Controversial Issues that Effect the Dental Implant Industry
Analysis of the Shortcomings of Zest’s Locator® Implant System and “Fixed” Solution
May 2, 2023 | Dr. Gerald Niznick
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Zest’s Overdenture implant is a tapered screw with a threaded post projecting upwards from an external hex used to insert the implant. The threaded projection limits the function of this implant to the attachment of a locator abutment. Because the implant does not have an internal shaft, it can be made in two diameters under 3.0mm. The smaller the diameter, the less engagement with and support from the bone. Small diameter implants are also more vulnerable to fracture and overloading. Internal conical connection implants are in wide clinical use because of the stability and versatility of the connection. Unlike the Zest implant, internal conical connection implants allows attachment of a variety of straight and angled abutments for overdentures, screw-retained bridges and cemented restorations. Insertion of Zest Overdenture implants are a dead-end solution in that they offer no options should the patient wish to upgrade from an overdenture to a fixed prosthesis. Furthermore, if the bone dictates the need to insert the implant at an angle to avoid the sinus or other vital structures, the Zest Implant/abutment connection does not allow for angle correction.
$220 if ordered as All-in-1 Packaging; $270 if implant and abutment ordered separately Compared to $150 For NizPlant™ with All-in-1 Packaging
All-in-1 packaging should simplify the ordering and add value but in Zest’s case, packaging of the Locator abutment with the implant adds a layer of complexity that is unavoidable. With 6 implant diameters, 4 implant lengths and 5 abutment heights, the dentist wanting to take advantage of the All-in-1 $50 savings over buying the Implant and abutment separately, has a total of 120 combinations to choose from. While the dentist can select the right length and diameter of implant based on treatment planning with a Cone Beam CT scan, one cannot predict the thickness of the tissue prior to surgery. The height of the abutment provided in the All-in-1 package may need to be changed, necessitating the dentist also inventory a selection of abutment heights to substitute for the one that came with the implant. To further add confusion and cost, Zest offers two different types of locator abutments for its Implants with the Locator R-Tx adding another $50 to the cost. This price difference cannot be justified since the cost of manufacturing the R-Tx abutment relative to the Locator abutment is probably less than a few dollars more. This problem compounds itself because the dentist needs to keep an inventory of both the Standard Inserts that can accommodate 20 degrees of divergence, the Extended Range Inserts that can accommodate 40 degrees of divergence and the R-Tx abutments (adding $220 to the cost of the $100 Implant) can accommodate 60 degrees of divergence. Zest does not offer angled Locator or R-Tx abutments to correct the mis-alignment at time of
Below are the 5 Locator abutment height options and the 6 Zest implant diameter options, each available in only 4 lengths. The 6mm high Locator and all 5 heights of R-Tx abutments can only be purchased individually. On the right are the prepackaged options for the 3.5mmD Implant. In total, the dentist has to choose from 96 pre-packaged combinations with 240 in total.
Compare the NizPlant™ with 24 implants to the Zest System
The NizPlant™ implant comes packaged with all the overdenture attachment components for only $150. NizPlant™ has 5 lengths and 6 diameters for 30 variations with the abutment platform of this 1-piece implant the same for all implants. The variation in tissue depth is managed by the placement depth of the implant and is determined chair-side as the implant approaches full seating. This is made possible because the implant has a 2mm long machined neck with score lines and, like the GEN5™ implants, the implant portion adds 1mm to the length of each implant. To this is added an additional 3mm of height for the abutment portion of the 1-piece implant. If the dentist prepares the site for a 13mm implant, 4 mm will project above the bone. If the site is prepared to a drill depth of 11.5mm, 5.5mm will project above the bone.
Alternately, if the 11.5mm implant is selected but the site is prepared to the 13mm line on the drill, only 2.5mm will project above the bone, corresponding to the shortest abutment height offered with the Locator implant system. An additional 1.5mm of height can be gained by adding the extender abutment that duplicates the cap-engaging outer surface of the implant platform.
The platform of the NizPlant™ serves a dual function as a 1-piece implant with an overdenture attachment platform and a 2-piece implant with a 45 degree lead-in bevel plus a internal hex and threads. By removing its internal set screw and attaching an abutment or coping, the NizPlant™ can be converted to a MUA. The coping includes an Angled Screw Channel for 25 degree angle correction.
