Socket shield technique and custom emergence profile

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Posted on By yiannis vergoullis In Implants

In the past three years I have been developing with my partner Mr. George Papps,CDT an emergence profile management system. We developed, patented and clinically tested the system and finally after tons of work the system will be available in the market soon.
I wanted to share this with all my good friends and mentors here in DentalXP. Please do not consider this as a promotion of the product, I just feel DentalXP community as a scientific family of mine and this is why I am posting this case where we utilised the system.

Yiannis


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18 Comments

Yiannis. IMO the SPoT On way to go! SITE PRESERVATION of TISSUE in all shapes and forms. I just joined Facebook and the VPI system caught my attention on Follow the Pink. Richard and Armando if you recall our past conversations, this is the approach I think makes most sense. I will implement this system into my practice. Great post my friend. Chuck


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Yiannis is it univeral for ALL implant connections and platforms? Great idea. regards Maurice


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Ioannis great idea! Finally we can have a better emergency profile in a simple and predictable way! Thanks a lot for sharing your expirience. I definitelly try it!
Regards
Jorg


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Thank you all three of you! coming from you means a lot!

Maurice currently is compatible with trilobe connections (Replace etc), with CrossFit (Straumann bone level) and internal hex 45' (Zimmer, MIS, ImplantDirect, etc). It will soon be available in different versions compatible with all widely used prosthetic connections.

Yiannis


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Yiannis,it looks like a huge step forward.Please hurry up with all implant systems!
Thank you for sharing!
Best regards
Snjezana


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Yiannis, very nice idea and results. I think this is the ultimate level of treatment we should aim for.
I see it is similar in a certain way to Dr Chu's i-shell concept?
Thanks for sharing and keep us posted when this would be available in America.
Best regards,
Manuel


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Snjezana and Manuel thank you so much, it is nice to see people you value and respect expressing their appreciation for a project that you have devoted countless time.

Snjezana, I have learned a lot from your posts so let me know what connection you like and I will push things forward :)

Manuel, Dr. Chu's system is a great system that has some major differences from ours.

Our system has an indicator (guide) that allows you to evaluate the edentulous space and choose the right components needed.

Following the system has a mold that allows you to fabricate both the custom healing abutment and its duplicate impression post (both one piece or two pieces, whatever your preference is).
The custom body of these two elements is the same as the one of the indicator you initially used during evaluation. The system can be used for both anterior and posterior cases and also for immediate or delayed cases.

It also addresses the impression process in an easy way.
I think that it is imperative not only to generate a natural emergence profile but also to record it accurately and easily for your lab to be a able to design and fabricate the proper prosthesis. (If you find the time take a look of the video link I posted on the description).

Yiannis


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Great tool to simplify creating ideal emergence. Looking forward to ordering to system and working with it. Regards. Naheed


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Congrats !!! I am excited to have it in my office !!! I know how much effort you and George put into this !!!! Congrats !!! Follow the Pink ! Delia


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Yannis, very nice execution and innovative approach on healing phase. It is an interesting chair side approach: please do inform about other implant system upgrade. Thanks for sharing. Armando


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Naheed, Delia and Armando thank you for your nice words.

Armando the composite we use is scannable so if you modify the vpi healing abutment intraorally like a regular prep then you can scan it without medium powder and work digitally for temporary restorations (I will post a case soon). Magne et al, have shown promising results utilizing hybrid titanium-composite abutments..
However we are currently working on a full digital version of the system for doctors utilizing full digital process.

Yiannis


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Yiannis,

Great concept- I cant wait to see full production- I cannot see link?
Few questions- which video may answer- but one thought is could you make a universal for conical connection and one for hex-?

Cheers,

Richard


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Thank you so much Richard! It would be nice to make a universal mold but this would be innacurate and compromised, due to:
1. Differences on prosthetic connections diameters, depths and bevel
2. Differences on screw diameters and threads
3. You would not be able to use all of the 24 wells of the mold with all different platforms of the same type connection. E.g. Now an int.Hex user with the EP Mold v.06 can utilise all of the 24 wells of the mold with any given platform (3.2 up to 5.7). I wish it could be done :(

Sorry here is the link

Youtube video: https://youtu.be/OagS3tuxNVA

Yiannis


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Yiannis,

Took a look at video- great concept- do you supply the injectable composite? And the posts- do you supply or are these from implant company- In the anterior maxilla the emergence shape is somewhat of a sounded triangular form- available in kit? And you said scannable ? Could you theoretically remove the VPI- place traditional scan body and flow composite around to maintain emergence while scanning?

When you expect to market?
Love the innovation!

Cheers,

Richard


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Yiannis,

Took a look at video- great concept- do you supply the injectable composite? And the posts- do you supply or are these from implant company- In the anterior maxilla the emergence shape is somewhat of a sounded triangular form- available in kit? And you said scannable ? Could you theoretically remove the VPI- place traditional scan body and flow composite around to maintain emergence while scanning?

When you expect to market?
Love the innovation!

Cheers,

Richard


Reply

Thank you Richard, to answer your questions:
1. Yes, the composite will be available. I have done all the original testing with different composites. Nano and even micro hybrid works well as long as it is polished well and cleaned with steaming before use. We knew this already from Dr. Chus' work and it is confirmed by a very nice recent paper (Luchinskaya D, et al. Implant Dent. 2017 Feb;26(1):12-23.). What we did with our composite was to add enough Ti-oxide in order to make it scannable.

2. We do supply compatible titanium core abutments and impression posts where we utilised a design that allows easy and secure attachment of the composite, however the temporary abutments (one piece or two pieces, titanium or peek) and impression posts of the implant companies can be used instead as well.

3. You are right the shapes and sizes you can fabricate mimic the root trunk shapes and sizes of natural dentition (anterior, premolars and molars)

4. You are correct, within the mold you can make a duplicate scannable impression post, utilising your scan body and pouring the composite around it. The use of customisable scan body has already been published ( Joda T, et al. Clin Oral Implants Res. 2014 Mar;25(3):395-7.). So as soon as you remove your VPI abutment immediately replace it with your scan body that has a duplicate custom body, this makes your life easier particularly in cases of multiple implants since the body supports the tissue and increases your available working time. You do not need to pour the composite intra-orally, it is messy and difficult (blood, saliva, etc), you have it ready from the mold before you even start the impression process.

We did not re-invent any concept we only invented and brought to life a system that allows the clinician to apply all these concepts in an easy, fast and predictable manner.

The System will be launched at the upcoming IDS in Cologne this March. I will be there and I will be happy to see you or any other dentalXP member being there and show you in person the system (IDS, Cologne, Germany, March 21-25, 2017.HALL 11.3 AISLE G 049)

Yiannis


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Richard; here you see a scenario where the dentist wishes temporarization of the case. He can prep the VPI healing abutments intra-orally (supra-gingivally) and scan, then a cad-cam temp prosthesis can be fabricated. Since no sub-gingival prep is made, you can still use the duplicate impression posts at time of impression and be accurate.

You can see that the composite is scanned quite nicely without powder mediums.

Yiannis


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Yainnis,

Great stuff thank you for the detailed response unfortunately I will not be at IDS please can you put me down for orders one and two!!you noted that you can use the Zimmer connection does that mean I could also use biohorizons ? since it essentially the same? would love to try and incorporate into what we do every day

Cheers,

Richard


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