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Go with a winner

by: Dr. Scott MacLean

Don’t let the NobelActive revolution catch you by surprise!

Dr. Scott MacLean of Halifax, Nova Scotia, usually tells his patients that “people who have lost all their teeth, started out by losing just one.” It’s his job, he says, to prevent collateral damage and to prevent as much further tooth loss as possible. NobelActive is his primary means to that end.

Since its launch in 2008, the NobelActive implant has revolutionized my dental practice. My days in the operatory have changed enormously, and this product has redefined my model for implant care.

During the intervening years, my implant practice has grown from a few referrals made by my own dental partners to a steady stream of referrals coming from many other dentists, who entrust me with their patients for either solely surgical or surgical and restorative solutions.

Thanks to NobelActive, I can meet the needs of discerning patients who are prepared to invest in the quality of- life improvements that an implant- based restoration can provide.

I both enjoy my work and find it financially rewarding, but most of all, I am proud to be able to offer my patients a treatment option that causes no harm to adjacent teeth.

Patients I treat are very impressed with the level of care they receive as they undergo dental implant treatment. As a result, they tend to be highly motivated to replace any new missing teeth as soon as possible.

Without a doubt, NobelActive has been the catalyst for my success. The large thread design, with its dual, variable-pitch thread pattern, allows dentists like me to place this implant with an impressively high level of initial stability (compared to industry standards). The 3.2 mm tip of the RP 4.3 can be locked into bone at impressive torque in as little as 3 mm of bone height.

Most manufacturers offer “implant stability” at a maximum surgical torque of 45 Ncm, meaning that if you are able to reach this torque, then you can choose to temporize the implant.

By comparison, Nobel Biocare recommends that NobelActive can be torqued to 70 Ncm, which, in my experience, is routinely achieved.

Why is torque so important?

Initial stability is one of the critical factors for immediate placement. NobelActive gives me just that. I now offer emergency implant placements for my referring dentists. The patient can be in and out of my office in one hour using the extraction, implant placement and temporization techniques that I present on the Scott MacLean Channel on YouTube.

For both stability and success of integration — which are closely correlated — I am achieving 99% rates using NobelActive. Patients value this treatment service since it minimizes pain and precludes the need for temporary partials and interim healing before restoration.

NobelActive is a high-performance implant. Consider this analogy: In the same way you want an elevator cable to be able to bear at least double the load of the elevator you are riding in, you should also want your implants to be able to carry much more than the minimum load.

Many researchers have cited 35–45 Ncm as the initial torque required to perform immediate temporization.1,2,3 I ordinarily install the NobelActive implant at 70 Ncm in the maxilla. Being able to attain 70 Ncm is crucial for achieving the level of success required to routinely perform this protocol. Patients do not want to have this procedure done twice, after all.

This implant also has a moderately rough TiUnite surface, which considerably improves secondary stability, and the NobelActive prosthetic connection is almost too good to be true.

The platform shift, conical seal, and anti-rotational hex have been shown by meta-analysis to maintain crestal bone.4

It is important to me to have an implant that preserves bone and maintains soft tissue around the implant. The five-year results for my patients have been outstanding. I get a free shot of adrenalin whenever I take follow-up X-rays!

Appearances are important for my patients, who want restorations that look like the original. This implant delivers the goods!

Now that the NobelActive 3.0 mm implant has been introduced, I have a solution for tight upper laterals and lower incisors. The immediate placement protocol maintains the soft tissues exceptionally well. It is truly a pleasure to have this implant design in my repertoire.

Join me, won’t you? Get active with NobelActive!

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1 Garber DA. Immediate Total Tooth Replacement. Compendium March 2001 Vol 22 (3) 210-218

2 MacLean S. Case Report of an Immediate Placement and Temporization using a NobelActive Implant. Australasian Dental Practice Sept/Oct 2009 166-174

3 Lang NP et al. A Systematic Review on Survival and Success Rates of Implants Placed Immediately into Fresh Extraction Sockets after at least 1 year. Clin Oral Implants Res. 2012 Feb;23 Suppl 5:39-6

4 Atieh, M. Et al. Platform Switching for Marginal Bone Preservation Around Dental Implants: A Systematic Review and Meta-Analysis. Journal of Periodontology – 2010, Vol 81, No 10, 1350-1366

Garber DA. Salama H, Salama MA. Two stage versus one-stage – Is there really a controversy? J Periodontol. 2001;72;417-421.

Esposito M. et al. The Effectiveness of Immediate , Early, and Conventional Loading of Dental Implants: A Cochrane Systematic Review of Randomized Controlled Clinical Trials. Int J Oral Maxillofac Implants 2007;22:893-904