TEORIE ȘI HANDS-ON • 7 MAI 2018 • 10:00-18:00

INITIERE IN IMPLANTOLOGIE. BIOMATERIALE.

SISTEMUL ALPHA-BIO
ANATOMIE PARODONTALA

NOTIUNI DE ANATOMIE
• Parodontiul (periodontium)

• Tesutul peri-implantar (peri-implant soft tissue)

• Insertia epiteliala / gingivala (gingival attachment)

• Latimea biologica (Biological width)

• Gingia Fixa. Gingia atasata. (keratinised/fixed gingiva)

• Osul maxilar / mandibular

ANATOMIE

PARODONTIUL. TESUTUL PERI-IMPLANTAR

A. Sculean, Periodontal Regenerative Therapy

IMPLANT OSSEOINTEGRATION: SOFT-TISSUE AND BONE. SCHEMATIC DIAGRAM ILLUSTRATING THE HISTOMETRIC MEASUREMENTS. AJE, APICAL TERMINATION OF JUNCTIONAL EPITHELIUM; CT, SUPRACRESTAL CONNECTIVE TISSUE;
HPISB, HEIGHT OF THE PERI-IMPLANT SOFT TISSUE BARRIER; JE = JUNCTIONAL EPITHELIUM; PM, PERI-IMPLANT MUCOSAL MARGIN; SE, SULCULAR EPITHELIUM. (COURTESY OF GLAUSER R. CLIN IMPLANT DENT RELAT RES. 7(I), 2005;
WILEY-BLACKWELL).
 ANATOMIE

LATIMEA BIOLOGICA (BIOLOGICAL WIDTH)

Latime biologica = jonctiune epiteliala +

grosime tesut conjunctiv = 2,04-2,91mm

D. Buser, U. Belser, D. Wismeijer, ITI Treatment Guide

 ANATOMIE

INSERTIA EPITELIALA / GINGIVALA

• remodelarea osoasa pentru crearea

inelului gingival peri-implantar

• Latimea bilogica = dimensiunea

verticala a tesuturilor moi din jurul
implanturilor

• Celulele epiteliale sunt atasate prin

hemi-desmozomi si membrana bazala
Orientarea fibrelor de colagen la dintele natural vs implant
• fibrele conjuctive sunt orientate
paralel cu suprafata implantului
ANATOMIE PARODONTALA

GINGIA FIXA

• poate influenta durata de viata a implantului pe arcada (cf

studiilor) - prin persistenta inflamatiei si a sangerarilor

• considerente estetice

• protejeaza parodontiul de agresiuni externe (dinti naturali)

• stabilizeaza marginea gingivala oferind protectie importiva

fortelor mecanice
ANATOMIE PARODONTALA

GINGIA FIXA - DINTII NATURALI

• Gingia fixa - importante existentei ei la d. natural

• Gingia fixa - implant

 ANATOMIE PARODONTALA

GINGIA KERATINIZATA

• Lang & Loe, 1972 - min 2 mm

gingie keratinizata, din care
min 1 mm atasata.

• ≥2mm - stabilitate
parodontala

• <2mm - inflamatie

Gary Greenstein, DDS, MS; and John Cavallaro, DDS, The Clinical Significance of Keratinized Gingiva around Dental Implants, October 2011 Issue - Expires October 31st, 2014
Compendium of Continuing Education in Dentistry
ANATOMIE. FIZIOLOGIE

DINTE NATURAL VS. IMPLANT

ANATOMIE
Distanta dintre nivelul osos interproximal si nivelul osos pe vestibular

BIOTIPUL GINGIVAL
• subtire - dinti
triunghiulari, papile
alungite, margine
gingivala libera
fina, cu convexitate
accentuata pe
vestibular Shah R, Sowmya N K, Thomas R, Mehta DS. Periodontal biotype: Basics and clinical considerations. J Interdiscip Dentistry 2016;6:44-9

• gros - dinti mai

patrati, papile cu
aspect mai turtit,
margine gingivala
mai plina cu
convexitate mai
scazuta pe
vestibular
Bhat V, Shetty S. Prevalence of different gingival biotypes in individuals with varying forms of maxillary central incisors: A survey. J Dent Implant 2013;3:116-2

Relatia dintre forma incisivului central si biotipul gingival

ANATOMIE

GROSIMEA TESUTULUI MOALE INFLUENTEAZA NIVELUL OSULUI CRESTAL DIN JURUL IMPLANTURILOR
• Daca grosimea tesutului e 2.0 mm sau mai
putin, ne putem astepta la o rezorbtie osoasa
de pana la 1.45mm chiar si in cazul unei
jonctiuni bont/implant pozitionata supracrestal

• Daca grosimea tesutului moale e 2.5 mm

sau mai mult, putem anticipa o pierdere de os
de aprox 0.26mm

•Rezorbtia osoasa semnificativa poate fi evitata

prin plasarea jonctiunii bont/implant la aprox
2mm supracrestal; in aceasta situatie o
pieredere de os neglijabila, de aporx 0.2mm,
poate sa apara

T Linkevicius et al., J Oral Maxillofac Surg 68 (9), 2272-2277. 9 2010, ‘Influence of Thin Mucosal Tissues on Crestal Bone Stability Around Implants With Platform
Switching: A 1-Year Pilot Study’
ANATOMIE

GROSIMEA TESUTULUI MOALE INFLUENTEAZA NIVELUL OSULUI CRESTAL DIN JURUL IMPLANTURILOR
La evaluarea rezorbtiei de os din jurul implanturilor, masurarea grosimii tesuturilor
moi este obligatorie.

De aceea palsarea la nivel juxta-crestal a impalnturilor trebuie evitata in cazul unui

biotip subtire, prezent la locul implantarii, sau, daca este necesar, sa se faca
transformarea biotipului din subtire in gros

Intr-un studiu al lui Linkevicius et al. (2009), pieredera medie de os la 1 an a fost

corelata invers proportional cu grosimea tesulului peri-implant

• mucoasa peri-implant subtire, < 2 mm, pierdere de os insemnata

• mucoasa peri-implant medie, 2.1–3.0 mm

• mucoasa peri-implant groasa, > 3.1 mm, pierdere de os minima

In concluzie este important sa luam in considerare influenta pe care o are grosimea

mucoasei (biotipul) asupra stabilitatii osului crestal din jurul implantului, inaintea
inserarii acestuia, mai ales in zona estetica. (Linkevicius et al., 2009).
ANATOMIE

DENSITATEA OSOASA Misch bone density classification

FIZIOLOGIE

VINDECARE

• Latimea Biologica - formarea se definitiveaza la 6

saptamani (Morphogenesis of the mucosal attachment at implants (Berglundh et al
2006))
SELECTIA PACIENTULUI

FACTORI DE RISC GENERALI

• Factori demografici • Factori care tin de implant

• sex • implanturi scurte (<8mm)

• varsta • implanturi diametru redus (<4mm)

• Starea generala de sanatate • tratament de suprafata

• status medical compromis • Factori referitori la interventiile asociate

• fumatul • timpul devindecare al tesutului augmentat

• antecedente de boala parodontala • Alti factori

• tratamente endodontice anterioare ale dintelui • lipsa gingiei keratinizate

inlocuit prin implant
• igiena orala precara
• Factori anatomici
• acumularea de placa
• pozitia pe arcada a dintelui de inlocuit
• supra-incarcarea ocluzala
• calitatea osului

• pozitia de vecinatate cu alti dinti sau implanturi

(spatiul dintre)

• numarul de implanturi la acelasi pacient

SELECTIA PACIENTULUI

FACTORII DE RISC

Status Fumat Implant 2 timpi Implant 1 timp

1 an nefumator 97,1 91,1

fumator 88,2 67,6

5 ani nefumator 92,91 79,53

fumator 73,47 38,26

Valerie A. Vehemente, BS; Sung-Kiang Chuang, DMD, MD; Shadi Daher, DMD; Ali Muftu, DDS, MS; Thomas B. Dodson, DMD, MPH; “RISK FACTORS AFFECTING DENTAL
IMPLANT SURVIVAL”, Journal of Oral Implantology, pg:74, Vol. XXVIII/No. Two/2002
 SELECTIA PACIENTULUI

RATA DE SUPRAVIETUIRE A IMPLANTULUI

• Rata generala de supravietuire a implantului: 92,2% (Brocard et al. 2000) - 95% (Lindhe et al., 1998)

• Restaurari unidentare - 96,7%-97,5% (la 7 ani) Lindhe et al., 1998

• Restaurari partiale fixe - 92,5%-93,6% (la 7 ani) Lindhe et al., 1998

• Restaurari cu extensie - 94,4% Romeo et al. 2004

• Restaurari mixte, dinte - implant - 90,6% Romeo et al. 2004

• Restaurari tip supraprotezare - 95,7% Romeo et al. 2004

• diferente functie de localizare (maxilar, mandibula)

• diferente functie de tipul restaurarii (coroana solo, stalp punte, element mentinere supraproteza)

Sursa: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872851/
Comparison of Long-term Survival of Implants and Endodontically Treated Teeth
F.C. Setzer and S. Kim
J Dent Res. 2014 Jan; 93(1): 19–26.
SELECTIA PACIENTULUI

EVALUAREA RISCULUI ESTETIC

Esthetic Risk Factors Low Medium High

Healthy patient and Reduced immune

Medical status
intact immune system system
Light smoker (<10 Heavy smoker (>10
Smoking habit Non-smoker
cig/day) cig/day)
Patient’s esthetic
Low Medium High
expectation

Lip line Low Medium High

Medium-scalloped,
Gingival biotype Low-scalloped, thick High-scalloped, thin
medium-thick
Shape of tooth and
Rectangular Triangular
crowns
Infection at implant
None Chronic Acute
site
Bone level at adjacent <=5mm to contact 5,5 to 6,5 mm to
>=7mm
teeth point contact point
Restorative status of
Virgin Restored
neighbouring teeth
Width of edentulous 1 tooth (>=7mm) 1 tooth (<7mm)
2 teeth or more
space 1 tooth (>=5,5mm) 1 tooth (<5,5mm)

Soft-tissue anatomy Intact soft tissue Soft-tissue defects

Bone anatomy of Alveolar crest without Horizontal bone Vertical bone

alveolar crest bone deficiency deficency deficiency
SELECTIA PACIENTULUI

DIFICULTATEA CAZULUI
Risk or Degree of Difficulty
Site Factors
Low Moderate High

Bone Volume
Deficient, allowing simultaneous Deficient, require prior
Horizontal Adequate
augmentation augmentation
Small deficiency crestally, requiring slightly
deeper corono-apical implant position Deficient ridge requiring
Vertical Adequate Small definency apically due to proximity to prior augmentation
anatomical structures, requiring shorter than
standard implant length
Anatomic Risk
Proximity to vital anatomic structures Minimal risk of involvement Moderate risk of involvement High risk of involvement
Esthetic Risk
Esthetic zone No Yes
Biotype Thick Thin
Thickness of facial bone wall Sufficient >=1mm Insufficient <1mm
Complexity
Number of prior or simultaneous Implant placement without Implant placement with simultaneous Implant placement with
procedures adjunctivee procedures procedures staged procedures
Complications
Risk of surgical complications Minimal Moderate High
Severely compromised
Consequences of complications No adverse effect Suboptimal outcome
outcome
ALPHA-BIO

SISTEMUL ALPHA-BIO

Making Implantology Simple

SISTEMUL ALPHA-BIO

SMART IMPLATOLOGY SOLUTIONS. ALPHA-BIO 6 SMART IMPLANTOLOGY SOLUTIONS

Scan to view the

corporate movie:

Smart Implantology Solutions

• TRADITIE - de peste 25 ani leader in dezvoltarea si fabricarea
implanturilor, componentelor protetice, biomateialelor si instrumentelor
For over 25 years Alpha-Bio Tec has been a leader in developing, manufacturing and marketing
implants, prosthetics parts, biomaterials and a variety of dental surgical instrumentation.
Alpha-Bio Tec believes in making implantology simple, while manufacturing the highest
quality products for the global market and providing customers with the best service

chirurgicale
possible... Simplantology!

SIMPLICITY: Through advanced research and years of development, Alpha-Bio Tec offers implant
systems that are highly developed and easy to use, in most of clinical situations.

• SIMPLITATE - usurinta in utilizare, componente inter-schimbabile, trusa

At Alpha-Bio Tec we believe in making the work of dental professionals, dentists and lab technicians,
as easy as possible; that's why we have created a single prosthetic platform for Internal Hex
implant family, allowing prosthetic parts to be interchanged. Further evidence of our development
of 'simplicity' is the creation of a universal surgical kit, where surgeons have all the tools they need

chirurgicala unica
to perform any procedure.

All of Alpha-Bio Tec's new products are designed and developed with existing systems and tools in
mind, allowing for a minimal learning curve, reduced stocks and cost efficiency.

GLOBAL: Alpha-Bio Tec has strengthened its global sales and marketing team to focus its attention

• GLOBALIZARE - extindere la nivel global cu dezvoltarea continua a

on the varied needs of dental professionals worldwide. Alpha-Bio Tec is focused on broadening its
international reach in order to increase the feedback from the global marketplace, leading to even
more specialized products and services.

gamei de produse pentru a intampina nevoile oricarei piete

QUALITY: Alpha-Bio Tec has established strict quality system that complies with the highest level
of quality system standards.

Alpha-Bio Tec's products are cleared for marketing in the USA* and are CE-marked in accordance
with the Council Directive 93/42/EEC and Amendment 2007/47/EC. Alpha-Bio Tec complies
with EN ISO 13485:2012 and the Canadian Medical Devices Conformity Assessment System

• CALITATE - corespunde cu cele mai inalte standarde de calitate: USA si

(CMDCAS).

SERVICES: Alpha-Bio Tec highly values great customer service and sells its products through a
network of distributors and sales representatives worldwide. Alpha-Bio Tec's new Training and

CE (directiva 93/42/EEC si Amendamentul 2007/47/EC), precum si EN

Education Center provides highly professional courses, lectures, and practical training to dental
professionals around the world.

ISO 13485:2012
Alpha-Bio Tec provides a Lifetime Warranty on its range of implants, providing the implantologist
with peace of mind.

• SERVICII - retea internationala de distribuitori, centre de Training si

Educatie, Garantie pe Viata * Product availability may vary between countries. Some products may not be available in the USA.
ARTIS. ALPHA BIO. GEISTLICH

ALPHA-BIO. ARTIS

❑ Afacere de familie coordonata de Dr. Cristiana Bica, 25 de ani experienta in

industria stomatologica
❑ Focalizata pe implantologie, chirurgie orala si regenerare osoasa ghidata
❑ Echipa dedicata si instruita permanent
❑ Suport profesional chirurgie, implantologie, protetica, parodontologie si tehnica
dentara
❑ Organizator de evenimente in tara si strainatate
SISTEMUL ALPHA-BIO

SUPRAFATA IMPLANTULUI - NANOTEC TM

SEM of implant surface

Tianium alloy Ti 6AI 4V ELI

Suprapata NanoTecTM - suprafata hibrida obtinuta prin

sablare cu particule mari (20-20 microni) si dublu tratament
termic/acid pentru crearea de micro pori (1-5 microni).
Aceasta procedura face posibila realizarea unei
Magnification: X 100 Magnification: X 1000 Magnification: X 5000
microarhitecturi 3D ce promoveaza absorbtia rapida a
proteinelor din sange si plasma direct in micro-porozitatile Histology*
suprafetei, imediat dupa implantare.
Avantaje

• Faciliteaza atasarea precoce a osului de suprafata

implantului

• Atasare osoasa durabila

• Proces de osteointegrare accelerat si imbunatatit Magnification: X 10 Magnification: X 100 Magnification: X 200

• Perioada de vindecare scurtata * References: Light microscopy photography of non-decalcified histology staining toloidin blue. TUBIA of New Zealand rabbits.
The study of Dr. Omer Cohen and Prof. Ofer Moses, Tel-Aviv University. Histology performed in laboratory of Prof. Dr. Dr. Daniel Rothamel,
• Predictibilitate crescuta a rezultatului University of Cologne, 2014.
SISTEMUL ALPHA-BIO
Internal Hex PACK ARROW PACK

MULTI-FUNCTION PACKAGE Plastic holder

Cover screw

• Multiple posibilitati de inserare - Vial seal, transparent for increased visibility

cheia ratchet, piesa de mana,

FOR EXAMPLE FOR EXAMPLE
manerul port-implant, manual
The Multi-function Implant Package is based on extensive research and development. It presents new
SPI
Multi-function implant holder
ARRP
Ø 4.2 Label with implant name and dimensions Ø 3.3
L11.5 L10

• Simplitate si usurinta in utilizare -

Implant can be removed from the plastic holder and inserted into the bone in your method of choice:
acces usor la continutul ambalajului
The implant can be removed from the package and initially

The package is opened easily, allowing comfortable access to the implant

• Functionalitate - inscriptionare la
All the necessary details are clearly marked both on the patient label and on a round
vedere
The new package is a transparent blister with a transparent vial for optimal visibility

• Transparenta - vizibilitate optima a

continutului
MANUALLY SURGICAL TOOL MOUNT

• Steril - ambalaj dublu pentru o

siguranta sporita

RATCHET WRENCH SURGICAL SCREWDRIVER

SISTEMUL ALPHA-BIO

NEO PACKAGE
ALPHA-BIO

SISTEMUL ALPHA-BIO
• Simplitatea

• o singura trusa chirurgicala

• conexiune hex /con+hex

• Varietate dimensionala

• diametru 3.2-6mm

• lungime 6-16mm

• Solutii complexe pentru restaurari protetice

• Garantie pe viata
ALPHA-BIO

CLASE DE IMPLANTURI Implanturi

Transgingivale 
 Implanturi Temporare

Arrow Press
 Arrow

Conexiune conică Hexagon intern

2.5mm

NEO NICE SPI ICE DFI ATID

ALPHA-BIO

SISTEMUL DE IMPLANTURI CU HEX INTERN 2.5MM

ALPHA-BIO

ATID
• Implant cilindric

• condensare osoasa
• edentatii verticala prin design-ul
spirei
unidentare, partiale,
subtotale si totle • stabilitate primara buna

• tip os I si II • margine apicala

dreapta
• inaltime limitata a
crestei
6 MM

5 MM 6 MM
ALPHA BIO
DFI
• Edentatii unidentare,
partiale, subtotale si
totale
• Inaltime limitata a crestei
• In interventii care inclus si
sinus-lift intern sau extern
• Regenerare osoasa
ghidata
• Potrivit pentru toate
tipurile de os
• 1. Implant conic
• 2. Condensare osoasa
• 3. stabilitate primara
marita
• 4. spirele coronare
condenseaza osul prin care
au trecut spirele apicale
• 6. margine apicala dreapta
(previne leziunile
formatiunilor Anatomice)
 ALPHA BIO

ICE • 1. La nivelul cotetului este

con invers – pentru a
mentine corticala osoasa

•Pentru toate tipurile de
os
• Ideal pentru un os dur
• In interventii care inclus
si sinus-lift intern sau
extern
• Regenerare osoasa
ghidata
• 2. Condensare osoasa
• 3. Stabilitate primara marita
• 4. Spirele coronare
condenseaza osul prin care
au trecut spirele apicale
• 6. margine apicala dreapta
(previne leziunile
formatiunilor Anatomice)
• 7. Disponibil si in varianta
de 6mm lungime!
ALPHA BIO
SPI
•Edentatii unidentare,
partiale, subtotale si
totale
•Potrivit pentru toate
tipurile de os
•Implantare imediata si
inserare
•Regenerare osoasa
ghidata
•Sinus lift intern - extern
1. Primul implant spirala
2. Pasul filetului este mai mare (2x2.4 mm)
3. Proprietatea de condensare osoasa si
stabilitate primara puternica.
4. Autofiletant in directia insertiei.
5. Permite schimbarea directiei pentru pozitie
protetica optima.
6. Realizeaza osteotomie care conduce la
minimalizarea pierderii de os si trauma redusa.
7. Permite expandarea crestelor inguste.
8. Reduce riscul de lezare a dintilor vecini.
9. Reduce riscul de perforare a cortexulurilor
bucal sau lingual.
ALPHA-BIO

NICE (NARROW ICE)

•Edentatii unidentare,
partiale cu creasta limitata
•Potrivit pentru toate tipurile
de os
•Implantare imediata si
inserare
•Regenerare osoasa ghidata
•1. Proprietatea de condensare
osoasa si stabilitate primara
puternica.
•2. Autofiletant in directia insertiei.
•3. Permite schimbarea directiei
pentru pozitie protetica optima.
•4. Realizeaza osteotomie care
conduce la minimalizarea
pierderii de os si trauma redusa.

•5. Permite expandarea crestelor

inguste.

•6. Reduce riscul de lezare a

dintilor vecini.

3.2 mm •7. Reduce riscul de perforare a

cortexulurilor bucal sau lingual.
ALPHA-BIO

NEO - AVANTAJE CLINICE

• Conexiune solida si puternica

• simplitate in utilizare datorita compatibilitatii conexiunii deja

existente

• ‘platform switching’ pentru implanturile de diametru redus

• impregnare bacteriana redusa de-a lungul interfetei bont-

implant

• resorbtie osoasa crestala redusa

ALPHA-BIO

NEO
• Portiune coronara dreapta

• Corp cu conicitate redusa – 0.5°

• 3.5° conicitate apicala

• Forma de baza - conica

3.2 3.5 3.75 4.2 5

ALPHA-BIO

Soft bone, immediate

NEO - CARACTERISTICI High primary

stability
implantation & loading

Bone
condensing
CONSERVE IMPROVE

Fast insertion,
angle change

Narrow Enables most

apical part clinical
procedures

Narrow
Platform switching
diameters
Standard ▪ Internal Hex Connection
Diameter ▪ Hexagon - 2.5mm Modern
▪ Platform shifting (0.1-0.35mm) design

Reduce pressure
CONSERVE IMPROVE on cortical part

Bone
▪ Conical hex connection maintenance
Narrow ▪ Cone angle - 22.5°
▪ Hexagon - 2.1mm Increase
Diameter ▪ Platform shifting (~0.3mm)
Extend the clinical surface area
procedures: bone
ALPHA-BIO

SISTEME PROTETICE
Solutii complete pentru toate optiunile de restaurari protetice:

• Restaurari prin cimentare (inaltime bont > 4 mm)

• Restaurari insurubabile (inaltime bont < 3 mm)

• Sisteme CAD CAM

• Restaurari estetice si pe oxid de zirconiu

• Supraprotezare

• Reabilitare totala
ALPHA-BIO

SISTEME PROTETICE
Solutii complete pentru toate optiunile de restaurari protetice:

• Restaurari prin cimentare (inaltime bont > 4 mm)

• Restaurari insurubabile (inaltime bont < 3 mm)

• Sisteme CAD CAM

• Restaurari estetice si pe oxid de zirconiu

• Supraprotezare

• Reabilitare totala
ALPHA-BIO

SISTEME PROTETICE
Solutii complete pentru toate optiunile de restaurari protetice:

• Restaurari prin cimentare (inaltime bont > 4 mm)

• Restaurari insurubabile (inaltime bont < 3 mm)

• Sisteme CAD CAM

• Restaurari estetice si pe oxid de zirconiu

• Supraprotezare

• Reabilitare totala
ALPHA - BIO CAD CAM

CAD CAM RESTORATION LINE

• Dual use scan-bodies

• Titanium bases

• Adhesive copings

• Pre-milled blanks
CAD CAM RESTORATION WORK FLOW
10 CAD/CAM Ordering Information for Alpha-Bio Tec Solution Digital Solutions by Alpha-Bio Tec 11

Step 1 Step 2 Step 3 Step 4 Step 5

Restoration

Cli
b

b
b
nic

La

La

La
La

nic
Cli
work flow ·

To optimize your work simply

follow our 5 steps restoration
workflow. Before you begin,
please ensure that you and the
Take a Traditional Model Casting CAD Design CAM Cementation and
lab have all the required library
Impression & Scanning Manufacturing Final Restoration
files and restoration parts in
place, ready for use. What is required: What is required: What is required: What is required: What is required:
Standard ABT's Transfers- Standard ABT's libratory Library files are available for CAM systems that can Ti Bases for cemented or
For detailed ordering information, Please choose from ABT's Analogs - Please choose from leading CAD/CAM systems. produce parts designed by our adhesive copings for screw
refer to the CAD/CAM catalog catalog. ABT's catalog. Please refer to our updated supported CAD systems. retained level.
on our website at: Standard tray and impression Dual use scan bodies list of supported systems Please refer to the updated list Cementation materials.

IH
materials (Open or closed). Multi Unit parts- available on our web site: of our supported CAD Abutment screws (provided
www.alpha-bio.net when required. www.alpha-bio.net systems available on our web with the bases/copings)
Tips: site at: www.alpha-bio.net

Tips: For screw retained, place

TCT-N or TSA-N on analog or
For best accuracy take
use special screw retained
impression at the desired
analogs.
restoration level
Place respective scan
(Implant or screw retained).
abutment for scan.
Scan at desired restoration
level (Implant or screw retained).

Or
Take a Digital Impression
(Intraoral Scanning) Tips: Tips: Tips:
Library files are available in 2 Choose glue gap according Refer to IFU for resin cement
What is required:
nic

versions: Regular or wide glue to technology and system type recommendation.

Send File to Lab

Dual Use Scan Bodies gap. (use wide glue gap when instructions used. Choose engaged or non
Cli

restoration is manufactured For best results, milling engaged parts according to

using laser sintering) strategy and choice of tools restoration type.
should be considered. When cementation performed
CHC

in a patients mouth, make sure

you unattach after hardening
Tips: and remove excessive glue.
No need for anti-glare spray
For best accuracy take impression at the desired
restoration level (implant or screw retained)
Dental Wings, AmannGirrbach, 3shape, exocad and egs are trademarks or registered trademarks of their respective owners: Dental Wings
Available for Internal Hex & Conical Hex Connection
LLc., Amann Gribbach AG, 3Shape A/S, exocad GmbH and E.G.S S.r.l. Alpha Bio Tec. is neither endorsed, nor sponsored, nor affiliated with the
platforms owners of these trademarks or registered trademarks.
 ALPHA-BIO

PROTOCOL DE INSERARE

1. Incizia
2. Marcarea - round burr
3. Forarea primara - pilot drill
4. Verificarea paralelismului si adancimii - parallel gauge
5. Forarea secundara progresiva - twist drill
6. Prepararea corticala - cortical drill
7. Inserarea implantului
8. Sutura (Cover screw/ healing abutment)
9. Descoperirea implantului
ALPHA-BIO

PROTOCOL DE INSERARE timpul protetic

timpul chirurgical
ALPHA-BIO. HANDS-ON

PROTOCOL LUCRU

• utilizarea stopperelor

• siguranta

• protectia structurilor
anatolice invecinate

• precizia adancimii
forajului
ALPHA-BIO. HANDS-ON

PROTOCOL LUCRU

• Freze drepte

• Freze ‘step’

• Stopper-e
ALPHA-BIO. HANDS-ON

PROTOCOL LUCRU
ALPHA-BIO. HANDS-ON

IMPLANTARE GHIDATA
PROTOCOL INSERARE. GUIDED SURGERY
PROTOCOL INSERARE. INCIZIA
PROTOCOL INSERARE. SUTURA
PROTOCOL INSERARE
PROTOCOL INSERARE

POZITIA IMPLANTULUI
PROTOCOL INSERARE

POZITIA IMPLANTULUI. DISTANTA DE SIGURANTA

VIDEO animation - Alpha-Bio - Implant insertion
PROTOCOL INSERARE

TIPURI DE INCIZII -

•Incizia primara - orientare fata de mijlocul crestei edentate

•Incizia secundara - de descarcare (intrasulculara, simpla

sau extinsa)

•Incizia cu conservarea papilara 1 (in ‘H’)

•Incizia cu conservarea papilara 2 (in ‘U’)

PROTOCOL INSERARE - INCIZIA

Incizia cu conservarea papilara

in ‘H’
PROTOCOL INSERARE - INCIZIA

Incizia cu descarcare
verticala, lambou
trapezoidal, muco-periostal

Incizia cu descarcare
intrasulculara dintii vecini,
lambou ‘plic’, muco-periostal

Incizia cu conservare
papilara, in “U”
PROTOCOL INSERARE - INCIZIA

Incizia cu conservare
papilara in “U”, cu
posibilitatea de rotire a
lamboului vestibular
PROTOCOL INSERARE. INCIZIA. SUTURA
PROTOCOL INSERARE. INCIZIA. SUTURA
PROTOCOL INSERARE. INCIZIA. SUTURA
PROTOCOL INSERARE. INCIZIA. SUTURA
CAD CAM - INTRAORAL SCANNING

63
REGENERARE TISULARA

REGENERAREA TISULARA GHIDATA. REGENERAREA OSOASA GHIDATA

 REGENERAREA OSOASA GHIDATA. REGENERAREA TISULARA GHIDATA

REGENERAREA TISULARA GHIDATA (GTR)

• are ca scop refacerea tesuturilor moi si ligamentului periodontal, din jurul dintilor
naturali, prin fibre de colagen corect orientate si organizate, inserate in cement
nou format si os regenerat.

• se adreseaza defectelor osoase produse prin rezorbtie in cadrul bolii parodontale

GBR GTR

S. Nyman, J. Lindhe, T. Karring, and H. Rylander, “New attachment following surgical treatment of
human periodontal disease,” Journal of Clinical Periodontology, vol. 9, no. 4, pp. 290– 296, 1982.
 REGENERAREA OSOASA GHIDATA. REGENERAREA TISULARA GHIDATA

REGENERAREA OSOASA GHIDATA (GBR)

• are ca scop mentinerea volumului alveolei post-extractionale care tinde in mod
natural sa se modifice

• reconstruirea volumului osos pierdut postextractional in vederea inserarii unui

implant dentar

• corectarea dehiscentelor si fenestratiilor peri-implant

• reconstructia osului din jurul implanturilor, pierdut prin peri-implantita

GBR GTR
A. Linde, P. Alberius, C. Dahlin, K. Bjurstam, and Y. Sundin, “Osteopromotion: a so
-tissue exclusion principle using a membrane for bone healing and bone
neogenesis,” Journal of Periodontology, vol. 64, no. 11, pp. 1116–1128, 1993.
 REGENERAREA OSOASA GHIDATA. REGENERAREA TISULARA GHIDATA

FACTORI DE PROGNOSTIC - GBR/GTR

1. U.M.Wikesjo and R.Nilve ú s,“Periodontal repair in dogs:
• stabilitatea cheagului (1, 2) effect of wound stabilisation on healing,” Journal of
Periodontology, vol. 61, no. 12, pp. 719–724, 1990.
• vindecare per-primam 2. J. M. Haney, R. E. Nilve u
́ s, P. J. McMillan, and U. M.
Wikesjo ̈ , “Periodontal repair in dogs: expanded
• izolarea defectului de tesutul moale polytetrafluoroethylene barrier membranes support
wound stabilisation and enhance bone regeneration,”
Journal of Periodontology, vol. 64, no. 9, pp. 883–890,
(efectul de bariera) 1993.

• mentinerea spatiului (3, 4)

3. G. Polimeni, A. V. Xiropaidis, and U. M. E. Wikesjo ̈ , “Biology and principles of periodontal wound
healing/regeneration,” Periodontology 2000, vol. 41, no. 1, pp. 30–47, 2006.

4. M. Retzepi and N. Donos, “Guided bone regeneration: bio- logical principle and therapeutic
applications,” Clinical Oral Implants Research, vol. 21, no. 6, pp. 567–576, 2010.
REGENERAREA OSOASA GHIDATA. REGENERAREA TISULARA GHIDATA

REGENERARE TISULARA GHIDATA

membrana = bariera pentru tesutul epitelial
REGENERAREA OSOASA GHIDATA. REGENERAREA TISULARA GHIDATA

REGENERARE OSOASA GHIDATA

 REGENERARE TISULARA

BIOMATERIALE GEISTLICH
•Lider mondial in
Geistlich Bio-Oss®
regenerarea osoasa si
tisulara Geistlich Bio-Oss Pen® Alveola post-extractionala Augmentari osoase minore

•Substituenti ososi si Geistlich Bio-Oss® Collagen

membrane resorbabile
Geistlich Bio-Gide®
•Cercetare
Geistlich Bio-Gide® Compressed Regenerarea tesutului moale Augmentari osoase majore
internationala in peste
150 de universitati, cu Geistlich Bio-Gide® Perio
peste 100 de studii
Geistlich Combi-Kit Collagen
aflate in derulare, in
prezent. Perio-System Combi-Pack
Defectele parodontale
Peri-implantita

•Rezultate clinice pe Geistlich Mucograft®

termen lung, de Geistlich Mucograft® Seal
aproape
Geistlich Fibro-gide®
• 30 de ani Liftingul de sinus
LINIA DE PRODUSE

BIO-OSS Pictures by Geistlich Pharma AG,

Os Uman(50x) Geistlich Bio-Oss® (50x)

HA/ß-TCP (87x) Granule de sticla (50x)

LINIA DE PRODUSE GEISTLICH

BIO-OSS GRANULATIE MICA SI MARE

Granulatie mica: 0.25-1mm

0.25g, 0.5g, 2g

1g ≅ 2.05cm3
• Pentru defecte cu
•Pentru defecte mari
dimensiuni de pana la 2
alveole
•spatiu mai mare
intre granule
• Pentru conturarea Granulatie mare: 1-2mm
blocurilor autogene
•regenerare
(permite contactul 0.5g, 2g
imbunatatita in
apropiat cu peretii ososi
spatii ample 1g ≅ 3.13cm3
invecinati)
LINIA DE PRODUSE GEISTLICH

BIO-OSS COLLAGEN
• Geistlich Bio-Oss® Collagen

• 100mg spongiosa granules +

10% collagen (porcin)

• 0.2 – 0.3 cm3

• Pentru defecte mici, prezervare de

creasta si alveola si defecte parodontale
• 250mg spongiosa granules +
10% collagen (porcin)

• 0.5 – 0.6 cm3

 LINIA DE PRODUSE GEISTLICH

BIO-GIDE

• Membrana naturala de colagen

• Origine porcina

• Design bistratificat datorita

proceselor de productie
specifice

• Dual-layer
GBR GTR
• Structura naturala a fibrelor
 LINIA DE PRODUSE GEISTLICH

BIO-GIDE (DUAL LAYER)

Pictures by Geistlich Pharma AG, Wolhusen

Pictures by Prof. Benner, Munich

Functie de bariera, ghid pentru Membrana 3-dimensionala pentru Geistlich Bio-Gide®
 Structura mebranei 

celulele de granulatie + vase de integrare tisulara Structura naturala de colagen Schneideriene umane
sange Stratul rugos (SEM 3000x) (SEM 2000x) (SEM 2000x)
Stratul compact de la suprafata
(Scanare cu microscop electronic
(SEM) 1500x)
LINIA DE PRODUSE GEISTLICH

BIO-GIDE (DUAL LAYER)

Geistlich Bio-Gide® 25 x 25 mm:

à defecte mici in implantologie

Geistlich Bio-Gide® 30 x 40 mm:

à Defecte mari in implantologie

à Utilizare in tehnica dublu strat

Geistlich Bio-Gide® Compressed

à Defecte mari in implantologie (sausage

technique), augmentare orizontala si verticala

à Mai fermă, mai usor de manevrat

LINIA DE PRODUSE GEISTLICH

BIO-GIDE PERIO

Geistlich Bio-Gide® Perio 16 x 22 mm

Cu sabloane de taiere:

à Aceleasi proprietati biologice ca si

Geistlich Bio-Gide®

à Suprafata superioara este netezita

pentru a prelungi timpul de absortie
LINIA DE PRODUSE GEISTLICH

COMBI-PACK

Combi-System Combi-Pack

(Geistlich Bio-Gide® Perio 16 x 22 mm

cu sabloane sterile + Geistlich Bio-Oss®
Collagen 100 mg):

Combi-Kit Collagen

(Geistlich Bio-Gide® 16 x 22 mm +
Geistlich Bio-Oss® Collagen 100 mg):
LINIA DE PRODUSE GEISTLICH

MUCOGRAFT Geistlich Mucograft este destinat augmentarii tesuturilor moi de la

nivelul cavitatii orale, de exemplu in:

• Proceduri de regenerare tisulara ghidata;

• Reconstructia crestei alveolare;

• Augmentarea tesuturilor moi in jurul implanturilor si a dintilor

naturali;

• Augmentarea alveolelor postextractionale;

• Augmentarea defectelor osoase dupa rezectie apicala,

chistectomie, odontectomii;

• In procedurile de regenerare osoasa ghidata (GBR)

LINIA DE PRODUSE GEISTLICH

FIBRO-GIDE
• Matrice de colagen,
resorbabila, cu volum
constant, structura poroasa,
de origine porcina.

• Colagen cross-linked,
promoveaza angiogeneza,
formarea de testut conjunctiv
in vindecarea inchisa

• Este o buna alternativa la

grefa de tesut conjunctiv
(CTG)
LINIA DE PRODUSE GEISTLICH

MEMBRANE COLAGEN - INDICATII

Implantologie:

1. Dehiscente, fenestratii

2. Obtinerea zonei de gingie keratinizata

3. Prezervare alveola postextractionala

Parodontologie:
4. Augumentala Orizontala si Verticala
1. Defecte intraosoase cu 2, 3 pereti
5. Sinus-lift intern si extern
2. Defecte la nivelul furcatiei
6. Periimplantite
3. Tratamentul retractiilor gingivale

4. Largirea zonei de gingie fixa

REGENERAREA TISULARA

CAZURI CLINICE - GBR/GTR. BIOMATERIALE

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dr. Alexandru Georgescu
alexg22@yahoo.com

Vă Mulțumesc!
7 mai 2018
HANDS ON

HANDS-ON
dr. Alexandru Georgescu
alexg22@yahoo.com

Vă Mulțumesc!
7 mai 2018