• #24 - Innovations With Teeth • MedicalExpo e-Magazine

    The Smart Magazine About Medical Technology Innovations

    Innovations With Teeth

    Open wide! But just your eyes. This new issue of MedicalExpo e-mag focuses on dental innovations. Read why Stratasys thinks 3D printing permanent teeth remains the biggest challenge. You’ll also learn about the competition among new dental implant materials and surgical navigation systems. We also describe the history of dental extractors but don’t worry—we won’t pull any of your teeth while you’re busy reading.

    Last but not least, and in an entirely different domain, we offer a simple explanation of the revolutionary genome editing method, CRISPR-Cas9, and why it’s generating so many ethical questions.

    Fullpage WAS
    Hot Topic
    It’s fine to be able to print models, surgical guides or partial frameworks, but ideally we want to be able to print teeth
    3D-printed crown and bridge stone models (Courtesy of Stratasys)

    About eight years ago, Stratasys, a global leader in 3D printing technology, created its first 3D printers for dentistry. The past four years have seen an explosion of innovations in this sector. Eric Erickson, Dental Business Manager for Europe at Stratasys, explained what today’s 3D dental printers can do and the...

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    Banner AgriExpo
    Hot Topic
    Since the beginning of mankind, humans have used dental implants in one form or another to replace missing teeth
    Titanium vs. Zirconia (Courtesy of IDS)

    A promising development is emerging in the area of dental implants. New materials—including zirconia and plastics—are being used in addition to time-tested titanium.


    In the 1967 film classic The Graduate, there’s a famous scene at a party for the new graduate in which a family friend offers him some advice about the future. “I want to say one word to you. Just one word,” says the friend. A pause: “Plastics.”

    That very word is expected to cause a buzz at the International Dental Show (IDS) in March 2017 in Cologne, Germany.

    “Plastic implants are becoming interesting. For example, those made out of PEEK (polyether ether ketone) are suitable for the minimally invasive flapless method (insertion without mucoperiosteal flaps). In the future, related materials could also gain in significance, namely PEKK (polyether ketone ketone). In addition to the pure ceramics and pure plastics, hybrid materials that attempt to combine the best of both worlds are also exciting,” wrote IDS organizers in a press release.

    Dr. James Rutkowski, a Pennsylvania dental implant specialist, is editor of the Journal of Oral Implantology published by the American Academy of Implant Dentistry. In his opinion, plastics offer some possibilities for dental implants, but are not yet ready for prime time. “PEEK shows some promise, but not a lot,” he told us. He believes it has demonstrated its benefits in orthopedic spinal fusion, “but currently does not withstand the environment of the oral cavity well.” Rutkowski added that PEKK is very new and may be useful in temporary restorations. “PEEK and PEKK need further development,” he said.

    Zirconia Is Popular for Cosmetic Reasons


    Zirconia implants (Courtesy of Chaldentistry)

    One alternative is zirconium dioxide, a white crystalline substance known as zirconia.

    Rutkowski said zirconia, which is considered a ceramic and not a metal, is especially popular for cosmetic reasons. “The upside to zirconia implants is that there is no dark color. It is white or more tooth-colored as it emerges from the gum,” he said. “The aesthetics are better, so it’s better for the front of the mouth.”

    Traditionally, zirconia implants come in one-piece models. “However, various two-piece alternatives should be available in time for IDS 2017—optionally with an adhesive bond or a screw connection,” noted the IDS announcement.

    “[The new zirconia implants] are devised to enable a closed healing, which is as a rule not possible with one-piece implants. If it ‘only’ comes down to the aesthetics, a host of ready-made ceramic abutments for titanium implants are available as a further option. Alternatively, individual abutments can be made using the CAD/CAM technology.”

    It All Started With Gold

    Dental implantology has seen its materials evolve. “Since the beginning of mankind, humans have used dental implants in one form or another to replace missing teeth,” said Celeste Abraham, DDS, in The Open Dentistry Journal. Abraham is associate professor in the Department of Periodontics and Stomatology Center at Texas A&M University in Dallas.

    Ancient Egyptians bound teeth using gold wire and plates (Courtesy of Museum of Artifacts)

    Ancient Egyptians bound teeth using gold wire and plates (Courtesy of Museum of Artifacts)

    It all started with gold in 2500 BCE in Egypt and moved through ivory and stone to bits of shell used by the Maya. There were even some dubious attempts to replace missing teeth involving grave robbers. The modern era for implants began in the 1930s. After noting that orthopedic surgeons used Vitallium (a chromium-cobalt alloy) in hip bones, researchers produced a Vitallium screw to anchor and support replacement teeth.

    Refinements in design and materials continued. Cobalt and stainless steel implants were used, but there were problems. “The stainless steel corroded, and the chrome cobalt leaked some of its minerals,” Rutkowski said. “It is referred to as ‘stain-less,’ not stain impossible.”

    The real breakthrough was implants made from titanium and titanium alloys.

    Gabor Balogh, DDS, who practices in Vancouver, Canada, said, “Today’s modern day dental implants developed through an accidental discovery in medical research back in 1952. A Swedish doctor found that when titanium was placed into contact with bone and left undisturbed, the bone grew right against the surface, making the titanium objects un-removable without cutting out the bone around the titanium. This developed into today’s implants.”

    When titanium was placed into contact with bone and left undisturbed, the bone grew right against the surface.

    Still, researchers and manufacturers have continued to explore alternatives. Arun Garg, DMD, a former professor of surgery in the Division of Oral/Maxillofacial Surgery at the University of Miami now in private practice, said some patients resist the idea of putting metal in their mouths, fearing autoimmune diseases.

    Garg stressed that there is no proof that titanium causes any health problems. “Since titanium dental implants have been in use, there has not been one report of an allergy or reaction to the metal itself. Nevertheless, there are some people who have either an allergy or sensitivity to other metals (e.g., prevalence of nickel allergy is about 5%) and/or simply have concerns about any metals within the body,” said Balogh.

    Banner AeroExpo
    Innovation Focus
    For every disease whose genetic origin is known, we can theoretically treat patients by intervening in the defective gene
    The revolutionary genome editing method, CRISPR-Cas9, generates questions.

    The revolutionary genome editing method, CRISPR-Cas9, broadens horizons immeasurably in the health field. Discovered four years ago, it makes it possible to rapidly, efficiently and cheaply modify the DNA of plants, animals and humans to correct genetic anomalies. However, changing the genetic code of human embryos to...

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    Celia Sampol

    Celia Sampol is a journalist with 13 years of experience in Paris, Brussels and Washington. She’s now the editor-in-chief of MedicalExpo e-magazine.

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    Ludovic Nachury

    Ludovic Nachury has been innovation enthusiast for more than 10 years.

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    Howard Wolinsky

    Howard Wolinsky is a Chicago-based freelance journalist specializing in health-care topics.

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    Laura Newman

    Laura Newman is a New York-based medical writer who writes frequently about medical technological advances and health policy.

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