NOBELESTHETICS FOR UNSURPASSED PATIENT SATISFACTION. the finest esthetics, the most. beautiful smile

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Joel Stafford
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1 NOBELESTHETICS FOR UNSURPASSED PATIENT SATISFACTION the finest esthetics, the most beautiful smile

2 stunning results time after time

3 industry-leading solutions for optimum success You don t need any special equipment or knowledge to benefit from our porcelain and ceramic products. Whether you re working with teeth or implants the ceramic esthetic capabilities of the Procera products are unsurpassed anywhere. A look at the table below also confirms the extreme strength of Procera Bridge Zirconia. Combine these outstanding qualities and you ll understand why Procera is the very best way to give your patients a faultless, long-lasting, beautiful metal-free smile time after time. Procera Bridge Zirconia Flexural Strength Material Comparison 1200 Source: Data on file tried and trusted all over the world The success of Procera is proven. Results from 10 years of clinical studies have confirmed that pure ceramic provides a superior alternative to traditional porcelain-fused-to-metal alternatives. In short, metalfree Procera has helped eliminate black lines. So it s no surprise that nearly 6 million units have already been sold, and the Procera network of dental laboratories now extends across approximately 60 countries worldwide MPa Procera Bridge Zirconia Competing zirconia milled Bridge Alumina

better business and bigger profits for your practice Procera technologies offer unprecedented levels of precision so appointments for remakes

This reduces patient chair-time, giving you more opportunity to build your patient base and improving your profit potential.

prosthetics. So you have all the practice-building possibilities you need.

4 better business and bigger profits for your practice Procera technologies offer unprecedented levels of precision so appointments for remakes become a thing of the past. This reduces patient chair-time, giving you more opportunity to build your patient base and improving your profit potential. Through Procera Nobel Biocare also provides you with a complete suite of solutions from laminates, crowns and bridges right through to implant prosthetics. So you have all the practice-building possibilities you need. With the best ceramic options on the market we also want to help you use Procera to its full potential. Our online Procera network means you can keep up to date with new developments in our products, thinking and applications. You can design and plan on computer, take training and order online, and feel part of a growing and informed community.

More and more people now think of beautiful fully functioning teeth as their birthright and our industry is at last in a position to deliver.

5 NobelEsthetics better looking smiles for all your patients Esthetic dentistry is an idea whose day has come. With the enormous advances in implant dentistry, there has never been a more exciting time to be a dentist. More and more people now think of beautiful fully functioning teeth as their birthright and our industry is at last in a position to deliver. Together, modern dental professionals and Nobel Biocare the pioneering world leader of the field can confidently answer this demand. We now have all the solutions we need for creating healthy happy patients.

6 making existing teeth perfect a scientific approach to perfection We ve also looked into areas many miss. Our collaborative clinical studies record not just the technology, but the practice, art and success of esthetic dentistry from professional and patient standpoints. Just tap Procera into MedLine and you ll see over 200 references. Which is why we are the world leaders in esthetic, ceramic metal-free dental restoration.

Procera Laminates and Crowns Procera Laminate Alumina 0.

Crowns Procera Crown 0.4mm for superior esthetics with unsurpassed translucency 0.

7mm when the extra strength of zirconia is wanted Procera Crowns and Bridges can be ordered from your laboratory with

7 Procera Laminates and Crowns Procera Laminate Alumina 0.25mm Combines optimal strength with excellent esthetics Significantly less labor than traditional techniques Procera Crowns Procera Crown 0.4mm for superior esthetics with unsurpassed translucency 0.6mm for use in all indications Procera Crown Zirconia 0.7mm when the extra strength of zirconia is wanted Procera Crowns and Bridges can be ordered from your laboratory with individualized outer shape of the framework for optimal porcelain support Can be cemented with conventional methods Procera Unsurpassed fit Bridge Superior zirconia strength and esthetics NobelRondo An extremely strong porcelain (120Mpa) Highest esthetic results from unique layering technique

8 placing beautiful teeth on implants Have you ever considered maximizing your profit potential even further by placing implants yourself? Our NobelDirect implant solution is as close to crown and bridge as you can get. And the unique flapless surgery involved means your patient can have beautiful teeth with Immediate Function in one treatment session. Procera also provides esthetics for the Straumann implant system as well as other implant systems.

Procera Implant Bridge Predictable perfect fit from one piece of

design of framework Procera Abutments Customized design (angulation, height,

all-ceramic Crowns or Bridges for the ultimate esthetics Abutments are

from Straumann, Regular Neck 4.8 and Wide Neck 6.5, 3i 3.

9 Procera Implant Bridge Predictable perfect fit from one piece of biocompatible titanium Available on implant level and abutment level Free design of framework Procera Abutments Customized design (angulation, height, width) Available in Zirconia or Titanium Choose cementable Procera all-ceramic Crowns or Bridges for the ultimate esthetics Abutments are available for all Nobel Biocare Implant Systems as well as implant systems from Straumann, Regular Neck 4.8 and Wide Neck 6.5, 3i 3.75, Lifecore Biomedical, Restore 3.75, Zimmer Dental Taperlock 4.0 and Sterngold Implamed 3.75 Courtesy of Dr. Iñaki Gamborina

10 Indication-based beauty Procera is a unique system from Nobel Biocare for the fabrication of esthetic and functional dental restorations. Development of the Procera system commenced in 1983 and the first patient was treated in Since their commercial introduction in 1994, nearly 6 million Procera restorations have been produced and installed. In addition, approximately 60 countries are represented in the Procera network and work with Procera. Procera offers you the optimal restorative system, including crowns, laminates, abutments and bridges, for all indications. The combination of beauty and strength gives you a simple and predictable clinical procedure, excellent esthetic results and improved long-term performance. Based on the latest scanning, CAD/CAM and production technology, cores of densely sintered alumina or zirconia are fabricated with high accuracy to ensure a perfect fit. This material s properties result in top-notch clinical features: Extreme strength Translucence Cementability Biocompatibility and make it almost impossible to distinguish the restoration from a natural tooth. Procera, together with the world s strongest prosthetic materials and the extremely strong porcelain material NobelRondo (engineered specifically for Procera ), all add up to an unbeatable combination. If you have any questions or need more information regarding Procera, please visit our website: Procera + Zirconia/Alumina + NobelRondo = Unbeatable indication-based precision, strength, beauty! Unique 10 year results from clinical studies reveal that Procera provides a superior alternative to the use of traditional porcelain-fusedto-metal (PFM) restorations. Crowns Bridges Implant Bridges Abutments Laminates

Procera Crown Zirconia or alumina Excellent strength with beautiful

New Freehand coping design that provides increased porcelain-support

Tooth Preparation 10 years of clinical documentation 3D CADDesign

million units produced Cementation To save chair-time, use

cementation must never be used For more information about

11 Procera Crown Zirconia or alumina Excellent strength with beautiful all-ceramic esthetics Biocompatible Easy technique, saves chair-time New Freehand coping design that provides increased porcelain-support and even stronger results for all indications. Tooth Preparation 10 years of clinical documentation 3D CADDesign freedom for the ultimate esthetic outcome and strength Nearly 6 million units produced Cementation To save chair-time, use conventional crown and bridge cementing instead of bonding Temporary cementation must never be used For more information about cementing/bonding, see the relevant section, Procera Clinical Procedure. Clinical case courtesy of Dr. Eric van Dooren, Belgium

12 Procera Laminate Alumina Excellent strength with beautiful all-ceramic esthetics Biocompatible Easy technique, saves chair-time Tooth Preparation Note! The laminate core is only 0.25mm thick. Cementation Procera Laminates must be bonded. See the relevant section later. Clinical case courtesy of Dr. Vincent Prestipino

Procera Bridge Indications Contraindications Zirconia Proven strength

saves chair-time Defect-free precision milled from a solid piece of zirconia

allergies and/or esthetics are indications for posterior placement Can also

Tooth Preparation Cases where the anterior and/or posterior cantilevers have

Cementation To save chair-time, use conventional crown and bridge cementing

13 Procera Bridge Indications Contraindications Zirconia Proven strength Beautiful all-ceramic esthetics Biocompatible Easy cementable technique, saves chair-time Defect-free precision milled from a solid piece of zirconia Especially appropriate as an esthetic solution in the anterior Metal allergies and/or esthetics are indications for posterior placement Can also be used in conjunction with implant treatments Two- to four-unit bridges Tooth Preparation Cases where the anterior and/or posterior cantilevers have a length of more than one unit Bruxism and/or periodontal problems Cementation To save chair-time, use conventional crown and bridge cementing instead of bonding. See the relevant section for more details. Clinical case courtesy of Ernst A. Hegenbarth, MDT

Procera Implant Bridge Predictable precision-fit < 20µm Predictability eliminates try-in steps and reduces costly chair-time

satisfaction Exceptionally strong lightweight framework: free from distortions and defects Platform Options Nobel Biocare

5mm Wide Neck endosseous implants (implant level only) Indications Full arch or partial restorations on both abutment and

c to alloys may be an indication Prosthetic Options Choose any veneering

14 Procera Implant Bridge Predictable precision-fit < 20µm Predictability eliminates try-in steps and reduces costly chair-time Precision milled from a solid piece of titanium Biocompatible Freedom of design for the ultimate esthetic outcome and patient satisfaction Exceptionally strong lightweight framework: free from distortions and defects Platform Options Nobel Biocare implant systems Procera Implant Bridge Octagon (titanium) for Straumann Regular Neck 4.8mm and 6.5mm Wide Neck endosseous implants (implant level only) Indications Full arch or partial restorations on both abutment and implant level Patients allergic to alloys may be an indication Prosthetic Options Choose any veneering materials (e.g. denture teeth and acrylic, composite or porcelain), for example: Wrap-around Traditional acrylic Ti-Porcelain Ti-Porcelain and Procera ceramic crowns Connection Abutment level tighten the prosthetic screws to 15Ncm Implant level tighten the abutment screws to 35Ncm Clinical case courtesy of Robert Nölken, Dr. Med. Dent.

Procera Abutment Zirconia or titanium Customized for superior esthetics Cost-effective, no need to stock pre-fabricated abutments Easy to make with the Procera 3D CADDesign program or by

Can also compensate for odd angles and implant alignments Platform Options Brånemark System & Replace Select implant systems NobelPerfect implant system Abutments are also available for

75 Indications Single or multiple implant restorations Fully edentulous or partially edentulous arch Preparation If minor adjustments are necessary, you can adjust the preparation

15 Procera Abutment Zirconia or titanium Customized for superior esthetics Cost-effective, no need to stock pre-fabricated abutments Easy to make with the Procera 3D CADDesign program or by scanning a wax-up Biocompatible Designed to fit practically any angle, taper, finish line, height, width and cross-sectional form. Can also compensate for odd angles and implant alignments Platform Options Brånemark System & Replace Select implant systems NobelPerfect implant system Abutments are also available for implant systems from 3i 3.75, Lifecore Biomedical, Restore 3.75, Zimmer Dental Taper-lock 4.0 and Sterngold Implamed 3.75 Indications Single or multiple implant restorations Fully edentulous or partially edentulous arch Preparation If minor adjustments are necessary, you can adjust the preparation intra-orally using carbide burs or diamonds, together with copious irrigation Connection Tighten Procera abutment screws to 35Ncm The restoration is cemented over the customized abutments following the same basic protocol as for toothsupported crowns and fixed, partial dentures Clinical case courtesy of Dr. Iñaki Gamborena

Procera Instruments Procera needs only your conventional preparation techniques, a moderate chamfer margin and rounded internal line angles.

The shapes are of standard design and can also be purchased separately from other suppliers. Each of the preparation kits includes the necessary diamonds for preparation.

adjacent teeth according to the Vita shade guide, as this will provide the optimum match for the veneering porcelain that is best suited to Procera restorations.

16 Procera Instruments Procera needs only your conventional preparation techniques, a moderate chamfer margin and rounded internal line angles. Brasseler USA (in collaboration with Nobel Biocare) has developed preparation kits for use with Procera restorations, which are available in most markets. The shapes are of standard design and can also be purchased separately from other suppliers. Each of the preparation kits includes the necessary diamonds for preparation. # : Procera Preparation kit # : Procera Laminate kit Impression Taking Your ability to accurately capture an impression is critical for the correct transfer of information to the laboratory. Use your preferred impression material and method Verify that the impression is free of voids, inconsistencies, or tears Shade Selection It is essential to accurately document the color of the adjacent teeth according to the Vita shade guide, as this will provide the optimum match for the veneering porcelain that is best suited to Procera restorations. Thereafter, the NobelRondo procedure is an ideal alternative that offers unlimited possibilities for achieving customized esthetics, e.g. in terms of the hue, chroma and value of the teeth. 6 steps of shade selection with NobelRondo : 1. Selection of the NobelRondo shade group 2. Selection of the basic hue 3. Variations of color intensity 4. Inner structures of the tooth 5. Variations of lightness (value) and contrasts 6. Texture and shine of the tooth surface For more information, see the NobelRondo Ceramic Concept and Procedures manual.

Cementation Once you receive your Procera restoration from the laboratory: Check the restoration for damage on the die Seat the Procera restoration on the

margins Note! Procera Laminate must be bonded. Employ dual cure resin cements using adhesive bonding techniques.

thus, provides exceptional cementation strength without further preparation Consider the translucency of the restoration and adhesive material when cementing

17 Cementation Once you receive your Procera restoration from the laboratory: Check the restoration for damage on the die Seat the Procera restoration on the tooth Check the proximal contact Once the definitive restoration is seated, allow the excess cement to set completely Gently remove any excess cement from the margins Note! Procera Laminate must be bonded. Employ dual cure resin cements using adhesive bonding techniques. Evaluate fit, occlusion, and esthetics prior to connection The internal Procera surface roughness is similar to that of a porcelain surface after etching and, thus, provides exceptional cementation strength without further preparation Consider the translucency of the restoration and adhesive material when cementing in the anterior region Apply selected material in the Procera Crown or Procera Bridge. The use of too much cement can make the seating of the restoration difficult Seat the restoration using finger pressure

Bonding Documented composite bond strength for Procera Crown and Laminate restorations are with phosphatebonded monomercontaining composites After try-in at the clinic, remove proteins by rubbing

18 Bonding Documented composite bond strength for Procera Crown and Laminate restorations are with phosphatebonded monomercontaining composites After try-in at the clinic, remove proteins by rubbing with 37% phosphoric acid and rinse with water for one minute. After dry blasting, the restoration is dehydrated with alcohol The tooth is treated and the bonding material is applied in accordance with the recommendations provided by the manufacturer of the composite cement After seating, the restoration must be light-cured in accordance with the manufacturer s recommendations. When using Procera Laminate, self-curing is recommended in order to avoid the influence of the chair-side lamp on curing time

19 Material Information For more detailed information about Procera materials, see the Center For Excellence an established long-term research collaboration between the University of Michigan and Nobel Biocare. Procera Bridge Zirconia Flexural Strength Material Comparison MPa Procera Bridge Zirconia Competing zirconia milled bridge Alumina Source: Data on file Load to Fracture: Average load to fracture: 1100N (range: N). (All bridges reached 99.8% of the full theoretical density.) Note! Normal bite power in mouth ranges from 40 to 250N. Bridge data (average): width of beam (max): 3.05mm, height of beam (max): 3.10mm, coping thickness: 0.6mm.

Procera Crown Procera Crown Flexural Strength Material Comparison 1200 1000 MPa 800 600 400 * Source: WC Wagner, TM Chu.

20 Procera Crown Procera Crown Flexural Strength Material Comparison MPa * Source: WC Wagner, TM Chu. Biaxial Flexural Strength and Indentation Fracture Toughness of Three New Dental Core Ceramics. The Journal of Prosthetic Dentistry, August Procera (zirconia)** Procera (alumina)* In-Ceram (Vita zahnfabrik)* Empress (Ivoclar)* ** Source: Sierraalta M, Odén A, and Razzoog ME. Material Strength of Zirconia Produced with Two Methods. [Abstract #450] J Dent Res NobelRondo Flexural Strength Material Comparison MPa * Source: Study performed by 0 NobelRondo * Vita VM7 AllCeram* (Degudent) Cerabien (Noritake) ISO Standard University of Michigan.

what customers say More and more are choosing Procera Saves time and money Strong and beautiful Chosen around

Lang, DDS, MS USA The Procera system is a very significant contribution to oral health; I m proud to be

Bernard Touati, DDS, DSO France The amazing thing about Procera Alumina is that you can achieve superior

21 what customers say More and more are choosing Procera Saves time and money Strong and beautiful Chosen around the world Brien R. Lang, DDS, MS USA The Procera system is a very significant contribution to oral health; I m proud to be associated with it. Bernard Touati, DDS, DSO France The amazing thing about Procera Alumina is that you can achieve superior esthetic results and still prepare and cement it as if it was a PFM. Eric van Dooren, DDS Belgium The ability to utilize traditional cementation techniques with Procera Alumina is translated into simplified clinical procedures, fewer post-operative complications and significantly reduced chair-time.

our qualifications are your security Achievements Inheritors and developers of the work of Professor Brånemark founder of modern implantology.

osseointegration, Immediate Function and Soft Tissue Integration Creators of CAD/CAM dentistry Creators of unique Procera System one seamless procedure from 3D planning to fully guided surgery right

22 our qualifications are your security Achievements Inheritors and developers of the work of Professor Brånemark founder of modern implantology. World leaders in the field Providers of the most comprehensive and flexible crown, bridge and implant solutions in the world Creators of unique biocompatible material TiUnite for optimal osseointegration, Immediate Function and Soft Tissue Integration Creators of CAD/CAM dentistry Creators of unique Procera System one seamless procedure from 3D planning to fully guided surgery right through to customized ceramic restoration FDA cleared for Immediate Function (except 3.0 and Zygoma) FDA cleared for Teeth-In-An-Hour in 2004 Quality Zero non-conformities in 2004 FDA inspection of Nobel Biocare production units in Göteborg, Karlskoga and Stockholm Nobel Biocare cares about the environment and all production units are certified according to Environmental Management System ISO Research Formal collaboration with over 50 academic institutions and 600 independent scientists around the world More clinical studies on immediate or early loading than all other competitors combined (Medline Feb 2005) More prospective clinical studies with at least 5-year follow-up than all other competitors combined (Berglund et al 2002) Support 165,000 customers trained by 1,985 dental professionals in 37 countries and in 19 languages, during 2004 Own sales organizations with local Nobel Biocare staff in 29 countries Leading business website in 8 languages, with complete online service supplying all products and at least 500 courses available at all times GB 0505 Printed in Sweden. Nobel Biocare Services AG, Nobel Biocare, the Nobel Biocare logotype and all other trademarks used in this document are, if nothing else is stated or is evident from the context in a certain case, trademarks of the Nobel Biocare group.

NobelProcera Product Overview

NobelProcera Product Overview TM EXPERIENCE THE NEW WORLD OF CAD/CAM DENTISTRY Most versatile product and material portfolio Latest production technology for Precision Milled Restorations PMR Cutting-edge