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“Handling of the NobelPearl implant is easy, and the outcome is clinically reliable. These are the most important factors for a successful integration of ceramic implants in daily dental practice.”
Patient: 57-year-old, female, no health problems, good oral health
Clinical situation: patient seeking restoration of a healed premolar and molar site following extraction, with a single dehiscence defect.
Surgical solution: NobelPearl™ Tapered dental implant system Ø 4.2 mm x 10 mm
Restorative solution: NobelPearl Abutment Straight Inter-X RP 1 mm with splinted monolithic zirconia crowns
Surgery date: July 2018
Total treatment time: 4 months
Tooth position: 45, 46 (FDI system)
Case courtesy of Dr. Jens Tartsch.
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Initial clinical solution
Healed site following extraction of teeth in positions 45 and 46, 3 months and 1 year before surgery, respectively.
Presurgical cone beam computed tomography showed lateral defect near tooth position 45.
Cleaning of the alveolar bone at tooth position 45 (left).
Suitable bone for implant insertion at tooth position 46, and lateral defect at position 45 (right).
Manual Insertion of NobelPearl Ø 4.2 mm x 10 mm using NobelPearl Implant Driver Inter-X following preparation of both sites (left).
Both implants with partially machined collar were inserted 0.6 mm supracrestal. Primary stability was good (right).
NobelPearl Cover Screw Inter-X in situ (left).
Horizontal augmentation using deproteinized bovine bone (right).
Implants covered with a resorbable collagen membrane (left).
With a two-piece implant system, primary wound closure is possible (right).
Orthopantomogram (OPG) at surgery (left).
3-month post-surgical OPG control, before restorative procedure (right).
Re-entry after 3 months for placement of two NobelPearl Healing Abutment Inter-X, with a small roll flap (left).
Soft tissue two weeks after re-entry (right).
NobelPearl Impression Coping Open Tray Inter-X placed on implants and splinted for precision (left).
NobelPearl Abutment Straight Inter-X placed on the master cast with gingiva mask (right).
Monolithic zirconia crowns placed on the master cast. For stability and because of the augmentation at position 45, the crowns are splinted (left).
Final restoration and abutments before insertion (right).
Healthy and thick keratinized peri-implant mucosa seen following removal of the NobelPearl Healing Abutment Inter-X (left).
Try-in of the NobelPearl abutments (right).
The screw channels were sealed with Teflon, and abutments prepared for cementation (left).
Restorations cemented to the abutments (right).
After cementation, Teflon can be removed through the screw channel (left).
The final restoration was taken out of the mouth for cleaning (right).
For the final installation of the restoration the VICARBO® screw is torqued at 25 Ncm and the screw channel is closed again with Teflon band (left).
Final restoration in situ after screw channel closure and sealing with composite to produce a 100% metal-free screw-retained restoration (right).
X-ray control after delivery of restoration (left).
X-ray control 6 months after loading which shows a stable bone level (center).
1-year follow-up which shows stable bone and even bone gain (right).
Excellent esthetic outcome at 1-year follow-up (left).
Note the healthy soft tissue and natural looking prostheses (right).
Unique metal-free, two-piece ceramic dental implant solution. An evolution of ceramic implants.
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© Nobel Biocare Services AG, 2019. All rights reserved. NobelPearl™ distributed by: Nobel Biocare. Legal manufacturer: Dentalpoint AG, Bodenäckerstrasse 5, 8957 Spreitenbach, Switzerland. VICARBO and ZERAFIL are trademarks of Dentalpoint AG. Nobel Biocare, the Nobel Biocare logotype and all other trademarks are, if nothing else is stated or is evident from the context in a certain case, trademarks of Nobel Biocare. Please refer to nobelbiocare.com/trademarks for more information. Product images are not necessarily to scale. All product images are for illustration purposes only and may not be an exact representation of the product. Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. For prescription use only. Caution: Federal (United States) law restricts this device to sale by or on the order of a licensed clinician, medical professional or physician. See Instructions For Use for full prescribing information, including indications, contraindications, warnings and precautions. Nobel Biocare does not take any liability for any injury or damage to any person or property arising from the use of this clinical case. This clinical case is not intended to recommend any measures, techniques, procedures or products, or give advice, and is not a substitute for medical training or your own clinical judgement as a healthcare professional. Viewers should never disregard professional medical advice or delay seeking medical treatment because of something they have seen in this clinical case. Full procedure is not shown. Certain sequences have been cut.
For more information, please check the Nobel Biocare Instruction for use for NobelPearl™ Tapered Dental Implant System.