A professional experience report by Dr. Alexandre Greco and Dr. Gustavo Greco.
We have used the Arcsys system since 2016 in our clinic and in our immersion, professional development and specialization courses in implantology and dental prosthesis. The factors that led us to choose the use of this system were, mainly, the macrogeometry and the surface treatment of the implants, which allow for their use with all bone types of the maxillomandibular region requiring just the adequation of the surgical technique (milling or sub-milling), their simple conformity and their easiness to understand since the components present one single interface, minimizing the need of material inventory and optimizing our work.
The mechanical activation of the components, in a frictional man ner, without screws, is a special feature of the Arcsys Implant System. This connection, called frictional cone Morse, with no need of screws, promotes cold forming between the prosthetic abutment/implant, avoiding the formation of spaces in the interface of the assembly, promoting sealing and avoiding bacterial colonization of the region.
The prosthetic abutment/implant interface is a critical area due to its position at the level of the bone crest. When the assembly is subject to masticatory strengths, the screw-retained abutment/implant systems tend to undergo a reduction in their stability, allowing for micro-movements. The microbiological seal of the implant/component interface of the internal hexagonal and conic systems have been researched and studied in the literature, demonstrating their capacity for microbiological sealing. We have carried out research during my doctorate studies in implantology with the Arcsys system aiming at the in vitro assessment of the microbiological sealing capacity in the frictional implant/component interface. The results, which will be published shortly, demonstrated the effectiveness of the microbiological sealing of the frictional system. That is a factor of critical importance when choosing the implant system since an effective microbiological sealing allows for the tissue stability in the region considered the most critical, the interface between the implant/component and the alveolar ridge. With that effective biological sealing, it is possible to achieve bone neoformation in the area adjacent to the implant/component interface, with the achievement of superior biological, functional and esthetic results.
An implant-supported oral rehabilitation in the maxilla was carried out. It started with the exodontia of the present teeth and the installation of an immediate total prosthesis. 90 days later, with the duplication of the prosthesis of the patient, a CT-scan guide was manufactured and the tridimensional exam was carried out for the surgical planning. Then, 8 implants were installed in the maxilla, with the purpose of a future manufacture of a ceramic protocol. 90 days after the installation of the implants, the procedures of reopening and manipulation of soft tissue was carried out in order to gain peri-implant keratinized gingivae. With the healing of the soft tissues, the screw-retained protocol prosthesis, in ceramics, was manufactured. The patient is now in the three-year follow up phase. In the panoramic and periapical control radiographs, it was possible to note the bone neoformation in the region adjacent to the implant/component assembly, allowing tissue stability. The bone neoformation is possible thanks to the capacity and effectiveness of the microbiological sealing in the implant/component interface, allowed by the Arcsys frictional system, preventing the bacterial colonization in the region and consequently, avoiding periimplantitis and the peri-implant marginal bone loss.
Authors: Dr. Alexandre Greco and Dr. Gustavo Greco.