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“I'm proud to be the leader of such a competent team and such a great product that has its roots in scientific evidence-based technique.”

W&H Dentalwerk Bürmoos GmbH – Middle East

Malin Gustavsson, the CEO of Osstell, shares her perspective on leading Osstell into the future. (Image: Osstell)
Dental Tribune Middle East

Dental Tribune Middle East

Fri. 5 April 2024


Dental Tribune Middle East had the pleasure of speaking with Malin Gustavsson, the new CEO of Osstell. In this interview, she chats about her choice to pursue this role at the W&H Group and reveals what she finds most rewarding about leading the dental brand’s team. She explains how Osstell’s patented technology works and what the solution is and talks about the company’s newest features.

Can you share the reasons behind your decision to accept the position of CEO at Osstell in 2023? What challenges do you foresee in leading such a highly recognised brand in the dental market?

One and a half years ago, I decided to join the company because I believe in the journey that we have in front of us. At W&H, we are seeking to connect all devices and thereby contribute to a digital workflow—and that is one of my main interests. I really would like to take part in that journey, specifically in the context of the medical device industry because at the end of the day, there is a patient who has the benefit of all the improved procedures and products. That’s why I love the dental industry, both from a digital perspective and a patient benefit perspective. The journey that W&H is on is bringing innovative products to the market that are focused on enabling digital workflows. That is what motivated me to become part of the W&H Group - it genuinely stems from my passion for oral surgery and improving workflows.

Could you explain the technique behind Osstell’s approach to measuring implant stability with the use of resonance frequency analysis (RFA), which has made a significant contribution to the predictability of dental implant treatment? Could you share the story behind the development and evolution of this technology?

Our mission at Osstell is to help clinicians provide each patient with optimal time to teeth. Osstell’s implant stability technology is based on Resonance Frequency Analysis (RFA). RFA normally gives you a frequency value in Hertz. To make it easier to interpret the measured value, Osstell introduced the ISQ unit.

The implant stability measurement is objective and non-destructive, meaning, it does not impact the osseointegration. There is no discomfort for the patient during the measurement and it takes less than a minute to measure the implant stability utilizing a non-invasive measurement technique using magnetic pulses to excite the SmartPeg.

Just like a tuning fork resonates with different pitches based on its length, RFA involves assessing the resonance of an Osstell SmartPeg, which is a small aluminum pin with a magnet on top. The SmartPeg is attached to the implant prosthetic connection.

Our patented technology has been available now for almost 25 years and has a strong evidence-base with more than 1500 published studies.

What is the ISQ measuring Osstell Beacon? Could you walk us through the Osstell procedure and its significance in dental implantology?

Consider the scenario of having a fever: I can feel on your forehead whether you are warm or hot or seem normal, but I’d have to take your temperature with a thermometer to be sure. The reading will tell you it’s an emergency. Using the device tells you in black or white whether you have a fever.

The same applies to implant stability. Is it stable or not? When you place the implant, you can feel whether you’re implanting into soft or hard bone. Immediately, you can feel the mechanical stability when you place the implant, but it doesn’t tell you anything about the degree of stability in the osseointegration process. You’ll have to see whether it is ready for restoration, right? You don’t know, but you just have to follow the standard protocol that after the standard healing period the dental implant is osseointegrated.

We truly believe that we must respect bone remodelling and the biological process. The only way to know whether the implant is ready for loading or not is to objectively measure stability. Every patient is unique—may be a smoker, may have diabetes, may have poor oral hygiene—and his or her health is relevant to the healing process.

So how do you know? Of course, there are many studies from implant manufacturers telling you that you should wait for a six-week or eight-week healing period to be on the safe side. Sometimes though, that is not enough, and you need to wait for a longer time. Osstell’s technology really tells you when you can load the implant since it’s based on factual measurements that reflect the current clinical reality of that patient.

There are so many factors that the dentist needs to take into account, and we try to simplify to make it as smooth as possible for both the dentist and for the patient to make the right decision. That’s really what drives me—Osstell’s approach is reliable, it’s measured, it’s stable. It supports the dentist in providing a predictable treatment.

I truly believe that we must respect bone remodelling and the biological process. The only way to know whether the implant is ready for loading or not is to objectively measure stability.

What are the standard and lower-risk ISQ threshold values when using Osstell, and how do these values impact decision-making in dental procedures?

The ISQ value ranges from 1 to 100. We present this numerically and visually according to a scale we developed. For example, below a certain value range, the dentist will be shown the associated traffic light colour of red, meaning the implant cannot yet be loaded. After a longer healing period, the dentist will call the patient back into the office again and measure osseointegration again. Hopefully, this time the ISQ reading will indicate yellow or even green. Some implants never get a green light, and then the dentist knows to be careful. It may be necessary to call the patient into the dental office more regularly than she or he would do for another patient.

Can RFA be effectively used in cases involving bone grafting?

To measure RFA, it does not matter if the area has been grafted or a sinus lift has been performed, for example, because the measurement concerns implant stability in the bone it has been placed into. For stability, you need to have remodelling, whether that has been established aided by the grafting material or by the natural bone.

Osstell offers a range of instruments to assist practitioners. Which instrument is particularly beneficial for dentists, and how does it enhance their daily work? For readers who may not be familiar with Osstell products, could you provide a brief description of the Osstell Beacon and its role in implant stability measurement?

Our latest version of the measuring device is the Osstell Beacon. It uses bluetooth and can be connected to a computer, iPad or cellphone. The Osstell Beacon converts the RFA measured and communicates this to the connected device as an ISQ value.

The Osstell Beacon is used with the SmartPeg, which is specific to the implant connection used. We have SmartPegs suitable for all the major implant systems all over the world, regardless of whether the clinician is in South America or the Middle East. The SmartPeg is mounted onto the implant manually to the correct torque to ensure it is stable on the implant. SmartPegs are single-use per patient because they are delicate and made of a soft material to avoid any damage to the implant. The Osstell device, however, can be used for many, many years.

I have been traveling around a lot for the last year to understand the different markets. In Turkey last year, the government issued guidelines on the implant treatment of patients that include a requirement to measure the implant stability as part of this procedure. In some states of the US, this is also mandatory as part of insurance for the dentist. The requirement to know the implant’s ISQ value provides security for the patient and the dentist.

How does OsstellConnect enhance the workflow for practitioners, and what advantages does it bring to the table?

OsstellConnect is a free cloud-based solution and tool offering a new way for clinicians to use data to enhance their dental implant treatments. It is one of the world’s largest implant online portal with more than a quarter of a million datapoints. It is a free access to with their purchase of the Osstell Beacon and Osstell IDx. The background for developing OsstellConnect is that we understood from dentists that sometimes it is difficult to explain to a patient what the ISQ number means and why he or she must wait for example eight weeks for a restoration when he or she knows of someone else who received his or her restoration within two weeks or even immediately. In our scientific network, we thus started discussing this feedback and worked out that we could support the communication between the dentist and the patient. That is why we developed this software. It is a great visual aid to the dentist and helps him or her guide the patient through the implant journey based on the ISQ value and supports his or her understanding.

What are your goals for Osstell’s product line, both in the short term and long term? Can we expect any exciting developments or surprises?

W&H as a group has many interesting products and solutions that will be released in the coming years and will add new areas of application—W&H is not just a handpiece or steriliser manufacturer. Also, more devices will be connected to one another, in support of the knowledge that every aspect, such as instrument cleanliness and drill speed, affects treatment. This will allow us to collect a lot of information and in the future learn from it which enables us to give more valuable guidance to the professionals.

Lastly, as the CEO, what do you consider the best and worst parts of your role in leading a prominent dental brand like Osstell?

I would like to highlight that we have a dedicated team. Many of the employees within Osstell have been working at the company for many years. They know the products and really have a passion and heart for our technologies and customers. We are convinced that this technology improves not only dentists’ or nurses’ work but also patients’ health. This engagement and commitment is heartening and makes me proud. I’m proud to be the leader of such a competent team and such a great product that has its roots in an evidence-based technique. Now, we are part of the W&H family, part of a larger network. Osstell’s devices are not a single technology, but part of a greater portfolio of technologies.


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