Since placing his first implant nearly 45 years ago, Dr. Jack Hahn has spent much of his career as an implantologist thinking of ways to make treatment more accessible to the practitioner as well as the patient. Implant design has improved dramatically during that time, with Dr. Hahn spearheading key innovations that have helped make implant therapy the essential mode of dental treatment it is today. From the early blade-form implants he helped develop in the late ’70s to the newly released Hahn™ Tapered Implant (Glidewell Direct; Irvine, Calif.), Dr. Hahn’s efforts have been driven by the desire to continually improve products and procedures in order to make treatment simpler and more predictable.
“The easier we make it to position the implant for a restoration that looks like a natural tooth, the better results we’ll have,” asserted Dr. Hahn in a recent interview. It was this line of thinking that inspired Dr. Hahn’s idea for the first tapered implant. After a long day that included several cases in which he had difficulty placing parallel-walled implants in the anatomically restricted space of the anterior maxilla, Dr. Hahn had an epiphany: “The tooth I was replacing was taper-shaped, so why was I putting in a square peg?” That very night, he sketched out the concept.
Steve Hurson, former chief scientist for Nobel Biocare, has said of this industry-changing innovation: “Dr. Hahn identified a need for an implant with a narrower apex, which would achieve higher primary stability in soft bone. The concept was to have an implant design that would have the tapered shape of a tooth root, to be used in difficult-to-treat sites such as type 4 bone, extraction sockets, areas with converging roots and areas with labial undercuts, while also performing well in hard bone qualities, resulting in a system with outstanding predictability.”
In essence, this was an extension of the philosophy that inspired the design of the machined collar that Dr. Hahn helped Steri-Oss develop. “By designing a machined collar that was more like the neck of a natural tooth root, we were able to prevent crestal bone loss and improve outcomes,” recalled Dr. Hahn.
Insisting on Innovation
This drive to constantly improve has not always been met with open arms. After experimenting with aluminum oxide fixtures, Dr. Hahn and engineer Tom Driskell created a “finned,” root-form titanium implant. “As it turned out, the finned implant we developed had some problems. It had a locking taper abutment connection that would lose its retention after a few years. In many cases, the restoration would come off and the doctor would have to cement the abutment onto the implant.”
“The second problem was that the implant had fins that would become exposed if there was any crestal bone loss. This would require raising a flap and cutting the fins away, but then you still had the esthetic problem of metal showing. So I proposed a machined collar with a new prosthetic connection. They said they couldn’t do it because it would be too expensive to change the machinery. I didn’t want to have my name associated with the implant any longer if they weren’t going to correct the problems.” This led Dr. Hahn to other endeavors, including his role with Steri-Oss and, eventually, Nobel Biocare.
Dr. Hahn in his Cincinnati office holding the patent for the original tapered implant design.
Like the NobelReplace® implant (Nobel Biocare; Yorba Linda, Calif.), the design for the original Steri-Oss implant began on a piece of notebook paper. After a patient introduced him to Ralph Stern, who owned a dental company and was interested in getting involved with implants, Dr. Hahn proposed they drive up to United Titanium (Wooster, Ohio). There they could have his sketch of a new implant, which featured parallel walls and a machined collar, engineered and milled. After returning to Cincinnati with fifty 3.8 mm x 16 mm implants, Dr. Hahn immediately went to work placing the implants.
“We didn’t have drills at that point, just hand reamers. After placing all of the implants, I felt like my hands were about to fall off.” Stern and Dr. Hahn then joined forces with engineers Ken Krueger and Steve Hurson to hone the design of the implant, create abutments and develop more sizes. “Initially, there were just straight and angled abutments that had to be cemented onto the implants, but the design was eventually converted to a flat-top so the abutments could be attached to the implant with a prosthetic screw. We added a hex connection for anti-rotation, and the implant really just took off from there,” recounts Dr. Hahn.
As Dr. Hahn lectured around the country, the Steri-Oss implant surged in popularity. “We would show cases, radiographs and the great results we were achieving, and everyone would leave the courses with implants in their hands.”
The Original Tapered Implant
After treating a series of patients requiring single-tooth replacements in the area of teeth #7–10, where the implant would have to be tilted at a severe labial-buccal angle in order to avoid perforating the bone in the limited space of the anterior maxilla, Dr. Hahn conceived the design innovation for which he has become most known. “I called the president of Steri-Oss at that time, and told him, ‘I’ve got an idea that’s going change the way we make implants. It’s tapered; it looks like the root of a tooth. You’ll be able to put it in anatomically constricted areas, it will have a wider prosthetic table, and it’s going to be stable because it’s like a wedge.’
Dr. Hahn is presented with an implant achievement award by Nobel Biocare CEO Richard Laube in Sochi, Russia, on June 11, 2014.
Dr. Hahn receiving the Lifetime Achievement Award from the American Academy of Implant Dentistry on June 15, 2015.
“I wanted to call it ‘Replace,’ because that’s what we do — we replace teeth.” In another example of the uphill climb Dr. Hahn has at times faced in making his design concepts a reality, the company was not initially interested. “There was worry that it would kill their other product.”
Ultimately, Steri-Oss agreed to produce some prototypes, which Dr. Hahn eagerly began placing and monitoring, achieving excellent results in all areas of the mouth, including the anterior maxilla. “I said, ‘Don’t take my word for it; let’s give some implants to 10 other doctors and see what they think,” recounted Dr. Hahn. “They all loved it. The implant came to market in 1997 and took off like gangbusters. Replace became their No. 1 implant.”
Dr. Hahn’s experiences with Nobel Biocare, which officially acquired Steri-Oss in 1998, went far beyond the collaboration that produced the industry-changing Replace implant. “I had many good years with Steri-Oss and Nobel in developing devices, techniques and course presentations, as well as active involvement in some important clinical studies. Working with those organizations truly was an honor and a privilege.”
Dr. Hahn also speaks highly of what Nobel Biocare accomplished in making implant therapy a widely accepted mode of dental treatment. “Nobel Biocare has a great history that goes back to the ’60s with Dr. Per-Ingvar Brånemark. Although Dr. Brånemark didn’t come to the forefront until the early ’80s, they did some very crucial things that changed the industry. They went to the oral surgeon at a time when the economy was bad and trained them to place their implants. They also went to the universities with all of their research and documentation and got their buy-in. This was essential in making implant dentistry ‘legitimate’ across all specialties of dentistry. They elevated implants to a place where they were no longer considered experimental.”
Dr. Hahn conducts a course on the immediate extraction and implant placement procedure.
Dr. Hahn helps a student during the hands-on portion of the class.
GPs, Specialists, and Expanding Patient Access to Treatment
One of Dr. Hahn’s primary goals as both a clinician and innovator is to broaden patient access to implant therapy. In addition to designing implants that are simpler and more predictable for everyone, including GPs, to place, this effort has involved a tireless devotion to educating doctors. “If we want to get the life-changing benefits of implant therapy to more patients, I’ve always thought it crucial that we educate the general dentist,” said Dr. Hahn, who has taught thousands of practitioners to place implants over the course of his career.
“Having a better understanding of implant therapy means that you’ll be considering it as an option for more of your patients,” Dr. Hahn explained. “And most GPs are only going to be doing relatively straightforward single- or 2-unit cases like molars, immediate extractions, and maybe some overdentures. They’re going to be sending the more complex cases to the specialist, and everyone wins — especially the patient.”
The Advent of the Hahn Tapered Implant System
Dr. Hahn and a team of engineers discuss implant design features at Glidewell Laboratories.
After the NobelReplace tapered implant system was launched in 1997, Dr. Hahn continued placing and restoring impants at a relentless pace, completing thousands of cases. This experience afforded clinical observations that would serve as the basis for a new implant design that Dr. Hahn considers his best.
“I had been placing implants for decades, and there were still problems we could solve with a new design. I had this implant that would be even easier for doctors to place, with a simpler drilling protocol and a thread design that would allow for efficient placement and a high degree of primary stability.”
To take his design concept to the next level, Dr. Hahn began pursuing alternatives, an effort that led him to the implant manufacturing division of Glidewell Laboratories. “I couldn’t have it manufactured on my own, and certainly not at a price that would make implant therapy affordable for more patients. I knew a lot of the Glidewell people from my days at Steri-Oss and Nobel Biocare, and they were happy to work with me.”
Thus began a series of meetings that reunited Dr. Hahn with some of the same engineering personnel and business leaders with whom he had successfully collaborated in the past. “By this time, I was having all of my lab work done by Glidewell, and I was really blown away by the quality of their prosthetic components and restorations,” said Dr. Hahn of his early experiences with the lab. When he first visited the ISO-certified facility at Prismatik Dentalcraft, Inc., the manufacturing arm of Glidewell Laboratories, he was impressed with what he found. “It was immediately apparent that their manufacturing capabilities are state-of-the-art. Their engineering team has the technology and know-how to bring design concepts to life with astonishing speed and precision, and their expertise on the prosthetic side of implant dentistry has been invaluable in creating an implant that is as simple to restore as it is to place.”
Dr. Hahn, Implant Division Vice President Grant Bullis and engineer Brian Kim work on fine-tuning the design of the Hahn Tapered Implant.
“We were able to fine-tune a design that accounts for everything I’ve learned since the original tapered implant came out nearly 20 years ago. They translated my conceptual drawings into prototypes and then into implants that could be placed with great efficiency, zeroing in on the exact thread design needed to keep the implant engaged with a maximum amount of bone.”
Importantly, Glidewell Laboratories shares Dr. Hahn’s big-tent philosophy when it comes to dental implant education. “Glidewell not only wanted to engineer and manufacture the Hahn Tapered Implant, they also share my goal of getting more GPs involved in all aspects of implant treatment. Glidewell already works with so many general dentists; it’s the perfect platform.”
“After several meetings with their key business and manufacturing guys, they offered me exactly what I’d been looking for. They said: ‘We want to make your implant. You be the designer and do your courses, and we’ll handle the manufacturing. We want to help general dentists get more involved with implantology, and you’re the voice of the GP.’”
Dr. Hahn notes that the versatility of the implant will appeal to GPs and specialists alike. “This implant performs well in every clinical situation I’ve encountered, from immediate extraction replacements to complex full-arch restorations. I think the specialists will catch on once they see how much control the implant can be placed with and the kind of primary stability they can achieve.”
President and CEO Jim Glidewell, CDT, gives Dr. Hahn a tour of the implant manufacturing facility at Glidewell Laboratories.
In Glidewell Laboratories President and CEO Jim Glidewell, CDT, who is also well-known for introducing industry-changing innovations, he found an individual equally committed to enhancing the quality of treatment while reducing the cost of care. “After meeting with Jim, it was clear that we shared the same goal of expanding the availability of high-quality treatment to more patients. We both wanted to do something that would give back to an industry that has given us so much,” said Dr. Hahn of the partnership that has brought his idea for a better, more affordable implant to life.
“But I didn’t want to put my name on the product unless the quality was up to my standards. What I found at the Glidewell manufacturing center in Irvine, California, convinced me that Jim was serious about this venture. He had spared no expense in developing a world-class facility and assembling a team of engineers that was more than capable of carrying out my vision.”
This partnership culminated in the recent launch of the Hahn Tapered Implant System, and Dr. Hahn couldn’t be happier with the results. “Working with Glidewell Laboratories has allowed me to develop a cost-effective implant that improves the quality of treatment. Patients want a restoration that looks like a natural tooth, and this implant helps clinicians achieve the positioning and stability that are essential to such an outcome.”
Implant Division Vice President Grant Bullis notes Dr. Hahn’s unique perspective as both an implant practitioner and design innovator. “Dr. Hahn brings decades of experience designing, placing and restoring implants to the table. It’s hard to imagine anyone with a better understanding of how design characteristics affect treatment outcomes. Under his direction, our engineering team has devised an implant that addresses the day-to-day challenges that clinicians face.”
Implant Division Vice President Grant Bullis, President of Prismatik Dentalcraft, Inc. Dave Casper, Chief Operating Officer Greg Minzenmayer, Dr. Hahn and Jim Glidewell gathered on the implant manufacturing floor in Irvine, California.
The end result is the realization of Dr. Hahn’s goal to create a simpler, more predictable implant system. “We ended up with an implant that makes everything easier, with fewer drilling steps and a thread design that keeps the implant right where you want it during placement. This system will make it easier for people just getting started in implant dentistry and encourage them to keep doing it and continue their education. At the same time, it will help boost clinical efficiency for the experienced implantologists out there,” said Dr. Hahn.
Dr. Hahn and Jim Glidewell with the product of their collaboration in hand.
With a career that speaks volumes on the importance of continual innovation, Dr. Hahn is proud to have his name associated with an implant that contributes to the forward progression of implant dentistry. “The better we make implant design, the more accessible we can make implant dentistry to doctors so they can improve their practices and the quality of life of their patients.”