NobelActive: Initial Impressions?

NobelActiveAny 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?

73 thoughts on “NobelActive: Initial Impressions?

  1. The Nobel Active implant is a direct copy of the Eeziplant from Osteo-Ti. As such it should work well, albeit at twice the price.

  2. I think it is smilar MIS SEVEN which has an internal connection.
    Dose anyone know what type fixture/abutment ?
    Internal tri-lobe ?

  3. 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.

  4. 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-Oss-Easy to all those mentioned above.

    So what else is new?

    I would not want an implant system without documentation in my mouth. Why would I consider this in my patients?

  6. It is an exact copy of Alpha Bio implant. I am wondering why are they (Nobel) trying to convince everybody that this is a NEW thread pattern.Is this the result of research and innovation?
    Nowadays the companies tells you what you have to do.
    They provide and everybody will do it!!!

  7. 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, should 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. Dr Fromovich is a good surgeon.

  8. If you want to review my 4 page/12 picture “Critical Analysis” of the NobelActive Implant and Nobel’s new Curvy Platform Shifting abutment, go to Implant Direct’s web site and look at the Nobel Biocare secton of the “Compare System” page to open the PDF. If this does not convince you that the Research Spirit on which the Branemark System was based, is dead at Nobel Biocare, nothing will.

  9. 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 etc….

  10. ….there is no problem or Nobel users to maintain or accept new products.
    They belong to what they think is good….fashion!
    Poor patients!

  11. 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 suport a bad system. You Dr Niznick stop to tell all the other products if they are not yours are bad.I knew you in Marrakesh where we lecture together. I did not like your presentation and I can’t like persons like you. You think you are “GOD”?
    I will use Nobel Active and I am sure it will be a big success

  12. Pardon as my english is not phantastic when I say a “good and clever system” I want to say “a bad and stupid system”

  13. and now phantastic english (thank you to my wonderful translator Carmen)
    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.

  14. it is a copy of OsteoCare Maxi Z dental implants produced in the UK, I use Maxi Z with great success, ofcourse Nobel version will be triple the price

  15. Dear Mahamed I believe you are a dentist but yours eyes are not well.Maxi Z can be excellent, but the new Nobel Active is completly different.I like to give the best to my patients; price is relative. Good luck to your implant practice.

  16. joao they copied the concept not the design and did u see maxi z in the first place?

  17. Dear Mohamed yes I saw; is completly different; even the concept. But doesn’t matter, go on applying your “excelent implants”; I prefer work with companies offering to me studies, research, esthetic solutions, etc.

  18. Well Nobel biocare don’t offer studies or anything now, just pure commercial work.. remember the problems with there on piece implant recentely?
    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

  19. Dear Moahmed
    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.

  20. We should only comment on the design of the implant, not how good or bad the company that market 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.

  21. ohhhhhhhh Joao, not so personal, not so personal…..Nobel will not thank you nothing…..

  22. Nobel Biocare is good company they transform the clients in VIP and sell them cheapper 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 spits thowsands/hour, but always we decide where we gonna buy…

  23. 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 away your marketing to them and finally you have hundreds of convinced doctors marketing your products by themselves!
    I now 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.

  24. 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 Diahrea.
    What is wrong in my oppinion 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 and as the implant is turned to place, it expands and compacts the bone increasing initial stability. The NobelActive copy of Alpha Bio’s clone of Oraltrontics implant is the same diameter at the bottom as 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 Fromovitch 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 preplacement. Apparently the NobelActive is not only for soft bone, it is for multiple splinted implant cases. 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.

  25. It seems that external Morse taper implant is very similar to Impladent Laminoss implant. Any decent occlusal reduction will eliminate the possibility to remove the implant, unless it is tapped off. I estimate the following dimentions for the implant post, hex, abutment. Post – 3.5mm, hex – 1.2 – 1.5mm, space between the the top of the hex and the bottom of the abutment threaded bore – 0.7mm, threaded bore – 1.0mm. Total of about 6.7mm. Not an impalnt for tight interocclusal areas unless you place implant under the bone level. Impladent recommendes placing implants 2mm subcrestally.

  26. 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 its us, the people who apply implant therapy, who make them the market leader!

  27. I wonder if anyone could give me reviews about the MIS implant system. WHat is your feedback on bone compression/ expansion screws from MIS?

  28. Nobel has now posted the Instruction manuals for the NobelActive Internal and External hex implants. Reminds me of the movie “Dumb and Dumber”. The body of both are the same, with a signficant 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 ie 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 alrady 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 “oppinion 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.

  29. No doubt that the new implant from NobelBiocare really bothers Mr. Niznick.
    Apparently he is not only threatened by this one but by all successful implant companies. In recent lectures, he has attacked and defamed all implants made by the three leading companies – NobelBiocare, Biomet-3i and Straumann.
    In his words they are all “garbage”.
    That makes 70% of the world’s implanting dentists – complete idiots.
    It also means that 70% of the implant patients worldwide have flawed implant born restorations. That is if we listen to Mr. Niznick.
    Mr. Niznick does not talk as a scientist or a Doctor anymore but as a business man for whom all competitors are enemies, successful ones in particular. Therefore his words, spoken and written, should be treated accordingly.
    Mr. Niznick knows that innovative implants like the NobelActive are far superior in many aspects and in many cases are the only ones capable of high initial stability.
    In fact he is so sure of it that he offered to buy the company that originated the new design (but they would not sell to him) and now he is promising a new implant along the same lines. It would be called the Proactive.
    From what he writes and states I was not aware he is that pro active.
    But then it takes a crooked mind to understand a crooked mind and no one is that crooked.
    Would you buy a used car from this man, or any other thing for that matter?
    No one in their right mind would buy anything from this man, ideas or products. He is too twisted and dishonest.

  30. Would anyone on earth recommend NobelActive implant for insertion in the extraction socket of fractured canine along with BioOss+BioGide grafting and immediate loading (NBC Immediate Temporary Abutment), since a colleague had such a presentation in our local implant study club?!?!?

  31. Immediate placement and minor grafting possibly, but not immediate loading. Although that may work and well in certain instances, why risk complications that can be easily avoided. Do no harm.

  32. To dr. Niznick: Generally, I agree with most of your work. But, you are attacking all the colleagues who are not your followers or Spectra System users and they are defending their own interest, knowledge and/or (lack of) exprience. Btw. why do you have different shapes in your system? In my opinion, if not compromised by the surgeon, infection or overload osseointegration works on every dental implant 🙂

  33. Dr. Niznick is, in my opinion, right about the following things 1) external Morse taper connection was patented by Driskell, and other “innovations” are not inventions. 2) Self-threading and bone expanding capabilities are likely not better than other systems. 3) Implant direction needs to be controlled at the time of osteotomy preparation.
    Dr. Niznick is, in my opinion, wrong when he states that implants have to be parallel to receive the bridge. Nobel will provide the angled abutments. Standard abutments can also be prepared. When Dr. Niznick compares the adaptation of Alpha Bio and Screw Plant implant/abutment interface, he orients Screw Plant implant in a wrong direction, to conceal the junction, since Screw Plant implant is using external conical connection (same as IMTEC Endure implants), the picture has to be taken from the apical end, not from the coronal end. There is one definite advantage to external Morse taper connection nobody can argue with – any implant can receive any abutment. Everything new is a well forgotten past (Russian saying).

  34. Dear friends: this new implant has been in the market for a few years under Alpha Bio trade mark. Not even one of the NobelBiocare users paied attention to it during this time!. Beyond that if people from the company stated that I was using this implant in the past, they kindly asked me not to participate in their meetings or training programs. So what is different now?
    I was present during the EAO corporate forum presentation of NobelBiocare. There was a live surgery from Israel performed by Dr Ophir Fromovich. I just can say that I will never bring my mother to him to place an implant or any other dental procedure!!!!
    Dr. Niznick may be wrong saying that any one that is not usin his system is not doing things well but we need someone brave enough to possition himself in front of this powerful companies telling them that they cannot say anything that comes out from their marketing departments!
    I will never place a NobelActive implant becouse I really don’t think it is offering me any advatage compared to what I am using right now.
    Good luck to everybody!

  35. Alexander Weinstein Says:
    No doubt that the new implant from NobelBiocare really bothers Mr. Niznick. Apparently he is not only threatened by this one but by all successful implant companies. In recent lectures, he has attacked and defamed all implants made by the three leading companies – NobelBiocare, Biomet-3i and Straumann. In his words they are all “garbage”.

    RESPONSE: I have never said any implant is garbage – I have pointed out the shortcomings of implants from all three of these companies. That is called comparative competitive marketing. People in the audience either agree with me or not but that should not stop me from stating my point of view. For example, I have spoken against acid etched surfaces of of 3i for a decade… surface studies show it is as smooth as the old machined surfaces of Branemark, which I also was critical of and is now obsolete. I am critical of the 3.5mmD NobelReplace implant, made of pure titanium because of its potential for fracture and although I have duplicated the dimensions of this implant in the 3.5mmD RePlant implant, and made it out of alloy for 20% more strength, I also advise dentists to use our RePlus implant which adds 44% to the wall thickness by using a 3.7mmD as its smallest dimension. I spoke against the Straumann one-stage implant for its esthetic limitations – to achieve a lower margin, dentists had to push the implant farther into the bone, putting the smooth surface below the bone, which encourages bone loss. Straumann finally came up with a new two-stage implant, but that one falls short by not being self-tapping, not being tapered and not having micro-threads or grooves near the top. I even point out how Zimmer’s popular Screw-Vent implant that I developed, can be improved by extending the rough surface to the top, eliminating the apical vent and raising the threads.

    POSTING: That makes 70% of the world’s implanting dentists – complete idiots. It also means that 70% of the implant patients worldwide have flawed implant born restorations. That is if we listen to Mr. Niznick. Mr. Niznick does not talk as a scientist or a Doctor anymore but as a business man for whom all competitors are enemies, successful ones in particular. Therefore his words, spoken and written, should be treated accordingly.

    RESPONSE: AND SO YOU SHOULD JUDGE MY WORDS AS A COMMERCIAL PERSON… but you should also question the words spoken by these major companies’ paid spokesmen advocating their systems. In the end, those doctors who rely on their own good judgement to select the products that give them the best value and clinicala results are being smart, and those who beleive everything they are told just because it is Nobel, Straumann or 3i are not excercising good judgement. My contribution for 25 years has been to speak out against implants and implant features that I believe fall short of what would give the best clinical results. Some of the features that I spoke out against are now obsolete such as smooth surfaces, weak materials, unstable connections, complicated surgical procedures, non-self-tapping implants, expensive products etc. Those who would silence me like Weinstein, have their own agenda in being critical of anyone who questions the systems and business practices of the major implant companies. 70% of the dentists are using implants from these major implant companies because up until now they did not have a credible alternative at a reasonable price to buy a high quality, broad product line, with, in some cases, surgical and prosthetic compatibility to the systems they were trained to use. Implant Direct now offers this and it will change how the major implant companies have to do business to be competitive. Every dentist benefits from competition. Nobel and Straumann are publically traded companies and both Zimmer and 3i are owned by publically traded companies. They have large expensive organizations of salespeople, exectives, oppinion leaders etc, and they are driven by the need to maintain high margins to puff up their stock prices. Implant Direct, selling primarily over the internet and owned by a single person (me), with no investors has the ability to quickly launch competive products like ProActive with deeper threads for those who like this feature, while maintaining the successful features of our other products such as an even taper for bone expansion and the use of the tri-lobe connection with platform switching, so that the Nobel customer does not need to abandon his existing inventory of prosthetic components or re-train his or her referral dentists. I do this while providing substantial savings compared to Nobel’s prices. I would never duplicate something as limiting as the NobelActive External.. that concept was tried in the 1980’s with the Miter implant and abandoned after clinical complications because of the prosthetic limitations. The same thing will happen with NobelActive External because Nobel, in its desparation to launch new products, has not relied on the wisdon and knowledge its many experienced oppinion leaders but instead just bought a design from Alpha Bio, a company that built its business selling poor quality clones of my Screw-Vent system.

  36. i am interestested to read the blogs out there.its qiute simple.The Ankylos implant now has 20 years of data.the system is absolutly unchanged in terms of screw pitch flank and has all the qualities that mr nitznic esposues.even better the surface is over the top of the implant and subcrestal placement of the 3.5 diameter implant complete with a platform swithch in the presence of a morse taper connection is perfect.Years of university based studies,a morse taper connection with a clapming screw-to produce the no smell implant.A taper with a progressive thread design for excellent primary stabibilty in type 4 bone and a tap for ease of placement in type 1 economic series of machined abutments in as may angles as you need.also the implant comes with the cover screw included and a shape of emgerence profiles of the connecting parts that wont loose your soft tissue seen with parallel or flared healing and abutmnt profiles.the joint produces zero micromotion under load cycles and to cap it all its as cheap as chips.having used all the major systems watch this space-carlsburg dont do implants but if they did they would look like ankylos-funny they are starting to!

  37. nothing wrong with morse taper.ankylos was designed by an oral surgeon and an engeneer,thus
    difficult to solve from prosthetic point.

  38. Although Dr.Niznick’s comments on Nobel Active are partially correct, I do not see what is new in Dr.Niznick’s own ProActive implant as well !

    Mini threads idea from ASTRA, shape of normal threads same as shape of threads of Hungarian company PROTETIM dental implants on sale in Hungary and Romania since more than 15 years ago, principle of combination of tapered body and tapered threads shape same as the one applied by several Italian implants from 1990ies and my own implant system SDV 1 introduced back in 1991.

    As a Russian colleague wrote it above – all new is well forgotten past.

    Implants with threads height of 0.4 up to 1.2 mm work quite well. Certain designs with high threads can be self – tapped even in D1 bone without use of tapping tool, if made of Grade 4 Ti or Ti6Al4V. Colleagues need to learn more about achievements of Italian Implant Dentistry School going back 20 or more years ago.

    Implant dentistry today has reached a plateau and is not moving ahead as far as we speak about implant design. What is needed for example is to understand why there is no statistically significant difference of success rates between all different rough surfaces used by different manufacturers and what exactly is going on at the implant – bone interface after implants are inserted and loaded.

    Dr.Valeri Stefanov

  39. Warning don’t buy anything from Niznick

    Ive used Niznick’s implants and have had horrible results. In my opinion his products should be banned from the market. He should spend more time analyzing his own faulty designs.

  40. I’d like Dr. Pawel to be more specific. What kind of problems did you have? How is the implants design faulty7

  41. Nobel Active is a clone of Alpha Bio SFB implant, which is a very good implant. But, because of the inverted cone at the platform of the implant, i would not indicated this implant in immedaite implantation in sinus lifting cases.

  42. Nobel Active is different from the Alpha Bio SFB. There are numerous differences, surface, thread design, connections as well as prosthetics.

    most implants look a like from far away, but are different

  43. Why should nobel active be different from sfb,if on nobel website one can see dr.Fromovich performing surgery using nobel active?

  44. Nobel Active pays off its money, but still is an product emerged from a crisis of “innovation diahreea”!

  45. Dr. Pawel Says:
    January 17th, 2008 at 9:08 pm
    Warning don’t buy anything from Niznick

    Ive used Niznick’s implants and have had horrible results. In my opinion his products should be banned from the market. He should spend more time analyzing his own faulty designs.

    Niznick Response: We have checked our records and do not find the sale of any implants to any doctor named Pawel. The party that posted this claim also never responded to the doctor that asked him for more details so my guess is that it was a Nobel sales purson. Nobel annouced it just bought Alpha Bio for $95M… Way to go Dr. Fromovich. Nobel will now be able to get rid of the low priced version of its NobelActive implant making Implant Direct’s ReActive implant (changed name from ProActive) even more attractive.

  46. hi
    can the specialists here guide me about any experiences with Leone exacone implants,which have morse taper connection with solid abutments…..please give some insights as it has cylinderical bodybut with threads….

  47. NobelActive ( previously named SFB Alfa-Bio) is a great implant for certain clinical situations ( LIKE ANY OTHER IMPLANT that WE USE ). Almost 3 years of experience without problems( along with placement of 3i, BioHorizons and Bicon
    implants ).

  48. Very interesting comments form everyone, but I’d really be worried about about Dr. Pawel’s comments about horrible results with ID. I’ve used many systems over the last 18 years including ID and I can say that they all work and they all can fail. If someone is having exceptionally bad results, then my first look would be at the surgeon/ techniques rather than the implant system.

  49. Well, I too was attending the Nobel show at the EAO meeting last september, and I can only agree with P.P. remarks of that incredible live surgery no B-level horror moviemaker could have imagined.
    By the way, I’ve been trained in implantology using Hex-hole screw Vent Implants, and >98% of them placed 20 years ago next june are still perfectly working, and I mean from a bone-perio and prosthetic point of view. It was a smart simple system, difficult to handle properly mostly because the various form discrepancies between the “impression coping” and the plastic castable abutment, and for sure it was really a challenge to take perfect implant level impression, not to mention the work to lute the post and to clean the post and remove excess cement. But it was not impossible to use, and with the normal handling capacity of a newcomer from dental school.
    The frequent changes in implant connection form, type and size Dr Niznick made in the years 1990-91, not so quickly transferred in Italy, forced me to choose a more “stable” system. I feel anyway that only those who don’t do nothing, don’t take a risk for failure (pardon my english, but I feel that the meaning is clear enough), but they do not provide any support to progress. And osseointegrated dental implant ARE progress.
    Take care of your patients, and be honest with yourself, and have the best outcome of your life

  50. Most implant systems on the market has high success rates. It depends on the familiarization of the surgical and prothetic techniques. Whether it is worthwhile paying 2 to 3 times the cost is up to the individual. The feel good factor may be priceless.

  51. “Dr. XYZ on April 17th, 2008 6:37 pm Very interesting comments form everyone, but I’d really be worried about about Dr. Pawel’s comments about horrible results with ID. I’ve used many systems over the last 18 years including ID and I can say that they all work and they all can fail. If someone is having exceptionally bad results, then my first look would be at the surgeon/ techniques rather than the implant system.”

    Dr. Niznick’s Comments.
    As I stated above, I do not think there is a Dr. Pawel – it is most likely a Nobel Rep. We have no doctor in our records as having ever bought a product. On a salesrep blog, a Nobel rep posted this comment. “thank god that we have enough reps on the street to scare the shit out of docs in using your product with our drills.” I spoke yesterday to a doctor who had placed over a thousand RePlant implants using Nobel Replace drills (we will soon have our own drills for RePlant and Nobel Replace implants), and he claimed to have 100% success to date. Montefiore Hospital has placed over 1200 RePlus implants from Implant Direct (a tri-lobe connection with a Tapered body like the Tapered Screw-Vent and our Spectra-System), with only 3 failures. When you get these kind of results, it demonstrates not only that titanium osseointegrates, but also the design and surface of the implants contribute to success (I will provide the names and phone numbers to these doctors if anyone contacts me directly), As for NobelActive, This implant has serious design flaws including to rapid a taper to the body (one doctor told me two jammed in to the bone before full seating and could not be unscrewed – had to be cut out), a tapered coronal portion (will leave a gap between the implant and the bone at the crest), and two sharp an apical cutting surface (could tear the membrane if it enters the sinus).

  52. hey let’s not get carried away. Does anyone claim to have 100% success ? Does anyone never see an implant break loosen get infected or have the porcelain chip? Implants are titanium screws that are replacing a lost tooth they work period. there is no panacea remember the patient lost his her tooth likely due to poor oh gum disease or trauma. We are hard working clinicians trying to make living and at the same time help our patients. The implant companies have one primary objective MAKE MONEY. Don’t blame them . Go with a proven system that you would feel comfortable having it placed in yoiur mouth. I’ve used nobel ,corevent ., implamed ,Hitec ,MIS ,Adin , Alpha BIO, they all work . But i will never forgive NIznick for the cemented posts he sold us in the 80’s. So does the new Alpha Active work sure it does but why spend three times as much as the alpha bio implant ?

  53. sorry for english:)
    intresting discussion
    i work with implants, maybe for 3 years. started with nobel, then tryed biohorizons, 3i only fo better price. sorry but i came back to nobel again, maybe it is too expensive, but, i never had any problem. about active, one thing, witch i hate in this system- why they still don’t have the same temporal abutment with screw, as they have in groovy??????? only strange thing is the plastic cap for cementation?

  54. Just got the news from Nobel that NobelActive External implant will not be released. The reason – “lack of interest”. Dr. Niznick correctly pointed the factors which led to this “lack of interest” environment – no internal threaded bore for screw retained prosthesis/ framework/ ball abutment; external hex/ pillar combination too high. I should add the inability to take implant level impressions, unpredictability of abutment insertion distance (depends on the number of taps, force of taps…), healing abutment with 7mm heights (about the same as permanent abutments). Good prediction on this one Dr. Niznick.

  55. What about the NEOSS implant company? Does anyone have any comments on this company? It looks like a great implant and I have found it is easy to restore. Less components to purchase. I like the way the product comes packaged.

  56. incredible but true …..Niznick have time to read everything and to answer it !!(properly)…..for me its simple …change the name NobelAdictive instead of Active….dear Dr. Niznick be coool…..of course the history its important but who could said who is right?????

  57. No-one is saying its a terrible implant….But it is not innovative and designed by Nobel. Its basically the MIS Seven. This is the company that has had systems colossally fail in the market and routinely has implant body failures at the time of surgery on the smallest size implant. Both are unacceptable results from a “premium” implant company. Most intelligent dentists have shifted from Marketing based companies and Paying $640 per implant.

    As Implants have become the standard the Shift is towards science based systems with outstanding products like BioHorizons. There is a reason that virtually ALL the top Opinion leaders are placing , lecturing and talking about BioHorizons.

    They are the best. Never had an implant body break, Proven to maintain crestal bone, Only system proven to achieve aggressive soft tissue attachment at the Laser-Lok collar (Nevins, Shapoff, Linkow) and on and on. Plus the abutment, cover cap come with the implant and is used for the impression. All for the cost of Nisnicks knockoffs!!!!!!!!! Only better tolerances and you are treated with respect by a very classy company. Nisnick is arrogant and thinks all dentists are idiots and will buy anything.

    Do you want to align yourself with that guy?

  58. Gentlemen/Ladies
    My surgical and prosthetic implant experience dates back to 1971 with the Linkow blade. With good technique and skills, they work!! This applies to all other implants, they all can and will work with attention to details. After placing and restoring thousands of implants of all companies and designs, a lot the success comes from good appreciation of the bone and soft tissues. Good technique trumps all other considerations. I now limit my work to just implants and their restoration. My purpose of logging onto this forum is to try to learn from others experiences with implants. What I find is a waste of time bashing each other. I have known Dr. Niznick for many years and have used his products. We have shared steamed crabs at my house. His products are no better, no worse than many others. Cost is not a consideration, these are passed directly to the patient. What I would like to find here is less bickering and more professional discussion. I am particularily interested in real clilnical, personal experience with the Nobel Active implant. I do not believe I have seen any comments here from someone that has actually used them. I have and I find them to be quite interesting and really like the basic design and placement protocol. Only time wil tell. I have some doubts about parts of the protocol they preach. These are my own observations after using quite a few of them over the last 8 or 9 months: I have had some posterative discomfort with those that are torqued to the suggested 70 ncm. One of the principals of implants is that the implant should be basically passive in the bone or at least well within the elastic limits of bone. I have never placed implants with that much pressure (on the threads by the torque). These Active implants have all integrated but I have never had post operative discomfort of any kind. I now place these implants to the level I intended, back them up and then proceed, back up, go forward and end up with virtually neutral torque on the the implant. Post operative discomfort has dissappeared. As to redirecting the implant. You do not seat it and then realign it, the change is made as the implant is advanced , slowly changing direction. This works quite well in the upper anterior where the buccal plate is thin and you move the implant toward the palate by first penetrating the palatal cortical plate at an exagerated angle and then rotating the advancing implant more to the vertical. The buccal space is then obturated with graft. This works exceptionally well. The extreme torque advocated by the Nobel people simply does not make sense to me, but that does not make the implant bad. Virtually all of the Actives I have used have been in the maxilla. I generally do not use the osteotomy drill much beyond the opening through the cortical plate no wider than the implant apex and no deeper than enough for the implant to engage the bone. I would like to hear from others that have had actual experience with this and if they encountered the same post operative course. Thanks

  59. So much talk about so many new companies and implants! So confusing. What about the patient and the end result? All implants work! But why do we have to pay such high prices? There is a new company in town called Neoss. Does anyone have information to share on this company?

  60. I am curious about the Nobel Active implant system and was wondering if anyone could provide information on how the soft tissue looks once you remove a healing abutment, as well I am even more interested in the maintenance of marginal bone levels. Is Nobel Active achieving the same bone loss rates as their previous systems (i.e. up to 1.5mm in the first year) and is there any significant documentation that suggests what the expectation should be for bone loss over time when using this system. I have seen some Astra documentation which suggests they are seeing an average bone loss of .4mm or less over a five year period. Is this now the norm with most internal connection implant systems?

    Thanks in advance.

  61. I’m new to implant dentistry. I started with Nobel Biocare since that’s what the UCLA program used. Since then I realized there are so many companies. Nobel is very expensive. I’m afraid to use implants from less well “marketed” companies. I don’t have the experience or the time to research all the implants out there. I rely on my surgeons for advise too. So what is someone like me to do if I want more affordable implants? This forum does not seem to come to some sort of concensus.

  62. I Have Used 3I, Biohorizons, Corevent, Dentsply,Noble Biocare, I have also placed over 300 blades. The Blades were Mostly in the sixties. I see blades almost on a Regular basis and they stiil look good. My experience is that when you place the implant you can almost tell if it will be successful or not. All systems sem to work well. I am now placing the noble active and I like it very much.

  63. I have been using the Nobel Active for a year. The concept and design is very good, regardless if it is a copy or not. The implant is easy to handle and predictable. Currently I have only used it extensively in the maxilla from singles to full arch reconstruction as I think the Imtec Endure is better suited to harder bone of the mandible. I have had two failures when brought into immediate function in the anterior maxilla. Both failed quickly when patient bit into something hard and broke the buccal plate. With 30 years of experience and basically knowing better, I do not immediately functionalize the implant or any other, for that matter. What is 90 to 120 days with a temporary in the big picture? My primary complaint is with the prosthetics. There is no way to be certain the impression coping and/or the “narrow profile” post is seated. This being said, when completed, the results are excellent. I do not like and do not believe in the “platform shift” idea and would prefer a post that seats on top of the implant. The Imtec Endure post does just that, but the Endure internal screw is too long. Substitute the Nobel screw and all works great. The Procera esthetic posts for the Nobel are ok, just not enough experience yet to comment.
    The concept of changing directions is real. The one factor not generally brought out is that if you are going to change direction, do it as you advance the implant. Do not seat it and then try to change its long axis. As the implant is advancing, I prefer the long screw driver handle to the handpiece, simply redirect the long axis as you turn it home. It works beautifully.
    I use the flapless approach with a 4mm biopsy punch (good only if you have experience in what the bone looks like). This week, with a congenitally missing lateral incisor, I had the implant in place and patient ready to leave within 10 minutes, not counting the anesthesia.
    An additional comment is that I will rarely use a drill more than the diameter of the apex of the implant (the second in the series) and never to depth, only through the cortical plate and then only 1/4 of the way down to start the trajectory of the long axis.
    Great implant, expensive yes. I teach implants at the dental school and Nobel extends a nice discount for faculty. Ask for a discount, nothing ventured, nothing gained.

  64. I get great enjoyment out of reading everyone’s realistic viewpoints and experiences on the various implant systems that they use in teir clinics and I appreciate everyones comments, I always take something away from real life experiences. The niznick’s of the world I ma not so sure about, though I ma sure he knows his stuff, maybe it is a bit too much of a sales push.

    It has really striked me that there has not been a lot of discussion on bone loss or long term esthetics for patients when deciding on which implant system to use. I know how imporatnt service is a s well from your reps and to me that is a valued consideration when looking at which implant system to use.

    I want to be clear that I am not a doctor however I do work in the dental field and have a keen interest in dental implants.
    Coming from a patients perspective, and knwoing what I know about implants now, why would a doctor not choose an implant system that has minimal bone loss, high success rates, well documented research to support the system, and use a system that has been around for a while. I personally have an implant in the 8 position and it has been there for 4 years now. I am dealing with the famous black hole issue and I am not overly excited about it because I am going to have to pay to have my crown re done. I am not knowledgable on a lot of different implant systems though I try and do my own research on some of the more popular systems being used in my area, those being Ankylos, Astra Tech, Nobel Active, Nobel Replace, 3I, Bio Horizons, and a little bit of Straumann.

    According the the research that I have been able to find it seems to me that the Astra system and Ankylos system is getting about .4mm of bone loss over a 5 year period, on average, and the Nobel active is getting .8-1.2mm of bone loss after the first year (I couldn’t find any long term data on bone loss rates for the Noel Active system, and I am not sure what the Straumann or Bio Horizons rates are averaging for bone loss over the long term so I can’t comment on those systems, maybe they are similar.

    I see everyones comments about how good systems are surgically but what about the considerations that have to be taken restoratively. How about the patient five years down the road, is there one system that will provide a better esthetic result after five years if bone loss is not as much, are there systems that are easier to use restoratively, which systems do a better job shaping the tissues once the surgical healing process is complete, who’s Cad/Cam abutments are better, etc..

    Shouldn’t these issues all be evaluated when looking at an implant system. I guess I care about the patient’s perspective more so than ease of use for the surgeon, but is there that much of a difference in the osseointegration success between one implant system and another, i think they are all around the high nineties.

    Food for thought. I would love to get peoples feedback on some of the points that I bring up.

    Thanks, and please keep the great discussion going.

  65. The implant Nobel Active is just another marketing strategies for Nobel Biocare to “lead the market.” I personally believe that the market is saturated worse by this company, do the following enumeration, Nobel Biocare said to be the world leader in innovation and research, but all that does is saturate the market and confuse your customers with commercial and scientific concepts that are ambiguous, since talk of research and evidence, but this is not the result of their own but of rigged procedures, the which we want to sell the market as a panacea.

    Why do not we wonder what happened to the Nobel Direct? The Nobel Speady? Will this company be to hide its failures in commercial and scientific smokescreens and commercial traps, showing the Nobel Active implant of the future? ? Seven of the implant MIS was developed first and that the asset has more research and the cost is 50% lower.
    Just look at sales results in certain countries and they will realize that the power of NOBEL just in the paper, since the reality is that this will be another failure.

  66. I was speaking to one of my Oral Surgeon clients about the Nobel Active Implant and he mentioned that before he considers using them in a procedure that he needs to see it be used in the industry for over 1 year. This will allow adequate time to assess the pros and cons of the technology.

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