Part 7 - Clinical data of AQB Implants
1. Statistical analysis conducted on clinical cases of AQB one-stage type implant since the opening of theclinicOral Surgery, Tokyo West Tokushukai Hospital 1)
Oral and Maxillofacial Surgery, Shonan Atsugi Hospital 2)
Implant Clinical Society in West Tokyo District 3)
Dr. Atsushi Kawai 1)3)
Dr. Tsuguo Sano 1)3)
Dr. Ario Hashimoto 1)3)
Dr. Takeshi Odani 1)3)
Dr. Hisatoshi Matsumoto 1)3)
Dr. Atsushi Kishima 2)3)
Dr. Hiroshi Shimizu 3)
Dr. Yoshinori Ogawa 3)
Dr. Takaaki Watabe 3)
Dr. Yohei Kashida 3)
Introduction
There has been a recent increase in the demand for implants that have the ability to endure early loadingof the superstructures to shorten the treatment times. AQB one-stage implant (ADVANCE Co., Ltd.) thatmeets this demand has become a popular tool. An implant center was opened with the dental surgery
clinic in West Tokyo Tokushukai Hospital in September 2005. The AQB one-stage type implant was
adopted as the mainstream treatment. A period of two and a half years has passed since the start.
We conducted clinical analysis of the cases using AQB one-stage implants for 21/2 years during the periodof September 2005 to March 2008. The case examples are presented in the following sections with added
commentary.
The test targets
The case examples of 650 individuals treated in West Tokyo Tokushukai Hospital, excluding thosereferred to from other clinics, during the 21/2 years period between September 2005 and March 2008, were
subjected to analysis.
The analysis criteria were: 1. Sex; 2. Average age; 3. Age group; 4. No. of implants installed; 5. Area ofimplantation and 6. Period till superstructure placement.

1., 2.

Sex, male to female ratio, and average ages

Male: 320 individuals, female: 330 individuals

Average age of male; 54.4 years old

Sex ratio - 1 :1.03(16 yrs old – 84 yrs old)
Average age of female; 53.8 years old(17 yrs old – 8- yrs old)

3. Age group

4. No. of implants installed

5. Area of implantation

6. Period till superstructure placement

Discussion
The results showed that a third of the total number of cases was found to be implanted to the maxillary,
and another third to the mandibular molars. This finding suggested that there were a significant numberof cases that needed the treatment close to the sinus floor that could not be treated in other dental clinics.
The average age of both males and females were mid-50s, and the number of cases conducted on
individuals in their 50s was significantly higher than in any other age group. This period overlaps withthe period in which the tooth loss induced by periodontal disease is particularly prevalent, and thus
indicated the implant treatment to be in high demand by this age group as an alternative to bridge
prosthesis or artificial dentures.
The period till the superstructure placement was the shortest in the mandibular molars and the longest
in the maxillary molars such that the consolidation period of 2 to 21/2 months was required for the latter
cases. This can be said to be due to the differences in the composition of the bone, since the mandibles
have more compacted structure than the maxilla, therefore giving rise to the differences in the treatment
time indicating the difficulty in the implant treatment to the maxillary molars.
There have been a recent increase in the number of referrals, for cases of complicated maxillary molars,made from other clinics to the Tokyo West Tokushuku Hospital, or more specifically, to the implant clinic
from other facilities. We consider this to be due to the high success rate with the uses of low invasion,socket-lift technique, which have been given great approval by the sources of referral. This is the result of
the high expectation of the method which was established to overcome the weaknesses of the one-stage
type implant; and to our responsibility to treat the high risk scenarios (August 24th 2008).

2. Statistical analysis conducted on the clinical cases of AQB Implants performed in the last five years
in the clinic.
Omori dental clinic 1)
Section of Oral Implantology, Department of Oral Rehabilitation, Fukuoka Dental College 2)
Dr. Keiji Omori 1)2)
Dr. Hiroshi Kido 2)
Dr. Masaro Matsuura 2)
ObjectiveAQB Implants with a recrystallized HA coating layer of 35 μm have been shown to rapidly bond with thebone with significant strength, rarely giving rise to loss of implant. AQB Implant system was firstdeveloped in 1990 and its clinical trials were initiated in 1992. The cases in which a period of over 11/2
after the placement of the superstructures to AQB implants bodies have been included in the analysis.
MethodA total of 577 implants in 305 areas of 196 patients, placed with superstructures from February 1998 toJanuary 2003 were subjected to analysis. The cases were categorized according to: 1. Age; 2. Sex; 3.
Implanted area; 4. Period till superstructure placement; 5. Implant size; 6. If bone augmentation
technique was applied; 7. Survival rate.
Results
Out of the total of 196 patients enrolled onto the clinical trials, 135 (68.9%) were female and theremaining 61 were male, ranging from 21 to 87 years with the average age of 51.2. Over half (55.6%), 321,
implants were installed to the mandibular molars; 175 (30%), to the maxillary molars; 51 (8.8%) to themaxillary anterior; 27 (4.7%) to the mandibular anterior. The sizes of the fixture used were with 4 mmdiameter with 10 mm length in 280 implants (48.5%); and 4 mm diameter with 8 mm length in 173
implants (30.0%).
There were 66 cases (21.6%) in which the bone augmentation procedures were performed. There were ten
implant prosthesis (1.7%) that came out in which two of these were before the superstructure placement,
and the remaining eight occurred after superstructure placement.
Discussion and conclusion
The survival rate of the implants from 11/2 to 6 years was 98.3%, and the implants lost accounted for 10 of
the cases. The average number of days from the implantation to loading was 54 days for the mandibles,and 70 days for the maxilla. Even though these were significantly shorter than the implant treatment
protocols of the past, the progress made was favorable, indicating the clinical efficacy of AQB Implantsystem as a highly effective implant treatment. In particular, the one-piece type implant that requires norotational forces at the time of abutment placement was thought to be suitable for immediate
implantation after extraction and immediate loading techniques.

Summary of survey
Investigation period

From February 1998 to January 2003

No. of cases

305 cases

No. of patients

196 people

Total number of implant installed

577

Average number of implant per patient

2.9

The maximum number of implants implanted in a patient

21 implants

Product used

AQB implant of ADVANCE CO., LTD

The number of cases per year

Age and sex of patients
Age

Number of Cases

Male to Female Ratio
No. of Patients

60
50
40
30
20
10
0

140
120

53
18

51

100

58

80

16

1st year 2nd year

135

60

3rd year

4th year

5th year

1st year (February 1998 - January 1999)
2nd year (February 1999 - January 2000)
3rd year (February 2000 - January 2001)
4th year (February 2001- January 2002)
5th year (February 2002 - January 2003)

40

61

20

31%

0

Men

Area of Implantation

350
300
250
200

321

150
100
50

51

Women

Ave. Age (yr) - Both: 52.1 Male: 50.3

Area of Implantation 1
Number of Implants

69%

175

9%

30%

Maxillary
Anteriors

Maxillary
Molars

0

56%

27

5%

Mandibular
Anteriors

MandibularmolarsFemale:Area of Implantation 2

MaxillaMandible
Number of Implants

Number of Implants
180

180

160

160

140

140

120

120

100

100

80

80

60

60

40
20
0

18

17

16

#8, #9 #7, #
10

#6,
#11

40

41

63

145

40
20

30

6

7

14

26

#25,
#24

#26,
#23

#27,
#22

#28,
#21

0
#5,
#12

#4,
#13

#3,
#14

#2,
#15

88

65
#29,
#20

#30,
#19

#31, #
18

Sizes of Fixtures

Nu
300
250
200
280

150
100
50

173
8
1%

49%

30%

0
4 mm 6 mm

1
0%

6
1%

20
3%

32
6%

28
5%

3 mm 8 mm

3 mm 10 mm

3 mm12 mm

5 mm 8 mm

5 mm 10 mm

27
5%
4 mm 8 mm

4 mm 10 mm

4 mm 12 mm

Average No. of days till Superstructure Placement

Days

60
40

70.3

20

54.0

59.0

0
MaxillaMandibula

Average

5 mm 6 mm

Ratio of Bone Augmentation in All of the Cases

Number of Days Till Superstructure
Placement (Day)

80

2
0%

Ratio of Bone Augmentation
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%

78.4
21.6

%

%
With bone

Without boneaugmentation

augmentation

Period till the Superstructure Placement of Bone Augmentation Cases

Number of Bone Augmented Cases (Ratio)

Days

25

90
80
70
60
50
40
30
20
10
0

20
15

23

10
5

19

34%

9
14%

29%

Sinus socket

Sinus lift

Ridge expansion

0

15
23%
Site derating

Number of Bone
Augmentation
Cases (day)

84.5

55.5
Without boneWith boneaugmentation

augmentation

Survival Rates and Removal Rate of Implant and Reasons for Extraction

Survival Rate and Extraction
Rate

Number of Cases
8

100.0%

6

80.0%
60.0%

Reasons for Implant Extraction

8

4
2

98.3%

40.0%

0

20.0%

1.7%

0.0%
Survival rate

Removal rate

2
Poor intergration

Poor
convalescence
after prosthesis
placement3. Statistical analysis of the clinical implanted state and implant cases with various AQB Implant types
and the model
Vice Director of Medical Clinic, Ministry of Foreign Affairs Division of Health and Welfare
Dr. Yoshichika Tsutsumi
Introduction
AQB implants treated with recrystallized HA are known to integrate rapidly with jaw bone, and havehigh biocompatibility with the gingivae. In order to re-assess its properties and clinical efficacy, theclinical evaluation of the AQB implants were conducted with regards to the implanted state, clinicalprogress, and survival rate with the various types and forms of the AQB implant installed to the upperand lower mandibles.
Test subjects
The implanted states of 139 cases, with a total of 329 implants (on average 2.37 implants/case), installed
within a period of two years and two months, between October 2006 to December 2008, were evaluatedwith respect to the type and the model of AQB implants. These were divided into the anterior, right andleft molars for the upper and lower mandibles to investigate and analyze each implant types with theirclinical progress and the survival rates.
The sexes, male to female ratio, as well as the average age of test subjects are as shown in Table 1.

No. of patients

Male

Female49

90

No. of patients (Total)

139

No. of patients (Comparison)

01:01.8

Average age

62

61.4

Age range

37-82

33-83

Table 1 Sex, male to female ratio, and average age
The type, form and the number of implants in each region
The type and the number of AQB implants installed into the upper and lower mandibles; and left andright molars are summarized in Fig. 1, and the number of each implant types, given in Table 2. The
implant type and the model have been chosen on the grounds of the area of implantation and the jaw
bone/gingivae, the adjacent and opposing teeth. With regards to the one-piece type, T-type has been
selected over the straight type since it was placed on the market.
The figures show that the number of implants installed into the anterior teeth is significantly less thanthose to the molar regions, with 28 implants (8.5%) within which only four (12%) to the lower mandible,
compared to 136 to the upper, and 165 to the lower mandibular molars resulting in 1:121 ratio. The
numbers of implantations to the left and right molars were relatively equal on both sides with 149 to theleft, and 152 to the right.
In comparing the types of implants used to the upper and lower mandibles: 76 one-piece type and T-types;
and 84 two-piece types were implanted into the maxilla; 149 one-piece type and T-types; and 20 two-piecetypes to the mandibles. This resulted in 1:1.11 ratio for the maxilla and 1:0.13 ratio for the mandible,
showing that the significantly higher usage of two-piece type in the maxilla, and the one-piece andT-types in the mandible. These results largely reflect the presence of the maxillary sinus.
MaxillaOne piece: 17

One piece: 1

One piece: 15

T type: 21

T type: 1

T type: 21

Two piece: 36

Two piece: 22

Two piece: 26

Total: 74 implants

Total: 24 implants

Total: 62 implants

Right

Left
One piece: 45

One piece: 0

One piece: 49

T type: 26

T type: 1

T type: 28

Two piece: 7

Two piece: 3

Two piece: 10

Total: 78 implants

Total: 4 implants

Total: 87 implants

MandibleFig. 1 – The type and the number of implants in each region of the oral cavity

Type

NumberOne-piece127

T-type98

Two-piece

104

Total Number

329

Table 2 - The number of each implanttypes

The number of one-piece type and its models categorized with respect to the area installed
The number of one-piece type installed to each region in the upper and lower mandibles and its modeltype were summarized in Fig 2.
The implantation of on-piece type to the anterior maxilla was found to be 1/ 127 (0.79%), a significantly
small number. The total number of one piece type was 33 to the upper mandible, and 94 to the lower
mandibles, resulting in 1:2.85, indicating its higher usage rate to the lower mandibles.
In comparing the model types used, 4SS were employed in 20/33 cases (60.6%) to the maxilla showing ahigh selection rate. Meanwhile, to the lower mandibles, 29, 4MS (30.9%); 20, 5SS (21.3%); and 15, 5MS(16.0%) were chosen.
The diameters of the implants used in the maxilla were: 28 for 3 and 4 mm; and 5 for 5 mm, and in themandible: 52 for 3 and 4 mm; and 42 for 5 mm. These resulted in 1: 0.18 for maxilla and 1:0.81, for the useof 3 & 4 mm against 5 mm diameter implants to the upper and lower mandibles, respectively, indicatingthat implants of thicker diameter to be used to the lower mandible.

Maxilla
468: 1
4SS: 94SM: 3
4MS: 1566: 1
5SS: 1
5SM: 1
Total: 17 implants

3MS: 1

4SS: 11
4SM: 1
4MS: 1
5SS: 1
5SM: 1

Total: 1 implant

Total: 15 implants

Right

Left
3MS: 2
4SS: 4
4SM: 3
4MS: 14566: 1
5SS: 7
5SM: 4
5MS: 10
Total: 45 implants

3MS: 1
4SS: 8
4SM: 3
4MS: 15566: 2
5SS: 13
5SM: 2
5MS: 5
Total: 0 implant

Total: 47 implants

MandibleFig. 2 –: The number of one-piece type installed to each region
The number of T-type and its models categorized with respect to the area installed
The number of T-type installed to each region in the upper and lower mandibles and its model type weresummarized in Fig 3.
In comparing the implantation of T-type with respect to the area, the implant to the anterior region inboth upper and lower mandibles were found to be significantly low with installation of one each, thus
resulting in 2/98 (2.04%). The ratio of the upper to lower mandible with 43 and 55 resulted in 1:1.28,
relatively higher to the mandible. This indicated that the application of T-type to the maxilla has
increased in comparison to the one-piece type, reflecting its improved ability to achieve primary stability.
The number of T4SS model applied was the highest with 20/43 (46.5%) to the maxilla; T4MS with 26/55(47%) was the highest for mandible followed by T4SS with 15/55 (27.3%).
The number of various diameters of the implants used were 31 for 3 and 4 mm; 12 for 5 mm in the
maxilla; and 49 for 3 and 4 mm; and 6 for 5 mm in the mandible, thus resulting in the ratios of 1:0.39 and
1:0.12 for maxilla and mandible, respectively. The ratios indicated that the implants with thicker
diameter were used in the maxilla, which was opposite to the one-piece type. This can be owing to the factthat the number of socket-lift techniques performed on the maxilla, where tapered region of T-type withthicker diameter has been chosen to aid the primary stability.

Maxilla
T46S: 1
T4SS: 12
T4SM: 2
T4MS: 1
T5SS: 5T3 mm : 1

T4SS: 8
T4SM: 4
T4MS: 2
T5SS: 6
T5SM: 1

Total: 21 implants

Total: 1implant

Total: 21implants

Right

Left
T3MS: 2T 3 mm: 1
T4SS: 8
T4SM: 2
T4MS: 12
T5SM: 1

T3MS: 1

T4SS: 7
T4SM: 1
T4MS: 14
T4MM: 1
T5SS: 3
T5SM:2

Total: 26 implants

Total: 1 implant

Total: 28 implants

MandibleFig. 3 –The number of the T-type installed to each region
The number of two-piece type and its models categorized with respect to the area installed.
The number of two-piece type installed to each region in the upper and lower mandibles and its modeltype were summarized in Fig 4.
In comparing the implantation of two-piece type with respect to the area, the implant to the anterior
region to the maxilla was 22 and 3 to the mandibles, thus resulting in the total of 25/104 (24.0%), whichshowed the highest selection rate than other implant types. This frequent use in the anterior region is togain esthetics by angled features.
The number of implants to the maxilla was 84, and whereas to the mandibles was 20 giving the ratio of
1:0.24, the significantly higher use to the maxilla to reflect its application with consideration to themaxillary sinus in socket-lift technique.
Maxilla4082: 164102: 155082: 5
Total: 36 implants

4082: 94102: 125102: 1

4082: 214102: 5

Total: 22 implants Total: 26 implants

Right

Left
4082: 24102: 54082: 1
4102: 24082: 34102: 7

Total: 7 implants

Total: 3 implants

Total: 10 implants

MandibleFig. 4 – The number of two-piece types installed to each region

As to the model types used, out of the 104 two-piece types implanted into the upper and lower mandibles:
52 (50.0%) for 4082; 46 (44.2%) for 4102; 5 (4.8%) for 5082; and 1 (1.0%) for 5102.
The number of 4 mm diameters applied were 98; and 6 for 5 mm diameters in total to both upper andlower mandibles, giving 1:0.06 ratio, indicating a significantly higher selection for the 4 mm diameter
type.
The number of model type used in conjunction with the socket-lift procedure
The AQB Implant that has improved osteoinduction and bone integration have also shown high clinicalefficacy in conjunction with the socket-lift procedure.
The number of the model types used in various region of the maxilla is summarized in Fig. 5.
The socket-lift procedure had been conducted in 34 of the 329 cases in total thus in 10.3% of the cases in
1:0.62 (right maxilla: left maxilla) ratio, with higher incidence on the right.
The types of implants used were in the order of T-type, two-piece and one-piece types, with 18, 9 and 7
implants, respectively, giving rise to the ratio, 3.9:1.3:1. There was no significant difference in clinicalprogress with the different types, and all have shown satisfactory outcome.
MaxillaRight

Socket lift:
21implants

Socket lift: 13
implants

4SS: 3
T4SS: 54082: 4
468: 1
T4SM: 24102: 1
5SM: 1
T5SS: 35082: 1

4SS: 1
T4SS: 34082: 3
4MS: 1
T4MS: 1
T5SS: 4

Left

Fig. 5 The number of the types installed to each region in cases with socket lift:
Other factors affecting the selection of the model type from other clinical cases
The cases that were deemed worth mentioning in these statistical analyses have been summarized in Fig.
6. In these particular cases, there were 10 cases (10 implants) in which the selected model type of theimplants were different from what was initially planned. Over half, 6 cases, were presented withinsufficient bone quantity; 2 of the cases for issues with clearance; 1 for the insufficient depth due todifficulties in the bone milling; and one where the implant was changed to two-piece type due toperforation of the maxillary sinus floor, were given as the reasons. There was another example in which
due to the exposure of HA coating after its insertion, the HA was removed, but all of these examples haveshown satisfactory progress and no issues have been detected.
There were seven implants (2.1%) in five cases in which recovery procedure was conducted. These were
all done to the right maxilla and the details of which have been summarized in Table 3. Two out of the fivecases have undergone the procedure twice. The reason for these failures were due to overload, but in anattempt to clarify the conditions in which the implant fell out, parameters such as the time till the fall
out; state of the bone; and the surgical conditions were summarized (Table 4).
In analyzing the failed examples, the main reason was discovered to be the loss of integration with thebone from the overload, and three of these cases presented with the thinness of the bone, between 1 mm
to 3 mm, resulting from socket-lift technique, and the remaining two cases were those, where the loadingfrom the prosthesis could not be prevented following the operative procedure.
The recovery methods are to be conducted having confirmed that there are no load exerted from thedental prosthesis, and reduce the amount applied as much as possible. Next, the place the implant to thearea with sufficient bone quantity, and either select two-piece type that is less affected by the loads till
establishing firm connection with the bone, or T-type that has good primary stability.
During the period of 2007 to 2008, there has not been any case in which re-implantation was conducted,
when taking the past practices with regards to the selection of the type and model; the area ofimplantation; limit the amount of weight exerted onto the installed implant, as well as the increased
number of applications of T-type implants into consideration.
MaxillaRecovery: 5 cases(7 implants)* Details described inTable 3

Total: 7 implants

Changed model: 2
・One-piece → 4082: 1
Maxillary sinus perforation
・φ 5 → T4SS: 1
Lack of bone quantity
Total: 0 implant

Total: 2 implants

Right

Left
Coating layer exposed: 1(One-piece)
Model change: 4
・φ 4 → 3MS: 1
Lack of bone shortage
・4MS → 4SS: 2
Lack of bone shortage
・5MS → 5SS: 1
Clearance

Changed the model: 4
・φ 4 → 3MS: 2
Lack of bone shortage
・4MS → 4SS: 1
Unable to dig
・T4MS → T4SS: 1
Clearance

Total: 4 implants

Total: 0 implant

Total: 5 implants

MandibleFig. 6 Special cases: The number of the types installed to each region

1st Time

2nd Time

3rd Time

5082

T5SS

4082

4082

4102

Traumatic occlusion (Crossbite)

4SS

T5SS

Lataral excessive load from buccal

468

566

4082

4082

T4ss

The reasons for the fall out
Bruxism and exert load before osseointegration

Overload by final prosthesis
No bone adhesion due to the overweight from the denture baseTable 3 – The number of recovery cases and the types and the model of the implants
NumberDates of surgery (column below: days)

Details (e.g. State of the bone, surgical procedures)

1st Time

2nd Time

3rd Time

2007/2/24

2007/6/23

2007/12/22 Since the bone width was merely 2 mm in thickness,

199 days

182 days

1out of the two, two-piece types, 4082 and 5082,
installed, 5082 fell out. T5SS was re-implanted but
fell out for a second time, therefore 4082 was
implanted to the position No. 15 shifting from No.14.
# 3and installed 4082. Convalescence has been well.

2007/3/7
2

2007/7/11

Type 4082 that was implanted, fell out, so 4102 type

126 days

was re-implanted at a slightly different location.
Satisfactory progress has been made.

2007/3/24

2007/6/2

4SS implant installed with socket-lift to a narrowpiece of bone that was 1 to 2 mm, fell out. T-type

70 days

3

T5SS was installed to the same position, andsatisfactory outcome has been achieved thus far.

2007/4/14

2007/7/4

2008/4/7

81 days

278 days

4

468 model of one-piece type implant was placed withsocket-lift technique to a narrow piece of bone with 2
to 3 mm, but fell out. therefore second attempt wasdone with 566 type. This fell out again after 9months therefore the type was changed to T4SS toinsert to a shifted position, and a satisfactory
progress has been made so far.

2007/6/27

2007/9/3

Three two-piece 4082 models were implanted to a
position where the gingivae were found to be thick,68 days

and a significant amount of bleeding resulted during

5

the operation. One of the implants fell out from theweight exerted from the floor denture therefore 4082
model was re-implanted, having removed theweight. The progress has been satisfactory thus far.

Ave. number of days

92.8 days

230 days

Survival rate of AQB implant: 97.87%

Table 4 – Treatment details of the fall out cases (the number of cases are the same as those in Table 3)

Observation
It has been 25 years since the clinical studies were initiated in the oral cavities of humans with AQB
implants that were developed with novel recrystallized HA coating employing international patented
technology. The number of AQB implants installed has surpassed 500,000 and have shown clinicalefficacy without encountering any significant problems.
The factor supporting this clinical success is the recrystallized hydroxyapatite coating technology. This
enables the rapid and sufficient bonding with the bone, and the high biocompatibility with the gingivae
acts as an effective barrier for the invasion of pathogens.
In the present statistical analysis, a total of 139 cases with 329 implants (av. 2.37/case) during the twoyears and two months, during the period of October 2006 to December 2008 were subjected to analysis.
The survival rates from these cases were shown to be 97.87%. It was also shown from inspection andanalysis of the details of the cases where recovery intervention was required; by considering the key
points, it was possible to conduct the treatment procedures without any mistakes. The key points are asshown below:①

By preventing the exertion of weight and movement onto the implant with occlusion, prevent theinitial bonding with the bone to be disrupted.

②

Inspect the conditions of the bone, and ensure that the implant is placed into a position in which
sufficient bone quantity is present, and in the direction that is less likely to be subjected to lateral
movements.

③

Select a type and model of the implant that is suitable for the observed state of the bone, andconstruct a hole with a depth that is adequate to fully insert the implant body without exposing the
HA coating.

④

The superstructure design should be one that prevents excessive amounts of weight loaded onto theimplant, with a parameter such as the occlusal area and dispersion of stress.

When the restoration procedure was conducted on 5 cases with 7 implants, while bearing the above points
in mind, a satisfactory progress was seen and outcome alongside all of the other cases. The AQB implants
with its high biocompatibility, has no need for special procedures to be conducted, and a good clinicalresults can be achieved simply by following the general procedures with upmost care.
I have not yet encountered any cases in need of recovery interventions having implemented the pastexperiences, and currently experiencing the excellent properties of AQB implants.