Analysis Of The Shortcomings Of Zest’s Locator® Implant System And “Fixed” Solution

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

CleanShot-2024-03-04-at-12.56.47@2x-1

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.

CleanShot-2024-03-04-at-13.00.47@2x
CleanShot-2023-09-08-at-14.56.47@2x

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 2.5mm long smooth 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.

CleanShot-2024-03-04-at-13.02.17@2x
Gen5 cover

RESEARCH SUPPORTS REDUCTION OF PERI-IMPLANTITIS BY USING A HYBRID DESIGN SURFACE WITH THE IMPLANT-ABUTMENT JUNCTION SUPRA-CRESTAL

Applies to Straumann’s TLX implant and Paragon’s GEN5™ implant BUT not the BLX

Dr. Niznick Article: AO News Vol.33 No. 2, 2022: Dr. Buser cites a Swedish 10-year study comparing three implants: Astra, NobelBiocare and Straumann’s Tissue Level implant, claiming the latter exhibited significantly less peri-implantitis. Assuming part of the smooth neck of the Straumann TL implant was inserted in bone, this would give it a hybrid bone interface. It also adds the variable that the implant-abutment connection would be supra-crestal… [which] is at least as important a factor in minimizing peri-implantitis as a hybrid surface.”
Dr. Michael Dard, Prof. NYU Interview:
1. Explains peri-implantitis and
2. 
Discusses results of the Derks et al study

peri-implantitis study
Dr. Daniel Buser tissue level

This case control study measured early crestal bone changes around sub-crestal placed platform-switched implants surrounded by thin soft tissue and compared them with regular, matching-platform implants placed in a supra-crestal position and surrounded by thick soft tissue. After 1 year, mean bone loss was 0.28mm (SD:0.36 mm; range: 0.1-1.63mm) in the control group and -0.6 mm (SD:0.55mm; range: 0.05-1.8mm) in the test group. Platform-switched implants placed in a subcrestal position in vertically thin soft tissues showed statistically significantly more bone loss than non-platform-switched implants placed supra-crestal with vertically thick tissues.

crestal bone case

Paragon’s GEN5, GEN5+™ and NizPlantimplants have the same implant body with a 2.5mm machined, anodized neck. Depth gauge lines at 1mm, 2mm and 2.5mm from the top (Pat. Pend.), along with 2 depths of drill stops, facilitate placement level with or 1mm above the crest of the ridge. The insertion depth control, in conjunction with the ability to varying the height of the prosthetic screw, minimizes the need and cost of maintaining an inventory of abutment heights. The GEN5+™ offers the additional flexibility of a 2mm friction-fit collar that can serve as the trans-mucosal collar of an abutment or be removed for abutment connection directly to the top of the implant for unprecedented vertical flexibility.

Paragon-Implant-Systems

Each Paragon implant is 1mm longer than the standard lengths of the respective Screw-Vent and Legacy implants. Paragon’s surgical system includes two options of drill stops. One is for placement 1mm supra-crestal, which moves the implant-abutment junction away from the bone and and creates a 1mm supra-crestal zone of titanium for undisturbed soft tissue attachment when prosthetic components are attached and removed from the implant. The other drill stop positions the implant level with the highest point on the the ridge, usually on the lingual, leaving the smooth neck exposed if there is bone recession on the labial/buccal. The diameters of the drill stops and the freedom of rotation of the drills within the drill stops allow there use through surgical guide without the need for keys.

paragon surgical system
gen5 friction-fit extender

Simulated case (right) shows 8 GEN5+™ implants replacing exposed implants (left). Little or no bone grafting needed because only smooth surfaces exposed. Attaching a Prosthetic Screw converts platform to standard MUA.

gen5 implant simulated case
patented features of nizplant
Share the Post:

Related Posts

paragon-logos-full-negative-black

Our mission is to provide high-quality, innovative, dental implants and abutments through internet sales at factory-direct prices.

STAY CONNECTED