Exclusive Look
at Prof Nicolau's
2016 EAO
Presentation

DISTINCT NANO-STRUCTURES PRESENT ON THE SLACTIVE SURFACE27,28

Roxolid® SLA®
Roxolid® SLActive®

Distinct nano-structures recently discovered on the SLActive® surface, prove for the first time, that the SLActive® surface topography differs from that of SLA.®

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NANO-STRUCTURES ON SLACTIVE® INCREASE SURFACE
AREA BY MORE THAN 50%25

Implant surface area increase:
+50% more than Roxolid ® SLA®

Y-axis: 1 = 100 %

How to maximize
your implant surface?

Advanced in-vitro research shows
nano-structures support early osseointegration23,24

ENHANCED FIBRIN NETWORK FORMATION ON SLACTIVE® WITH NANO-STRUCTURES23,24

Roxolid® SLActive® surface
without nano-structures**
Roxolid® SLActive® surface
with nano-structures

SEM imaging of fibrin network formation on Roxolid® SLActive® (15 min incubation with human whole blood).*

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HIGHER BONE CELL MINERALISATION ON SLACTIVE® WITH NANO-STRUCTURE23,24

Mineralisation of human bone cells measured after 28 days laid on top of blood incubated surfaces. Summarized Ca2+ concentrations at the end of culture as a function of surface.*




* Empa, Swiss Federal Laboratories for Materials Science and Technology. www.empa.ch
** Experimental surface to study the effect of nanostructures

Immediate
Loading

High predictability
in immediate loading

Compromised
Patients

Outstanding success
rates in compromised
patient groups

Enhanced
Bone Grafting

Significantly higher
formation of new
bone aggregate

Setting the standard for success.
Performance beyond imagination.

Together with leading clinicians worldwide, Straumann has studied the clinical performance of SLActive® implants under the most challenging medical conditions and treatment protocols to demonstrate the outstanding healing capacity of the SLActive® surface.

As new insights emerge and new data becomes available, discover how you can benefit from the high performance SLActive® surface to support your patients’ healing capabilities.

implant survival rate in
immediate loading after
10 years2
 
98.2%
survival rate
Randomised controlled
multicenter study
(30 patients, 39 implants)

IMPLANT SUCCESS RATE
IN IRRADIATED PATIENTS
WITH COMPROMISED
BONE, AFTER 1 YEAR3

100%
success rate

Randomised
Clinical Trial
(19 patients, 97 implants)

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Immediate loading

with long-lasting results.

Immediate loading allows the patient to benefit from the restoration straightaway after implant placement. 
However, this demanding protocol carries a higher risk of implant failure.

implant survival rate in
immediate loading after
10 years2
98.2%
survival rate
Randomised controlled
multicenter study
(30 patients, 39 implants)
  • New long-term data from randomized, controlled, multicenter study demonstrates impressive performance of SLActive® with immediate loading.
  • In fact, the SLActive® implants delivered a 10-year survival rate of 98.2 % in this challenging protocol.2

Key researchers behind the study

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Download Study Overview
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SLActive® in irradiated patients.

Predictability beyond expectations

One of the most challenging patient groups for implant treatment includes patients who have undergone a combination of tumor surgery, chemotherapy and radiotherapy. The bone quality in these patients is severely compromised.

SLActive® Performance in irradiated patients

1-year follow-up3

1 patient was excluded from the study due to tumour recurrence. The graph is thus based on 19 patients with 97 implants.

5-year follow-up13,14

Excluding 4 further patients deceased due to cancer The graph is thus based on 15 patients with 79 implants.

Randomized Clinical Trial:3
  • 102 implants, 20 patients
  • Post-surgery, radiotherapy and chemotherapy for oral carcinoma
* Success criteria as per Buser D. et al. Long-term stability of osseointegrated implants in augmented bone: A 5-year prospective study in partially edentulous patients. Int J Periodont Restor Dent. 2002; 22: 108–17.
** Adjusted, excluding the patients deceased due to cancer mortality.

5-year follow up:
latest publication

What clinicians say

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NEWS UPDATE from Dental Tribune International

Watch an interview with Prof Nelson to get to know more about the study and challenges of prosthetic rehabilitation of irradiated patients.

Discover how SLActive® implants improved the quality of life in these patients.

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Download Study Overview
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Uncompromised performance.

Even in diabetic patients.

  • Patients with diabetes have reduced wound healing capacity,15,16 which puts implants at risk
  • Worldwide, 1 in 6 adults 60 years of age and older  has diabetes.17

Given the ever rising prevalence of type 2 diabetes, how can clinicians address this risk particularly in older patients?


GROWING CLINICAL EVIDENCE OF highly predictable PERFORMANCE OF SLActive® IN DIABETIC PATIENTS:

A new clinical study19 that compared SLActive® performance in patients with and without dia­betes showed uncompromised performance of SLActive® implants:

  • 100 % implant success rate in the diabetic group after 2 years
  • Bone changes similar to those in healthy individuals
  • Despite the observed lower levels of bone quality all implants in this study showed good primary stability.

Performance in
diabetic patient group19

100%
success rate
Prospective case-control
clinical study (15 diabetic and
14 non-diabetic individuals)

Key Researchers Behind the Study

What clinicians say

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Download Study Overview
2-year results, as presented at EAO 2017
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The placement of implants in smokers is often associated with high failure rates, risk of post-operative infections, and marginal bone loss.29


HIGH PREDICTABILITY IN SMOKERS:
  • A recent clinical study comparing SLActive® performance in smokers and non-smoker patient groups reported excellent outcomes with SLActive®:
  • Roxolid® SLActive® narrow diameter implants showed 100% survival rate in the smokers group after 6 months
  • No difference in marginal bone loss between smokers and non-smokers

Performance in
smoker patient group30

100%
survival rate
Prospective case-control
clinical study (37 smokers and
36 non-smokers)
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Roxolid SLActive® surface stimulates an early anti-inflammatory cell response20
  • New research shows SLActive® surface stimulates an early anti-inflammatory cell response compared to non SLActive surface as measured in vitro as a reduction in pro inflammatory markers* and an increase in anti-inflammatory** markers.31
  • SLActive® is associated with an increased anti-inflammatory macrophage response in the early healing phase in both healthy and diabetic animals. This may be an important mechanism to improve osseous healing under compromised systemic conditions.21
Brand new data on the SLActive®’s anti-inflammatory cell response has been presented at the 95th General Session of International Association for Dental Research, US:
 
Learn more
*Il1b, Il6, Tnfa, IL-1beta, IL-6, TNF-alpha, (pro-inflammatory)
**Il10, Tgfb1, Chil3, Rentla, IL-4, IL-10 (anti-inflammatory)
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Download the SLActive® Brochure
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Enhanced bone regeneration.

Even at compromised sites.

Enhanced
Bone Grafting

Bone defects can greatly compromise the predictability of osseointegration.

  • In a recent preclinical study22, SLActive® showed significantly higher formation of new bone aggregate within eight weeks compared to the standard Straumann® SLA® hydrophobic surface.

Bone aggregate formation at 8 weeks.22

Histological views of bone aggregate (new bone and grafting material) 8 weeks post-grafting.

What clinicians say

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Discover the healing power of the high performance surface

What Clinicians Say

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REFERENCES

1 Straumann SLActive implants compared to Straumann SLA implants. Lang NP, Salvi GE, Huynh-Ba G, Ivanovski S, Donos N, Bosshardt DD. Early osseointegration to hydrophilic and hydrophobic implant surfaces in humans. Clin Oral Implants Res. 2011 Apr;22(4):349-56. doi: 10.1111/j.1600-0501.2011.02172.x; Rupp F, Scheideler L, Olshanska N, de Wild M, Wieland M, Geis-Gerstorfer J. Enhancing surface free energy and hydrophilicity through chemical modification of microstructured titanium implant surfaces. Journal of Biomedical Materials Research A, 76(2):323-334, 2006. ; De Wild M. Superhydrophilic SLActive® implants. Straumann document 151.52, 2005 ; Katharina Maniura. Laboratory for Materials – Biology Interactions Empa, St. Gallen, Switzerland Protein and blood adsorption on Ti and TiZr implants as a model for osseointegration. EAO 22nd Annual Scientific Meeting, October 17 – 19 2013, Dublin ; Schwarz, F., et al., Bone regeneration in dehiscence-type defects at non-submerged and submerged chemically modified (SLActive®) and conventional SLA® titanium implants: an immunohistochemical study in dogs. J Clin.Periodontol. 35.1 (2008): 64–75. ; Rausch-fan X, Qu Z, Wieland M, Matejka M, Schedle A. Differentiation and cytokine synthesis of human alveolar osteoblasts compared to osteoblast-like cells (MG63) in response to titanium surfaces. Dental Materials 2008 Jan;24(1):102-10. Epub 2007 Apr 27. ; Schwarz F, Herten M, Sager M, Wieland M, Dard M, Becker J. Histological and immunohistochemical analysis of initial and early osseous integration at chemically modified and conventional SLA® titanium implants: Preliminary results of a pilot study in dogs. Clinical Oral Implants Research, 11(4): 481-488, 2007. Raghavendra S, Wood MC, Taylor TD. Int. J. Oral Maxillofac. Implants. 2005 May–Jun;20(3):425–31. 9 Oates TW, Valderrama P, Bischof M, Nedir R, Jones A, Simpson J, Toutenburg H, Cochran DL. Enhanced implant stability with a chemically modified SLA® surface: a randomized pilot study. Int. J. Oral Maxillofac. Implants. 2007;22(5):755–760.

2 Nicolau P, Guerra F, Reis R, Krafft T, Benz K , Jackowski J 10-year results from a randomized controlled multicenter study with immediately and early loaded SLActive implants in posterior jaws. Accepted for oral presentation at 25th Annual Scientific Meeting of the European Association of Osseointegration – 29 Sep – 1 Oct 2016, Paris.

3 Patients treated with dental implants after surgery and radio-chemotherapy of oral cancer. Heberer S, Kilic S, Hossamo J, Raguse J-D, Nelson K. Rehabilitation of irradiated patients with modified and conventional sandblasted, acid-etched implants: preliminary results of a split-mouth study. Clin. Oral Impl. Res. 22, 2011; 546–551.

4 Yerit, K., Posch, M., Seemann, M., Hainich, S., Dortbudak, O., Turhani, D., Ozyuvaci, H., Watzinger, R. and Ewers, R. (2006) Implant Survival in Mandibles of Irradiated Oral Cancer Patients. Clinical Oral Implants Research, 17, 337-344. http://dx.doi.org/10.1111/j.1600-0501.2005.01160.x.

5 Verdonck, H.W.D., Meijer, G.J., Laurin, T., Nieman, F.H.M., Stoll, C., Riediger, D., Stoelinga, P.J.W. and de Baat, C. (2007) Assessment of Vascularity in Irradiated and Non-Irradiated Maxillary and Mandibular Alveolar Minipig Bone Using Laser Doppler Flowmetry. International Journal of Oral Maxillofacial Implants, 22, 774-778.

6 Hu, W.W., Ward, B.B., Wang, Z. and Krebsbach, P.H. (2010) Bone Regeneration in Defects Compromised by Radiotherapy. Journal of Dental Research, 89, 77-81. http://dx.doi.org/10.1177/0022034509352151.

7 Wang, R., Pillai, K. and Jones, P.K. (1998) Dosimetric Measurements of Scatter Radiation from Dental Implants in Stimulated Head and Neck Radiotherapy. International Journal of Oral Maxillofacial Implants, 13, 197-203.

8 Grotz, K.A., Al-Nawas, B., Piepkorn, B., Reichert, T.E., Duschner, H. and Wagner, W.(1999) Micromorphological Findings in Jaw Bone after Radiotherapy. Mund-, Kiefer- und Gesichtschirurgie, 3, 140-145.

9 Chambrone L, Mandia J, Shibli JA, Romito GA, Abrahao M. Dental Implants Installed in Irradiated Jaws: A Systematic Review. Journal of Dental Research. 2013;92(12 Suppl):119S-130S. doi:10.1177/0022034513504947.

10 Shugaa-Addin B, Al-Shamiri H-M, Al-Maweri S, Tarakji B. The effect of radiotherapy on survival of dental implants in head and neck cancer patients. Journal of Clinical and Experimental Dentistry. 2016;8(2):e194-e200. doi:10.4317/jced.52346.

11 Nooh N. Dental implant survival in irradiated oral cancer patients: a systematic review of the literature. Int J Oral Maxillofac Implants. 2013 Sep-Oct;28(5):1233-42. doi: 10.11607/jomi.3045.

12 Dholam KP, Gurav SV. Dental implants in irradiated jaws: A literature review. J Can Res Ther [serial online] 2012 [cited 2016 Aug 17];8:85-93. Available from: http://www.cancerjournal.net/text.asp?2012/8/6/85/92220.

13 Nelson, K., Stricker, A., Raguse, J.-D. and Nahles, S. (2016), Rehabilitation of irradiated patients with chemically modified and conventional SLA implants: a clinical clarification. J Oral Rehabil, 43: 871–872. doi:10.1111/joor.12434

14 C. NACK, J.-D. RAGUSE, A. STRICKER , K. NELSON & S. NAHLES. Rehabilitation of irradiated patients with chemically modified and conventional SLA implants: five-year follow-up. Journal of Oral Rehabilitation 2015 42; 57—64.

15 Devlin H, Garland H, Sloan P. Healing of tooth extraction sockets in experimental diabetes mellitus. J. of Oral Maxillofac. Surg. 1996; 54:1087-1091

16 Wang F1, Song YL, Li DH, Li CX, Wang Y, Zhang N, Wang BG. Type 2 diabetes mellitus impairs bone healing of dental implants in GK rats. Diabetes Res Clin Pract. 2010; 88:e7-9.

17 IDF Diabetes Atlas, 7th Edition, 2015 http://www.diabetesatlas.org/.

18 US Centers for Disease Control and Prevention. Diabetes 2014 report card. Available from: www.cdc.gov/diabetes/library/reports/congress.html. Accessed September 2015.

19 Cabrera-Domínguez J, Castellanos-Cosano L, Torres-Lagares D, Machuca-Portillo G. A Prospective Case-Control Clinical Study of Titanium-Zirconium Alloy Implants with a Hydrophilic Surface in Patients with Type 2 Diabetes Mellitus. Int J Oral Maxillofac Implants. 2017 Sep/Oct;32(5):1135-1144. doi: 10.11607/jomi.5577;   Cabrera-Domínguez J. A prospective, two-year clinical trial of titanium-zirconium alloy implants (Roxolid® Straumann®) with hydrophilic surface (SLActive®) in patients with Type 2 Diabetes Mellitus. presented during 26th Annual Scientific Meeting of the European Association of Osseointegration – 5-7 Oct 2017, Madrid, Spain.

20 Hotchkiss KM, Ayad NB, Hyzy SL, Boyan BD, Olivares-Navarrete R. Dental implant surface chemistry and energy alter macrophage activation in vitro. Clin. Oral Impl. Res. 00, 2016, 1–10. doi: 10.1111/clr.12814.

21 Lee R, Hamlet SM, Ivanovski S. The influence of titanium surface characteristics on macrophage phenotype polarization during osseous healing in type I diabetic rats: A pilot study. Clin Oral Impl Res (accepted 4/8/2016).

22 Straumann (2016). SLActive supports enhanced bone formation in a minipig surgical GBR model with coronal circumferential defects. Unpublished data.

23 Müller E, Rottmar M, Guimond S, Tobler U, Stephan M, Berner S, Maniura K The interplay of surface chemistry and (nano-)topography defines the osseointegrative potential of Roxolid® dental implant surfaces. eCM Meeting Abstracts 2017, Collection 3; SSB+RM (page 31).

24 EMPA (2017) Report additional experiments: Impact of RXD SLA, RXD SLAnano, RXD SLActive, and RXD pmod SLA surfaces on protein adsorption, blood coagulation, and osteogenic differentiation of HBCs. Final report: Impact of RXD SLA, RXD SLAnano, RXD SLActive, and RXD pmod SLA surfaces on protein adsorption, blood coagulation, and osteogenic differentiation of HBCs. EMPA, Swiss Federal Laboratories for Materials Science and Technology (data on file).

25 Strauamnn (2017) Developed area ratio by nanostructures on Rxd modMA surface. Report SR0748. Unpublished data.

26 Wennerberg A, Albrektsson T. On implant surfaces: a review of current knowledge and opinions. Int J Oral maxillofac Implants 2009: 24:63-74

27 Kopf BS, Ruch S, Berner S, Spencer ND, Maniura-Weber K. 2015. The role of nanostructures and hydrophilicity in osseointegration: In-vitro protein-adsorption and blood-interaction studies. J Biomed Mater Res Part A2015:103A:2661–2672.

28 Wennerberg A, Jimbo R, Stübinger S, Obrecht M, Dard M, Berner S. Nanostructures and hydrophilicity influence osseointegration – A biomechanical study in the rabbit tibia. Clin. Oral Impl. Res. 25, 2014, 1041–1050doi: 10.1111/clr.12213

29 Chrcanovic BR, Albrektsson T, Wennerberg A Smoking and dental implants: A systematic review and meta-analysis. J Dent. 2015 May;43(5):487-98

30 ChenY, Man Y Clinical evaluation of SLActive Titaniumzirconium narrow diameter implants for anterior and posterior crowns in smokers and nonsmokers group. Presented at the ITI World Symposium, Basel, May4-6, 2017 Abstract booklet: Clinical Research 045, p18.

31 Hotchkiss K.M, Sowers K.T, Olivares-Navarrete R. Clinical Implants Differentially Modulate Inflammatory Response and Osteogenic Differentiation. Presented at 95th General Session of International Association for Dental Research, USA, March 22-25, 2017. https://iadr2017.zerista.com/event/member?item_id=5725415

32 Hsu JT, Shen YW, Kuo CW, Wang RT, Fuh LJ, Huang HL. Impacts of 3D bone-to- implant contact and implant diameter on primary stability of dental implant. J Formos Med Assoc. 2017 Aug;116(8):582-590. ; Buser D, Schenk RK, Steinemann S, Fiorellini JP, Fox CH, Stich H. Influence of surface characteristics on bone integration of titanium implants. A histomorphometric study in miniature pigs. J Biomed Mater Res. 1991 Jul;25(7):889-902 ; Smeets R, Stadlinger B, Schwarz F, Beck-Broichsitter B, Jung O, Precht C, Kloss F, Gröbe A, Heiland M, Ebker T. Impact of Dental Implant Surface Modifications on Osseointegration. Biomed Res Int. 2016;2016:6285620. ; Goyal N., Priyanka R. K. Effect of various implant surface treatments on osseointegration – a literature review. Indian Journal of Dental Sciences. 2012;4:154–157

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