Is Straumann Slowing Down?

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Last week Straumann´s stock fell more than 10%, the most in almost 10 months, after
the company’s second-quarter profit and sales rose less than
Wall Street analysts expected and the company lowered its full-year outlook.

Naturally Straumann remained upbeat about its prospects, including SLActive, Straumann´s third-generation surface technology. The company did, however, state that it "continues to absorb the costs of production build-up in the US and new production technology." Goldman Sachs was clearly not impressed and they downgraded the company´s stock saying, "The absence of a sales growth recovery in the US coupled with higher than expected start-up costs for the US plant and SLActive production are the key reasons for our downgrade."

What are you thoughts? Is Straumann´s slowed growth in the US mainly a short-term issue, or is it a reflection of growing competition in the dental implant market?  For an interesting discussion on SLActive, you may want to check out this blog.

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5 Responses to “ Is Straumann Slowing Down? ”

• International Implant Foundation, Munich/Germany August 16th, 2006

  
  

  SLActive: pure marketing and money for the authors: A Critical Appraisal of an important citation on the influence of surface on implant osseointegration:
  Reference: Buser D., Broggini N., Wieland M., et al (2001)
  Enhanced Bone Apposition to a Chemically Modified SLA Titanium Surface.
  J Dent Res;83(7):529-533

  Abstract
  Changes in the surface topography and composition of dental implants are under discussion to have a clinically useable influence on the velocity of early pre-bony tissues. This article discusses this strategy of adapting the surface composition of dental implants to achieve early loading possibilities of dental implants. As a result it can be concluded, that due to the properties and timed sequences of the bony healing, a clinically useful advantage of a modified implant surface under review here, can not be expected.

  Key words
  Implant Surface influence, early loading, bone healing
  Introduction
  Immediate loading has become a hot topic in implant dentistry. It shortens the treatment time and makes it possible to provide the patient with an aesthetic reconstruction even during most of the treatment period. Historically, dental implantologists have followed the well-established Brånemark protocol(1). This protocol requires two surgical procedures separated by a 3- to 6- month healing period(2). Success rates with conventional implant methods are relatively high(3); however, clinically, many patients express the strong desire to receive fixed provisional bridgework immediately after the surgical phase of the treatment.
  Given the desire to produce implants that can be safely administered in immediate loading protocols, manufacturers are eager to achieve this goal by modifying the implant or implant surface that promotes faster healing. Considering the tremendous importance of this endeavor, and the potential for overly optimistic claims, we thought it would be important to look at this topic more critically. Since several studies have been published, including a systematic review(4), on the clinical outcome of immediate loading, our aim was to take a pivotal article used by other researchers and manufacturers to support clinical decision making and claims and to examine its purpose, methods, results and conclusions with a critical eye. The findings from this appraisal may be applied to many studies in dental implantology; therefore, a second purpose is for the reader to consider the strength and limitations of this paper in preparation for future dental implant research.
  Article summary
  The purpose of this study by Buser et al was to examine bone apposition to a modified SLA (modSLA) surface in the maxillae of miniature pigs as compared with a standard SLA surface. The authors hypothesized that the mod SLA surface would promote a faster bone apposition in comparison with the standard SLA surface. This was a prospective matched-cohort animal study using six adult miniature pigs. The test implants were a modSLA surface rinsed under N protection and continuously stored in an isotonic NaCl solution. The control implants had a standard SLA surface. All implants were cylindrical titanium with two circular bone chambers with a depth of 0.75 mm and a height of 1.8 mm (Institut Straumann AG, Waldenburg, Switzerland). Both sets of implants underwent the same sandblasting and acid-etching procedure. Two surgical procedures per pig were performed. In the first surgery, the anterior teeth in the maxilla were removed by means of a flap elevation, careful osteotomy, and tooth separation. After wound closure, the sites were allowed to heal for at least 6 months. In the second surgery, titanium implants were inserted according to a low-trauma surgical technique. The implants were placed, with good primary stability provided by the press-fit of the implants with the bone walls of the prepared implant beds. Three or four implants were inserted on either side of the maxilla, in a split-mouth design. Following irrigation, primary wound closure was achieved with interrupted sutures, and implants were left to heal in a submerged position.
  Four different methods were used for a surface analysis: surface topography, quantitative 3-D topographical analysis, surface wettability, and chemical composition. For the histological preparation and analysis, two miniature pigs were killed after 2, 4, and 8 weeks of healing respectively. In each animal, two bone blocks were removed and immersed in a solution of formaldehyde (4%) combined with CaCl2 (1%). The specimens were dehydrated and embedded in methylmethacrylate. Approximately 500 µm thickness sections were prepared and stained superficially with toluidine blue followed by basic fuchsin. An assessment of “bony ingrowth” and “bone density” was performed. For the histomorphometric analysis, bone to implant contact (BIC; %) was calculated at 2, 4, and 8 weeks.
  The authors reported the following results: No qualitative differences observed in surface topography. No statistically significant differences in surface roughness parameters using quantitative 3-D topographical analysis. Dynamic contact angle (DCA) measurements indicated that SLA was hydrophobic (DCA = 138.3o ± 4.2) and modSLA was hydrophilic (DCA = 0 o; p

• Anonymous August 17th, 2006

  
  

  Who wrote this? Where did it come from? Where is it published? Thanks for the info!

• Anonymous August 21st, 2006

  
  

  This is not the study done to support the claim that you have increased stability in weaks 2-4 with SLActive. This study shows increased bone to implant contact another study shows an increased stability while the body is moving from primary to secondary stability. The surfaces are roughened the same way so they look the same under loops or a microscope. If you think that wetting your existing implants will make them hydrophillic then draw some blood. Wet an implant with Saline for however long you like and then dip the tip of this wet implant in the blood. You will not see the blood wick up the implant, with SLA, or TiUnite or Osseotite or fill in the blank. The saline protects what was done during a specialized manufacturing process for the SLActive implant. The Saline is not what makes titanium hydrophillic.

  Anyway the question posed was about the slowing of Straumanns growth and any suspected causes? Does anyone know the cost of a dental implant in Europe vs. the United States? As I doubt that Straumann Clones in the U.S. like Blue Sky or Lifecore are stealing marketshare from Straumann in Europe.

• Anonymous August 28th, 2006

  
  

  To come back to the original question of slower growth in the USA: Nobel Biocare looks like the powermachine with growth of 25.4%, enabled by strong product portfolio, excellent marketing etc. However, i would not say that Straumann has a slowdown in the USA, as it maintained the 15% growth trend in Q2 as in Q1. This is even higher than American based 3i, also a strong player in the industry. 3i posted growth of 9% in the USA. So, nothing to be too worried about Straumann. Anyway, judging a company on a single quarter is ridiculous, as various things (new products, higher comparison base etc.) can have a big influence. The argument of Goldman Sachs are not serious, by the way, claiming higher than expected costs. They were as high as expected by the financial community, just the slightly lower sales growth and the nature of the business (high fixed costs) let the margin go down temporarily.

• Anonymous December 5th, 2006

  
  

  Lack of representation has been a chronic problem with Straumann! Straumann has a fabulous product. I am concerned though about them. Really I am tempted to go over to Blue Sky! Neither of them have representation but Blue sky is WAY cheaper, has threads in the cervical part of the implant for implants below the sinus and has a different implant mount that allows you to back out a seized implant easilly. BTW I have no financial interest in neither company. I have been a loyal Straumann customer. But hey, what happened to loyalty from the implant company? Look at what Nobelbiocare did to their loyal specialist customers. They justify their greedy actions by playing to their stock holders for profit in blatent disregard for patient safety. How long are we going to take it? Perhaps we as clinicians need to look at our corporate bottom line also. Any of these copycat implants are working just as good for a lot less.

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