Dr. Annette Felderhoff

“My patients’ satisfaction is the most rewarding benefit”

Dr. Annette Felderhoff-Fischer on the Nobel Biocare N1™ system

Dr. Annette Felderhoff-Fischer was the very first clinician to introduce the Nobel Biocare N1 implant system to her practice. A new solution with a simplified surgical protocol based on the latest science behind osseointegration, she explains her experience and how it has benefited her practice.

Dr. Felderhoff-Fischer, can you tell us a little about your experience and specialism?

My name is Annette Felderhoff-Fischer, I am an oral surgeon and have a referral practice for oral surgery in Munich. I’ve been working in implantology for over 25 years now, and as a trainer and speaker, I have a special focus on navigated implantology.

When did you first find out about the Nobel Biocare N1 concept? What did you think?

I was in a small group of clinicians, engineers, and a scientist specializing in osseointegration in New York, to whom Nobel Biocare first presented it back in 2014. At first, I was quite surprised Nobel Biocare was already looking to create a whole new implant system; other products such as NobelActive®, for example, had gained a lot of momentum. Nonetheless, when I saw the N1 concept, it was very exciting. I was enthusiastic to be part of this development: a whole system and concept, based on the latest science behind osseointegration, not simply a new implant. I then became involved in the R&D process, with a whole team on-site where we tested many indications, and as a surgeon, I gave feedback to the engineers to incorporate into each iteration and help continuous improvement at every step.

In how many cases have you chosen the Nobel Biocare N1 system since its official launch?

I have had around 50 cases in practice so far.

As the very first Nobel Biocare N1 customer, what benefits has it offered your practice?

My patients’ satisfaction is the most rewarding benefit of the Nobel Biocare N1 system at my practice so far. Especially for patients who’ve had implant treatment before: they notice a difference. Compared to their previous treatments, which used conventional site preparation protocols, they have told me that this time they experienced less discomfort. OsseoShaper site preparation has much less noise and vibration, and this is a clear benefit for the experience of my patients.

Why would you recommend the Nobel Biocare N1 system to other clinicians?

It has many, many advantages. First from a scientific perspective, it’s been developed with biological principles in mind to minimize cell death and create viable implant sites that enable fast osseointegration. The new TiUltra™ and Xeal™ surfaces are also featured, which are great new innovations with surface chemistry.
From a practical side, the simplified surgical protocol follows a ‘direct, shape, place’ principle, so site preparation is very straightforward. I also highly recommend the new trioval conical connection feature, as it lets the abutment simply slide into place.

Practices may think starting a new implant system costs too much time and money. How easy do you think it is to start using it – especially for GPs and non-specialists?

I see this implant system as a very good opportunity for GPs because of its versatility for many indications, and the straightforward surgical protocol. In most cases,* site preparation only requires two steps and the OsseoShaper creates a specific osteotomy for a co-packed implant, so you have much less guesswork and decision-making compared to conventional drilling protocols.
I see the Nobel Biocare N1 system as an especially great choice for getting started in implantology when paired with 3D planning in advance. To get started, of course, as with all systems, fundamental knowledge of implantology is needed, and system-specific training should be taken.

Imagine a clinician who is unsure whether to start using the N1 system. What should they ask themselves to help make that decision?

A clinician should ask themselves: How many of my patients find implant treatment too uncomfortable? Do I or my team need more confidence in decision making during site preparation? Do I want my practice to stand out from the rest by using the latest technology? These are just a few questions for which the N1 system may help bring solutions – not just for starters or GPs, but also for highly experienced specialists.

If you had to describe the Nobel Biocare N1™ system in just three words, what would they be?

Direct, Shape, Place!

In this video, Dr. Annette Felderhoff-Fischer presents a clinical case with 18-months’ follow-up, which was conducted during the development of the concept.

*According to survey of clinicians