Journal of Cosmetic Dentistry, Summer 2012Reprint from:

Research published in 1983documenting the long-term successof titanium screw implants which, by a process called Osseointegration,became firmly attached to bone,changed the course of implantdentistry.1,2 The Brånemark external hex implants used in that studyoffered a single abutment option for a screw-retained attachment of a hybrid prosthesis for restoring edentulous jaws.

The Core-Vent hollow basket implanthad been introduced in 1982.3 UnlikeBrånemark’s 0.7-mm short externalhex implant, the Core-Vent had an 8-mm deep internal hex for ratchetinginsertion and to receive a variety ofcemented abutments. This system was the first to document the useof freestanding implants to retain an overdenture, screw-retained baroverdentures, and single toothreplacements with bendable andcastable abutments.4

In 1986, Core-Vent introduced theScrew-Vent implant, featuring aninternal lead-in bevel, hex, andthreaded connection.5 This becamethe cornerstone of modern implantdesign and is today referred to as a“conical connection.” This advancepaved the way for greater use ofcemented restorations, which resultedin acceptance by general practitionersof fixed prosthetics on implants, as theprocedures more closely paralleled therestoration of natural teeth. Theinternal connection provided a greater tactile sense when seating anabutment, thus eliminating the needfor x-rays to determine whethertransfers and abutments were fullyseated. It also allowed for smaller-diameter implants with adequatestrength to be designed, therebyexpanding clinical applications.

Implant dentistry is a prostheticdiscipline with a surgical component;thus, Core-Vent’s system was designedfor simplified surgical procedures,allowing general practitioners to learn implant placement.

The key to proper training was toestablish educational courses thatfocused on case selection andtreatment planning.

In the three decades since the Core-Vent and Brånemark systemswere introduced, the number anddiversity of implant designs, surfacetreatments, and abutment optionshave proliferated. I believe this hasbeen spurred primarily by implantcompanies, in an attempt to justifyprice increases. Unfortunately, this has compounded the confusionassociated with selecting the implantsystem that best suits an individualdentist’s practice and budget.

In the 30 years I have been involvedwith the implant industry, my most

difficult task has been to overcome thestereotypical thinking that thereis a direct relationship between animplant’s cost and clinical success.Many implant companies use paidopinion leaders in private practiceand academia, along with large sales forces, to perpetuate this myth. Today, however, the Internet hasleveled the playing field, making itpossible to educate more dentists to the benefits and features of“appropriately priced” products—some with cross-compatibility tothe surgical protocols and prostheticconnections with which dentists arefamiliar. Offering application-specificimplants with All-in-1 Packagingsimplifies implant selection, eliminatesconfusion with ordering ancillaryproducts, and provides unprecedentedvalue, thus allowing more patients tobenefit from implant dentistry.Additionally, online education—aidedby live surgical videos, lectures,product comparisons, and, especially,online ordering—is changing theimplant industry’s dynamics.

Today, most patients know about thebenefits of implant solutions for theirmissing teeth, resulting in morerestorative dentists making theinvestment in education to be able tooffer these services in their practices.

Dr. Niznick graduated from the University ofManitoba Dental School in 1966 and earned aMaster’s degree in prosthodontics from IndianaUniversity in 1968. He has been awarded 36 U.S.Patents and has received honorary doctoratesfrom the University of Manitoba and Tel AvivUniversity. Dr. Niznick can be reached atdrniznick@implantdirect.com.

Disclosure: Dr. Niznick is founder and presidentof Implant Direct. He developed the Core-Ventsystem discussed in this editorial.

Implant Prosthodontics:Past, Present, and Future

References

1. Zarb GA. Introduction to osseointegration in clinicaldentistry. J Prosth Dent. 1983;49(6)824.

2. Kasemo B. Biocompatibility of titanium implants:surface science aspects. J Prosth Dent. 1983; 49(6)832-837.

3. Niznick G, inventor. Endosseous dental implantsystem for overdenture retention, crown and bridgesupport. United Statespatent US 4431416. 1984 Feb 14.

4. Niznick GA. The Core-Vent implant system. J OralImplantol. 1982;10(3):379-418.

5. Niznick G, inventor. Screw-type dental implant ancho.United States patent US 4960381. 1990 Oct 2. jCD