Dennis Nagata, DDS ; and James Michino, DMD
A 60-year-old male patient presented to Dr. Nagata's practice with a chief complaint of wanting to replace his maxillary teeth and remove existing failed implants and an implant bridge previously placed by a different practitioner. After a discussion of the protocols and benefits of implant treatment, the patient accepted the All-on-4® treatment concept. Dr. Nagata referred the patient to Dr. Michino. An implant bridge in the mandible had put the patient into severe malocclusion, as well as functional and esthetic imbalance. The patient intends to restore the mandibular arch. The NobelProcera® Zirconia Implant Bridge (Nobel Biocare, nobelbiocare.com) in the maxillary arch will serve as a framework to rehabilitate the mandibular implant bridge, creating balance and occlusion. Following the surgical procedure and placement of TiUltra™ implants, Xeal™ Multi-unit Abutments were placed. The case was immediately loaded with a provisional screw-retained denture fabricated by Hiro Kobayashi, RDT (Hiro's Dental Studio, Honolulu, Hawaii). After 2 months of healing, the provisional denture was removed by Dr. Nagata. Tissue around the abutments looked completely healed with no inflammation. Multi-unit abutment-level open-tray impressions were taken along with vertical dimension of occlusion and occlusal records to proceed toward fabrication of the NobelProcera Zirconia Implant Bridge. Mr. Kobayashi designed a bridge spanning from Nos. 3 to 14 using DTX Studio™ Lab software.
TiUltra implants feature a gradual change in topography, becoming moderately rough and porous toward the implant apex, promoting early osseointegration and supporting bone stability. The surface chemistry and ultra-hydrophilicity of the implants are designed to speed up the natural healing process.
Xeal, available on multi-unit abutments, is designed to promote soft-tissue attachment through its smooth, non-porous surface and enhanced surface chemistry. Both TiUltra and Xeal from Nobel Biocare are built on decades of anodization experience.
Made for esthetics, NobelProcera Zirconia Implant Bridge is a premium restoration that is cement-free and provides extensive flexibility. This simplifies the partnership between clinicians and technicians, offering restorative freedom.
Dennis Nagata, DDS
Restorative Dentist,
Private Practice,
Honolulu, Hawaii
James Michino, DMD
Oral and Maxillofacial Surgeon,
Private Practice,
Honolulu, Hawaii
Figures and Images
Fig 1
Fig 2
Fig 3
Fig 4
Fig 5
Fig 6
Fig 7
Fig 8
Fig 9
Fig 10
Fig 11
