A Clinician s Guide to Restoring Screw Retained Full Zirconia Implant Crowns.

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1994 A Clinician s Guide to Restoring Screw Retained Full Zirconia Implant Crowns ABSOLUTE DENTAL SERVICES NOBELPROCERA FCZ & ASC PROTOCOL

NobelProcera Full Contour Zirconia (FCZ) What is NobelProcera FCZ? This innovative technology allows fabrication of a monolithic zirconia screw retained implant crown. The process eliminates the need for cement and therefore eradicates possible cement residue. This has been shown to be a common cause of inflammatory soft tissue complications* and in most cases the number one reason for implant failure. The system features a metal adapter into the implant creating a very strong and lasting connection. Fully retrievable No cement cleanup Monolithic design No chipping Economical Anterior hybrid as well as Posterior application Metal interface FCZ System Features Extremely efficient and stress-free chairside protocol No cementation equates to no implant failures due to cement residue Available on all Nobel Conical Connection implants Design file archiving allows for impression-less remake if ever required Metal Adapter creates strong connection between implant and abutment-crown Monolithic design minimizes chipping under function Compatible with all Vita shades Request Nobel Conical Connection implants to allow for this technology! *Peri-Implant Mucositis and Peri-Implantitis: A Current Understanding of Their Diagnoses and Clinical Implications, developed under the direction of the Task Force on Peri-Implantitis and approved by the Board of Trustees of the American Academy of Periodontology. J Periodontol 2013;84:436-443.

NobelProcera Angulated Screw Channel Correction (ASC) What is NobelProcera ASC? This technology enables the restorative team to re-angulate the screw access channel without the use of a correction abutment. Combining the ASC & FCZ technologies allows us to design Hybrid Anterior as well as Monolithic Posterior zirconia screw retained crowns. ASC allows the surgeon to place the implant in a more ideal position without having to adjust for access. This allows for a screw retained option without compromise. ASC technology allows us to re-angulate screw access without the use of a correctional abutment Economical anterior & posterior application FCZ System Features Allows for a more ideal implant placement without the need to consider screw access Enables screw retained options in both anterior and posterior applications Adjust screw access up to 25 degrees Rotate access up to 360 degrees to manage accessibility Traditional Nobel Biocare torque settings Omnigrip screwdriver fits standard Nobel Biocare torque wrench

Full Contour Zirconia Case Flow Case courtesy of Dr. Thomas Leech Posterior Screw Retained Monolithic Crown IMPRESSION AND PROCESSING Implant level impression Absolute digital design NobelProcera CAD milling & sintering Absolute Lab final contouring & staining DELIVERY Available on all Nobel Biocare Conical Connections Attach metal adapter Position the crown Adjust interproximal & occlusal contacts Torque to Nobel Biocare protocols Protect screw head with cotton plug Plug access using composite material Final delivery I delivered my first FCZ implant retained crown in less than 10 minutes. Prescribing this procedure with its retrievable option and no cement residue will change how we restore implants in the future. I truly believe this technology to be a more predictable, economical and functional way to restore dental implants. Thomas A Leech DDS, Dentistry at the Park, NC

Combination Full Contour Zirconia with ASC IMPRESSION AND LAB PROCESS Case courtesy of Dr. Brandon Kofford Removal of Immediate Temporary Implant level impression DELIVERY APPOINTMENT NobelProcera Milling and Sintering Diagnostic wax-up Cut back and preparation for layering Ceramics Hybrid Monolithic/Layered option for Anterior and Posterior application Digitizing the wax-up on the NobelProcera 2G Scanner Absolute Lab Processing Porcelain application to facial Digital cutback and access correction using ASC Lab delivery of processed crown Position and finger tighten crown Radiographical verification of seating Test and adjust occlusal and interproximal contacts Torque to traditional Nobel Biocare torque settings If using ASC a special screw will be provided with case. Note the blue screw head for ASC. A special Omnigrip screw driver is needed to engage an ASC screw. This driver fits into a standard Nobel Biocare wrench. Protect screw head Close access with composite Monolithic Lingual /Layered Facial Final Delivery After restoring my first hybrid FCZ screw-retained crown with Angulated Screw Channel Correction, I found the process very predictable and the results achieved to be both functional and esthetic. By prescribing these technologies I was able to solve the cement residue and screw access issues in one application. Brandon Kofford DMD, MS, FACP, Royal Oak Dental Group, NC

Clinical & Laboratory Components needed to restore FCZ & ASC Noble Biocare order numbers shown, contact your rep for more information. Impression Coping* NP: 36258 narrow x short 36260 narrow x long 36259 intermediate x short 36261 intermediate x long RP: 36263 narrow x short 36262 narrow x long 36265 intermediate x short 36264 intermediate x long 36267 wide x short 36266 wide x long WP: 37855 intermediate x short 37854 intermediate x long 37857 wide x short 37856 wide x long LAB NEEDS CLINICAL NEEDS Unigrip manual driver 29148 20mm // 29149 28mm // 29150 36mm Omnigrip manual driver ASC application 37367 20mm // 37377 28mm // 37378 36mm ASC Driver for torque wrench 37379 20mm // 37380 25mm // 37381 30mm // 37382 35mm Nobel Biocare torque wrench 34584 Prosthetic Kit 3744 Lab analogs NP: 36697 // RP: 36698 // WP: 37879 FCZ wax-up sleeve NP: 37449 // RP: 37450 // WP: 37608 Abutment wax up holders NP: 36746 RP: 36747 WP: 37568 NobelProcera 2G scanner 37260 *Narrow, intermediate or wide refers to emergence profile. Long (14mm) or short (10mm) refers to length of post.

Absolute Dental Lab Established in 1994, Absolute Dental started as a fixed prosthetics lab serving clinicians in the Triangle area of North Carolina. Two decades later, Absolute s restorative focus is much broader but their attention to product detail and exceptional customer service has not changed. Today, the Absolute team is renowned for their expertise in creating world-class dental esthetics. Their use of cutting edge technology in CAD and milling departments, as well as their extraordinary dental implant and high end removables sections, enables them to deliver lifelike and functional dental prosthetics. Staying abreast of new technologies, yet only implementing relevant protocols and procedures, has earned Absolute a reputation for being a trusted partner to discerning clinicians throughout the United States. Serving their customers with Absolute Excellence has always been the primary focus of the owners, branch partners and team members...this remains true today. Conrad J. Rensburg ND & NHD in Tech. Conrad J. Rensburg graduated under full scholarship from Pretoria Tech in 1992, with a fouryear Baccalaureate Degree in Technology. Since that time, he has specialized in fixed prosthetics with a heavy emphasis on dental implant restorations. While employed by ADW Dental as Senior Ceramist, Mr. Rensburg received managerial certification from the SADTC in 1995. After, he owned and operated RensTech Fixed Prosthetics in Pretoria, South Africa. In 1999 he relocated to the U.S. and was hired as the General Manager of Absolute Dental Services. During that time, he created the nationally renowned Absolute Implant Department. Mr. Rensburg and his business partner, Drew Van Aarde, purchased Absolute Dental in 2004. With Drew as Senior Ceramist and Conrad as head of Absolute Dental Implant and Pre-Ceramics sections, they created a world class dental lab in the Triangle area of North Carolina. Mr. Rensburg is a board-certified technician in good standing with the SADTC and NCDLA. He has been a CE accredited speaker for several dental implant manufacturers since 2002, and has been the keynote speaker at special events across the U.S. His seminars are focused on educating restorative dentists on the latest techniques and materials, as well as keeping them up-to-date with the ever-evolving dental implant market.