Neoss is the major distributor for Osstell and offers unrivalled support and information thanks to its affiliation with the inventor.
