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exhibitors20 Pacific Dental Conference — March 5, 2015 n Large extraction sockets, limited accessibility, tough-to-remove excess cement and high occlusal forces. These arejustsomeofthechallengesaclinician faceswhenrestoringasingletoothinthe posterior. And, with molar replacement being among the most common indica- tions, these challenges are encountered repeatedly. A solution that addresses all these problems in an efficient and predictable way will make life easier for dental pro- fessionals and patients. That’s precisely why Nobel Biocare is bringing innova- tion back to the posterior region with its newcompleteposteriorsolution–anori- ginalcombinationofnewwide-platform implants and restorative options, all specially designed for molar sites. Animplantlikenoother MultipleNobelBiocareinnovationscom- bine to make this solution complete, but the foundation for treatment success is the implant itself. Here Nobel Biocare offers several options, each engineered forthespecificdemandsoftheposterior. All are intended to shorten time to teeth for the patient by enabling immediate loading whenever possible. One option is NobelActive. Many clinicians are already familiar with this award-winning implant (details of award wins can be found at www. nobelbiocare.com). Its distinctive design and the surgical protocol form a unique combination that can enable immediate function in cases where it might other- wise not be achieveable.1,2,3 To condense bone gradually, its tapered body features threads that nar- row towards the apex, while the apex itselffeaturesdrillingbladestopreserve bone by allowing a smaller osteotomy. These features are all designed for high primary stability, even in soft bone and extraction sockets. Now, a new variant offers the bene- fits of the NobelActive family but with dimensions ideal for the molar region. NobelActive WP (wide platform) pos- sesses a wider diameter implant body (5.5 mm) to better fit the large extrac- tion sites in the molar region and a wider implant platform for an optimal emergenceprofile.NobelActiveWPalso comes in an option with a shorter body (7mm)toavoidcriticalanatomicalstruc- tures such as nerves. Stabilityandflexibilityinparallel Alternatively, clinicians can opt for NobelParallel Conical Connection (CC). Combining a parallel-walled implant body that is well documented with an advanced internal connection, Nobel- Parallel CC offers extraordinary flex- ibility. It is engineered for use in all bone qualities and for a wide range of indications.The5.5mm wide platform option is designed for an opti- mized emergence pro- fileforlargemolarsites. Both experienced clinicians and those earlyintheirimplantcareerswillappre- ciateNobelParallelCC’sstraightforward surgicalprotocol.Itoffersflexibilityand shortens treatment time, benefitting the patient too. Together, the surgical protocol and implant design form a unique combina- tion that’s intended to allow immediate functioninmorecasesbyprovidinghigh primarystability.Thethreaddesignand tapered apex of NobelParallel CC are designed for underpreparation of the surgical site and bicortical anchorage – techniques that support immediate loading.4,5 High stability during the initial heal- ing phase is then maintained by Nobel Biocare’s unique TiUnite surface.6 In addition, patented grooves enhance osseointegration7 for a predictable end result. Strengthmeetsflexibility Both new implants benefit from Nobel Biocare’s internal conical connection. This advanced connection’s conical seal and hexagonal interlocking mechanism provide high mechanical strength.8 It offers restorative flexibility too, being compatible with Nobel Biocare’s most innovative restorative solutions, includ- ing those designed specifically for the posterior. These include the new PEEK Healing andPEEKTemporaryAbutments,which are anatomically shaped to match the molarcontours.AsthePEEKAbutments come ready-shaped for an optimized emergence profile, fewer adjustments are needed. This can simplify treatment and reduce costly chair time. Thecrownthatrules When it comes to the final restoration, the FCZ (full-contour zirconia) Implant Crown is designed for strength and pre- dictability even under the high occlusal forces of the posterior. There’s no worry- ing about chipping either, as the full- contour nature of the NobelProcera FCZ Implant Crown removes the need for veneering. The biocompatibility of the materials used contributes to biological stability in the areas it matters most. Plus, being screw retained, the FCZ Implant Crown is completely cement free, avoiding the risks associated with cement excess entirely. Even the titanium adapter is mechanically retained. Fig. 1: Multiple innovations combine to create one complete posterior solution. (Photos/Provided by Nobel Biocare) Bringing innovation back The ability to use an angu- lated screw channel (ASC) allows the screw access hole on the FCZ Implant Crown to be placed any- where between 0° and 25° in a 360° radius. This means it can be angled towards the front of the mouth for easy access, even in the posterior. It also helps avoid placing the access channelonthecuspofatooth,where it could affect occlusion. The asso- ciated Omnigrip Screw- driver further simplifies work on the restoration. Its effective pick-up func- tion and secure grip on the screw help the clin- ician to work safely and efficiently. Natural-looking tooth color is another benefit offeredbytheFCZImplant Crown. Whichever of the eight available shades is used, the color is applied throughout the material. This means discolora- tion isn’t a concern when making adjustments. Cut- backs and staining can alsobeusedtoachievethe desired esthetic effect. Onecompletesolution While each product within Nobel Bio- care’scompleteposteriorsolutionstands out on its own, they stand stronger together. Like all Nobel Biocare innova- tions,theyaretestedtogetherasonesys- tem,astheyexistinthepatient’smouth. Combining Nobel Biocare compon- ents means all elements are designed to work in synergy for the optimal treat- ment outcome. Restoring single molars representsaclinicalchallengeformany reasons, but now, by uniting new and proven innovations, Nobel Biocare has the answer. Find out more at nobelbiocare.com/ bringinginnovationback. References 1 Kolinski ML, Cherry JE, McAllister BS, Parrish KD, Pumphrey DW, Schroering RL. Evalua- tion of a variable-thread tapered implant in extraction sites with immediate temporiza- tion: A three-year multicenter clinical study. JPeriodontol.2014M. 2 Arnhart C, Kielbassa AM, Martinez-de Fuen- tes R, Goldstein M, Jackowski J, Lorenzoni M, Maiorana C, Mericske- Stern R, Pozzi A, Rompen E, Sanz M, Strub JR. Comparison of variable-thread tapered implant designs By Nobel Biocare Staff Figs. 2a, b: Both NobelActive (left) and NobelParallel Conical Connection (right) are available in wide platform variants that are designed to provide optimized results in the posterior. Anatomically shaped, the PEEK Temporary Abutments and PEEK Healing Abutments (left and right respect- ively) match the contours of the molars. In addition to supporting an improved emer- gence profile, this can help reduce chair time by reducing the num- ber of adjustments needed. Here at the PDC LearnabouttheNobel Biocarecompletepos- terior solution in the Nobel Biocare Can- ada booth, No. 1429. Nobel Biocare introduces a complete posterior solution to a standard tapered implant design after immediateloading.Athree-yearmulticenter randomized controlled trial. Eur J Oral Im- plantol.20125:123-36. 3 Babbush CA, Brokloff J. A Single-Center Retrospective Analysis of 1001 Consecutively Placed NobelActive Implants. Implant Dent. 2012:21(1):28-35. 4 Tallarico M, Vaccarella A, Marzi GC, Alviani A, Campana V. A prospective case-control clinical trial comparing one- and two-stage Nobel Biocare tiunite implants: resonance frequency analysis assessed by osstell men- tor during integration. Quintessence Int. 2011;42(8):635-644. 5 Agliardi EL, Pozzi A, Stappert CF, Benzi R, Romeo D, Gherlone E. Immediate Fixed Re- habilitation of the Edentulous Maxilla: A Prospective Clinical and Radiological Study after 3 Years of Loading. Clin Implant Dent RelatRes.epubahead2012. 6 Glauser R, Portmann M, Ruhstaller P, Lund- grenAK,HammerleCH,andGottlowJ.Stabil- ity measurements of immediately loaded machined and oxidized implants in the pos- terior maxilla. A comparative clinical study usingresonancefrequencyanalysis.ApplOs- seointegrationRes2001,2:27-29. 7 Hall J, Miranda-Burgos P, Sennerby L. Stimu- lation of directed bone growth at oxidized implants by macroscopic grooves: an in vivo study. Clin Implant Dent Relat Res 2005;7 (Suppl1):76-82. 8 Dataonfile. Figs. 3a, b: The advanced internal conical connection provides access to innova- tive restorative solutions such as the FCZ (full-contour zirconia) Implant Crown. This can incorporate an angu- lated screw channel (ASC), which allows the screw ac- cess hole to be positioned for easier access and better esthetics.