The article by Varghese et al. [1] mentioning about a novel implant (HYBRID IMPLANT submitted for patency), is similar to IHDE onlay miniplate integrated implant [2] marketed as BAC and BAC2 (not to be confused with their classical lateral osteotomy BOI implant) a manufacturer from Germany which is registered and Swiss patent specification CH 690 416 A5 and a corollary to EP 99250289.8 for which the production calming for more than 25 years.
Points of disagreement are:
-
A.
Obviously there is no way for the single piece implants to remain completely “nonloaded” once they are located within the bone; part of this rationale is to insert the superstructure while excellent primary stability is present. Following this logic, prosthetic loading should take place within the 8–12 days (but sooner, the better), while author advocated a prosthetic phase in third month which makes the suprastructure more prone to preload stress and further higher rate of its failure.
-
B.
As rigid splinting is not possible for single-tooth implants, immediate restorations without or with reduced occlusal contacts have been advocated for single tooth implants [3]. And more logically in selection criteria of such implant cases must have minimum placement of three implants to control the vector and occlusal force by tripod effect.
-
C.
Furthermore, the values of bone density must be the primary criteria even for disk/plate supported implants. In general, researchers and developers have worked on three different approaches: adapted anchoring implants, improved load distribution, and augmentation techniques [4]. The load can often exceed the strain tolerance of osteoporotic bone. This may result in microfracture, resorption of the bone, failure of fixation [5]. Author implant is purely based on the concept of onlay miniplate and fixation with mini screws, but author failed to consider the vital principle to improve the success of their implant cases.
References
- 1.Varghese M, et al. Hybrid implant: a novel implant system. J Maxillofac Oral Surg. 2015;14(3):720–727. doi: 10.1007/s12663-014-0722-9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.http://www.implant.com/images/kataloge/Katalog_EN.pdf p 100
- 3.Wöhrle PS. Single-tooth replacement in the aesthetic zone with immediate provisionalization: fourteen consecutive case reports. Pract Periodontics Aesthet Dent. 1998;10:1107–1114. [PubMed] [Google Scholar]
- 4.Curtis R, Goldhahn J, Schwyn R, et al. Fixation principles in metaphyseal bone: a patent based review. Osteoporos Int. 2005;16(2):S54–S64. doi: 10.1007/s00198-004-1763-6. [DOI] [PubMed] [Google Scholar]
- 5.Giannoudis PV, Schneider E. Principles of fixation of osteoporotic fractures. J Bone Joint Surg Br. 2006;88-B:1272–1278. doi: 10.1302/0301-620X.88B10.17683. [DOI] [PubMed] [Google Scholar]