protesis total superior

New technologies for complete edentulous with O.I. implants�

alejandro kleinman

associate professor implant dentistry

loma linda university

FIXED COMPLETE DENTURE

Traditional FC traditional FCD (hybbrid)

a new method of producing frameworks for implant supported prostheses

CAD/CAM technology

Procera® Implant Bridge

Applications Procera System

Procera AllCeram

Procera AllTitan

Procera AllZircon

Procera Custom Abutment

Single Crowns

Veneers Fixed Prosthesis

Single Crowns

Fixed Partial Denture Fixed Complete Denture

Copings for Single Units

Fixed prosthesis

Titanium

Zirconia AKS

CAD/CAM FCD

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Prosthesis misfit and marginal bone loss in edentulous implant patients Jemt T, Book K.

Int J Oral Maxillofac Implants 1996;11:620-5

Stresses introduced at the time of prostheses placement may remain after several years of functioning

Strategies to achieve fit in implant prosthodontics: a review of the literarture Wee AG. et al.

Int J Oral Prosthodont 1999 Mar-Apr;12(2):167-78

Multiple factors preclude that the concept of “passive fit” can be achieved in implant prosthodontics,even with the use of advanced strategies

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Parel 1989 Thoupos 1995 Rubeling 1999 Wat 2000 Iglesia 2001 Jemt 2002 Luk 2004

soldering, modified casting techniques, “cast to” technique, spark-erosion, lasser welding, cementation, double casting technique have been advocate to minimize the problem

The single-piece milled titanium implant bridge Parel SM.

Dent Today, 2003 Feb;22(2):90-9

this new technology offers the possibility of a consistently excellent passive fit compare with conventional casting techniques

CAD/CAM FCD

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Fit of implant frameworks: an in vitro comparision between two fabrication techniques Takahashi T, Gunne J.

J Prsthet Dent Today, 2003 Mar;89(3):2569-60

19 frameworks, 14 Procera, 5 cast gold-alloy

A total of 95 implants, 70 in the Procera and 25 cast frameworks were evaluated

The total mean value for Procera frameworks was 26.9 micr. (SD 9.3), and for conventional was 46.8 micr. (8.8)

CAD/CAM FCD

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ü precision fit

ü biocompatible material ü strong - One piece

ü high, uniform quality

Advantages

CAD/CAM FCD

Procera® Implant Bridge

Ti-Porcelain Wrap aroundnd Traditional

acrylic Individualidual

Procera Crowns

Ti-Porcelainrcelain

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Ti-Porcelain all Zi Procera crowns

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PIB wrap-around

ü profitable ü faster lab procedure ü lower framework price

ü shorter turnaround time (3 days) ü precision-fit ü biocompatible

why wrap-around?

Procera® Implant Bridge

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PIB wrap-around

what is wrap-around? § Lab Procedure ü Standard verified soft

tissue master model

Procera® Implant Bridge

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PIB wrap-around

what is wrap-around? § Lab Procedure ü Standard framework fabrication of resin framework ü Designed as a bar with cylinders

Procera® Implant Bridge

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PIB wrap-around

what is wrap-around?

Procera® Implant Bridge

AKS 8 years

Procera® Implant Bridge

PIB wrap-around

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Procera® Implant Bridge

PIB wrap-around

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Procera® Implant Bridge

PIB wrap-around

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Procera® Implant Bridge

PIB wrap-around

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Procera® Implant Bridge

PIB wrap-around

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Procera® Implant Bridge

PIB wrap-around

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Procera® Implant Bridge

PIB wrap-around

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Procera® Implant Bridge

PIB wrap-around

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Procera® Implant Bridge

PIB wrap-around

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Procera® Implant Bridge

PIB wrap-around

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Procera® Implant Bridge

PIB wrap-around

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Procera® Implant Bridge

PIB wrap-around

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Traditional PIB

Procera® Implant Bridge

Procera® Implant Bridge Ti PIB

Procera® Implant Bridge Ti PIB

Procera® Implant Bridge

Ti PIB

Procera® Implant Bridge

Ti PIB

Procera® Implant Bridge Ti PIB

Procera® Implant Bridge � Ti PIB

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Procera® Implant Bridge

PIB all ceramic crowns

Pract Proced Aesthet Dent 2008;20(3):185-191

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PIB all ceramic crowns

Procera® Implant Bridge

Pract Proced Aesthet Dent 2008;20(3):185-191

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Procera® Implant Bridge

PIB all ceramic crowns

Pract Proced Aesthet Dent 2008;20(3):185-191

Procera® Implant Bridge

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PIB all ceramic crowns

Pract Proced Aesthet Dent 2008;20(3):185-191

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Procera® Implant Bridge PIB all ceramic crowns

Pract Proced Aesthet Dent 2008;20(3):185-191

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Procera® Implant Bridge PIB all ceramic crowns

Pract Proced Aesthet Dent 2008;20(3):185-191

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Procera® Implant Bridge PIB all ceramic crowns

Pract Proced Aesthet Dent 2008;20(3):185-191

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PIB all ceramic crowns

Procera® Implant Bridge

Pract Proced Aesthet Dent 2008;20(3):185-191

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Procera® Implant Bridge PIB all ceramic crowns

Pract Proced Aesthet Dent 2008;20(3):185-191

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Procera® Implant Bridge PIB all ceramic crowns

Pract Proced Aesthet Dent 2008;20(3):185-191

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PIB all ceramic crowns

Procera® Implant Bridge

Pract Proced Aesthet Dent 2008;20(3):185-191

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Procera® Implant Bridge PIB all ceramic crowns

Pract Proced Aesthet Dent 2008;20(3):185-191

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PIB all ceramic crowns

Procera® Implant Bridge

Pract Proced Aesthet Dent 2008;20(3):185-191

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PIB all ceramic crowns

Procera® Implant Bridge

Pract Proced Aesthet Dent 2008;20(3):185-191

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PIB all ceramic crowns

Procera® Implant Bridge

Pract Proced Aesthet Dent 2008;20(3):185-191

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Procera® Implant Bridge PIB all ceramic crowns

Pract Proced Aesthet Dent 2008;20(3):185-191

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Procera® Implant Bridge PIB all ceramic crowns

Pract Proced Aesthet Dent 2008;20(3):185-191

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PIB all ceramic crowns

Procera® Implant Bridge

Pract Proced Aesthet Dent 2008;20(3):185-191

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PIB all ceramic crowns

Procera® Implant Bridge

Pract Proced Aesthet Dent 2008;20(3):185-191

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Procera® Implant Bridge

PIB all ceramic crowns

Pract Proced Aesthet Dent 2008;20(3):185-191

Procera® Implant Bridge �

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PIB all zirconio

One-piece

Procera® Implant Bridge �

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PIB all zirconio

One-piece

Procera® Implant Bridge �

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PIB all zirconio

One-piece

Verification jig

Procera® Implant Bridge �

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PIB all zirconio

One-piece

Verification jig

Procera® Implant Bridge �

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PIB all zirconio

One-piece

Verification jig

Procera® Implant Bridge �

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PIB all zirconio

One-piece

Resin superstructure

Procera® Implant Bridge �

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PIB all zirconio

One-piece

Silicone guide

Procera® Implant Bridge �

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PIB all zirconio

One-piece

Zi superstructure

Procera® Implant Bridge �

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PIB all zirconio

One-piece

Zi superstructure

Procera® Implant Bridge �

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PIB all zirconio

One-piece

Zi superstructure try-in

Procera® Implant Bridge �

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PIB all zirconio

One-piece

Final PIB

Procera® Implant Bridge �

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PIB all zirconio

One-piece

Final PIB

Procera® Implant Bridge �

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PIB all zirconio

One-piece

Final PIB

Procera® Implant Bridge �

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PIB all zirconio

One-piece

Final PIB

CAM/3i �fixed complete denture

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CAM/3i �fixed complete denture

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CAM/3i �fixed complete denture

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CAM/3i �fixed complete denture

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CAM/3i �fixed complete denture

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thank you for your attention akleinman@llu.edu