I have been looking into this new implant system called Paragon Gen5+ by Dr.Niznick. What drew my attention to this system is Nobel’s on1 concept. Anyone has or had first hand experience in using paragon Gen5 or Gen5+ Implants? Any input is much appreciated ?
Niznick has a new system? Guy reinvents the implant every few years and sells them to a bigger company. I’m skeptical that there is any real benefit to a new system, as they all seem to work well nowadays. But, surely Niznick knows better than anyone else.
Yes indeed. Summer or Fall of 2024 they should be releasing it to the market. The factory is based in Calabasas, CA.
I am currently in lookout for alternate brands that are doing on1 concept.
What is the on1 concept and why would an implant based on it be better than anything else that is already in use? Is it a new type of implant design? I don’t personally understand why new implant systems keep cropping up when existing systems work extremely well. I mean I understand making clones of proven systems for lower prices (sort of what Implant Direct did), but a new implant design?
On1 base concept is to protect the connective tissue or the cuff or the collar from repeated removal of the prosthetic connections above the implant platform.
Current trending philosophy of Nobel camp or similar camps is to bring the best of the worlds together in one design.
Which is, Bone level or submerged implants and Tissue level implants.
In this concept, after you place the Bone level implant, you place on 1 base and cover screw on it. When you are ready for the restorative phase, you only unscrew the cover screw, continue the restorative workflow.
In other words, take a Tissue level implant, slice the polished collar into two halves. First /lower half ( on1 base ) is attached to the bone level implant at the time of the implant placement and never to be removed. Now the second half can be anything you desire based on the restorative work flow.
Check the photo for the restorative work flow.
I hope I answered your question.
Thanks! Very helpful.
The only other implant system , that I can think of having on1 base concept is Paragon Gen5+ as described on their website. This product is not even on the shelves yet.
But with tissue level fixtures there is no extra piece and the long term data already exists. Seems like lipstick on a pig since the desired outcome for this system is just to duplicate Straumann TL.
Conceptually , I think Nobel is reinventing the wheel. However, I do see the added benefit in cases where Tissue level Implants are not possible such as
- Aesthetic concerns 2) Limited restorative space 3) Bone grafting is needed at the time of implant placement 4) limited mesio distal space.
As a result we can avoid the " hurting abutment /healing abutment " ( Nobel camp’s lingo ) and protect the much coveted connective tissue / “mucointegration” ( Nobel camp’s lingo ).
I like the old school / one stage tissue level , but open to new innovative ways.
looks like more bells and whistles. You would only use tissue lvl implants in the posterior. Its use is rather limited because lots of requirements have to be met. Implants placed correctly with correct restoration should have minimal bone loss. Most of implants you would be placing would be bone level. More system you use the more steps and parts you have to use. I thought you want to keep it simple?
I am still with the simple system camp. I may have bunch of posteriors (3,14,18,19,28,29) coming up in my practice. Based on the PA there is good amount of bone to place 8-10 mm without involving vital structures. So, kinda looking into Tissue level implants also, one surgery and less trauma to the patient. 
Even bone lvl. It’s also one surgery. I often just place a healing abutment after implant placement. I usually don’t bury the implant.
With two piece implants, one stage or two stage, you have to repeatedly remove the healing abutment disrupting the weak biologic width ( lack of sharpey fibers ) during your restorative phase. With one piece implants, repeated removal of healing abutment or abutment has less chances of disrupting the biologic width, considering the location of abutment - implant junction more coronal to the bone crest or is in the sulcular area of the gingiva.
Dr. You are thinking way too much into implants. 
by definition. There are no sharpey fibers because implants have no cementum. I don’t think collegen fibers can attach to implants. At least I never read about it. I could be wrong. But there’s plenty of collagen fibers in the gingiva that run circular around the healing abutment. In the end you pick which ever implant system you believe in because you are the one placing it. After using and restoring so many different implant systems. Other than implant direct and hiossen, I’ve restored Megagen, straumman, blue sky bio, bio horizon, Nobel, Astra, I don’t know about other Drs like Scotty who probably placed and restored more than me. In the end I feel they all similar.
I think you are spot on in your with your thinking. From the early days of tissue level implants we have been amazed at the results and now the bone level camp has decided that platform switching/conical abutments is the answer except that they fail to produce the same exceptional results. I agree 100% that the disruption of the soft tissue from repeated removal of components is the culprit and while ZimVie has done a great thing with the Encode it still falls short of the original tissue level concept when it comes to results. This product you show still has the issue of a bone level interface so I doubt it will live up to the original tissue level as that one piece simple system has been too simple and too good for modern cutting edge ideas to duplicate…
If you have ever removed a healing abutment for any reason and then placed it back after a period of time, as little as a minute, you have probably noticed that the tissue collapses around the fixture and you must blanch the tissue in order to replace the healing abutment. This collapsing and repositioning of the tissue is a form of trauma and source of inflammation which can be avoided by using tissue level fixtures and never having to manipulate the transmucosal tissue. ZimVie came out with the Encode a number of years ago to reduce to number of times that we intrude on this transmucosal tissue and it has been a great addition but still not as good as the original tissue level concept. I am in bed with and have an affiliation with ZimVie but I still prefer the original tissue level concept over anything in their catalog which is why I was on a call with their R&D team recently in hopes of launching a tissue level fixture in the TSV line. Unfortunately the market does not support the investment in such a product because our profession has sold out to bone level fixtures in favor of versatility over predictability. I am guilty of jumping ship and going 100% bone level for a while too but I have come full circle back to the original…
Who knows, you and zimvie could resurrect the One piece/Tissue Level again.
Too much of a fascination with full arch therapy to market a tissue level fixture today.
that’s not true. for my AOX. i place straight tissue lvl implants–screwindirect from implant direct. it has a MUA already built in. but i understand what you pushing and it does make sense. But it all depends on what kind of full arch you’re doing. either straight implants or angled implants like AO4 or zygo/pterygoids.