CLINICAL CASE

Single tooth restoration with NobelPearl™

Dr. Michael Gahlert, Germany

For me the most important attributes of NobelPearl ceramic implants are the unique carbon-fibre screw for effective abutment anchorage, strong alumina-toughened zirconia material, and the micro-rough surface for predictable osseointegration. Two-piece NobelPearl ceramic implants are the future metal-free alternative for established titanium implants!

Patient: Female, 42 years old, healthy

Clinical situation: Healthy oral conditions, good bone quality. Anodontia tooth 35 and 45 (FDI Scheme) 

Surgical solution: NobelPearl™ single implant

Restorative solution: Prefabricated ceramic abutment retained by VICARBO® Definitive Clinical Screw. The full ceramic crown was cemented with Ketac™ Cem Glass ionomer cement.

Surgery date: August 7, 2018 and October 11, 2018

Tooth position: Tooth gap 25 (FDI Scheme)

Total treatment time: 4 months

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Initial clinical situation

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Healthy soft-tissue condition. The persistent primary tooth 75 is visible under normal bite conditions (left).

Lip line during laughing shows the tooth gap (top right).

Healthy soft-tissue conditions and adequate bone for implantation (bottom right).

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Visible gap 25 and persistent primary teeth 75 and 85, but no other pathologic alterations in the orthopantomogram (OPG).

Surgical procedure

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Good anatomic condition for implant insertion (left).

Prepare implant site using NobelPearl Tapered Twist Drill (right).

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NobelPearl Tapered Drill creates the tapered osteotomy. The diameter is indicated on each tool by color code (yellow for 4.2 mm diameter) (left).

The ridge of the drill stopped at the bone level to ensure the machined collar of the implant (1.6 mm) is placed supracrestal.(right).

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Pick-up of the NobelPearl implant with the implant driver out of the sterile box (left).

Occlusal view after implant placement. PEEK Cover Screw Inter-X for closing the inner part of the implant and protecting thread during the submerged healing (right).

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Side view after implant placement. PEEK Cover Screw Inter-X for closing the inner part of the implant (left).

PG 2 months after implant insertion (right).

Restorative procedure

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Occlusal view after healing period of 3 months. Soft-tissue without any irritation was growing around the implant and on top of the cover screw. 

Incision procedure as first step for prosthetic rehabilitation.

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Changing the PEEK Cover Screw with a PEEK NobelPearl Healing Abutment for soft-tissue contouring (top left).

The PEEK NobelPearl Healing Abutment allows the soft-tissue to form around the implant shoulder and the abutment (bottom left).

Occlusal view of the NobelPearl implant after removal of the Healing Abutment. Tissue around the implant shows no irritation (right).

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Screw-retained NobelPearl Impression Coping Open Tray. Inter-X was screwed to the implant in order to take an impression (left).

Screw-retained NobelPearl ceramic abutment was fixed with a VICARBO® Clinical Screw with a torque of 25 Ncm. Pattern resin was used to position the abutment (right).

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Occlusal view of final restoration. All ceramic crown fixed by Ketac™ Cem Glass ionomer cement on the ceramic abutment (left).

Side view of final restoration (right).

Outcome

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OPG before surgery (left).

OPG 3 months after surgery (right).

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Lip line during smiling shows the tooth gap before surgery (left).

Lip line during smiling shows the natural appearance and the esthetic result at 3 months after surgery (right). 

Related products

NobelPearl™

Natural esthetics and soft tissue harmony

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© Nobel Biocare Services AG, 2023. All rights reserved. Nobel Biocare, the Nobel Biocarelogotype and all other trademarks are, if nothing else is stated or is evident from the context in a certain case, trademarksof Nobel Biocare. Please refer to nobelbiocare.com/trademarks for more information. Product images are not necessarily to scale. Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocaresales office for current product assortment and availability. For prescription use only. Caution: Federal (United States) lawrestricts 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 Biocaredoes 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. Dr. Llobell is a paid consultant for Nobel Biocare. The opinions expressed are those of the doctor. Nobel Biocare is a medical device manufacturer and does not dispense medical advice. Clinicians should use their own professional judgment in treating their patients. Individual patient results may vary.