Restorative Overview
The Neoss Implant System comprises implants and abutments offering a logical and simplified approach for all treatment protocols including immediate and early loading, immediate placement and one or two stage placement.
The Neoss implant system is available in 5 diameters Ø3.5, 4.0, 4.5, 5.0 and 5.5mm and in addition there is a narrow Neoss Ø 3.25mm implant.
The packaging for Neoss implants and instruments used for a specific implant diameter (countersinks and screwtaps) have the following colour coding:
- Ø3.25mm Royal Blue
- Ø3.5mm Green
- Ø4.0mm Yellow
- Ø4.5mm Blue
- Ø5.0mm Peach
- Ø5.5mm Lilac
The Neoss implant has an internal connection. The implant is ‘picked up’ from a sterile glass vial with an Implant Inserter. The surgical drills provided are for single use and are delivered in a sterile condition for immediate use.
There is only one screwdriver connection in the assortment which is used for all components including covers screw, healing abutment screws and final abutment screws.
All Neoss implants, except Ø3.25, have a single abutment connection as there is a single platform for all standard implant diameters – simplifying the restorative phase, stock and instrument requirements.
Neoss implants are provided in kits which include a cover screw, two healing abutments (only 5mm with Ø3.25mm implant) and a healing screw. This complete delivery method allows the clinician to undertake either one or two stage surgery at time of placement without the need to have pre-ordered individual components.
There are also two stickers provided in the implant kit to assist in recording information on the patient’s chart.
Impressions
Generally to construct an accurate prosthesis using the Neoss System Abutments an Implant Level impression is required.
The exceptions are impressions with the Express and Access Abutment or when a Titanium Prepable Abutment is placed directly in the mouth and prepared intra-orally.
The purpose of an implant level impression is to accurately transfer to a laboratory model the position of the implant in relation to natural teeth or other implants as well as the soft tissue contours.
An Implant Level impression may be made at different stages during treatment and is dependant on operator preferences:
· At time of initial surgery – for one stage techniques, or to enable the delivery of a provisional crown at second stage surgery
· At second stage surgery
· Following soft tissue healing after a second stage surgical procedure
The Neoss System offers one Implant Level Impression Coping for both ‘Open’ and ‘Closed’ Tray impression techniques.
NeoLink™ - The Concept
The Neoss Implant System abutments have been designed to facilitate the fabrication of custom designed screw retained Gold, Titanium and Ceramic abutments or frameworks having a precision machined fit which are utilised in the production of cement or screw retained implant prosthesis.
Neoss abutments offer an efficient high accuracy prosthetic solution, whilst ensuring optimum quality control and offering an economical solution with numerous technical benefits.
The set of preformed plastic anatomical copings provide a complete range of abutment designs for different teeth, emergence profiles, heights and angulations.
There are a number of restorative options:
- CAD/CAM abutments/frameworks cemented or bonded to Titanium NeoLinks™. Bonding of CAD/CAM designed copings or frameworks may be done ‘prior to’ or ‘after’ application of the porcelain/restorative material.
- Invest and cast directly onto the Gold NeoLink™ with a suitable alloy.
- Remove the NeoLink™ from the waxed coping/framework and cast the anatomical coping/ framework (in a desired alloy) without the NeoLink™.
Three types of restorations can be produced; a restoration cemented onto custom abutments, a framework retained directly on the head of the implant fixture by abutment screws or an angulated screw retained solution using the Access abutment.
Because the cast abutment or framework can be bonded to the precision machined NeoLink™ a true passive fit can be achieved. Inaccuracies caused in casting or porcelain firing can therefore be eliminated.
Generally connection by cementation or bonding is carried out in the laboratory after the application of the restorative material.
CAD/CAM Solutions
For CAD/CAM abutments and frameworks: scan the abutment/framework according to the specific CAD/CAM system requirements. It is possible to produce abutments/frameworks with most major CAD/CAM systems. For further information contact your local Neoss representative.
Specific manufacturer’s guidelines in relation to investing, burnout times, temperatures, melting and casting should be adhered to.
When the abutment or framework has been cast the NeoLinks™ are relocated in the framework and reseated on the master model.
There are a number of cements and bonding materials suitable for this technique. The manufacturer’s recommendations should be adhered to.
Titanium Prepable Abutments
With the desire to simplify implant restorative procedures and make them more like conventional crown & bridge the use of straight and angulated prepable abutments has increased. They may be useful in either single or multiple unit prostheses which are then cement retained.
Prepable abutments may be placed directly into the patient’s mouth and prepared intra-orally or adjusted by the technician on a laboratory model.
The Neoss System offers Titanium prepable abutments in both straight 0° and 15° angulation with a collar height of 3mm and 1mm respectively and a maximum width of 5mm.
Express Abutments
The Neoss Express Abutment may be used to fabricate ‘cement retained’ crowns and partial bridges on Neoss System Implants in the maxilla and mandible. The Express Abutment is a pre-manufactured component and the fabrication process of the restoration is similar to that for conventional crowns and bridges. The impression is taken on the abutment level.
The Neoss System offers Express Abutments in collar heights of 0.7mm, 1.5mm and 2.5mm.
The Neoss Express Abutment is selected by the clinician in relation to the mucosal thickness. Depending on the specific requirements of individual cases, the Express Abutment may be placed at the time of initial surgery, at the time of second stage surgery or anytime thereafter.
Overdenture Solutions
Implant supported overdentures are a relatively simple and cost-effective treatment option for many patients. In some cases it is not necessary to construct a new prosthesis as the patient’s existing denture may be utilised. Implant supported overdentures may also be used as a provisional prosthesis.
There are three ways to retain implant supported overdentures using the Neoss system:
- Locator® Abutments
- Ball Abutments
- Bar Abutments
The use of ball abutments has traditionally been in the mandible utilising two implants.
Bar retained overdentures can either be rigid (multiple implants) or resilient (two implants) in design. Resilient designed overdentures are most commonly limited to the mandible and are implant retained and tissue borne. In the maxilla however bar retained overdentures are normally rigid in design and are implant retained and implant borne.
The Locator® Abutment is designed for use with full dentures or partial dentures retained by the Neoss Dental Implant in the maxilla or mandible. The self-locating design allows a patient to easily seat their denture.
Access Angulated Abutments
The Access Abutment design has wide-ranging applications for the Neoss system by enabling screw-retained straight and angulated restorations to be produced. Angulation may be as little as 10° with 4.5mm of interocclusal clearance.
The Access Abutment provides an axial straight or angulated extension to the implant. This facilitates working to, and restoration on, abutment level rather than directly on the implant.
The angulated 10°, 20° and 30° Access abutments optimise the screw access channel for implants with unfavorable angulations.
Restorations based on NeoLinks can be incorporated into gold, ceramic or solid frameworks in titanium or ceramic.
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.
