Clinical evidence and Science 7 THE PROMOTE® IMPLANT SURFACE Osseointegration with Promote® vs Promote® plus design In general, design changes and developments to improve the formation and maintenance of the soft and hard-tissue structures have systematically been tested in animal studies to prove their stateof-the-art technology. In 2006, the machined surface segment of the CAMLOG® implant neck was significantly reduced from 1.4 mm to 0.4 mm since studies have shown better bone-to-implant contact with rough surfaces. Schwarz et al. (2008) investigated the effect of this design change on crestal bone resorption in a dog study (5). Both implant types were inserted into the mandibles of dogs following the standard protocol for CAMLOG® implants (0.4 mm above the bone crest). Histological evaluation took place after 2 and 12 weeks. Bone changes were found in both implant types after 12 weeks. However, the coarse neck area in the CAMLOG® Promote® implants appeared to have a positive effect on bone formation (bone to implant contact) and crestal bone level change. Data demonstrated that the new surface design efficiently reduced the initial crestal bone changes (6). Vertical positioning of implants: effect of rough-machined border on bone resorption The above results were strengthened by a systematic review of Messias et al.: Provided that the implant neck (machined or micro-rough) is placed endosseous, machined collar implants had higher risk of early failure than micro-rough collar implants and 0.4 mm higher bone resorption (7). Another review by Schwarz et al. evaluated the impact of positioning of the machined collar (8). Derived from their conclusions a clinical expert panel recommended in the Camlog Foundation Consensus Report that the smooth-rough border of the implants should at best coincide with the adjacent alveolar bone and determine the insertion depth to limit the peri-implant bone remodeling (9). Fig. 4_Available implant variations from left to right, CAMLOG® PROGRESSIVE-LINE Promote® plus, CAMLOG® SCREW-LINE Promote® plus, CAMLOG® SCREW-LINE Promote®, CONELOG® PROGRESSIVE-LINE Promote® plus, CONELOG® SCREW-LINE Promote® plus CAMLOG® PROGRESSIVE- LINE Promote® plus CAMLOG® SCREW-LINE Promote® CONELOG® SCREW-LINE Promote® plus CAMLOG® SCREW-LINE Promote® plus CONELOG® PROGRESSIVE- LINE Promote® plus
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