NobelGuide Problems?

Dear Dr.M, I hope you learned the lesson about running with the bulls. Nobelbiocare is just pure business. That's all. The good science that once existed with the original Branemark implants is gone! Good luck talking to them in Vegas. Dr. V

Have you tried Simplant? Scatter is less of problem. Surgical stents usually take 2 weeks. Only problem is Dicom conversion is necessary (for a fee of course). No big complains with simplant except for these fees.

1.first, i agree their are issues with nobel support. this is a function of a complex technology with relatively few people trained in the software supporting a limited user group. 2. 2nd, scatter is NOT a function of software, it is a function of reflection during the scan. with proper positioning, i have not found this to be a major problem. have your center recheck their settings. too much resolution is not necessary and may be an issue. gary

Interesting That noone mentions lack of fit when placing the gude. I see that at no more than 10% of the cases It would be necessary to have a nobelguide. I agree with Dr Vegarar, Nobel is just business, marketing show.They got the money, but their guide is very far of being and indispensable tool. We have been doing implants successfully witout it for 20+years.

oh for sure Nobelbiocare is fully business,, it came to my attention how much stock is owned by Mrs. Canepa? have you seen that? What would you do with the company you lead when you have a huge amount of stock? It will be sold one day?

SimPlant vs NobelGuide Who copy who?

Nobelbiocare growth in latin America was taken after every order was invoiced, but they did not count how many of these invoices returned back....and they received honors of that and incentives of that

I agree with Dan Shapiro, Nobelguide is far from being an indispensable tool for implant placement. Probably less than 10% of the case you really need one. If implant site is properly developed , why the need? conventional methods has been proven succesful for over 30years.

I think Nobel is being sued by Simplant for copyright infringement. I use Simplant with no problems.

Dr. Shapiro, Sherman and others... in my opinion, Nobel Guide is not primarily about increased success of implant placement, but about increased convenience for the patient! The prosthesis is made BEFORE implants are placed! That's what makes it different from "conventional"! Is it "indispensable"? NO! But it sure is a HUGE advantage!

Another problem with Nobelguide. If the site is a maxillary posterior, often the sinus needs a little push or lift and since the guide/tube is 10.5 mm and the tissue is 3 + mms and the autogenous ridge is ?+ mms., very few techniques allow predictable sinus augmentation capability and that site would have to be passed or a sinus augmentation first done in a two stage approach and perhaps another CT, etc... I have heard of a new ISM (Internal Sinus Manipulation) technique that works through SIMPLANT, NObelguide, etc... that is easy and easier on the patient. Anyone hear about this new technique?

Simplant, Nobelguide, Facilitate and others are all variations of the same technique. Needed? No. Helpful? maybe to the inexperienced surgeon or extremely difficult case. I have used and researched these and other systems and found them to be useful in some situations but rarely necessary. Some prosthodontists who don't believe in grafting swear by this technique. Most "grafters" don't respect it much. Ultimately, we all can achieve results with the methods we feel most comfortable.

Every company is a business, even you as doctors. You don't cut patients a break on any dentistry options you give, I can bet. You charge 50K on a full mouth surgery -so you can get the newest model of BMW or take the misses on vacation. So why is it any different for NB etc? Every dental , medical etc. option out there is a useful tool for all to use. If people brushed their teeth and flossed everyday, they wouldn't need half of all the dentists out there. If people took better care of themselves they would need physicians. Same with car insurance, Police departments, etc. It is very ignorant statement.

The original comment about Nobel company was that it is "pure business". To me this means making money comes first while providing quality, predictably successful products is secondary in importance. The same applies for a dental practice. If the primary emphasis is to provide the best care for the patients, then it doesn't matter that the fees are very high. Likewise, if making the most money is the primary concern and proper care is not , then it doesn't matter if the fees are low. This applies to any business and their relationship to their customers. Fortunately, I believe most dentists and physicians operate this way.

Hi ! Nobelguid is not ethic ! Why place implants in sites where bone awailability is congortabele but in nonbiomechanik position. We have great tehniques of bone augmentation and sinuslifting. Place implants where they are needed. Make your bone in the site where implants should work. The greatest advantage of implants is bonemaintanence. Ask your patients what they prefere: restoration of their bone ore leaving boneresorbtion to continue. I do sinuslifting and implantplacement in less than one hour. My colleg is doing guided implant placement in more than an hour !

Nobelguide is an excellent tool for planning. Surgical guide and "teeth-in-an-hour" concept has not worked very well for us. We use iCAT CT scans and plan cases with NobelGuide or Simplant; then create Stereolithic models from BMI in Boston to plan surgery and create temporary prosthesis prior to surgery. It is like any new technology, you have to use the best of different products for a focussed goal of providing quality service to the patients and make profits for your practice. Personal attacks against women, attack against corporate profits etc show a great deal of conflicts and lack of education in diversity and business.

Have used Nobelguide for about a year and find it to be extremely useful in certain cases. I believe the Teeth in an Hour concept is over-rated as marketed. Perfect alignment and maximum use of available bone are huge benefits. I still graft to achieve best possible bone. Any tool can be misused. - patients do want less invasive procedures - patients do heal faster and resume lifestyle faster with flapless techniques - I only place a provisional prosthesis at the time of guided surgery - it is not a panecea but a very helpful tool

One of the many issues with nobel, is tha fact that they are selling the idea that implant dentistry is "as easy as 1, 2, 3". We , dentists that care about our patient, not just their money, know that, regardless of the car make I drive. They go all over stealing referrals from us specalists, telling GPs that with nobelguide is so simple anyone can do it. The truth is that there is no real figures with real numbers of all type of failures. I don´t keep track of how many implants I have placed, but believe me, and you know that, the more you do it, the more concerned you are with detail, and a CTguide will never give you the experience and vision to lessen mistakes. Yeah, they are nice, if I havee a case to use use one I do it, from Simplant OF COURSE, I am not so sure if it really is worth its cost, but.....believe me there a re a ton of issues with this company,

I disagree with Dr. Shapiro. While nothing is foolproof, a proper CTguide is a tremendous asset and will certainly improve your accuracy and lessen mistakes. I can't comment on the Nobelguide, since I haven't used it. I have used Implant Logic System guides, with cases planned either with Simplant or with their own VIP software. Rather than fabricating the stent after the CT scan is taken (which may be the reason they don't fit so well), the stent is fabricated before the CT from an ordinary model, and it is worn during the CT scan. Thus you have the opportunity to verify the fit of the appliance before the CT is even taken. The appliance will have barium teeth replacing the missing teeth, so you will see them clearly on the CT and planning the case is rather simple. The appliance is then CAD/CAM milled by ILS, and you can be very confident that it will fit well and be accurate. If you want your patient to benefit from less invasive surgery, less time "under the knife", and better accuracy, then it certainly is worth the cost.

Where shall I begin. I have been restoring impants for about 18 years and placing them for about 10 years. I fabricate surgical templates and use CAT scans when I feel they will offer additional diagnostic information that will improve my understanding of the bony topography and density of potential areas for implant placement. Let us agree that ALL implant and software manufacturers are in the marketplace to make a profit on their technology and sales; as are we. I have placed many implants with the use of conventional lab/office fabrcated templates. I have used Simplant fabricated templates. And lastly I have used nobelguide templates. You must agree that the Nobelguide template finally SCREAMS....the Incisal edge,occlusal table, buccal and lingual dimension are the parameters of placement of the implant. It has finally truly become a surgical extension of a Prosthetic restoration. This indeed is not a "one size fits all". It is used as a diagnostic tool just as is Simplant. Re-imagine that the potential implant sites are properly developed. The accuracy of fit of the template is checked and confirmed. The implants are now placed using a punch flap procedure. I defy any human at the time of surgery to free hand provide the accuracy of depth and angle as a software product mated with a standardized radiological survey and a stereolithographically fabricated template in a similar amout of time providing a similar post op comfort level and implant success. Medicine has moved through this phase and now on to robotic surgery. We are infants in a technology that medicine has been using. The average time for me to get a simplant or Nobelguide template was about 1 1/2 to 2 weeks. I have NEVER waited 5 weeks as was said above. Though all things are possible. It is in your hands as the Doctors to deceide if this technology is a valuable diagnostic tool to determine that more bone augmentation is needed and if and where implants may be placed that will support a prosthetic solution. The number of cases that you will use this technology for will purely be determined by your patient population. If 200 one or two arch totally or at least one full qadrant edentulous people walk into your office next week and all could avail themselves of punch flap surgery because they meet all the surgical criteria then this becomres a viable option you should at least entertain as a possible solution. To be totally transparent I teach the use of simplant and nobelguide to dentists at a dental school. I also teach for nobelbiocare. But most of all I wake up ever morning to the private practice of Dentistry. What a wonderful thing to possibly provide new and exciting technnology to our patients. Twenty five years ago root form implants were as close to voodoo as you can get. Look where we are today. Open yours and allow for growth.

Researchers at Sweden's Karolinska Instituet recently reported that Nobel's 'Teeth-in-an-Hour' may carry more risk of complications than conventional methods. The study examined 31 patients treated using the method and showed that complications such as the loss of fixtures and the need for adjustments arose for nearly a third. Nine percent of the 175 fixtures examined were lost. For more see the Feb 26th entry at: osseotech.com

Two weeks ago I was on a Perio Meeting in Rio de Janeiro, called SOBRAPE, and prof.Bjorn Klinge from Karolinska Institute, showed us the results with the Nobel´s Teeth-in-a-Hour protocol. The findings are not favorable to Nobel, indicating almost 30% more problems than when using convencional implant surgery. He sugests waiting a little bit more to take the right choice. With some small corrections the system can become a reliable way to deliver immediate implant support prothesis

Concerning Nobel Guide, i have been working with it for two years now. I have treated 78 patients and decreased bone grafts significant. The added value of Nobel Guide is to place the implants in best prosthetic position in relation to the amount of bone. I have not read this sentence in all the comments above, which gives my the idea that the placement of implants and the prosthetic solution that follows are still two separate solutions for many doctors. This is wrong, it is one. Placing implants will become a prosthetic driven profession, as it should be. Imagine the advantage it gives if we can promise our patients what kind of prosthetics we will give them. With a system like Nobel Guide, you can always do this, and have excellent results. But as any system, you have to use it the right way, and invest some time in a new technology, which will be the one of the future for sure. I have the impression lots of doctors feel themselves threatened by this system as if they can not place implants whitout the guide. Those doctors have not understood the goal of Nobel Guide. Final a remark concerning the Nobel Biocare compagny to be a show compagny.. I had the same impression some time ago, but i concluded it is the only compagny investing such an amount in scientific reports... I was surprised to read up to now 21 of the 70 studies they did on Teeth-in-an-hour. I believe no other compagny is doing these kinds of research, so there is a lot more than just show going on in Nobel Biocare.

on the suggestion every company has to make profit. That is true, but as a healthcare worker we also have responsibility to our patients. We don't sell things the way a normal company does. But is is a good thing we can meet eachother at sites as osseonews and discuss which things work well and which things don't, but we have to stop to stick to a brand and try to kill it. As a fact we better should state which features we like as a dentist, surgeon, etc and let the companies follow our demands instead of being dependend on what the companies think is good for us

The advantage to NOBELGUIDE, as I see it, is that I can place implants in prosthetically driven positions while utilizing the maximum bone support. Placing a rigid prosthesis immediately, whether provisional or final, allows healing to take place with the implants in identical position to my master cast which was fabricated with the surgical stent. Thus distortions from impression materials and gysum products have been eliminated. This also give the advantage of replacing a failed implant in an identical position thereby eliminating a repair or replacements of the prosthesis. Implants placed using the stent are by no means without variability in position, but, will heal to the preset position as those implants will loosen and retighten during the following six weeks after surgery. As a Prosthodontist, this is ideal.

Dear readers, I have completed 300 NobelGuide cases since the software was released in Las Vegas 2005 Whilst very happy with the results I feel that I must mention the following: Start to use NobelGuide or any other software for regular case analysis, it is an invaluable tool that should be used side by side with conventional diagnostics.

DICOM is an interface and protocol standard created by the medical industry to promote interoperability between imaging equipment and any equipment users want to connect.