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Bone Level Revisited Approach

Banner_Product Concept_In-Kone®, Revised Bone Level Implantology

The In-Kone® implant is a bone level type of implant. However, with respect to biological status, the positioning of the implant shoulder was revised so that the roughened chamfer could be sited under the cortical bone.

The aim of this positioning was to remove all constraints from the bony crest and recreate a favourable environment for setting the implant(1). The peri-implant bone plates support the mucosa and contribute to the aesthetic rendering of restorations.

With the In-Kone® system, this surgical technique is combined with use of “tulip” prosthetic components which are designed to reduce the route of entry for potentially undesirable bacteria and thicken the mucosal divisions(2).

 

 

2 PROFILES, UNIVERSAL® AND PRIMO®

The In-Kone® UNIVERSAL has a cylindro-conical profile. The variable depth double thread was created to provide both rapid progression of screw fixation of the implant into its socket and primary stability even in low density bone. The self-tapping double thread groove enables passage of a screw tap.

The UNIVERSAL profile is particularly recommended for immediate loading and post extraction socket implantation.

 

Product Concept_In-Kone® Universal vs Profile

 

The In-Kone® PRIMO has a slightly tapered profile. It has a simple thread, of regular depth, which provides more progressive screw fixation, particularly noticeable in high density bones. The implant is also self-tapping. In combination with the ULTIMATE drilling protocol, the In-Kone® Primo enables precision control of the vertical depth of the implant neck at the time of screw fixation into the bone.

SA²® SURFACE CONDITION

Concept Product_In-Kone® SA2 and 3, SEM Crowns

The SA2 surface condition is obtained by sandblasting followed by etching. Il It is certified ultraclean by international academy Clean Implant Foundation based in Berlin, Germany.

 

Concept Product_Clean Implant In-Kone® & Logo

 

3 weeks after placement of the implant in dogs, bone healing showed contact osteogenesis. The points of the implant threads were sited in the bone of the bone ridge of the implant site and new cancellous bone was visible in the thread spaces. The thread was not completely filled but the presence of many osteoblasts and osteoid tissue indicated that bone formation was underway.

 

After 12 weeks, the thread spaces were filled with newly formed bone. The remodelling was started: The primary bone was replaced by secondary osteons which was evidence of an advanced change process.

Dr C. Boll et al. Soft-tissue and marginal bone-adaptation on platform switched implants.with a morse cone connection: a histomorphometric study in dogs. The Intern. J. of Period. & Rest. Dent. (2015)

ULTIMATE® PROTOCOL

Product Concept_ULTIMATE® Surgery Kit

The ULTIMATE surgical protocol drills have a double cutting face which facilitates progression of the drill through the bone.  Laser markings which are striking facilitate visibility of movements during irrigation. The double thread grooves ensure excavation of bone slurry during rotation.

 

Product Concept_Ulimate Surgery Kit

 

The homothetic shape of the drills similar to the profile of the In-Kone® UNIVERSAL & PRIMO implants enables initial stable bone-implant connection and a primary anchorage which is uniformly spread over all threads held in the bone.

 

Friction cone type connection

Implants in the In-Kone range have a friction cone type connection. In bone level type implantology, the clinic currently seems unanimous about the superiority of such connections for peri-implant tissue remodelling.

This superiority is due to the antibacterial hermetic properties of cones and their ability to inhibit prosthetic micromovements(3). The risk of bacterial leaking can be significantly reduced compared to flat connections, in this way better preserving the integrity of the peri-implant biologic width.

CORTICAL BONE FORMATION

Product Concept_Cortical Bone_In-Kone® on site

Roughened chamfered shoulder

Along with the friction cone type connection, the In-Kone® neck was designed to enable ergonomic subcortical positioning of the implant.

The 45° chamfer aims to prevent a round sharp edge from being in contact with the cortical bone or the cancellous-cortical junction, and so reduce the risk of concentration of damaging mechanical constraints in this location(4).

The SA² type roughness of the chamfered part aims to promote healing then bone setting of the implant at the crestal level.

IN-KONE PROSTHESIS AND PERIODONTAL INTEGRATION®

Product Concept_In-Kone® Conventional Prostheses

 

Conventional Prosthetic Components

The narrow tulip-shaped periodontal profile of standard prosthetic components was designed with care for the aesthetic rendering of restorations at the transmucosal level.  Formation of a peripheral layer that is as thick as possible enables reducing the risks of greyish reflections sometimes seen on thin periodontal regions (5).

The profiles of the components are homothetic to that of the healing screws (emergence profile biological signatures) so as not to produce pressure on the ligaments or crushing of soft tissue during placement of the final prosthesis.

 

In-Kone® - Non-Conventional Prostheses

 

Prosthetic components for CAD/CAM

The CAD/CAM solution proposed by Global D is known as an open solution which enables any laboratory equipped with a machining centre to offer custom prostheses meeting the requirements of industrial tolerances defined by the Global D company.

Using a specific manufacturing process for custom machining, the laboratory commits to preserving the integrity of In-Kone® prosthetic interfaces and to the periodontal integration of implant-supported prosthetic restorations.

Global D Compliance

Product Concept_In-Kone® Compliance Prostheses

Global D offers a unique support service to prosthesis laboratories for manufacture of implant bridges. A Compliance laboratory means the laboratory has machining expertise guaranteeing the conformity of the prosthetic interfaces machined by CAD/CAM with our In-Kone® standard conical abutments.

 

Product Concept_In-Kone® Multiple Bar

In-Kone® Guided Surgery

 

Product Concept_Pilot Surgery and Surgery Kit ULTIMATE G In-Kone®

 

Guided surgery can be a less invasive technique when flap surgery is not required. It has been shown that guided surgery reduces post-operative pain compared to this (6).

With guided surgery, the procedure time is reduced with a gain in comfort. Guided surgery is also useful for patients with a complicated history. The guided surgery solution offered with the In-Kone® system can be an alternative which allows complicated procedures to be performed which sometimes have a complicated postoperative course.

(1) Evaluation of load transfer characteristics of five different implants in compact bone at different load levels by finite element analysis . D. Boskaya (2004)
(1) Influence du placement juxta crestal ou sous crestal de l’implant sur le remodelage osseux - Publié le 17.01.2019. L'Information Dentaire
(2) M. Redamagni . Soft tissue stability with immediate implant and concave abutments (2009)
(3) Microleakage at the Different Implant Abutment Interface: A Systematic Review, Mishra SK (2017)
(3) The Micromechanical Behavior of Implant Abutment Connections Under a Dynamic Load Protocol. Zipprich (2018)
(4) Evaluation of load transfer characteristics of five different implants in compact bone at different load levels by finite element analysis . D. Boskaya (2004)
(5) D. Farronato Influence of the implant abutment connection on the ratio between height and thickness of tissues at the buccal zenith: a randomized controlled trial on 188 implants placed in 104 patients (2020)
(6) Fortin (2006), Arisan (2010), Nkenk (2007)