TELOS MEDTECH LLC
30-40 million people in US alone are completely toothless in one of their jaws and about half the US adult population has atleast one lost tooth. The dental industry's gold standard for treating toothlessness is the use of screw like implant (see adjoining figure) that is embedded into the jaw bone onto which the surgeon mounts a crown or denture like prosthesis.
A natural outcome of the aging process is the loss of bone volume as well as bone density. Older patients form the majority of the implant receipients. The current root form/screw implant based solution for addressing such cases is akin to building furniture out of balsa wood that is held together with office staples. To compond problems, the masseter muscle used for chewing is the most powerful muscle in the body, exerting about 200lbs of force over the molars.
The annual global dental implant industry is over $3billion and growing at a double digit rate. The current market penetration of dental implant is less than single digit. The growing awareness of dental implants as a more effective treatment in comparison to bridges and dentures and its inclusion as a reimbursable treatment makes this industry attractive for new investments. The current dental implant systems lack product differentiation which forces the largest market segment to compromise and accept poor outcomes, high costs and long recovery periods. Telos Medtech has developed a dental and maxillofacial implant system that will solve needs of aging patient with low bone density and bone volume and has a precedent and clear regulatory pathway. We expect this innovation to open up a larger, previously inaccessible market segments.
I have intentionally not covered the implant design developed by Telos Medtech LLC.
Scroll below to learn more about the technical challenges with the current implant systems.
The adjoining figure shows the difference in a normal jaw bone and that of a person with tooth loss accompanied by bone atrophy (scroll over the image).
As you can see, there is very little room available for implant placement in the atrophied case. The depth to which an implant can be embedded in the mandible is further restricted by the presence of the inferior alveolar nerve (refer figure below). The presence of the nerve creates a challenge in replacing missing or bad molars with implants. The current solution is to place implants in the front of the mouth and then cantilever the molar portion of a prosthesis. Molars endure the maximum loads during chewing; the cantilevring of the prosthesis further magnifies the loads on the implant and supporting bone, leading to accelerated failure of the supporting bone.
Scroll over the image to see how both the structure of the face and underlying jawbones change due to bone atrophy.
The red line indicates the inferior alveolar nerve. Tooth loss triggers bone loss in the mandible thus further decreasing the available bone volume for receiving an implant.
In addition to extremem cantiliever loading of prosthetics, implants also face lateral forces that manifest as shear loading due to grinding action shape of the surface and position of the tooth prosthetic with respect to the supporting implants. Often, implants used are smaller than 1.5mm or 0.06". Such small sized implants are not suited for enduring high shear force or torque generated due to grinding motion during chewing.
The process of implant placement and prosthetic design are further complicated due to localized bone remodeling which may cause teeth and prosthesis to be misaligned. The issue is typically aesthetically addressed by building additional cantilever in the prosthesis or implant abutments to allow for the teeth to appear aligned. The added cantilever contributes to more force magnification.
The challenge of screw implant placement is not constrained only by the depth to which an implant can be placed. For implant to be stable, it needs to engage with the denser part of the bone called the cortical bone (the spongy portion of the bone is referred to as cancellous bone). Tooth loss exposes dental alveoli, which are the sockets in which teeth are embedded. The bone surrounding the alveoli is of marginal quality and the cavity left behind by the lost tooth prevents the placement of the implant at the very location where the root of the tooth was embedded. The natural root also confirms to the curves of the jaw; implants are cylindrical in shape and cannot replicate the freeform complexity. In order to engage better quality bone, the surgeon is forced to place the implant towards the lingual side of the bone and closer to an adjoining tooth. All these factors contribute to the cantilever loading that leads patient discomfort and implant & prosthesis failure.
Today the only alternative to solve cases of very severe bone atrophy is to resort to large bone grafts; frequently harvested from a sacrificial portion of the patient’s own bone (hip, chin, arm). Large bone graft surgeries are challenging; involving a high failure rate (graft rejection as well as complications at the donor bone site), low recovery time and high costs. For these reasons, most patients reject the option of large bone grafts and choose to live with a lower quality of life. Artificial bone grafts are available in the market but the chances of body rejecting the grafts is high leading to implant failure. Such grafts are also viable as substitutes over very miniscule volumes. Telos Medtech LLC’s solution addressed all issues covered of on this page and provided means of streamlining the process of implant design, implant placement and prosthesis design. Currently these tasks are largely disconnected as they are served by different specialists and the patient moves through the system rather than treatment being patient centric.