II. TOP Concepts of Fixture Design

According to the research findings, the best designs could lead zero bone loss. These findings shows that the Biomate implant design is qualified the best factors.

The top design concepts are as follows:

1. There are about five types of thread designs in the present market. Among these five thread designs, the trapezoidal thread design is the best. 

Even though the trapezoid thread design is still infrequent in the present market, it shows good performance with its resistance to micro movement, large bone-implant contact, stress distribution, and bone preservation.

Source:

A. Selection of Optimum Thread Shape Design on Stress Distribution Among 5 Different Implant Types: A Finite Element, Yosef Wakjira, Song Jeng Huang* and Yi Hsiung Chiu (2019), Analysis, Eng Technol Open Acc. 2019; 3(3): 555611.

2. The optimum pitch of the threads is 0.8mm.

This spacing can achieve the fastest and the best osseointegration effect.

 Source:

3. Bone-implant contact area has a great influence on osseointegration.

III. Design of Surface Treatment-PDL® Laser Treatment

1. PDL® laser creates special features.

A.PDL® Laser create greater resistance to physical stress

According to a study conducted by Mahidol University on the changes in the surface of posterior dental implants, scanning electron microscopy (SEM) revealed that Biomate Plus implants showed only minor damage. These damages included peeling, pits, and deformations. In contrast, SLA implants exhibited more pits, deformations, and fused areas compared to Biomate Plus. These defects were particularly noticeable in the threaded tip corresponding to the self-tapping design. Biomate Plus surfaces lacked sharp irregularities at the micro level, making them less susceptible to damage under high torque forces at macro-nano roughness levels. Conversely, SLA surfaces typically displayed sharp irregularities, which inevitably deformed under compressive forces. This demonstrates that Biomate Plus implant surfaces possess greater resistance to physical stresses, ensuring that implant retrieval and reinsertion during clinical applications do not compromise the implants.

Source: BANGKOK INTERNATIONAL DENTALIMPLANT SYSMPOSIUM; 2019

B.Laser creates an ultra-clean surface, no harmful residues on the surface. 

Compare to SLA treatment, laser treatment only applies energy without any chemicals. The X ray photoeclctron spectra (XPS) analysis by National Chung Shing University demonstrates that the only residues on BiomateSwiss implants are Ti, N, O, and C (which are from the environment). Other commercial implants all show the chemical residuals from the processing procedures.

Biomate: Ti.N.O.C / Xive: Ti.Si.N.O.C / Nobel Biocare: Ti.P.N.S.O.C /Straumann: Ti.Si.Zr.N.O.C

Source: 1st BIOMATE INTERNATIONAL SYMPOSIUM OF IMPLANT DENTISTRY, DECEMBER 7-9, 2018, Kaohsiung, Taiwan

C.Laser creates a thicker oxide layer to optimize protein adsorption and cell adhesion and regeneration

This argument was subsequently substantiated by further research from numerous scholars.  Laser treatment produces an oxide layer called TiO2. The TiO2 layer with anatase texture can effectively increase the adsorption of protein and enhances the osteoblast adhesion and proliferation, furthermore, promotes the calcification during the bone healing process. 

Compared to the 5.5-9.3nm oxide layer of Straumann implants, the oxide layer of BiomateSWISS implants is significantly thicker (110 nm), resulting in superior healing capability of the implant.

TEM analysis -Top of groove (ridge area): 110nm Bottom of groove: 45nm

Source: INTERNATIONAL DENTAL MATERIAL CONGRESS, NOVEMBER 4-5, 2021

2. Biomate implant uses laser technology to create a very unique surface, which could promote the followings:

1. The proteins adhesion which accelerate early bone healing

2. Osteoblast cells adhesion

3. The induction of angiogenesis

4. The initial calcification

5. The exchange of nutrients

6. Stabilizing surface bone structure

7. Inhibition of dental biofilm formation

1. The proteins adhesion which accelerate early bone healing

A. Prof. Dr. Chiang, Academic Chair of Biomate Implant Academy Institute (Biomate IAI,) conducted an experiment at Yongling Clinic using implants with two different surface structures. The experiment confirmed that surfaces treated with laser exhibited a high oxidative layer (45-110nm) due to the intense laser energy applied to these structures. This oxidative layer enhances blood compatibility, facilitating the attachment of fibronectin and promoting the formation of a temporary matrix critical for early-stage bone healing.

SLA treated surface         PDL® Laser treated surface

Source: 1st BIOMATE INTERNATIONAL SYMPOSIUM OF IMPLANT DENTISTRY, DECEMBER 7-9, 2018, Kaohsiung, Taiwan

B.Furthermore, in vitro experiments at Taipei Medical University confirmed that structures treated with laser on micro/nano-porous surfaces exhibiting hydrophilic properties showed higher cell adhesion, proliferation, differentiation, and prostaglandin E2 production compared to titanium metal polishing and titanium SLA-treated surfaces. Laser treatment can prepare hydrophilic micro/nano-porous titanium surfaces, enhancing these surface properties and promoting adhesion, proliferation, and differentiation of MG-63 cells.

Source: Journal of Alloys and Compounds Volume 684, 5 November 2016, Pages 726-732

2. Accelerate bone cell attachment

National Taiwan University conducted an academic study on the requested surface structure, published in the International Journal of Molecular Sciences under the title "Titanium Surfaces with a Laser-Produced Microchannel Structure Enhance Pre-Osteoblast Proliferation, Maturation, and Extracellular Mineralization in Vitro." The paper confirms that titanium surfaces with a novel laser-generated microchannel structure exhibit enhanced bone integration capabilities compared to SLA-treated and metal surfaces. The laser-treated surface significantly enhances pre-osteoblast proliferation, promotes mRNA and protein expression/secretion of COL1, SPP1, DCN, and TNFRSF11B, and facilitates extracellular mineralization. These findings strongly indicate that laser-treated titanium surfaces have profound beneficial effects on pre-osteoblast maturation and bone integration, highlighting substantial clinical application potential.

Source: International Journal of Molecular Sciences, 2024, 25, 3388

3. Induce new blood vessels

Prof. Dr. Yu Dayou at the Department of Dentistry at the National Defense University pointed out in his study that PDL laser-treated surfaces showed more MSCs attachment and more angiogenesis. The laser-treated surface structure has a higher affinity for periodontal ligament cells, inducing better peri-implant angiogenesis in vitro.

Source: Biomate International Webinar Symposium of Dental Implant 2021

4. Accelerate initial calcification

Experiments on the bone mineralization ability of laser surfaces, titanium metal surfaces and SLA-treated surfaces were conducted by National Taiwan University. In order to analyze the mineralization ability of preosteoblasts, energy scattering X-ray spectroscopy was initially used to detect microstructures close to nanostructures.  Precipitation of extracellular minerals is at the top of the channel. When embedded in this requested surface structure in acellular solution, there was no significant difference in the precipitation of calcium or potassium compounds compared to titanium metal surfaces or SLA-treated surfaces. However, when preosteoblasts were implanted into titanium plates, the requesting surface structure showed an increased rate of Alizarin Red S staining on day 18, indicating enhanced calcium ion secretion promoted by the requesting surface structure (Figure 6). This study proves that the requested surface has more significant bone cell mineralization ability than the SLA-treated titanium surface.

Figure 6. L-treated titanium surface promotion of pre-osteoblast extracellular mineralization. (A) Im ages were collected after a 4- or 18-day culture of 2.3 × 105 pre-osteoblast cells on titanium plateswith G-, SLA-, and L-treated surfaces. A scale bar of 100 µm is shown in the left column and a scale bar of 50 µm is shown in the right column. The reddish-brown calcium compound indicates the mineralization ability of pre-osteoblasts. (B) Quantitative results are shown according to the OD540level. A scale bar of 100 µm and 50 µm is used for the imaging in left and right column respectively. * p < 0.05 vs. G group.

Source: International Journal of Molecular Sciences, 2024, 25, 3388

5. Improve nutrient exchange

Satish Kandlika et al. pointed out in the book "Heat Transfer and Fluid Flow in Minichannels and Microchannels:" 

"Microchannels and microchannels provide excellent surface area for monolayer cell attachment while achieving good temperature regulation and liquid medium. Opportunities are for rapid exchange. It is suitable for the growth and differentiation of osteoblasts and endothelial cells inside and outside microchannels with nanostructures." PDL laser-treated surfaces should support the theory presented in the book.

6. Stabilize surface bone structure

It is known from research that initial bone formation starts from the upper edge of micron tubes and the lower edge of nanostructures. Clinically, the piezo removed PDL implant from a car accident patient shows a tightly integrated interface; this is completely different from an SLA implant and the bone interface structure. It shows that the PDL® laser surface and bone bonding ability are significantly better than the SLA surface. An animal experiment also showed that PDL® laser implants have good bone integration ability in the first two months after implantation, but SLA implants do not show integration until the third month. Comprehensive cell experiments, animal experiments and clinical manifestations, PDL laser treatment can indeed stabilize the bone structure on the implant surface.

7. Anti-plaque formation

Based on the research on bacterial membranes at the University of Milan, the PDL® laser-treated surface was compared with another Geass laser surface and a machined surface, a polished surface, and a sandblasted surface, a total of five surfaces to compare the formation and amount of biofilm. This study demonstrates that “Laser microtexturing of titanium surfaces created surface microtopographies and also influenced surface chemical composition. Both microtextures were equally effective in reducing biofilm formation and should be furtherly investigated for their capacity of preventing peri-implantitis in vivo.”

Source: CED-IADR/NOF Hybrid Oral Health Research Congress in Brussels, September 16-18, 202

IV. PDL® laser treated implants show predictable initial stability. 

Biomate implant is very suitable for Immediate replacement & loading

A preliminary study at the master program of oral implantology Cairo University conducted by Refky A, and Elkhadem A and presented on Bangkok International Dental Implant Symposium 2019, “The impact of PDL versus RBM implant surface treatment on implant stability during healing: A preliminary clinical study Aim: Compare changes in ISQ values of PDL versus RBM surfaces during the healing period.” This study finds that: Conventional sandblasted implant surfaces show implant stability dip from week 2-6 while PDL implants show gradual increase instability throughout the healing phase.

After this preliminary, Prof. Dr. Amr conducted a clinical study and presented the result on June 6, 2021, "Implant Stability Changes for PDL Versus SLA Treated Surfaces in Immediate Extraction Cases: A Randomized Controlled Clinical Trial." This study finds that 1. Laser treatment of the implant surface seems to be a promising approach to promote faster bone healing, 2 PDL implant maintained higher implant stability levels in immediate implants compared to SLA, and 3. PDL implant can be a game-changer in immediate extraction sockets.

V.Trapezoid Thread® Design

We designing dental implant instead of industrial screws, the V-threads might be too sharp to hurt bones (Animal study by Taipei Medical University in Taiwan has approved this point), so the tip of the V-shaped thread was cut and became a trapezoidal thread. This trapezoidal thread is designed as a lower angle of 25 degrees and an upper angle of 15 degrees, which becomes our current asymmetric trapezoidal thread.

The thread is also a so-called "mechanical tooth" in the screw industry. The trapezoid teeth are parallel, and the cutting speed is slower. When it is locked in, the cutting force is not so high and the force is relatively low. This trapezoidal thread can withstand the high energy of the laser at 1700 degrees Celsius, and there is no need to worry about the tip of the thread being flattened by the laser (V-threads are not suitable for the high energy of the laser because the tip of thread will be flattened). Finally, Biomate implant design the thread as the asymmetric trapezoidal thread.

The trapezoidal thread has a stronger ability to resist micro-movement and disperse stress than the V-shaped thread, and the BIC value is also the highest among all implants.

There are about five types of thread designs on the present market. Among these five thread designs, the trapezoidal thread design is the best. Even though the trapezoid thread design is still infrequent on the present market, it shows good performance with its resistant to micro movement, large bone implant contact, stress distribution and bone preservation.

Comparison of Thread Designs

VI. All Fixture sizes have same prosthetic connection with 10° internal hex connection

The prosthesis procedure is simplified with single prosthetic connection with single platform diameter and 10 ° internal hex connection for all fixture sizes.  The design of 10 ° connection makes wall thickness thicker. single prosthetic connection can let doctors choose any suitable prosthetic option in any clinical condition.

10。Morse Taper