Dr. Svenja Rogge, a product manager at Nobel Biocare, recently sat down with Steve Hurson, the company’s chief scientist, to ask a few questions about the new NobelReplace Conical Connection implants.
Since NobelReplace was first launched in 1997, this tapered implant design has become the most widely used implant system in the world. Nobel Biocare is now making a conical connection available as part of this popular system. What benefits does this feature offer?
Steve Hurson: Experience from the NobelActive implant system demonstrates that even though conical connection implants can be used for all indications, they are best suited for single-tooth and partially edentulous applications. The Nobel Biocare conical connection implants have a tight seal, narrower emergence profile and platform shifting. This type of design has been shown to result in out-standing soft tissue volume and esthetics.
Is a move towards the conical connection something we are likely to see around the world?
Hurson: As we have seen with the success of the NobelActive implant system, there is definitely a global trend toward conical connection implants for the treatment of the partially edentulous patient.
For edentulous applications, the Replace Select Tapered implant placed with the smooth collar in the soft tissue—combined with a Nobel-Procera Implant Bridge or Implant Bar Overdenture—provides a cost-effective treatment that is hard to beat. This treatment plan results in soft tissue adhesion to the collar of the implant, which remains undisturbed during prosthetic manipulation.
Together with Dr. Jack Hahn, one of the pioneers in the field, you developed NobelReplace about 15 years ago. Which scientific research outcomes and clinical experience did you implement when you were designing the original system?
Hurson: Self-tapping parallel-walled implants were the predominant modality at the time of the Replace development. Dr. Hahn identified a need for an implant with a narrower apex, which would achieve higher primary stability in soft bone. The concept was to have an implant design that would have the tapered shape of a tooth root, for use in difficult-to-treat sites such as type 4 bone, extraction sockets, areas with converging roots and areas with labial undercuts. At the same time, this implant was designed to perform well in hard bone qualities, resulting in a system with outstanding allaround predictability.
NobelReplace has been developed continuously based on the latest scientific research on implants. What important developments have had a lasting influence on the system?
Hurson: Two aspects of the design stand out. The tapered shape of the implant combined with TiUnite (a porous, moderately rough titanium oxide implant surface) provides excellent primary stability and rapid osseointegration, allowing the clinician the flexibility to treatment plan for one- and two-stage healing—and immediate loading. The NobelReplace tri-channel connection is the easiest to use in the industry and was specifically designed to provide long-term trouble-free prosthetic solutions.
NobelReplace is now the most widely used implant system in the world. Why do you think this implant system is the first choice for so many clinicians?
Hurson: It all revolves around predictability and ease of use. The surgical system is state-of-the-art, setting the standard for kit design, color-coding and drill design. The predictability of the straightforward surgical protocol makes this the day-to-day system of choice for experienced surgeons, as well as for teaching new clinicians. Restorative dentists choose the system because the prosthetics are easy-to-use and have a proven track record of providing high-strength, long-term, trouble-free restorations.
The flexibility of the implant system is frequently referred to as one of its major assets. What does that mean exactly from a clinical and prosthetic point of view? Hurson: There is literally a product for every application ranging from single-tooth restorations to All-on-4 graftless solutions. In demanding esthetic situations, NobelReplace T pered and now NobelReplace Conical Connection are placed at bone level and can be restored with standard or customized abutments and NobelProcera Crowns. For posterior and edentulous applications, Replace Select and Replace Select TC implants may be placed in a one-stage application leaving the smooth collar to remain undisturbed in the soft tissue during prosthetic reconstruction.
We see a revival of screw-retained restorations in the industry. NobelProcera products range from full-contoured single crowns to full-arch frameworks in titanium and zirconia. These products set the standard for fit, strength and soft tissue health.