Australasian Dentist Issue 93

CATEGORY 76 AUSTRALASIAN DENTIST LINICAL T he new Straumann® TLX Implant Systemwas developed on the basis of its model, the iconic Tissue Level. This means that long-term tissue stability, high primary stability and prosthetic efficiency combine to provide patients with the clinical results they desire. For this purpose, the designs of both the TLX implant screw and abutment connection have been optimized for immediate and CADCAM protocols. They facilitate treatment by reducing the number of sessions and avoiding augmentation surgery 1, 2 . In recent years these benefits have made immediate digital protocols more popular among both patients and clinicians 2, 3 . Immediate design reloaded With its conical and progressively threaded screw design the Straumann® TLX is ideally suited for immediate placement and restoration. The endosteal part of the implant is identical with the Straumann® BLX bone level optimized for immediacy. Both implants are based on the high-strength material Roxolid® and the hydrophilic SLActive® surface designed for excellent healing capacity. This is combined with the slim and fully tapered core and the minimized shoulder diameter. Both features facilitate the preparation of undersized osteotomies and reduce the need for augmentation, depending on the individual situation 4 . To achieve the high primary stability necessary for immediate placement and restoration, the Straumann® TLX has a conical and progressively cutting thread design 5, 6 . This is combined with a dynamic flute for the collection and condensing of bone chips during preparation, and bi-directional elements for reverse and forward cutting. Together with the deep apical threads designed for maximum engagement and stability, these features facilitate insertion, especially in immediate placement cases. Scan your patient All treatments start with taking a detailed history and clinical examination of the individual patient. This is also true for therapy using the Straumann® digital ecosystem, which is consistently integrated with the TLX (“born digital”). Following intra-oral or model-based scans and, if indicated, a cone beam computed tomography scan, the resulting data can be synchronized in a planning program like Straumann® coDiagnostiX® to find a clinically sound and minimally invasive protocol (Fig. 1). Again, both the narrow 3.75 mm diameter and the progressive thread design of the TLX are streamlined with this clinical approach. TLX: Immediate protocols welcome: Sound biology meets digital efficiency By Dr Jan H. Koch Photos (Figs. 4-5) courtesy of doctors Waldemar Polido, Wei-shao Lin and Dean Morton (USA) Photos (Figs. 1-3) courtesy of Dr. Matthieu Collin (France) Figure 4: Following digital planning, placement and osseointegration of a single TLX implant in the maxilla (position 26), tissues are ready for the final impression. Figure 5: View of the final zirconia crown (zerion® UTML, Straumann®) on the printed model and in the patient’s mouth. The complete workflow was digital, with immediate implant placement and temporary restoration – based on intraoral and CBCT scans, 3D planning, software-based diagnostic wax-up and CADCAM fabrication. Figure 1: Virtual planning for an implant-supported fixed full-arch temporary prosthesis to be delivered immediately after implant placement. Inclination of the posterior implants avoids augmentation despite missing bone. Figure 2: After osseointegration and complete soft tissue healing, a screw-retained zirconia CADCAM bridge has been fitted. Figure 2 shows the TorcFit™ connection of the TLX implants. Figure 3: After osseointegration and complete soft tissue healing, a screw-retained zirconia CADCAM bridge has been fitted. Figure 2 shows the TorcFit™ connection of the TLX implants.