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CMI Implants Optimized for AnyTime Loading

In the previous post, we confirmed that immobilization, rather than loading time, is the key factor for successful osseointegration of dental implants. For successful osseointegration, it is essential to have a prosthetic design that minimizes lateral forces, along with an implant design and drilling protocol that ensure the implants remain stable and immobile.

First, we will begin by examining the implant design in detail. The CMI Implant, specifically developed for AnyTime Loading, demonstrates remarkable success and reliability. The CMI IS-II & IS-III Active implants feature unique design elements, such as the magic thread, powerful taper apex, and SLA surface, ensuring strong primary stability and rapid osseointegration. Through various clinical studies, let's explore how the CMI Implant's design achieves optimal fixation.

Neobiotech’s 2006 Breakthrough: The Development of CMI Implants

In 2006, Neobiotech introduced the CMI Implant, featuring a unique taper and aggressive thread design aimed at ensuring good fixation even in soft bone. The CMI Implant series, designed for AnyTime Loading, has demonstrated remarkable success since its development.

Key Features of CMI Implants: Magic Thread, Taper Apex, and SLA Surface

CMI Implants feature a magic thread and powerful taper apex for strong primary stability, and an S.L.A. surface to ensure fast osseointegration.

• Magic Thread: CMI Implants are specifically designed to achieve strong fixation even in soft bone, capable of withstanding both occlusal and lateral forces

• Powerful Taper Apex: The narrow and tapered apex facilitates self-tapping and self-compaction, ensuring easy insertion and powerful apical fixation.
  

• S.L.A. Surface: The S.L.A(Sand-blasted, Large-grit, Acid-etched) surface has a combination of macropores and micropores formed by HA(Hydroxy Apatite) sandblasting with a particle size less than 50um and acid etching.

The more the surface area, the more direct bone-to implant contact(BIC) that stimulates osteoblasts and boosts blood flow leading to a faster and effective osseointegration.

IS-II Active vs. IS-III Active Implants: Comparing CMI Implant Features

The CMI implants’s IS System offer two main types, IS-II Active and IS-III Active, each with specific characteristics and indications suited to different clinical scenarios. Here's a detailed comparison of these two types:

[IS-II Active]

• BioSeal: A 0.5mm BioSeal that increase sealing of soft tissue and minimize bone loss at the crestal site

• Thread Pitch: 0.8mm thread pitch

• Surface Treatment: SLA surface, which increases the contact area between the implant and bone, promoting osseointegration.

• Indications:

  • Good for soft bone area(D3-D4)

  • Posterior maxilla

  • Immediate placement

  • Immediate loading in the posterior maxilla

[IS-III Active]

• Thread Pitch: 0.9mm thread pitch

• Surface Treatment: SLA surface

• Indications:

  • Good for hard bone area

  • All area

  • Immediate placement

  • Immediate loading

In summary, IS-II Active is particularly suitable for soft bone and the posterior maxilla, supporting immediate placement and immediate loading. On the other hand, IS-III Active is designed for hard bone and all areas, with platform switching that supports higher bone density.

By considering the specific characteristics and indications of each implant type, clinicians can enhance the success rate of implant procedures in various clinical scenarios.

Exploring Clinical Outcomes with CMI Implants

Let's examine CMI Implant’s clinical results in various cases to understand their effectiveness in different scenarios.

1) Achieving Stability in Soft Bone: CMI IS-II Active in Posterior Maxilla

In this case, CMI IS-II Active implants were successfully placed in the posterior maxilla, an area known for its challenging soft bone conditions. The posterior maxilla, particularly the sinus area, is softer and more difficult to achieve stable fixation in.

During the procedure, the implant was placed in the posterior maxilla where the bone quality was D4. Despite the softness of the bone, the CMI IS-II Active implant managed to secure a fixation ranging from 30-40N/cm. Due to the thread design of the CMI Implant, it achieved stability value of 80, 82, and 74, resulting in good fixation.

2) Overcoming Bone Deficiency: CMI IS-II Active Implant with Bone Graft

For this case, the patient presented with only 1mm of remaining bone in the posterior maxilla. Despite this challenging condition, the CMI IS-II Active implant was successfully placed and a bone graft was performed to ensure adequate support for the implant.

Four months post-surgery, a stability check was performed, yielding a value of 81. This high stability score indicates an excellent surface integration, showcasing the advanced design and surface quality of the CMI IS-II Active implant. The SLA surface characteristics that promotes faster and effective osseointegration contributed significantly to achieving this level of stability after 4 months.

3) Long-Term Success in Posterior Mandible with CMI IS-II Active

In this case, we explore the successful use of the CMI IS-II Active implant in the posterior mandible, demonstrating impressive long-term stability and integration.

The procedure began with the extraction of the tooth, followed by the immediate placement of the CMI IS-II Active implant directly into the extraction socket.

Three months post-procedure, the implant site showed significant healing, indicating successful integration of the implant into the bone.

8 months post-operative radiograph showed no signs of bone resorption around the implant.

Despite immediate placement of the implant in the extraction socket, follow-up results ranging from 2 to 9 years demonstrated that the implant was perfectly maintained. The radiograph clearly show the stability and integration of the implant over time, confirming the effectiveness of the CMI IS-II Active implant design in ensuring long-term success.

4) Initial Stability Changes of CMI IS-II Active Implant

In 2013, a study by Kim ST, Kim YT, Ki H, and Hwang SK, published in the Journal of Dental Implant Research, examined the initial stability changes of CMI IS-II active implants using an animal model with four beagle dogs. This study followed a clinical drilling and placement protocol developed by Dr. Heo and GAO colleagues since 2007. This protocol, specifically designed for CMI IS-II & IS-III implants, aimed to minimize the stability dip.

The study included two groups:

• Experimental Group: Neobiotech IS-II active implants

• Control Group: “C” implants

The results of the study indicated that, compared to other implants, the Neobiotech IS-II active implants exhibited no stability dip during the healing stage. This finding highlights the superior performance of IS-II active implants in maintaining stability. IS-II active implants demonstrated consistent stability, underscoring their reliability and effectiveness in implant procedures.

Summary & Next Step

In this post, we explored the remarkable success and reliability of the CMI Implant, introduced by Neobiotech in 2006. Specifically developed for AnyTime Loading, the CMI IS-II & IS-III Active features unique design elements, including the magic thread, powerful taper apex, and SLA surface, ensuring strong primary stability and rapid osseointegration. We have confirmed the effectiveness of the CMI Implant through various clinical studies that support its use in challenging scenarios, across different bone qualities and locations.

Do you believe that achieving high primary stability allows for Immediate Loading/Early Loading (IL/EL) “anytime”? If so, why don't we always aim for IL/EL by striving for the highest possible primary stability, such as insertion torque over 40N/cm? It’s because we know that a stability dip can occur from 1 to 8 weeks. In the next post, we will discuss how to eliminate the stability dip to make AnyTime Loading possible.