Dental Tribune United Kingdom

August 1-7, 201118 Implant Tribune United Kingdom Edition page 17DTß Fig 13c Fig 13d Fig 13e Fig 13f Fig 13g Fig 13h Fig 13i the risk of transfer losses. Case I: Lateral tooth resto- ration The first case presented con- cerns a 75-yearold female pa- tient and documents a situation that is commonly encountered. The plan was to treat tooth #14 with a single crown and place a bridge on two implants. Fur- thermore, teeth #23 and 24 were each to receive single crowns and, in addition, an implant bridge on three im- plants was planned (Figs 4a–f). In this case, what made the use of NobelGuide so attractive for patient, dental technician and surgeon? Easier handling Owing to the exact 3-D design with NobelGuide, the surgeon was able to proceed despite the reduced amount of avail- able bone. A sinus lift was not necessary. It was possi- ble to place all five implants without having to generate a flap, minimising the post-op- erative consequences such as pain, swelling and the forma- tion of haematomas. Moreo- ver, it allowed the impression for preparation of the master model over teeth and implants to be taken in the same surgi- cal session (Fig 5). The dental laboratory contributed to the production of the X-ray tem- plates early in the planning phase, was familiarised with the case and involved in the discussion about the desired implant positions. The benefits for the patient included a safe operation, since the surgeon planned the entire operation beforehand and thus expected a predictable result. A difficulty in the present case was the relatively soft quality of the bone. Under these circumstances, NobelAc- tive is beneficial for the experi- enced surgeon since it rotates into the bone much like a com- pression screw, which allows good primary stability to be at- tained. The NobelActive implant The TiUnite surface of No- belActive implants affords os- seointegration down to the level of the implant shoulder rather than to just below the implant shoulder owing to the biological width of at least 1mm as is customary for con- ventional implants. This is as- sociated with significant ad- vantages for the aesthetics of the red–white transition. The gingiva is more stabile and resection is less pronounced, which leads to the volume be- ing maintained. This effect is of crucial importance for the suc- cess of an implant treatment in the anterior region, where aes- thetic appearance is extremely significant. Ceramic-veneered and screw-retained implant bridges made of titanium For dental management of the final restoration, CAD/CAM- fabricated Procera Implant Bridges with screw retention at implant level were produced. The available framework ma- terials for this purpose are zir- conium-oxide ceramics and ti- tanium. Titanium was selected in the present case (Figs 6 & 7). Additional advantages of this technique are: • screw-retained abutment and bridge (Fig 8) • tension-free framework • bridge construction and im- plant are made of the same material • very high quality milled tita- nium material • no problems with chipping • bridges are aesthetically pleasing and easy to remove • no gingival irritation is caused by a cement gap, since there is no such gap (Fig 9) Screw-retained bridges and milled titanium are very popu- Fig 13j Fig 13k Fig 13l Fig 13m Fig 13n Fig 14 Fig 15 Fig 16 Fig 17 Fig 18 Fig 19 Fig 20 Fig 21 Fig 22 Fig 23 Fig 24 Fig 25 Fig 26 Fig 27