Scientifica implantology

International Journal of Oral and Maxillofacial Surgery 2014;18:59-64

The aim of this prospective study was to compare the use of a hand mallet versus an electrical mallet in osteotome-assisted surgery for split-crest procedures.
Methods: Partially edentulous patients, with an alveolar ridge width inferior to the optimally desirable implant diameter, were selected for this study. Forty-six split-crest procedures were performed in 46 patients. They were randomly divided in two groups: in the control group, 23 patients, the split crest was performed with osteotomes using a handheld mallet, while in the test group, 23 patients, the split crest was prepared with osteotomes using an electrical mallet. Alveolar ridge width and incision dimensions were measured with a periodontal probe, before and after the split-crest procedure. One hundred eighty-one implants were immediately placed. Follow-up examinations were performed at baseline and 6, 12, and 24 months.
Results: The survival rate, at 2-year follow-up, was 98.31 %. Indeed, two implants placed in the maxilla failed to integrate at second-stage surgery. The initial width of the alveolar ridge varied from 2 to 3.5 mm; the average was 2.8± 0.7 mm. The final ridge width varied from 5 to 8 mm; the average was 7.2±1.7 mm. The split length varied from 7 to 28 mm; the average was 17.5±7.7 mm. No statistically significant differences (P>0.05) were found between test and control group in split length and alveolar width values before and after the split-crest procedure.
Conclusions: The use of a magnetic mallet provided some essential clinical advantages during crest splitting and immediate implant placement in comparison with a hand mallet.
 

IMPLANTOLOGY, Dental Press Thematic Magazine

Magnetic Mallet (MM) is a new technique all over the world, having been developed since 2012, in which shaping the bone is possible by replaceable osteotomes, chisels, implant bed shapers, bent pieces placed in the handpieces of bone-modelling equipment controlled electromagnetically.

Conclusions
Magnetic mallet in bone-shaping, implantology.
• MM is an instrument applied in a wide range of oral surgical and implantological interventions.
• In the case of risk patients and lesser bone mass, it is possible to prepare implant sockets
by splitting and expanding the bone with minimal bone loss.
• The application of MM, with implants of favourable properties on their surfaces (e.g. Straumann SLActiv), increases the chance of success, even in high-risk cases.
• It can be well combined with other surgical techniques.
• Its application allows bone preservation even at the removal of teeth and roots.
• Based on our one and a half years’ favourable experience, it can be recommended for every-day praxis, especially in implant socket preparation, removal of teeth and roots and bone-splitting. It is indispensible in the case of little bone mass and in high risk patients.

Lekholm & Zarb 1985 Patient selection and preparation. In tissue-integrated prosthesis: Osseointegration in clinical dentistry. Chicago: Quintessence Publ Co. 1985; 199-209

In this report, the clinical experiences on the pre-clinical and clinical use of the magnetic mallet for osteotomies and tooth extractions is described after having introduced this clinical procedures in 2016.

In conclusion, the introduction of the magnetic mallet device in our training and clinical setting has broadened the field of minimal invasive indications, increased the safety of the described techniques, reduced the patient´s discomfort so far without any substantial adverse effects.

International Education & Research Journal, 2016, 2:9-10

Implant dentistry has become a revolutionary branch nowadays. The use of magnetic mallet has provided us with some clinical advantages during the surgical procedure over the traditional method of osteotomy using hand mallet and chisel. The present clinical report stated the procedure of surgical placement of an implant in the mandible using an innovative device known as Electrical Magnetic Mallet with great precision.

Int J Med Res Rev 2016;4 (6):1046-1048.doi: 10.17511/ijmrr.2016.i06.31

Dental extractions sounds scary to the patients due to complications like dry socket, delayed healing,paresthesia, bleeding from site etc. This case reportintroduces a novel and innovative magneto-dynamical patented device Magnetic Malletused for extraction of the tooth followed by immediate implant placement. This method is least traumatic to patient and produces no post extraction complications with good quality bone healing.

Clin Implant Dent Relat Res. 2016 Sep 30. Doi: 10.1111/cid.12454. [Epub ahead of print]

This interesting study, as the one that follows, shows how delayed implants placed in post-extraction sockets without the removal of the reactive soft tissue achieved a significant increase of peri-implant bone tissue at three years.

Clinical Implant Dentistry and Related Research, Early View, First Published online on 2012, August, 15th

138 implants were inserted in 50 patients in the maxilla with bone type D3 or D4. Osteotomes with a hand mallet were used in the Control Group, the Magnetic Mallet in the Test Group. At 24 months the implant survival in the Control Group was 92.75%, in the Test Group 97.10%. The bone gain obtained in all patients remained stable at 24 months in both groups. The patients who underwent operation with the Magnetic Mallet did not report any complications linked to benign paroxysmal positional vertigo, which instead was encountered in two patients operated with osteotomes with a hand mallet.

Clinical Implant Dentistry and Related Research, Early View, First Published online on 2012, January, 11th

36 patients received 50 implants with the manual osteotomic technique (Control Group) and with the Magnetic Mallet (Test Group). At the 12-month follow-up the height of the bone had increased significantly in both groups, and at the next control at 24 months the height had remained stable. 2 patients in the control group had reported benign paroxysmal positional vertigo following the use of osteotomes with hand hammer. At 24 months the cumulative survival rate was 86%, the bone gain did not present any differences in the two groups. The Magnetic Mallet offered important clinical advantages for patients in the post-surgical phase.

Numeri Uno 13, 2012, 16-18.

SURGICAL ADVANTAGES OF USING THE MAGNETIC MALLET

Bone expansion techniques, conceived to increase peri-implant bone volumes using the native bone of the site where the implant is to be inserted and the use of bone expanders to stabilise implants in type 3 and 4 bone structures, are well documented techniques recognised as valid and reliable by surgeons and by the
literature. The critical point of these techniques is that the protocol contemplates the use of a surgical mallet to guide the instruments in creating the implant bone socket. The impact produced by the surgical mallet may cause a vertigo syndrome in patients which may also be very annoying and sometimes long-lasting.
To avoid or reduce this symptom to a very significant extent, last year Sweden & Martina introduced the Magnetic Mallet, a dynamic magnetic instrument consisting of a handpiece powered by an electronic control unit which controls the forces and times of application. The aim is to bind an adjustable shock wave, with calibrated force application time, to the handpiece of the bone expanders and to transmit this shock wave to the tips of the bone expanders.
The Magnetic Mallet produces a greater energy with elevated accelerations applied in much shorter times compared with the classic surgical mallet. In this way a plastic deformation of the bone can be induced which absorbs the whole shock wave, thus avoiding the creation of inertia affecting the rest of the cranium.
The shock waves generated using the traditional surgical mallet and using the Magnetic Mallet have been measured on natural models.
1) With the surgical mallet the shock wave generated was 40 Dan (Deca Newton) (40 Kg) for a time of 200 µs; much of the energy thus obtained was not exhausted in the plastic deformation of the bone, but went on to influence the whole maxillary mass;
2) with the Magnetic Mallet the shock wave generated was 130 Dan (130 Kg) applied for 80 µs.
In this  way the plastic deformation of the bone was enormously facilitated and allowed the total absorption of the energy, while the acceleration on the maxillary mass remained minimum and indeed negligible.
The instrument perfectly performs the function for which it was designed, that is to make the manoeuvres more acceptable for the patient when it is necessary to divide the bone structure, widening it to create an adequate surgical socket, with an adequate position and thickness of the most critical walls of the socket
(namely the vestibular and the oral wall), in which to insert the implant.

The International Journal of Oral & Maxillofacial Implants, 2012; 27: 1144-50

120 implants were inserted in 80 patients while at the same time sinus floor elevation was performed in the Control Group using osteotomes with a manual mallet and in the Test Group with the Magnetic Mallet. The total implant survival at 24 months was 98.33%, the bone gain was on average about 4 mm, without any significant differences in the two groups, and this gain, found after the first 6 months, was stable at 24 months. 3 patients treated using osteotomes with a manual mallet complained of benign paroxysmal positional vertigo, whereas the use of the Magnetic Mallet did not give rise to complications.