SLActive® in irradiated patients.

Predictability beyond expectations

One of the most challenging patient groups for implant treatment includes patients who have undergone a combination of tumor surgery, chemotherapy and radiotherapy. The bone quality in these patients is severely compromised.

Learn why

SLActive® performance in irradiated patients

1-year follow-up³

1 patient was excluded from the study due to tumour recurrence. The graph is thus based on 19 patients with 97 implants.

5-year follow-up^13,14

Excluding 4 further patients deceased due to cancer The graph is thus based on 15 patients with 79 implants.

Randomized clinical trial:³102 implants, 20 patients
Post-surgery, radiotherapy and chemotherapy for oral carcinoma

5-year follow up: latest publication

What clinicians say

News update from Dental Tribune International

Watch an interview with Prof Nelson to get to know more about the study and challenges of prosthetic rehabilitation of irradiated patients. Discover how SLActive® implants improved the quality of life in these patients.

Watch interview

Download Study Overview

Uncompromised performance.

Even in diabetic patients.

Patients with diabetes have reduced wound healing capacity^15,16 which puts implants at risk. Learn more >

Worldwide, 1 in 6 adults 60 years of age and older has diabetes.¹⁷ Learn more >

Given the ever rising prevalence of type 2 diabetes, how can clinicians address this risk particularly in older patients?

Growing clinical evidence of highly predictable performance of slactive® in diabetic patients.
A new clinical study¹⁹ that compared SLActive® performance in patients with and without diabetes showed uncompromised performance of SLActive® implants.
100 % implant success rate in the diabetic group after 2 years
Bone changes similar to those in healthy individuals
Despite the observed lower levels of bone quality all implants in this study showed good primary stability.

Performance in diabetic patient group¹⁹

Prospective case-control clinical study (15 diabetic and 14 non-diabetic individuals)

100% implant success rate in the diabetic group after 2 years

Bone changes similar to those in healthy individuals

Despite the observed lower levels of bone quality all implants in this study showed good primary stability.

Key researchers behind the study

What clinicians say

Download Study Overview

The placement of implants in smokers is often associated with high failure rates, risk of post-operative infections, and marginal bone loss.²⁹

SLActive® – high predictability in smokers

A recent clinical study comparing SLActive® performance in smokers and non-smoker patient groups reported excellent outcomes with SLActive®:
96 patients, 130 SLActive® implants, 5-year follow-up, 100% survival rate

Latest publication

Performance in smoker patient group³⁰

Prospective case-control clinical study (47 smokers and 49 non-smokers)

Any questions? Contact us.

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References

* Success criteria as per Buser D. et al. Long-term stability of osseointegrated implants in augmented bone: A 5-year prospective study in partially edentulous patients. Int J Periodont Restor Dent. 2002; 22: 108–17.
** Adjusted, excluding the patients deceased due to cancer mortality.

1 Straumann SLActive implants compared to Straumann SLA implants. Lang NP, Salvi GE, Huynh-Ba G, Ivanovski S, Donos N, Bosshardt DD. Early osseointegration to hydrophilic and hydrophobic implant surfaces in humans. Clin Oral Implants Res. 2011 Apr;22(4):349-56. doi: 10.1111/j.1600-0501.2011.02172.x; Rupp F, Scheideler L, Olshanska N, de Wild M, Wieland M, Geis-Gerstorfer J. Enhancing surface free energy and hydrophilicity through chemical modification of microstructured titanium implant surfaces. Journal of Biomedical Materials Research A, 76(2):323-334, 2006. ; De Wild M. Superhydrophilic SLActive® implants. Straumann document 151.52, 2005 ; Katharina Maniura. Laboratory for Materials – Biology Interactions Empa, St. Gallen, Switzerland Protein and blood adsorption on Ti and TiZr implants as a model for osseointegration. EAO 22nd Annual Scientific Meeting, October 17 – 19 2013, Dublin ; Schwarz, F., et al., Bone regeneration in dehiscence-type defects at non-submerged and submerged chemically modified (SLActive®) and conventional SLA® titanium implants: an immunohistochemical study in dogs. J Clin.Periodontol. 35.1 (2008): 64–75. ; Rausch-fan X, Qu Z, Wieland M, Matejka M, Schedle A. Differentiation and cytokine synthesis of human alveolar osteoblasts compared to osteoblast-like cells (MG63) in response to titanium surfaces. Dental Materials 2008 Jan;24(1):102-10. Epub 2007 Apr 27. ; Schwarz F, Herten M, Sager M, Wieland M, Dard M, Becker J. Histological and immunohistochemical analysis of initial and early osseous integration at chemically modified and conventional SLA® titanium implants: Preliminary results of a pilot study in dogs. Clinical Oral Implants Research, 11(4): 481-488, 2007. Raghavendra S, Wood MC, Taylor TD. Int. J. Oral Maxillofac. Implants. 2005 May–Jun;20(3):425–31. 9 Oates TW, Valderrama P, Bischof M, Nedir R, Jones A, Simpson J, Toutenburg H, Cochran DL. Enhanced implant stability with a chemically modified SLA® surface: a randomized pilot study. Int. J. Oral Maxillofac. Implants. 2007;22(5):755–760.
2 Nicolau P, Guerra F, Reis R, Krafft T, Benz K, Jackowski J. 10-year outcomes with immediate and early loaded implants with a chemically modified SLA surface. Quintessence Int. 2018 Dec 18:2-12.
3 Patients treated with dental implants after surgery and radio-chemotherapy of oral cancer. Heberer S, Kilic S, Hossamo J, Raguse J-D, Nelson K. Rehabilitation of irradiated patients with modified and conventional sandblasted, acid-etched implants: preliminary results of a split-mouth study. Clin. Oral Impl. Res. 22, 2011; 546–551.
4 Yerit, K., Posch, M., Seemann, M., Hainich, S., Dortbudak, O., Turhani, D., Ozyuvaci, H., Watzinger, R. and Ewers, R. (2006) Implant Survival in Mandibles of Irradiated Oral Cancer Patients. Clinical Oral Implants Research, 17, 337-344. http://dx.doi.org/10.1111/j.1600-0501.2005.01160.x.
5 Verdonck, H.W.D., Meijer, G.J., Laurin, T., Nieman, F.H.M., Stoll, C., Riediger, D., Stoelinga, P.J.W. and de Baat, C. (2007) Assessment of Vascularity in Irradiated and Non-Irradiated Maxillary and Mandibular Alveolar Minipig Bone Using Laser Doppler Flowmetry. International Journal of Oral Maxillofacial Implants, 22, 774-778.
6 Hu, W.W., Ward, B.B., Wang, Z. and Krebsbach, P.H. (2010) Bone Regeneration in Defects Compromised by Radiotherapy. Journal of Dental Research, 89, 77-81. http://dx.doi.org/10.1177/0022034509352151.
7 Wang, R., Pillai, K. and Jones, P.K. (1998) Dosimetric Measurements of Scatter Radiation from Dental Implants in Stimulated Head and Neck Radiotherapy. International Journal of Oral Maxillofacial Implants, 13, 197-203.
8 Grotz, K.A., Al-Nawas, B., Piepkorn, B., Reichert, T.E., Duschner, H. and Wagner, W.(1999) Micromorphological Findings in Jaw Bone after Radiotherapy. Mund-, Kiefer- und Gesichtschirurgie, 3, 140-145.
9 Chambrone L, Mandia J, Shibli JA, Romito GA, Abrahao M. Dental Implants Installed in Irradiated Jaws: A Systematic Review. Journal of Dental Research. 2013;92(12 Suppl):119S-130S. doi:10.1177/0022034513504947.
10 Shugaa-Addin B, Al-Shamiri H-M, Al-Maweri S, Tarakji B. The effect of radiotherapy on survival of dental implants in head and neck cancer patients. Journal of Clinical and Experimental Dentistry. 2016;8(2):e194-e200. doi:10.4317/jced.52346.
11 Nooh N. Dental implant survival in irradiated oral cancer patients: a systematic review of the literature. Int J Oral Maxillofac Implants. 2013 Sep-Oct;28(5):1233-42. doi: 10.11607/jomi.3045.
12 Dholam KP, Gurav SV. Dental implants in irradiated jaws: A literature review. J Can Res Ther [serial online] 2012 [cited 2016 Aug 17];8:85-93. Available from: http://www.cancerjournal.net/text.asp?2012/8/6/85/92220.
13 Nelson, K., Stricker, A., Raguse, J.-D. and Nahles, S. (2016), Rehabilitation of irradiated patients with chemically modified and conventional SLA implants: a clinical clarification. J Oral Rehabil, 43: 871–872. doi:10.1111/joor.12434
14 C. NACK, J.-D. RAGUSE, A. STRICKER , K. NELSON & S. NAHLES. Rehabilitation of irradiated patients with chemically modified and conventional SLA implants: five-year follow-up. Journal of Oral Rehabilitation 2015 42; 57—64.
15 Devlin H, Garland H, Sloan P. Healing of tooth extraction sockets in experimental diabetes mellitus. J. of Oral Maxillofac. Surg. 1996; 54:1087-1091
16 Wang F1, Song YL, Li DH, Li CX, Wang Y, Zhang N, Wang BG. Type 2 diabetes mellitus impairs bone healing of dental implants in GK rats. Diabetes Res Clin Pract. 2010; 88:e7-9.
17 IDF Diabetes Atlas, 7th Edition, 2015 http://www.diabetesatlas.org/.
18 US Centers for Disease Control and Prevention. Diabetes 2014 report card. Available from: www.cdc.gov/diabetes/library/reports/congress.html. Accessed September 2015.
19 Cabrera-Domínguez J, Castellanos-Cosano L, Torres-Lagares D, Machuca-Portillo G. A Prospective Case-Control Clinical Study of Titanium-Zirconium Alloy Implants with a Hydrophilic Surface in Patients with Type 2 Diabetes Mellitus. Int J Oral Maxillofac Implants. 2017 Sep/Oct;32(5):1135-1144. doi: 10.11607/jomi.5577; Cabrera-Domínguez J. A prospective, two-year clinical trial of titanium-zirconium alloy implants (Roxolid® Straumann®) with hydrophilic surface (SLActive®) in patients with Type 2 Diabetes Mellitus. presented during 26th Annual Scientific Meeting of the European Association of Osseointegration – 5-7 Oct 2017, Madrid, Spain.
20 Hotchkiss KM, Ayad NB, Hyzy SL, Boyan BD, Olivares-Navarrete R. Dental implant surface chemistry and energy alter macrophage activation in vitro. Clin. Oral Impl. Res. 00, 2016, 1–10. doi: 10.1111/clr.12814.
21 Lee R, Hamlet SM, Ivanovski S. The influence of titanium surface characteristics on macrophage phenotype polarization during osseous healing in type I diabetic rats: A pilot study. Clin Oral Impl Res (accepted 4/8/2016).
22 El Chaar E, Zhang L, Zhou Y, et al. Osseointegration of Superhydrophilic Implants Placed in Defect Grafted Bones. International Journal of Oral & Maxillofacial Implants . Mar/Apr2019, Vol. 34 Issue 2, p443-450
23 Müller E, Rottmar M, Guimond S, Tobler U, Stephan M, Berner S, Maniura K The interplay of surface chemistry and (nano-)topography defines the osseointegrative potential of Roxolid® dental implant surfaces. eCM Meeting Abstracts 2017, Collection 3; SSB+RM (page 31).
24 EMPA (2017) Report additional experiments: Impact of RXD SLA, RXD SLAnano, RXD SLActive, and RXD pmod SLA surfaces on protein adsorption, blood coagulation, and osteogenic differentiation of HBCs. Final report: Impact of RXD SLA, RXD SLAnano, RXD SLActive, and RXD pmod SLA surfaces on protein adsorption, blood coagulation, and osteogenic differentiation of HBCs. EMPA, Swiss Federal Laboratories for Materials Science and Technology (data on file).
25Stavropoulos A et al. Greater Osseointegration Potential with Nanostructured Surfaces on TiZr: Accelerated vs. Real-Time Ageing. Materials (Basel). 2021 Mar 29;14(7):1678.
26 Wennerberg A, Albrektsson T. On implant surfaces: a review of current knowledge and opinions. Int J Oral maxillofac Implants 2009: 24:63-74
27 Kopf BS, Ruch S, Berner S, Spencer ND, Maniura-Weber K. 2015. The role of nanostructures and hydrophilicity in osseointegration: In-vitro protein-adsorption and blood-interaction studies. J Biomed Mater Res Part A2015:103A:2661–2672.
28 Wennerberg A, Jimbo R, Stübinger S, Obrecht M, Dard M, Berner S. Nanostructures and hydrophilicity influence osseointegration – A biomechanical study in the rabbit tibia. Clin. Oral Impl. Res. 25, 2014, 1041–1050doi: 10.1111/clr.12213
29 Chrcanovic BR, Albrektsson T, Wennerberg A Smoking and dental implants: A systematic review and meta-analysis. J Dent. 2015 May;43(5):487-98
30 Alsahhap A et al. Survival of Titanium-Zirconium and Titanium Dental Implants in Cigarette-smokers and Never-smokers: A 5-Year Follow-up. Chin J Dent Res. 2019;22(4):265-272
31 Hotchkiss KM et al. Novel in vitro comparative model of osteogenic and inflammatory cell response to dental implants. Dent Mater. 2019 Jan;35(1):176-184.
32 Hsu JT, Shen YW, Kuo CW, Wang RT, Fuh LJ, Huang HL. Impacts of 3D bone-to- implant contact and implant diameter on primary stability of dental implant. J Formos Med Assoc. 2017 Aug;116(8):582-590. ; Buser D, Schenk RK, Steinemann S, Fiorellini JP, Fox CH, Stich H. Influence of surface characteristics on bone integration of titanium implants. A histomorphometric study in miniature pigs. J Biomed Mater Res. 1991 Jul;25(7):889-902 ; Smeets R, Stadlinger B, Schwarz F, Beck-Broichsitter B, Jung O, Precht C, Kloss F, Gröbe A, Heiland M, Ebker T. Impact of Dental Implant Surface Modifications on Osseointegration. Biomed Res Int. 2016;2016:6285620. ; Goyal N., Priyanka R. K. Effect of various implant surface treatments on osseointegration – a literature review. Indian Journal of Dental Sciences. 2012;4:154–157

Performance

Immediate loading

Compromised patients

Anti-inflammatory response

Bone grafting

What clinicians say

SLActive® in irradiated patients.

Predictability beyond expectations

SLActive® performance in irradiated patients

1-year follow-up³

5-year follow-up^13,14

What clinicians say

News update from Dental Tribune International

Uncompromised performance.

Even in diabetic patients.

Given the ever rising prevalence of type 2 diabetes, how can clinicians address this risk particularly in older patients?

Performance in diabetic patient group¹⁹

Prospective case-control clinical study (15 diabetic and 14 non-diabetic individuals)

Key researchers behind the study

What clinicians say

The placement of implants in smokers is often associated with high failure rates, risk of post-operative infections, and marginal bone loss.²⁹

SLActive® – high predictability in smokers

Performance in smoker patient group³⁰

Prospective case-control clinical study (47 smokers and 49 non-smokers)

Any questions? Contact us.

References

Performance

Immediate loading

Compromised patients

Anti-inflammatory response

Bone grafting

What clinicians say

SLActive® in irradiated patients.

Predictability beyond expectations

SLActive® performance in irradiated patients

1-year follow-up3

5-year follow-up13,14

What clinicians say

News update from Dental Tribune International

Uncompromised performance.

Even in diabetic patients.

Given the ever rising prevalence of type 2 diabetes, how can clinicians address this risk particularly in older patients?

Performance in diabetic patient group19

Prospective case-control clinical study (15 diabetic and 14 non-diabetic individuals)

Key researchers behind the study

What clinicians say

The placement of implants in smokers is often associated with high failure rates, risk of post-operative infections, and marginal bone loss.29

SLActive® – high predictability in smokers​

Performance in smoker patient group30

Prospective case-control clinical study (47 smokers and 49 non-smokers)

Any questions? Contact us.

References

1-year follow-up³

5-year follow-up^13,14

Performance in diabetic patient group¹⁹

The placement of implants in smokers is often associated with high failure rates, risk of post-operative infections, and marginal bone loss.²⁹

SLActive® – high predictability in smokers

Performance in smoker patient group³⁰