CSR
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REDUCED NECK Convergent neck to provide more space at the crestal level and promote bone growth STRAIGHT NECK Straight, constant morphology throughout the entire body of the implant WIDE NECK Divergent neck to take advantage of the bicortical coupling and achieve great primary stability

The origins of the CSR implant The CSR implant was designed by Sweden & Martina in collaboration with the Department of Dentistry of the San Raffaele University Scientific Institute in Milan. The idea was to develop an implant that can tackle any clinical situation, ensuring good primary stability in any type of bone and a simple surgical phase with few instruments. Cylindrical body, double conical connection interface, different neck morphologies and the possibility to use the One Abutment-One time technique make the CSR an extremely versatile implant. STRAIGHT NECK WIDE NECK REDUCED NECK

CSR: different neck morphologies The CSR implant features a cylindrical morphology and full treated ZirTi surface, whose validity is documented by over 20 years of clinical success, with a bevel in the most coronal portion. CSR implants are available with three different neck morphologies, Wide Neck, Straight Neck and Reduced Neck, to meet different clinical needs. Wide Neck: coronal portion with 50° triangular thread and 0.30 mm pitch to achieve primary stability even in poorly mineralised bone Straight Neck and Reduced Neck: coronal portion with 50° triangular thread and 0.60 mm pitch...

Clinical case courtesy of Dr. Giuseppe Pellitteri, Bolzano 40-year-old female patient with Grade 3 furcation on element 16 and severe bone resorption of elements 14 and 15 that caused Grade 3 mobility. The patient was treated in two surgical stages about one and a half years apart. Considering the patient’s young age and in order to make oral hygiene easier, rehabilitation provided for the insertion of an implant and crown to replace each missing element. In the first surgical stage, the element 16 was extracted preserving the natural tooth socket, than a sinus lift procedure was performed,...

After impression taking and model development, the prosthesis is designed with Exocad software Placement of the screw-retained prosthesis made with CAD-CAM tecnhique The crown made with CAD-CAM technique is tested on the model Two months after the placement of the prosthesis, the growth of the papillae around the crown can be noted Intraoral X-ray at the time of placement of the crown and follow-up X-ray at 12 months: the recovery of bone volumes around the implant can be noted. At the same time it is possible to note the bone resorption around elements 14 and 15, also visible in the image

In the second surgical stage, element 14 is extracted and a CSR Straight Neck ø 3.80 mm implant is inserted; then element 15 is extracted, a mini sinus lift is performed, and a CSR Reduced Neck ø 4.20 mm implant is inserted, as shown by the X-ray done immediately after surgery Milled and polished temporary PEEK posts are screw-retained onto the implants Prefabricated teeth are stabilised on the posts X-ray at five months after surgery: on elements 14 and 15, the impression is taken with Pick-up transfers; it is possible to note the completion of the integration of the implant on element 16...

CSR: the narrow range CSR implants are also available with a small endosseous diameter of 3.00 and 3.50 mm, which is ideal for cases where there is limited prosthetic space in the anterior sectors or in the presence of thin ridges. Like the other implants in the range, the narrow diameter implants feature a full treated ZirTi surface and a bevel in the most coronal portion. Treated ZirTi neck without thread, 2.00 mm high 50° triangular thread and 0.60 mm pitch along the entire implant body Central cylindrical portion, with 30° triangular thread and 0.80 mm pitch Conical-shaped apex, with...

Clinical case courtesy of Dr. Giuseppe Pellitteri, Bolzano 70-year-old male patient with zirconia post fracture on element 31. After extraction of the residual element, a narrow diameter CSR implant was inserted and loaded immediately. Initial situation: element 31 has a fracture of the zirconia post Pre-surgery X-ray CSR Straight Neck ø 3.00 mm implant inserted after extraction. Due to the limited prosthetic space, an implant with a narrow diameter, high-performance thread is chosen The extraction of the residual element is planned and a post-extraction X-ray is done The implant is...

ZirTi Surface CSR implants are available with full treatment ZirTi, sandblasted with zirconium oxide and etched with mineral acids. Sand-blasting with zirconium oxide and etching with mineral acids gives to the surface a characteristic micromorphology capable of significantly increasing the bone-to-implant contact area and promoting osseointegration. ZirTi surface magnified 4,000 and 10,000 times under scanning electron microscope. Image of a portion of ZirTi surface obtained using a confocal microscope: the micromorphology of the surface and the regularity of the picks deriving from...

Roughness of the surfaces - Conclusions of the 2nd Consensus Conference of the EAO (European Association for Osseointegration), held in Monaco in 2009: “This review concludes that rough and moderately rough surfaces support a correct osseointegration. The highest level of BIC is associated with moderately rough surfaces (Sa value between 1 and 2 μm).” The roughness of ZirTi surface, with its Sa medium value of 1.4 - 1.7 μm, is considered ideal to achieve osseointegration. Wennerberg A., Albrektsson T. Effects of titanium surface topography on bone integration: a systematic review Clin Oral...

DAT conical connection The DAT (Double Action Tight) connection is the most innovative feature of the CSR implant: a double internal conical contact interface between the post and the implant and between the screw and post ensures excellent seal against bacterial infiltration, protecting the bone from the risk of peri-implant infections that could affect a correct osseointegration and the consequent implant survival. The narrow-sized ø 3.00 and ø 3.50-mm implants feature the DAT-N connection, that is the double conical interface connection in the narrow version. Gherlone E.F., Capparé P.,...