Material
Fig. 1: brezirkon - structure
The „brezirkon“ material is an yttrium oxide-stabilized, tetragonal polycrystalline zirconium oxide, i.e. zirconium oxide is doped with 3 mol percent to obtain the stable rectangular structure at room temperature as well.

Source: Marcel Schweiger, Ästhetische Zahnmedizin 5, 2004





Material table
Doping with yttrium oxide results in a minimal radiation level which is far below natural radioactivity* (e.g. 1,000 Bq for 1 kg of coffee).
*Definition of Becquerel (Bq)*: The becquerel (symbol Bq) is the SI derived unit of radioactivity, defined as the activity of a quantity of radioactive material in which one nucleus decays per second. Source: Wikipedia


Material
Fig. 2: brezirkon - unsurpassed strength












Material
Fig. 3: brezirkon - Structure of polycrystalline tetragonal zirconium oxide (TZP)


Material
Fig. 4: brezirkon - unsurpassed fracture toughness, i.e. integrated DefectBlocker DefektBlocker
Two values are used to measure the fracture toughness of a material:
■ K IC = critical stress intensity factor (white bar)
■ K IO = Threshold value for crack growth (grey bar)
The higher the values, the tougher the material.

Source: BioMed Central - R. Marx, F. Jungwirth 11/2004



Material
Fig. 5: brezirkon - excellent elasticity
The modulus of elasticity describes the elasticity of a material:
■ High value = brittle material = susceptible to fracture
■ Low value = soft material = easily deformed










Material
Fig. 6: brezirkon - resistant to high stress
Implant clamped in and exposed to vertical stress according to standard DIN EN ISO 14.801.:2003 D.

Fraktur erfolgte nach:
■ Upper load of 800 N
■ Deflection of approx. 1.1 mm

Source: Endolab GmbH – Test Report – Part II - 111.041216.50.3






Material
Fig. 7: brezirkon - lasting durability
Implant clamped in and exposed to vertical stress according to standard DIN EN ISO 14.801.:2003 D.br/>
Standard:
■ 2 million cycles

Survival of implant:
■ 5 million cycles
■ Bending moment 560 Ncm

Source: Endolab GmbH – Test Report – Part II - 111.041216.50.3 SKY Titan – Testbericht Fraunhofer IWM – V 185/2002

Design
Fig. 1: whiteSKY - adaptive thread
■ Bone condensation without additional working steps and instruments
■ Micro-compression of apical spongy bone
■ Additional comfort for the patient




















Design
Fig. 2: Three diameters















Design
Fig. 3: Five lengths












Design
Fig. 4: Double thread for inserting the implants
■ Few turns
■ Optimal distribution of force











Design
Fig. 5: whiteSKY - torque curve (screwing in implants)
■ Very quickly in situ (in approx. 6 sec) thanks to the double thread
■ Constantly and quickly ascending curve
■ Maximum value at the end
■ No stress

















Design
Fig. 6: Optimal implant position

Surface
Fig. 1: whiteSKY - microstructure within the µm range for rapid bone adaptation
■ Ra: 0,9 – 1,0 µm
■ Rt: 7,0 – 7,2 µm
■ Rz: 6,05 – 6,15 µm








Surface
Fig. 2: whiteSKY vs. SKY
The roughness of whiteSKY is within the range of the roughness of SKY.












Surface
Fig. 3: whiteSKY - surfaces (SEM)
Structure polished in the gingival area: micro-grooves allow alignment of gingivoblasts, perfect attachment of gingiva thanks to roughness value of > 0.5 µm









Surface
Fig. 4: Reduction of plaque adhesion in the gingival area
Scarano A , Piattelli M, Caputi S, Favero GA, Piattelli A: Bacterial adhesion on c.p. titanium and zirconium oxide disks: An in vivo human study. J Periodontol February 2004; Vol. 75, No.2, 276-280

Surgical protocol
Fig. 1:
Indications
■ Single tooth restoration
■ Partially edentulous ridges
Contraindications
■ N O T to be used for free-end situations
■ N O T to be used for edentulous ridges







Surgical protocol
Fig. 2: Final drill with conical design:
■ Smaller size compared to the implant body (whiteSKY design = SKY design)











Surgical protocol
Fig. 3: XL drills are cylindrical and enlarge the drill hole
■ In the crestal region (D3)
■ For hard bone (D1 + D2) not more than the implant length (whiteSKY design = SKY design)









Surgical protocol
Abb. 4: Design of drill












Surgical protocol
Fig. 5: Overview - surgical procedure based on bone quality
■ D1 to XL drill → implant length less 2 mm
■ D2 to XL drill → implant length less 2 mm
■ D3 to XL drill → depth of cortical bone (maximum: 3 mm)
■ D4 to final drill







Surgical protocol
Fig. 6: Pilot drilling and determination of depth












Surgical protocol
Fig. 7: Final drilling













Surgical protocol
Fig. 8: Preparation completed











Surgical protocol
Fig. 9: POnly expanding the cortical bone













Surgical protocol
Fig. 10: Preparation up to the respective implant length
(e.g. implant length 12 mm, drill 10 mm)











Surgical protocol
Fig. 11: Preparation up to the respective implant length
(e.g. implant length 12 mm, drill 10 mm)


The rough coronal section of whiteSKY and » blueSKY requires a change of the surgical procedure used for SKY » SKY.







Surgical protocol
Fig. 12: Screwing in the implant with a maximum torque of 30 Ncm
■ Manual screwing in using the torque ratchet
■ Mechanical screw-in device with W+H hexagon clamping system: perfect transfer of force and no deformation of the screw-in tool

Temporary restoration
Fig. 1:
whiteSKY - grinding with bredent ETERNA
■ Large variety of shapes
■ Considerably extended service life compared to burs with single coats









Temporary restoration
Fig. 2: whiteSKY - grinding with bredent ETERNA
■ Diamond burs with two coats












Temporary restoration
Fig. 3: whiteSKY - grinding with bredent ETERNA
■ Reduced generation of heat










Temporary restoration
Fig. 4: whiteSKY - Zirkon-Set
Normally, these designs are sufficient to achieve the desired contour of the WhiteSKY restoration.
■ Use the coarse diamond grit D 120 µm for preparing the shape









Temporary restoration
Fig. 5: whiteSKY - Zirkon-Set
Normally, these designs are sufficient to achieve the desired contour of the WhiteSKY restoration.
■ Use the fine diamond grit D 40 µm for finishing the surface









Temporary restoration
Fig. 6: Before integrating the temporary restoration:
■ Block out the notch
■ Grind the notch

Note: This notch is required for safe guidance of the implant in the placement instrument.






Temporary restoration
Fig. 7: Preparation requirements
■ Protection of the implant using a splint or by splinting with bars
■ Temporary restoration in the non-occlusion area even if adjacent teeth are under stress

■ Minimum 3-6 months

Clinical examples
Fig. 1: Speed: 1,200 – 1,500 rpm











Clinical examples
Fig. 2: Speed: 1,200 – 1,500 rpm













Clinical examples
Fig. 3: Speed: 800 – 1,500 rpm












Clinical examples
Fig. 4: Screwing in the implant using the torque ratchet
■ Maximum torque: 30 Ncm











Clinical examples
Fig. 5: Implant in situ












Clinical examples
Fig. 6: Grinding the implant abutment with the whiteSKY set for zirconium











Clinical examples
Fig. 7: Temporary restoration in situ