Presentation of the T.B.R. Group and the T.B.R. system Perio-Integration and Titanium Zirconium Technology MANUEL AMARO Material e Equipamento Dentário

The T.B.R. Group 20 Years of Experience Present in more than 25 Countries Founded the First European Private Center Training Implantologists The International Implantology Center Certifications : –ISO 9001 VS 2000 –13485 VS 2003 –CE 0459 MANUEL AMARO – Material e Equipamento Dentário

Competent Technical Assistance - Hot Line - User-friendly catalogues Competent Scientific Assistance - Clinical and Prosthetic Stages Outstanding Client Assistance Innovative approach Quality Products – the T.B.R. System The T.B.R. Group MANUEL AMARO – Material e Equipamento Dentário

Initiated by Dentists Implemented by Biomechanical Engineers Use technologies from the Astronautics Industry The system is: Simple, Secure and Esthetic Excellent Quality/Price ratio Business Integrity The T.B.R. system MANUEL AMARO – Material e Equipamento Dentário

The T.B.R. system Type of procedures: 1 surgical stage or 2 surgical stages Titanium: Grade 5 - TA6V4 Surface: Sand Blasted & Acid-Etched/Titanium Zirconium Surface Connections (Morse Tapered): Internal Octagonal / External Hexagonal Esthetics: perio-integration MANUEL AMARO – Material e Equipamento Dentário

Perfectly Esthetical Biocompatibility and excellent gingival tolerance: no bacterial colonization on the zirconium surface Strength of the Implant optimized by the Zirconium Ceramic Simple, Secure and Esthetics The T.B.R. system MANUEL AMARO – Material e Equipamento Dentário

The Z1 CONIC Conical screw type implant 1 operating stage Internal Octagonal connection Cruciform design at the buttom Transgingival emergence Zirconium color is Ivory (Color code B2) Color code: Grey MANUEL AMARO – Material e Equipamento Dentário

The CONIC Conical screw type implant 2 operating stages Internal Octagonal connection Cruciform design at the buttom. Color code: Yellow MANUEL AMARO – Material e Equipamento Dentário

The HEX – CONIC Conical screw type implant 2 operating stages External Hexagonal connection Cruciform design at the buttom. Color code: Red MANUEL AMARO – Material e Equipamento Dentário

1 KIT 3 SYSTEMS The T.B.R. kit

Sterilization of the implants In a Tube In a Thermosealed Blister - - Double sterile packaging: - The gamma ray treatment guarantees the sterility of the implants (Gamma irradiation) MANUEL AMARO – Material e Equipamento Dentário

Conic Advantages Better initial anchor: –Corner Effect – Allows immediate loading Anatomic Design: –Better distribution of occlusion forces on the implant –Adapted in difficult anatomic situations and narrow spaces The whorls are inside the implant diameter: –Conic implants are more resistant when using the same diameters MANUEL AMARO – Material e Equipamento Dentário

Titanium Zirconium Surface of the Z1 1 Stage Implant Sand Blasted & Acid-Etched With Smooth Titanium Collar + Smooth Integrated BioActive Zirconium Collar (5 years of experience) Rough Surface Smooth Surface Sand Blasted & Acid-Etched Smooth BioActive Zirconium Collar MANUEL AMARO – Material e Equipamento Dentário

Body Surface of 2 Stages Implants Sand Blasted & Acid-Etched (15 years of experience) With Smooth Collar Rough Surface Smooth Surface Sand Blasted & Acid-Etched MANUEL AMARO – Material e Equipamento Dentário

Zirconium Advantages 1 - OSSEO – INTEGRATION Titanium Zirconium Surface – Precisioned Sand Blasted and Acid Etched (S.L.A.) + BioActive Zirconium Collar, which ties and induces the creation of Osteoblasts Cells to the surface of the implant better than any other Titanium Implant (Publication in the JABB). Z1 implant MANUEL AMARO – Material e Equipamento Dentário

Zirconium Advantages 2 - PERIO – INTEGRATION - Enhancing Epithelial attachment formation - Creeping Attachment: gain of height - Biocompatibility of the zirconium / Surface more Smooth: less bacteria than in the titanium (Publication in the JOMI) - Optimal Peri Implant marginal tissue with Zirconia Collar – which ties and induces the creation of Fibroblasts Cells to the surface of the implant better than any other Titanium Implant (Publication in the JABB) Z1 implant MANUEL AMARO – Material e Equipamento Dentário

Follow up of Titanium Transmucosal Implants with a Zirconia Collar: an in vitro and in vivo study Author: A.E. Bianchi, M. Bosetti, G. Dolci, M.T. Sberna, F. Sanfilippo, M. Cannas In: The Journal of Applied Biomaterials & Biomechanics (JABB). Vol 2, Number 3, 2004 Publication on the Z1 (JABB) MANUEL AMARO – Material e Equipamento Dentário

Optimal Peri-Implant marginal tissue with Zirconia Collar Results in a more Healthy Tissue Implant with Zirconia CollarImplant with Titanium Collar IF: PD < 3mm, PAL< 2.5mm PD/PAL: Peri-Implant = Healthy IF: DIB < 3.5mm DIB: Peri-Implant = Stable Publication on the Z1 (JABB)

A comparison of Cell Growing and Adhesion between: CTR (White), Titanium collar implant (Black) and the Z1 Implant (Grey) Cell Adhesion: Zirconia Collar Implant ties more cells of Fibroblast and Osteoblast than CTR (Polimer used to induce cells adhesion) and much more than any Titanium Implant Cell Proliferation: Zirconia Collar Implant stimulates more creation of cells of Fibroblast and Osteoblast than CTR (Polimer used to induce cells adhesion) and much more than any Titanium Implant

Bacterial Colonization of Zirconia Ceramic Surfaces: an in vitro and in vivo study Author: Lisa Rimondini, Loredana Cerroni, Antonio Carrassi, Paola Torricelli. In: The international journal oral & maxillofacial implants (JOMI). Vol 17, Number 6, 2002 Publication on the Z1 (JOMI) MANUEL AMARO – Material e Equipamento Dentário

The international Journal of Oral & Maxillofacial Implants Comparison between 1 stage titanium implant and 1 stage zircon-titan implant Magnification x 6000 ZIRCONIUM-TITANIUM Very small colonization of bacteria TITANIUM Significant colonization of bacteria MIRROR STUDY Same patient – Same practitioner Publication on the Z1 (JOMI) MANUEL AMARO – Material e Equipamento Dentário

SEM micrograph of bacteria colonizing an as-fired Y-TZP surface (Tetragonal Zirconia Polycrystals Stabilized with Yttrium). A cluster of few cocci is Observable (original magnification x 6000; Bar = 1um) SEM micrograph of bacteria colonizing a TI surface (Commercially pure grade 2 Titanium). An homogeneous layer of cocci covers the specimen surface (original magnification x 6000;Bar = 1um) Publication on the Z1 (JOMI) MANUEL AMARO – Material e Equipamento Dentário

3 - ESTHETICS – In case of thin gingiva: natural transparency. 4 - SOLIDITY –Titanium circled with Zirconium : better resistance to occlusion forces. –The Z1 implants implants are up to a 3.5 times more resistant to occlusion forces than any other implant. Zirconium Advantages Z1 implant MANUEL AMARO – Material e Equipamento Dentário

An implant with no Zironium collar and with good Gingiva Grey Transparency MANUEL AMARO – Material e Equipamento Dentário

D = 0 D = 6 months 6 months after the prosthetics are attached, we notice an enhancement of the epithelial attachment formation Creeping Attachment MANUEL AMARO – Material e Equipamento Dentário

D = 24 months 24 months after the prosthetics are attached, we notice a confirmation of the epithelial attachment formation Creeping Attachment MANUEL AMARO – Material e Equipamento Dentário

D = 0 D = 12 months 12 months after the prosthetics are attached, we notice an enhancement of the epithelial attachment formation Creeping Attachment MANUEL AMARO – Material e Equipamento Dentário

Resistance of the Z1 implants 3.5 times more resistant than any titanium implants Resistibility up to 382 kg Resistibility of the titanium implants: kg OPTIMIZED RESISTIBILITY OF THE IMPLANT IN THE WORST-CASE SITUATION Shortest implant, smallest implant diameter, angulation of 35° Source COFRAC laboratory – French Ministry of Defense MANUEL AMARO – Material e Equipamento Dentário

Presentation of the T.B.R. Group and the T.B.R. system Perio-Integration and Titanium Zirconium Technology MANUEL AMARO Material Equipamento Dentário