Any truth to Zimmer's trabecular implant?

Anonymous

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A few of my Perios have received invitations to a Zimmer trabecular impant symposium recently. One of them plans on attending. Does anyone know if this thing really allows bone to grow IN to the implant? The Zimmer rep told my perio that it is coming over from ZImmer ortho with years of human data. He said that the implant will be stable after 2 weeks with final crown being able to be placed at 4 to 6 weeks after implant placement. This will KILL my implant business as all gp's want new "teeth" as fast as possible so their patients pay for their next set of implants and get paid faster.

A) Does Zimmer ortho really have such an "amazing" implant made of trabecular?

B) Does Zimmer Dental really expect to launch this thing anytime soon?


Thanks!
 




A few of my Perios have received invitations to a Zimmer trabecular impant symposium recently. One of them plans on attending. Does anyone know if this thing really allows bone to grow IN to the implant? The Zimmer rep told my perio that it is coming over from ZImmer ortho with years of human data. He said that the implant will be stable after 2 weeks with final crown being able to be placed at 4 to 6 weeks after implant placement. This will KILL my implant business as all gp's want new "teeth" as fast as possible so their patients pay for their next set of implants and get paid faster.

A) Does Zimmer ortho really have such an "amazing" implant made of trabecular?

B) Does Zimmer Dental really expect to launch this thing anytime soon?


Thanks!

I think it is not going to make an impact in Implant Dentistry the implant would be somewhat porous. What happens if it becomes exposed to the oral environment. Orthopedics is a closed system.

Zimmer® Trabecular Metal™ Technology
Frequently Asked Questions
What is the advantage of Trabecular Metal Technology over other joint replacement materials?

In addition to being the orthopaedic metal that more closely resembles the physical and mechanical properties of healthy bone, Zimmer Trabecular Metal Technology has been clinically shown to have several advantages over other implant materials:



•Greater initial stability.
•Allows rapid and extensive bone in-growth1,3
Why is bone in-growth important?

Joint and spine surgery and bone replacement involves removing or resurfacing damaged surfaces and restoring them with artificial implants. Implants are secured to human bone in one of two ways – they are either cemented (cement is used to secure the implant to the bone) or cementless (natural human bone grows into, or heals directly to, the artificial implant). Several factors determine which method is used; most notably the quality of the natural bone to which the implant must adhere. Trabecular Metal Implants have the porosity and structure that allows for extensive bone in-growth, which creates a bond between the implant and the bone, and eliminates the need for bone cement. For patients who have acceptable bone quality, cementless techniques are the preferable way to attach implants to existing human bone.

Why is porosity important in an implant?

Bone is living tissue that grows into your implant, incorporating it into your body. The more porous the implant material – in other words, the more nooks and crannies – the more space is available for bone to grow in and secure the implant. Whereas other materials used for orthopaedic implants are only 35 percent to 50 percent porous, Trabecular Metal material is 75-80 percent porous.1,2,3.


Why is flexibility important?

Although sturdy, healthy human bone has a certain degree of flexibility to withstand the body’s weight, and daily wear and tear. Trabecular Metal Implants possess flexibility similar to bone, whereas other implant materials are far more rigid. Studies have indicated that implant materials that don’t flex well can cause bones to recede and lose strength over time 5,6,7.



How is Trabecular Metal Material used?

Trabecular Metal material is used in hundreds of hip, knee, shoulder and spine implants. Zimmer, a global leader in orthopaedics, is the only company that offers this material. Whereas other porous joint replacement materials can only be coated or sprayed onto orthopaedic implants, Trabecular Metal material can be used to create an entire implant. This material also may be infused or bonded to other types of implants in the areas that come in contact with your natural bone, to allow bone in-growth. Trabecular Metal Implants are placed by orthopaedic surgeons via traditional joint replacement surgery and Zimmer’s less-invasive Minimally Invasive Solutions™ (MIS™) techniques.
 








I think it is not going to make an impact in Implant Dentistry the implant would be somewhat porous. What happens if it becomes exposed to the oral environment. Orthopedics is a closed system.

mmer® Trabecular Metal™ Technology
Frequently Asked Questions E
What is the advantage of Trabecular Metal Technology over other joint replacement materials?

In addition to being the orthopaedic metal that more closely resembles the physical and mechanical properties of healthy bone, Zimmer Trabecular Metal Technology has been clinically shown to have several advantages over other implant materials:



•Greater initial stability.
•Allows rapid and extensive bone in-growth1,3
Why is bone in-growth important?

Joint and spine surgery and bone replacement involves removing or resurfacing damaged surfaces and restoring them with artificial implants. Implants are secured to human bone in one of two ways – they are either cemented (cement is used to secure the implant to the bone) or cementless (natural human bone grows into, or heals directly to, the artificial implant). Several factors determine which method is used; most notably the quality of the natural bone to which the implant must adhere. Trabecular Metal Implants have the porosity and structure that allows for extensive bone in-growth, which creates a bond between the implant and the bone, and eliminates the need for bone cement. For patients who have acceptable bone quality, cementless techniques are the preferable way to attach implants to existing human bone.

Why is porosity important in an implant?

Bone is living tissue that grows into your implant, incorporating it into your body. The more porous the implant material – in other words, the more nooks and crannies – the more space is available for bone to grow in and secure the implant. Whereas other materials used for orthopaedic implants are only 35 percent to 50 percent porous, Trabecular Metal material is 75-80 percent porous.1,2,3.


Why is flexibility important?

Although sturdy, healthy human bone has a certain degree of flexibility to withstand the body’s weight, and daily wear and tear. Trabecular Metal Implants possess flexibility similar to bone, whereas other implant materials are far more rigid. Studies have indicated that implant materials that don’t flex well can cause bones to recede and lose strength over time 5,6,7.



How is Trabecular Metal Material used?

Trabecular Metal material is used in hundreds of hip, knee, shoulder and spine implants. Zimmer, a global leader in orthopaedics, is the only company that offers this material. Whereas other porous joint replacement materials can only be coated or sprayed onto orthopaedic implants, Trabecular Metal material can be used to create an entire implant. This material also may be infused or bonded to other types of implants in the areas that come in contact with your natural bone, to allow bone in-growth. Trabecular Metal Implants are placed by orthopaedic surgeons via traditional joint replacement surgery and Zimmer’s less-invasive Minimally Invasive Solutions™ (MIS™) techniques.




Sorry to play devil's advocate here, but for you to claim that it will not make an impact in implant dentistry with no real argument other than the question: "what if infection gets into the oral space, this is not closed surgery like in orthopaedics" is a weak and ignorant point.

In fact, I know a couple orthopods who said that that is the same fear mongering negative strategy that competitive device reps said when Zimmer launched TMT in '98. I think that you really have no clue as to the science, capability, or engineering of this new implant and it's design ( i.e. the implant having acid etched titanium micro threads at the coronal aspec of the implant w/ the porous trabecular metal always sub crestal, thereby destroying your what if theory of " infection").

This is going to be a complete analog of what happened in total joins after Zimmer launhed TMT: competitors downplaying it's effect and subsequently losing tremendous matketshare to Zimmer. Zimmer lept from number 3 to number 1 one and a half years after TMT entered the space. And Zimmer has been #1 ever since.

And please, enogh with the "what about infection" scare tactics. We have infections w/out a porous implant anyways. And infections in the orthopaedics space are a life threatening concern instead of just annoyance like in dental. So for 12 years if surgeons still rely on TMT in orthopedics w/ the "fear of infection" being rendered a baseless claim, I'm confident the same pardigm shit will occur in dental.
 




Sorry to play devil's advocate here, but for you to claim that it will not make an impact in implant dentistry with no real argument other than the question: "what if infection gets into the oral space, this is not closed surgery like in orthopaedics" is a weak and ignorant point.

In fact, I know a couple orthopods who said that that is the same fear mongering negative strategy that competitive device reps said when Zimmer launched TMT in '98. I think that you really have no clue as to the science, capability, or engineering of this new implant and it's design ( i.e. the implant having acid etched titanium micro threads at the coronal aspec of the implant w/ the porous trabecular metal always sub crestal, thereby destroying your what if theory of " infection").

This is going to be a complete analog of what happened in total joins after Zimmer launhed TMT: competitors downplaying it's effect and subsequently losing tremendous matketshare to Zimmer. Zimmer lept from number 3 to number 1 one and a half years after TMT entered the space. And Zimmer has been #1 ever since.

And please, enogh with the "what about infection" scare tactics. We have infections w/out a porous implant anyways. And infections in the orthopaedics space are a life threatening concern instead of just annoyance like in dental. So for 12 years if surgeons still rely on TMT in orthopedics w/ the "fear of infection" being rendered a baseless claim, I'm confident the same pardigm shit will occur in dental.

Zimmer seems to be in the news with respect to issues with their orthopedic implants. And isn't Nobel involved in a class action law suit involving the NobelDirect fixture? Niznick mentioned that the design resulted in Nobel's surface being exposed to the oral environment because the inventor didn't think this would be a problem. Apparently that isn't the case.......................

Doesn't immediate or early loading have more to due with fixture geometry, thread design, insertion torque and initial RFA values? How about a thread pattern and fixture geometry that results in a reduced ITV's but establishes a high RFA reading at the time of insertion? I believe Clark Stanford published a paper showing the if fixture had a high initial RFA value it did not drop off at 3-4 weeks as many of us have been lead to believe.
 




In other words, this implant will end up in the same niche place that Medtronic's Infuse did in Dental. It will not be used in all implant applications because of the risk of loosing the entire implant to infection. Blasted surfaces can at least be nursed back, but trabecular surfaces will carry a small infection throughout the body of an implant causing the entire implant to fail. Its not a guess, it will happen and you will see clinicians very quickly shy away from this implant. Good for Zimmer for moving in this direction, but its not going to make a difference. Its just another short term ploy to create buzz, but this ortho application will not be as predictable in Dental.
 




In other words, this implant will end up in the same niche place that Medtronic's Infuse did in Dental. It will not be used in all implant applications because of the risk of loosing the entire implant to infection. Blasted surfaces can at least be nursed back, but trabecular surfaces will carry a small infection throughout the body of an implant causing the entire implant to fail. Its not a guess, it will happen and you will see clinicians very quickly shy away from this implant. Good for Zimmer for moving in this direction, but its not going to make a difference. Its just another short term ploy to create buzz, but this ortho application will not be as predictable in Dental.

All I can say is you are wrong.
 




Actually Implant Direct has a knock off of the Trabecular bone implant coming out, its called
"The Re-Trabecular Bone" implant. Should be out the day after Zimmer launches theirs.
 




To the dentist this will sound a lot like another zimmer innovation from orthopedics - HA coatings. Even though they are different materials there is some credence to the concerns about infection that are justified. Also for immediate load the design of the implant is just as/ more important than the surface.

Will look forward to the data on this implant before passing judgement.
 








Actually Implant Direct has a knock off of the Trabecular bone implant coming out, its called
"The Re-Trabecular Bone" implant. Should be out the day after Zimmer launches theirs.

After porous surface implants like TPS and Innova beads, it is unlikely that Niznick is going to change surfaces. After all, Zimmer is claiming 99% success with the Tapered Screw that Jerry sold them 9 years ago, so what improvement can one expect over those numbers. As for earlier loading, you can not get earlier than "immediate" and that is what you can do with any implant if it gets enough initial stabiltiy. Stability is enhanced with thread engagement....trabecular metal sections will be absent threads most likely.
 




After porous surface implants like TPS and Innova beads, it is unlikely that Niznick is going to change surfaces. After all, Zimmer is claiming 99% success with the Tapered Screw that Jerry sold them 9 years ago, so what improvement can one expect over those numbers. As for earlier loading, you can not get earlier than "immediate" and that is what you can do with any implant if it gets enough initial stabiltiy. Stability is enhanced with thread engagement....trabecular metal sections will be absent threads most likely.

Hey geniouses, get ready to get bi*%# slapped. Surgeons are placing and "FULLY RESTORING" these new Trabecular Metal Dental Implants in less than 1 month. I have seen them reverse torqued in the office after being in the mouth for only 2 weeks and they are solid. Tell me one other competitive product that even comes close. After Zimmer takes the #1 Market position and all of you bullsh$t competitive Reps are on the street wondering what happend to your cushy jobs, maybe you will really appreciate what is happening in Dental right now and get used to the unemployment line. :)
 








Hey geniouses, get ready to get bi*%# slapped. Surgeons are placing and "FULLY RESTORING" these new Trabecular Metal Dental Implants in less than 1 month. I have seen them reverse torqued in the office after being in the mouth for only 2 weeks and they are solid. Tell me one other competitive product that even comes close. After Zimmer takes the #1 Market position and all of you bullsh$t competitive Reps are on the street wondering what happend to your cushy jobs, maybe you will really appreciate what is happening in Dental right now and get used to the unemployment line. :)

Unfortunately, most implant placing dentists don't care about "speed of restoring" the implant. They care how much it is going to cost. They don't care about how much happier their patients will be having their case finished that quickly. They will whine about having to pay $200 more for the implant and say "my patients don't care how fast it gets restored".
 




Unfortunately, most implant placing dentists don't care about "speed of restoring" the implant. They care how much it is going to cost. They don't care about how much happier their patients will be having their case finished that quickly. They will whine about having to pay $200 more for the implant and say "my patients don't care how fast it gets restored".

This product is selling like crazy accorss the US. Surgeons are treatment planning this product at a higher price point to cover their additional matierial cost and actually making more profit to boot. Raising your Implant fee by $500 over the norm is working wonderfully and patients are more than willing to pay the extra $$$ for the latest technology and the highest level of service. Not only do the patients care how fast it gets restored, the Referalls really care as their ability to collect 5x faster is something they are really interested in. What business school did you drop out of?
 




"Raising your Implant fee by $500 over the norm is working wonderfully and patients are more than willing to pay the extra $$$ for the latest technology and the highest level of service."

Working wonderfully. They LIKE being charged $ 500 more per unit...

You should go to DC and work for Vladimir Hope & Change. He's going to need all the help like this he can get.
 




This product is selling like crazy accorss the US. Surgeons are treatment planning this product at a higher price point to cover their additional matierial cost and actually making more profit to boot. Raising your Implant fee by $500 over the norm is working wonderfully and patients are more than willing to pay the extra $$$ for the latest technology and the highest level of service. Not only do the patients care how fast it gets restored, the Referalls really care as their ability to collect 5x faster is something they are really interested in. What business school did you drop out of?

Ya, I'm sure surgeons are raising their fees $500 and patients are jumping at it. Surgeons have no clue how to upsell a patient. And if they were able to have a patient accept a $500 raise, they'd STILL get cheap and buy a lower priced implant.

Stop making shit up.
 




Ya, I'm sure surgeons are raising their fees $500 and patients are jumping at it. Surgeons have no clue how to upsell a patient. And if they were able to have a patient accept a $500 raise, they'd STILL get cheap and buy a lower priced implant.

Stop making shit up.

You must be one of the Competitive Reps bad mouthing the product. The Trabecular Metal Implant is selling like crazy. Almost $1 million in Sales in less than 3 months on the market. Do you think Surgeons are "eating the extra cost". NO. Stop telling yourself that it won't work when it clearly is working. Jerry doesn't have a clone copy for this one. Just because you tell yourself that your cheap shit Implants are good at your self help meetings, doesn't make them good. You are responsible for clueless patients getting the lowest quality products on the market. I can't imagine how well you sleep at night.
 




You must be one of the Competitive Reps bad mouthing the product. The Trabecular Metal Implant is selling like crazy. Almost $1 million in Sales in less than 3 months on the market. Do you think Surgeons are "eating the extra cost". NO. Stop telling yourself that it won't work when it clearly is working. Jerry doesn't have a clone copy for this one. Just because you tell yourself that your cheap shit Implants are good at your self help meetings, doesn't make them good. You are responsible for clueless patients getting the lowest quality products on the market. I can't imagine how well you sleep at night.

Why do you ASSume I work for a competitor? I don't. And "almost $1 mil in 3 months" isn't that good when you figure it costs $400+. That calculates out to about 20 implants/rep. That's only 1 or 2 surgeons in each territory buying. Big deal.
 




Pure comedy gold. The state-of-the-implant ground game. With laser-like intellect like this, no wonder America is doomed.

"Just because you tell yourself that your cheap shit Implants are good at your self help meetings, doesn't make them good. You are responsible for clueless patients getting the lowest quality products on the market. I can't imagine how well you sleep at night."

You should try out for the TSA. They need more brainwashed goons.