Osseo News Blog June 13, 2007- October 5, 2007- Nobel Active Intial Impressions

NobelActive: Initial Impressions?

 Any thoughts on Nobel Biocare’s recent introduction of NobelActive, a new dental implant design with an innovative thread pattern? 

According to Nobel Biocare: 

“The one-stage implant features a unique shape and a new thread design with a ’self-drilling’ capability to facilitate drilling protocols in areas of narrower osteotomy. The product is easy to use and provides high initial stability and good outcomes. NobelActive(tm) has been designed for increased soft tissue volume at the head of the implant, resulting in improved esthetics.” 

Any comments on this innovation? 

20 Responses to “NobelActive: Initial Impressions?” 

1. Bob Horowitz Says: 
June 14th, 2007 at 12:05 am The design is Alpha Bio from Israel at about 1/4 of the price. Very similar to MIS’s Seven implant which has a surface like SLA at about 1/4 of the price of the new Nobel Active. The only thing you are missing with the Seven is the money spent to convince you of the advantage of a more expensive implant. 

2. domis Says: 
June 14th, 2007 at 2:19 am This is obviously a new design based on combining all the progressive thread and taper designs that have appeared in the market before, started in 1980s with the Ankylos to the Pitt-Easy to all those mentioned above. So what else is new? 

3. Dr Skeptic Says: 
June 14th, 2007 at 3:09 am WHERE IS THE DOCUMENTATION? I would not want an implant system without documentation in my mouth. Why would I consider this in my patients? 

4. Dr P.P. Says: 
June 14th, 2007 at 5:44 am It is an exact copy of Alpha Bio implant. I am wondering why they (Nobel) are trying to convince everybody that this is a NEW thread pattern. Is this the result of research and innovation? Nowadays the companies tell you what you have to do. They provide and everybody will do it!!! 

5. Ruumi Daruwalla Says:
June 14th, 2007 at 6:32 am Nobel Active is replacement for the now-banned Nobel Direct. I saw the video of the surgery in which they change the direction of drill and also implant half-way. This seems crazy and impossible and illogical too. One has to wait and see. Maybe it does work. For anyone who wants to see this surgery, visit the website of Nobel Biocare and click on the Nobel Show that was held in Las Vegas. The surgery is in one of the Live Sessions. The clinician is Dr. Fromovich from Israel, who with 3 others sold the design to Nobel Biocare. 

6. J. Silva Says:
June 17th, 2007 at 12:31 pm Fantastic – Every year a new implant from Nobel. Are you talking about research? This is only a marketing policy. Nobel learns the principle with ZARA, H&M, etc…. 

7. Albert Hall Says:
June 17th, 2007 at 2:02 pm There is no problem for Nobel users to maintain or accept new products. They belong to what they think is good….fashion! Poor patients! 

8. joão pimenta Says:
June 18th, 2007 at 11:30 am I use Alpha Bio implant some years ago. Fantastic implant. – I attended Nobel World Congress. Nobel Active is not a copy but a big development of Alpha Bio concept. Nitzan Bichacho and Ophir Fromovich are honest and big implantologists in the world and never could support a bad system. I will use Nobel Active and I am sure it will be a big success 

9. joão pimenta Says:
June 18th, 2007 at 11:36 am I have been using the alpha bio spiral implant for more than 2 years. As far as I know more than 200000 implants have been placed in the last 4 years. I have tried several implant systems from the big 5 companies, and this one is the best by far. It can do things no other implant can do. Yes, NobelActive originated from this amazing implant with the enhancements they made (their TiUnite surface and new prosthetic components) that seem to make the system even better. I attended their meeting in Las Vegas – the system was presented in 3 different sessions and it was very impressive – I know it really works. 

10. Mohamed Foud Says:
June 24th, 2007 at 7:42 am It is a copy of OsteoCare Maxi Z dental implants produced in the UK, I use Maxi Z with great success, of course Nobel version will be triple the price 

11. joão pimenta Says:
June 25th, 2007 at 5:57 am Dear Mohamed yes I saw; is completely different; even the concept. But doesn’t matter, go on applying your “excellent implants”; I prefer work with companies offering to me studies, research, esthetic solutions, etc. 

12. Mohamed Foud Says:
June 25th, 2007 at 11:50 am Well Nobel BioCare doesn’t offer studies or anything now, just pure commercial work… remember the problems with there on piece implant recently? What’s the significant of groovy implants?? Yes they did a lot of research in the past but not now… by the way your responses to me are arrogant and don’t make sense 

13. joão pimenta Says:
June 26th, 2007 at 9:10 am Dear Mohamed I attended their meeting in Las Vegas a month ago and was exposed to a full description of their new Nobel Active. They did not show yet the two-piece system but I have been working with implants form Alpha-Bio, as I mentioned before, so I am sure that Nobel Active’s two piece system will be as good or even better. It is obvious that your impression is not based on facts. I suggest you give your opinion after studying this amazing system instead of basing it on irrelevant malicious gossip. 

14. Domis Says:
June 27th, 2007 at 10:32 pm We should only comment on the design of the implant, not how good or bad is the company that markets these. It is almost a given that these implants will work. But it is also obvious that the thread design is not original, and they should just give credit to all those from whom the inspirations were drawn instead of making bigger than life claims. 

15. Albert Hall Says:
June 29th, 2007 at 6:59 pm ohhhhhhhh Joao, not so personal, not so personal…..Nobel will not thank you nothing….. 

16. Rui Pinto Cardoso Says:
June 30th, 2007 at 5:46 am Nobel Biocare is good company they transform the clients in VIP and sell them cheaper but twice or more the price of other brands … The bone does not recognize the brand of the implant…It is only a screw, very expensive … it is produced in machines that spit thousands/hour, but always we decide where we going to buy… 

17. Dr P.P. Says:
July 20th, 2007 at 6:00 pm Dear Colleagues: This discussion is the test that confirms that marketing works. You invite some people from every country, you put them all in a big place (MGM arena), then you through your marketing at them and finally you have hundreds of convinced doctors marketing your products by themselves! I know that such a big event (Las Vegas World Congress) cost hundreds of thousands, but it just worked the way they wanted! Now they turned something that was old into a “new design”, something that was cheap into “expensive” and then they get the money not only to organize such a big event every two years but to earn an enormous amount of CHF, €, or $ in the mean while. Money comes from our pocket. Research and papers are supported by implant companies, we all now it. I will give credit to someone that is trying to sell me an implant at a reasonable price more than doing it to someone that increases the price of the implants without any reason to do it. 

18. Niznick Says:
July 27th, 2007 at 3:48 am At a meeting recently participated in, Dr. Bichacho was giving his lecture on what they are now calling NobelActive. I raised the question to him about how he thought he could insert the implant in dense bone and his answer was that this implant was not for dense bone. Another Nobel supporter lectured on a ceramic implant that Nobel will probably start selling. To him I asked “what problem is it solving”. I then turned to the Gotlander VP of Nobel sitting beside Nobel’s president, and told him I had two words that described Nobel new products – Innovation Diarrhea. What is wrong, in my opinion, with the NobelActive is that it cuts soft bone instead of spreading it. The idea of a tapered implant is that it can be inserted into an undersized socket in soft bone, expanding the bone as it is inserted, thereby increasing initial stability. The NobelActive copy of Alpha Bio’s clone of Oraltronics implant is the same outside thread diameter near the bottom as at the top so it will not go into a smaller socket and spread bone. A primary tenant of placing implants in soft bone is not to oversize the socket… so what did Fromovich do at Las Vegas. He put the implants in at a 45 degree angle to the lingual, and then grabbed the head of the implants and twisted them to the lingual to gain parallelism. But for cementing a temporary 4 unit bridge, the implants would have fallen out before the patient got out of the office. I would like to see him try this with a single tooth replacement. Apparently the NobelActive is not only just for soft bone, it is for multiple splinted implant cases in soft bone. Next Nobel will be selling an implant for the lower right posterior and a different one for the lower left. And someone will pay for it. 

19. MARC Says:
September 14th, 2007 at 1:57 am Looking at the resources Nobel spends on R&D (refer to last annual report with 3% – industry average is 7-11%) I am not surprised to see what kind of “innovation” they introduce to the market. But they obviously enjoy the largest market share and it’s us, the people who apply implant therapy, who make them the market leader! 

20. Gerald Niznick Says: 
October 5th, 2007 at 1:49 am Nobel has now posted the Instruction manuals for the NobelActive Internal and External hex implants. It reminds me of the movie “Dumb and Dumber”. The bodies of both are the same, with a significant taper to the inside of the threads while the outside remain straight. They claim this design is self-threading (as is any implant n soft bone) and that it was designed so the direction of the implant could be change while inserting it or after insertion. They show this on their video online i.e. grabbing the 4-5mm high post of the external hex implant and twisting it so that it is parallel with other implants after it is inserted. This may solve their inherent parallelism problem but has to reduce initial stability. The Tapered Screw-Vent was designed with a gentle taper to both the inside and outside threads, so that the implant could be started into an undersized socket in soft bone and expand the bone for increased stability. Having sharp deep threads at the apex of the NobelActive will allow you to change direction during or after insertion but this has never been a recommended surgical protocol. It is the tail wagging the dog because with a 5mm external hex, they need to get the implants parallel. The direction of the implant should be established through sequential cutting of drills and the use of guide pins or even image guided surgery. Once established in the surgical preparation, you want an implant that will track on the socket that you carefully prepared, not one that could be inserted in any path. There is no good reason to need to change direction of the implant during insertion so it is a disadvantage, not an advantage. Of course they can change direction by tipping the implant before it is all the way seated since only the tips of their sharp threads are in contact with bone. The idea of an external friction fit post comes from the late 1970’s Miter implant and was abandoned in place of the Bicon design with the post being in the abutment giving more latitude for angled heads. Nobel should have made the post an abutment head already instead of requiring a friction fit abutment be attached by tapping to what amounts to a 5mm high external hex. Another shortcoming of the design is that in dense bone, the final sizing drill is wider than the neck/platform of the implant, creating a trench around it like the old Straumann basket implants of 25 years ago. This is what happens when Implants are designed by clinicians who do not have an understanding of the history of implant design. If you do not learn from the past you are destined to make the same mistakes all over again. In Nobel’s case, as with the NobelDirect and NobelPerfect, they are motivated by locking in the professional support of the “opinion leaders” who sold them on this design. Calling the NobelActive the “Implant of the Future” just says that their current products are the implants of the past. I predict the NobelActive, with 2 studies underway, will follow the same path to oblivion as the NobelPerfect and the NobelDirect with TiUnite all the way to the top requiring preparation at time of insertion.