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NobelActive Internal and External Hex Implants Nobel Marketing Claims this is the “Implant of the Future”

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Screw-Vent Internal Hex/bevelNiznick Patent 1986

NobelActive is a Conglomeration of Common Features that work individually but not necessarily in combination

Astra 11Deg. Bevel

Osstem’s double Threads over entire length. NobelActive transition of sharp to flat threads not conducive for self-tapping insertion in dense bone

Oraltronics’ Pitt-Easy

Implant with Deep Apical

Threads

Alpha Bio Clone with

Conical Connection

NobelActive hex too deep to allow for 8mm implant length

45 Deg. Bevel Bevel with proven 20 year history of stability

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1.5mm High External Hex 3.5mm Morse Taper Post

NobelActive External -With External Locking Taper ConnectionNobel Marketing Claims this is the “Implant of the Future”

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NobelActive External - 5mm high tapered post requires parallelism Miter Implant with External Post – Evolved quickly to Internal Socket (Bicon)

Driskell Patent 1985: Tapered Post on Implant

“Locking taper concept – impacting the female taper of the implant head with the male counterpart on the root structure.”

Driskell Patent 1988: Tapered Socket in Implant

Locking Taper Concept “The head member has … a tapered rod

or socket for connection to the root”

“Those who cannot remember the past are condemned to repeat it” QUOTATION: George Santayana (1863–1952), U.S. philosopher,

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NobelActive (TiUnite) and Alpha Bio’s SFB (SLA) Implants BUT Nobel claims 98.3% Alpha Bio study applies to its new implant

ABOVE: Nobel Claims NobelActive success of “98.3% for up to 4 years” BELOW: Alpha Bio’s Catalog Claims same 98.3% success “after more than 5 years” but the surface is SLA (sand blasted with large grit followed by acid etching) like Straumann’s Surface

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Nobel Claims NobelActive Functions like “Corkscrew” Close Evaluation indicates they should have left it in the bottle

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Nobel Biocare’s NobelActive Marketing Claims

1.“bone-condensing – expands indication range and gives even higher initial stability.”2. “self-drilling”3.“ability to change direction during surgery”4.“unique press-fit connection of abutment – 5.-removes risk of excess cement”6.NobelActive Internal and External implants don’t cut through bone like

1.Higher than What – Replace? Increased stability achieved by spreading bone whereas deep threads cut bone

2.Self-threading – like any screw in soft bone.

3.Path of implant insertion should be established during surgery, not during implant insertion. That is what guide pins and end-cutting drills are for.

4.Nothing unique about press-fit connection. Miter Implant (1980) had external tapered post – evolved to internal press-fit connection of Bicon

5.If cement is a risk, why does NobelActive Internal have a screw-retained connection?

6.Why does NobelActive have spiral cutting grooves if not to “cut through bone like conventional (self-tapping) implants”?

NobelActive Marketing Claims Questionable Validity of Marketing Claims

conventional implants, they press through it like a corkscrew

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1. It is not a “one-piece implant – requires an abutment.

2. Does not have 2-piece flexibility – Can not use angled heads greater than 12 degrees, ball, screw-receiving or ceramic abutments. Require parallel placement of implants for bridges.

3. A one-piece implant eliminates “micro gap” but a precise-fitting internal connections maintain marginal integrity anyway. Nobel still sells external hex implants – less stable

1. “One piece implant

2. design with 2-piece flexibility”

3. locking tapered interface .. Eliminates bone level micro gap, micro-movement and the use of abutment screws.”

NobelActive External Claims Claims are not Valid

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Dense Bone Drill is 4.6mmD but Platform is 3.9mmDNobelActive Leaves Gap around neck of Implant in Dense Bone

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4.3mmD Replace Implant is better choice than 4.2mmD NobelActive for insertion into Immediate Extraction Sockets

Narrow Neck of NobelActive Requires Bone and Soft tissue Grafting to fill defect left at crest of ridge

5.0

5.0 5.03.9

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Compare NobelActive External Hex with ScrewDirect One-Piece Implant

The Prosthetic Advantages are Obvious & Cost Savings Significant

NobelActive ExternalRequires Attachment of one

of these four abutments

ScrewDirect $150 incl. Snap Transfer & Cap

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Attach & Remove Long Friction Fit Head to NobelActive

Straight Friction-fit abutment too longHeads of Implant exposed above bone

Tried to remove abutment with ForcepsTry in straight abutment.. Too long but locks in

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Attach Two Short Friction Fit Heads to NobelActive using Mallet

Jack off abutment using Removal Screw Shorter Abutment attached to Implants

Shorter Abutment attached to Distal Implant Tap on Taper Lock Abutments with Mallet

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Preferred placement is angled between buccal and lingual platesStraight Post of NobelActive External requires vertical placement

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Why Change Drills and Platforms, just to change threads?

NobelActive

1.RePlus and ReActive have compatible Tri-Lobe Connection 2.Both have Platform switching interface – of questionable value3.Both have even taper to allow insertion into an undersized socket for bone expansion,4.Nobel Active has straight outer threads with very tapered inside thread dimension5.RePlus and ReActive have Mini-threads whereas NobelActive has horizontal grooves. 6.RePlus and ReActive seal opening at crest of ridge whereas NobelActive 4.3 & 5.0 implants are narrower at top, leaving gap7.RePlus and ReActive have double lead threads on body for faster insertion.

RePlus ReActive

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Very deep threads apically cuts rather than compresses soft bone - any screw implant will self-tap in soft bone.

NobelActiveNo Taper to OD

of Threads

ScrewPlantGradual Taper for

Bone Expansion

Deep apical threads will not expand narrow ridge or compress soft bone

Soft Bone (Balsa) = 3.91 in/lbs Insertion TorqueHard Bone (Oak) = 6.35 in/lbs Insertion Torque

NobelActive™ ClaimThe product is easy to use and provides high initial stability and good outcomes. The Apical Threads are too aggressive for self-tapping insertion in Dense bone and are designed to cut threads in soft bone rather than expand and compress the bone for increased initial stability. Any Implant will self-tap in soft bone.

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ReActive with Tri-Lobe Connection and Platform SwitchingProjected Launch Date – January 2008

• Same taper to body as RePlus Implants allow insertion in undersized socket for expansion

• Flat-based deeper threads provide increased surface area for greater stability in soft bone

1.5Deg. 3.0Deg.