I mean ...recommending to first try inserting a tapered Screw-Vent and then remove it if it doesn't achieve the immediate load threshold of 35Ncm and replace it immediately with a TM implant so that you can load it in maybe 6-8 weeks instead of waiting 8-10 weeks. It is well documented that bone forms faster on an HA surface so why not just use the HA coated Screw-Vent and either load it immediately or wait 6/8 weeks in soft bone? Given the fact that the TM implant has half the thread surface of a Screw-Vent and is primarily straight, it is a poorer design for immediate load than the tapered Screw-Vent and it has no studies showing that it could be loaded in 6 weeks in bone quality compared to a Taperd Screw-Vent in the same bone.
The only justification for Zimmer selling the TM implant is it's $54 increased price. It comes at a greater risk of contamination if the TM surface becomes exposed, the increased risk of not achieving adequate initial stability in soft bone to achieve Osseointegration because of the lack of threads, and an increased risk of implant fracture in insertion or in function because threads in the mid-section were removed, leaving a narrow core to make room for TM with no structural strength.
I am not a "newby" but in fact am the inventor of the Straight (1986) and tapered(1999) Screw-Vend. I know how to improve the Screw-Vent which is why the Legacry2 was Voted one of the top 25 implant products of 2011 by Dental Products Review's readers. Zimmer apparently does not understand why the Tapered Screw-Vent was so successful, or they would not have made the Trabecular Metal version of the Screw-Vent.
What Zimmer understands well, is that selling your Screw-vent was not getting them to the promised land. They have had to discount the crap out of it to 2nd and 3rd tier surgeons just to sell it. It was and is not inspiring the big boys to get on the bus, and Zimmer has been wallowing in the 5 hole for years because of it.
Now, what did they need to do? That's right, COME UP WITH SOMETHING NEW ON THEIR OWN! Tough to do when you are the implant equivalent of a mafia store front. In fact, they DID NOT come up with something on their own, it was ripped off from daddy Zimmer Ortho. So, here's your trabecular metal thingy, and now we are on to PART II, which is to convince the surgical public that this contraption is a.) necessary, and b.) worth the added cost. (Let me be spoiler to the ending of the movie-it isn't, and it isn't.) Even if it actually WAS, Zimmer does not have the reputation and business base required to change the market. This is primarily where selling Mr. Niznick's product for years got them, and you have to dance with the girl that brung ya.
Niznick is right, and wrong, as usual. No one needs the unproven, mechanically and potentially periodontally unsound TM at $495, but we all do need to do better in the market than TSV and Legacy2. One of the "top 25" implant products of 2011? That's your selling point? Bro, it needs to be THE NUMBER 1 for you to have a shot at all at the title. Not too inspiring to the masses, Niz. That's like saying Miss Grenada has a chance of winning Miss Universe. No offense intended to all you Grenadians out there, of course.
Let unschooled Zimmer reps crow about it for a while because that's their job, I guess. In the end, it will fall to the scrap heap with the others, and Zimmer will have to try another avenue to move up from where they are. In either instance, it'll be fun to watch.
