A new dental implant solution, the patented Extended Anatomic Platform (EAP®), will be presented by its creator Prof Dr Mario Kern, an oral implantologist, researcher and inventor based in Hall, Tyrol, Austria, at IDS 2019, the international dental trade show, in Cologne, Germany, March 12–16, 2019. The EAP was produced using GE Additive’s dental hybrid solution, comprising a Concept Laser Mlab Cusing 200R, a milling machine from Georg Fischer, and Follow-Me hyperDENT software.
First invented simply to aid the chewing function, the focus for dental implant design has over time shifted from their mechanical requirements to more biological and aesthetic aspects, and for their appearance to be as close to nature as possible. Due to this shift, the long-term stability, predictability and aesthetic appeal of dental abutments – the connecting element between an implant and a crown – has gained more importance.
As more patients have begun to be fitted with dental implants, an infectious disease called peri-implantitis has begun to present more frequently. This disease inflames the gum and the bone structure around a dental implant, causing the soft tissue around the implant to recede and resulting in the metal abutment becoming visible. The cause of the infection may depend on several factors, such as the health of the soft tissue, the implant’s design and roughness, external morphology or excessive mechanical load.
To correct the problem, dental technicians using currently-available implant abutments must currently fire a piece of ceramic to the spot where the metal is visible. The result is neither aesthetically pleasing nor a permanent solution, as the ceramic can easily become loose.
Kern’s EAP is designed to cover all biological-aesthetical aspects required of an implant, while also offering a new design to address the problems caused by peri-implantitis. The final design is said to be the result of more than 5,000 hours of development time, during which he developed 200 prototypes and took 160 electron microscope images to document the cell behaviour scientifically. The EAP solution has already been granted patents in Europe, Canada and Australia.
Compared to existing, standard abutments, Kern’s solution incorporates ceramic behind the metal, as well as a bowl design that allows the ceramic to sit much lower. For patients with a recession of the gingiva (gums), dentists can now simply remove some of the metal to make the existing ceramic visible again, instead of firing additional ceramic material onto the implant.
The EAP hybrid abutment for dental implants is also said to more biocompatible, with better cell attachment, enhanced ease-of-use and high aesthetic appeal. It is said to have several advantages over existing titanium abutments. For example, the preparation margin is made entirely of ceramic, and additional modifications are always possible because the design-related glue joint of the hybrid abutment can be easily and quickly displaced coronally, resulting in a better reduction of the cytotoxic influence of the glue joint.
Cells in the mouth are said to find this an optimal condition to attach to the abutment, enabling the formation of ‘biological width’ to a physiological measure. Offering a larger surface also promotes solid cell attachment, while in traditional abutments the glue joint would prevent cell attachment and the development of hemidesmosomes. Smooth surfaces also make cell attachment difficult; the 02. to 0.5 µm roughness on the surface of an EAP abutment encourages cell growth.
Because the thin wall structures of the abutments could not be manufactured using conventional milling techniques, Kern began to explore the use of metal AM to produce the titanium structure of the EAP in 2017. In addition to the advantages of being able to manufacture complex, customised and precise frameworks and reportedly tension-free dental prostheses for improved fit in the mouth, he reported that he has seen several other additional benefits from using the GE Additive solution, such as reduced material waste and increased metallurgical properties.
“The dental hybrid process enables economical production of my abutment with highest accuracy,” he stated. “With its dental expertise and technical solutions, GE Additive is the perfect partner for my business. This solution combines the advantages of Additive Manufacturing with subtractive technology, to get the best out of both manufacturing worlds, which means a time and cost-efficient production process.”