A look at oral implantology

03 October 2024
Ingo Frank is a German prosthodontist specialising in oral implantology, aesthetic dentistry, and complex restorations.

The Dentist speaks to Ingo Frank about the importance of an effective implant system.

TD: How has your oral implantology practice evolved in the last decade?

IF: “At the start of my career, my colleagues and I worked with several referring doctors who sent us patients for dental implants. As they often specified the implants we had to use, we soon became very familiar with as many as 16 different implant brands. This was an ideal opportunity to explore and compare the advantages and disadvantages of each system as well as identify the most effective ones. 

“In our current clinic, we are privileged to have a multidisciplinary oral implantology team comprising 15 dentists, which means we can draw on several generations of experience. We discuss clinical cases and share our experiences collaboratively, and this has also helped considerably with my understanding of which implants work optimally and lead to the most successful outcomes.

“As a result, I have now completely moved to one system: the CopaSky from Bredent. In my view, it is the best system available. It gives me different implant lengths, which means I can avoid bone augmentation. In addition, due to the possibility of putting bone chips on the back taper of this implant to induce bone growth, I can place the implant subcrestally, and this gives me more predictable results and better outcomes in the longer term.”

“We are becoming a lot more digitally focused, harnessing CAD/CAM and 3D printing, and our treatment workflows are now fully guided. Recently, Bredent moved to a titanium scan body, which enables me and my team to carry out every aspect of the process in the digital workflow using Bredent products.”

TD: What aspects should a clinician consider when choosing a dental implant system? 

IF: “There are several elements to consider including the implant design, the surface, the shape, the length, the diameter, the implant stability, the technology, the micro and nanostructures.

“As I am also a prosthodontist, the prosthetic compatibility matters. With Bredent, I get a single connection with a monoplatform shoulder, and this approach really simplifies the stock-keeping in my dental practice. With 120 employees in the practice, you can imagine the complexity of ensuring that the right implant component is brought to you during surgery. I now avoid brands with numerous platforms and geometries, generating numerous components, as it gets too confusing in a busy practice.

“The clinical evidence is very important too. You want to work with a brand that gives you peace of mind and has given you successful outcomes medium and long term. I also believe a system must have a user-friendly surgical protocol.”

TD: What does it mean to have a 360-degree view of implantology?

IF: “One of the most important aspects of daily life is the work with our dental technicians. Sometimes, you need to place the implant where the bone is available, or it is just not in the perfect position. You have many different prosthetic components to solve these challenges in these situations. If you work closely together and focus on this 360-degree workflow, you achieve better results and you also learn a lot from one another because of constant feedback. However, this means that combining the implants with every implant component must be seamless, and Bredent gives me all this. It is evident that when it was first set up it was a dental technician-led company and, as a result, it supports this holistic approach that we need for our implant patients.”

TD: What makes the Bredent group, its implants and services so effective?

IF: “For the last 15 years, we have been loyal to Bredent. It is a small family-owned business, and we know the people behind the brand very well. They react fast and support us whenever needed. They also listen to customers and don’t hesitate to evolve and change components to suit our needs. This would not be possible with larger implant companies because of the way they are structured. In this part of Germany, where my dental clinic and Bredent are located, the focus is on engineering high-quality products of the best value for money. 

“CopaSky is a very easy and predictable system that would suit beginners and the most experienced implant experts. Its versatility is what makes it so impressive. In easy cases, you can implement a scan body directly after placing the implant, as you know that the primary stability will be optimally high. If you want immediate loading on implants, as with the SKY fast & fixed system, it works with several CopaSky components, making it easy and flexible to treat with.

“The company’s adherence to the generally accepted ‘Zero-Bone Loss’ concept is noteworthy. Not many brands have such an implant design that lets you place an implant subcrestally and achieve such predictable results. I want to see the implant positioned subcrestally with the bone above the shoulder, as I am reassured of the long-term stability.”

TD: What has your experience been with implant placement at the epi crestal and subcrestal level, and why is the microstructure on the backtaper so relevant?

IF: “The microstructured backtaper on CopaSky implants is crucial for bone preservation and stability at the crestal level. This design minimises bone loss and promotes better soft tissue attachment whilst supporting long-term implant success.

The micro-structure also encourages favourable bone modelling which is so important for maintaining the implant’s integrity and long-term stability.”

TD: How do the prosthetic components of the system give the clinician a winning edge in immediate restoration, soft tissue management and digital workflow?

IF: “The biggest advantage is the single geometry. There is a single connection that simplifies the stock-keeping. Another advantage is that for every angle one requires there is a component made available by Bredent. For example, with the company’s Sky fast & fixed system, you can place the implant exactly where the bone is available. As it is always preferable to avoid bone augmentation wherever possible, you can change the position of the angle of the implant with the prosthetic components, enabling the technician to give you an effective outcome.”

TD: Can you tell us what you understand by Platform - Switch, Zero Bone Loss, and Bone Growth Concepts?

IF: “The CopaSky system integrates these three elements. The platform switch allows the user to employ an abutment of a smaller diameter in comparison with the diameter of the implant. With zero bone loss, we can maintain the bone when we are placing an implant subcrestally and this position allows the bone to form around the implant and above the shoulder, providing long term stability.”

TD: What are the conditions for the bone growth concept?

IF: “You need primary stability. This can be achieved through the implant design although bone quality and quantity play an important role when drilling. You need to collect enough bone to place it above the implant shoulder, otherwise a bone graft is required. You need this biocompatibility of surfaces so that there is osseointegration around the implant.”

TD: What advice would you give to your peers?

IF: “In my view, every dentist can treat with implants. To start with, you need to invest in a CBCT device to achieve good diagnostics in 3D. It is vital to understand how much bone you are working with.

“Starting to treat with implants can be daunting, and that is why we talk to beginners at universities and offer workshops where the system can be demonstrated and surgical protocols explained.

“We discuss mistakes that can be made and focus on problem-solving, using clinical cases and hands-on practice. We show everyone we train with the CopaSky system, demonstrate how easy the workflow is and present clinical and radiological evidence of our long-term success. I hope that my experience can benefit some of my peers.”

For more information visit https://www.bredent-implants.com/