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Strong, tight fit and proven implant body

by: Alessandro Pozzi

Professor Alessandro Pozzi reports from his state-of-the-art private practice in Rome, where he has begun to use the new NobelReplace Conical Connection implant in a variety of cases.

To say the least, being introduced to the NobelReplace Conical Connection (CC) was a valuable experience. The NobelReplace CC has been developed to optimize the biomechanical, biological and clinical benefits of a widely used basic design. It demonstrates a new implant concept that merges the biomechanical and prosthetic advantages of a meticulously engineered third-generation internal connection with practical platform shifting, now incorporated into the well-proven implant body of the Nobel Replace Tapered. From all the experience I have gathered to date, the NobelReplace CC is a versatile, easy-to-use implant, which performs well in soft and hard bone alike.

In recent years, greater biomechanical demands have been placed on restorative solutions as the use of implants for single-tooth replacement in posterior regions of the mouth has become more widespread and new restorative designs based on axial and tilted implants have been introduced. These restorations require a stronger connection in order to withstand higher torque, lateral loading stress and to minimize forces on the retaining screw and prosthetic components.

In order to improve the biomechanical characteristics of the complete restoration, the internal connection concept was introduced to the world of implant design; but in its first iterations, the internal connection compromised the strength of both the connection and the implant itself.

Finite element analysis reveals that stresses resulting from functional loading are concentrated in the neck area of the implant. Up until now, internal connections have exacerbated this stress due to the weakness of implant walls and deficient load distribution to the bone, resulting from the designs themselves. The wall thickness of the implant in the critical stress zones has to be able to resist material fatigue and breakage under prolonged use while neither sacrificeing “osseointegratable” threads at the neck nor reducing the diameter of the connecting screw.

In the design of the NobelReplace CC implant, the depth of the connection has been optimized to obtain all the biomechanical and clinical benefits associated with an internal connection without substantially weakening the implant by reducing the thickness of its walls. The anti-rotational design of the conical connection minimizes torsion forces and allows the application of high insertion torques on the implant without incurring distortion.

Prosthetics

The conical connection design facilitates the attachment of prosthetic components. From the very first case, comfortable, easy handling becomes the norm, giving the clinician a sense of confidence and security as each connection is made. The design can be characterized as a sliding connection, which allows for contact with the surface of the prosthetic components, improving final placement and minimizing the risk of damage to the connecting surfaces. In fact, NobelReplace’s conical connection is so precise that proper seating of the prosthetic components does not even require radiographic verification (thus concurrently reducing total radiation exposure for the patient).

From the taking of the impression to the final delivery of the definitive restoration, one of the main causes of poor prosthetic precision is the misplacement of the prosthetic components in the implant connection. NobelReplace CC virtually eliminates this problem. The internal conical connection with hexagonal interlocking offers a tight seal, secure positioning of all the prosthetic components, and tactile feedback. These features help to improve the work flow of both the general practitioner and implant specialist alike. They serve to prevent mistakes, speed-up procedures and improve patient comfort.

Platform shifting

In addition to the conical connection, NobelReplace CC also adds platform shifting to the popular NobelReplace Tapered implant. By equipping the clinically well-proven implant body of the NobelReplace system with platform shifting and a tight prosthetic connection, the clinician has a better chance than ever before to secure healthy soft tissue around the implant in a predictable way.

The tight conical connection and platform shifting both are intended to improve the volume and health of gingival tissue. The tight conical connection is designed to preserve the marginal bone by minimizing micro-movements and eventual micro-leakage, leading to enhanced pink esthetics.

Without any soft tissue grafting procedures, the clinician can now produce a natural-looking restoration accompanied by healthy, soft tissue architecture. Given today’s high esthetic demands, NobelReplace CC is sure to improve not only patient comfort, but satisfaction as well. The bottom line: Quick and predictable implant treatment with long-term functional and esthetic stability.

Restorative flexibility

The new NobelReplace implants offer great restorative flexibility for the treatment of a wide variety of clinical indications, ranging from simple single-tooth restoration in the posterior—via highly challenging anterior tooth replacement—to advanced full-arch restoration, based on both axial and tilted-implant designs.

NobelReplace CC is suitable for use with standard abutments and customized CAD/CAM NobelProcera Abutments. The clinician is provided with a wide range of prosthetic solutions to make it easier to meet virtually any restorative challenge. The tapered configuration facilitates the achievement of primary stability in post-extraction sockets, in poor quality bone, as well as in anatomically restricted areas.

The instruments are very simple and can be employed according to the well-proven and easy-to-use NobelReplace Tapered drilling protocol.

Experienced NobelReplace Tapered and NobelActive users will feel familiar with the color-coded surgical and prosthetic kits, which flattens the learning curve. Appropriate for guided surgery, NobelReplace CC is fully compatible with this minimally invasive clinical approach.

The advent of NobelReplace CC is fully in line with my conviction that modern bone-anchored treatment should be characterized by a minimally invasive surgical approach, high biocompatible prosthetic accuracy and unparalleled patient comfort.

This implant makes it easier to restore the function, the soft tissue framework and the natural look of a healthy mouth.

The result of high-tech innovation springing from an evidence-based R&D culture, the new NobelReplace CC has become my implant of choice. NobelReplace CC is an implant system that meets the demands and requirements of both clinician and patient alike.

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