Implantation without bone replacement, or both together
The BIONIKA Medline Kft. as a research development manufacturer company focuses on cases with bone deficiencies during its 2017 innovational activity in dental, oral surgical implantology.

Some main instructional concepts of the current results and further ideas:

1. BIONIKA systems developed for implantation without bone augmentation
1.1. Short implants 
1.2. Thin implant 
2. BIONIKA instrument systems developed for bone replacement
2.1. Selections of titanium membrane nodes
2.2. Instruments of bone transplantation
3. Bone augmentation and implantation in one step

1.Implantation without bone replacement

 1.1. Typical case of implantation without bone replacement, when 5-6, perhaps 7 mm bone is provided in the rear region of the jaw bone.

The bone deterioration is particularly dangerous for jaw bone in the place of the molar teeth. Generally, this causes most of the problems during implantation, especially in the case if we want to avoid bone replacement. According to experiences, in the case of a 4-6 mm thick bone it is worth to insert a short implant. If there is no complete success, stable support can be achieved as part of a multi-member bridge with sufficient osseointegration. Prior to the upgrade, the BIONIKA CortiLog basic system, which is compatible with CamLog, had the shortest element of 9mm. In many cases it was proved to be long, thus BIONIKA developed the CortiLog Short solution with a length of 6 and 7 mm due to the request of the applying doctors.

The main characteristic of it compared to the basic system is the shorter tube-in-tube connection. It is designed with a mixed external thread structure consisting of a self-compressional epsilon thread, the same thread pitch and the several paragraphed of denser thread distance of micro threads. According to our calculations, by choosing the 5 mm and 6 mm diameter sizes, a significant stability can be achieved. The success can be affected significantly by not only the consideration of bone sizes, but the properties of the quality as well. A critical factor may be the surface unit load. According to our experiences, that the biological connection of the implant ensured by the medium, the bone nest, or the geometric appearance of the body, can be called a “basket” form, the quality of “BIOBASKET” is the basic factor that can overwrite all the cleverness despite the best intentions. In this way great diligence is required in the cases of bone deficiency.

The implantation can be performed with the Cortilog Short extra short implants without bone augmentation in the case of low bone supply as well.

The BIONIKA can produce short implants for other implant systems in the cases of bone deficiency.
This is a common request in the case of only 4-5 mm of bone height is available and the implantologist wants to insert the short implant as an intermediate support element for longer bridges.

1.2. The application of thin implants without bone augmentation

Nowadays there is a solution in most implant systems for implanting the thin “blade bone” without bone replacement using thin implants of 3.3 mm diameter. Here we are able to rely on the load-bearing ability of the cortical wall. The significance of spongy bone structure is very low.

This is also the goal of so-called mini implant systems, which are predominantly single-phase round headed geometries. Our Nanoplant system is such a system. The recently developed variants, which are from 1.8mm to 3.3mm, suitable for not only Ball head anchorage but also for wearing Torus head (locator type) or glued toothwork and for solutions, such as the screwed toothwork, which enables the usage of Multi-Unit abutments have also been applied in the Nanoplant implant system. The same benefits are ensured by new developments for patients with bone deficiency which can be performed with inserting implants.

The disadvantage of single-phase mini systems is the deformation resulting from the abrasion of the Ball and the Locator head. As a result, operational disorders may occur in shorter or longer periods of time. The thin Bioplant Bicortical implant construction of 1.8mm, 2.3mm, 2.8mm diameter was developed previously in order to overcome this disadvantage and further developing the new “HYBRID” system.

all-on-6 with hybrid mini implants

2. The BIONIKA instrument system for bone replacement

We are aware of and practice demonstrates that bone resorption occurs as a result of increased load and that close at rest helps implant insertion, the beneficial reconstruction of biobasket.Experiments have been going on for a long time to improve the quality of the biobasket, using different synthetic, foreign and its own bone material.

BIONIKA has developed a number of instruments for doctors who undertake bone augmentation to help them succeed.

The long-term replacement of wearing parts are provided by the “HYBRID” implant system as it is a bi-phase mini system that interchangeably incorporates all types of abutment types used as part of the standard implant family. It’s not impossible in the case of thin bones to perform the fashionable, money-saving All-on-4 and the safe All-on-6 constructional abutment system.

2.1. Selections of titanium membrane nodes

Natural and synthetic bone grafting materials require protection during the period of incorporation. We have developed very thin titanium nodes of different sizes for this purpose, the so-called membranes in thicknesses of 0.02mm, 0.1mm and 0.2mm.

special flat membranes

The bore, lattice-shaped membranes are available in different shapes and sizes.
· The flat nodes can be customized with surgical scissors.
· In addition to this, special shapes can be ordered that are precustomized in the factory according to the purpose of the utilization.

Membranes can be secured with titanium rivets using a rivet inserting tool.
We have developed several types of membrane rivets which can be chosen according to the notion and based on the complexity of the task:
· Flat headed rivet
· Threaded rivet with inner key aperture
· Cross-head self-tapping conical rivet screw

2.2. The instruments of bone transplantation

Bone transplantation may be necessary in case of severe deterioration. As a usual solution, taking out the bone block from the pelvic bone or the jaw bone to a place with bone deficiency eventuates the required result.

The bone screws and rivets are available with cross head, hexagonal or torx key aperture as well.

There has been news on the application of a bone block made of foreign bones based on CT scan manufactured with CAD-CAM technology. BIONIKA is able to contribute to successful bone block surgery by developing and manufacturing screws for fastening the bone block, by using screwdriving instruments and complete kits.

replaceable inserting screwdriver set

3. Bone augmentation and implantation in one step

It is an intelligent, logical pursuit for performing the necessary surgery without as less stress as possible. It means, that if there is an opportunity, we should carry out the consecutive interventions, in this case bone augmentation and implantation, in one step. We have developed a new generation of titanium nodes which is screwed to the implant to provide safe protection for bone replacement.

Hajdú József
MSc mechanic engineer, economic engineer,
health manager economist
BIONIKA Medline Kft.

Author information

  • Original publication Implantológia
  • Author Hajdú József
  • Date 2017/XIV. évf.-1. szám
  • URL www.dental.hu