Winter 2007 - Biomet 3i

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P R O D U C T I N N O V A T I O N S C O N C L U D E DSimplicity For Site PreparationHarold Baumgarten (Left), DMD, Philadelphia, PAAnd Alfred D. Nelson (Right), CDT, AmsterdamDental Laboratory, Philadelphia, PABIOMET 3i can help you make site preparation a simple process with two additions to thePSKT Surgical Kit Series:• The Starter Surgical Kit (PSKT01) is an excellent choice for surgeons who want tobegin placing BIOMET 3i Implants. With this basic kit, you can place either ExternalConnection Implants or Certain ® Internal Connection Implants up to 5mm in diameter.Components may be added to the kit as desired.• For surgeons placing only BIOMET 3i Certain Implants, the Certain Surgical Kit(PSKT35) is available.Additionally, the PSKT Surgical Kit Series offers surgeons:• Color-coded Grommets For Simple Replacement Of Instrumentation• Color-coded Steps For Selecting The Appropriate Instrumentation During Surgery• Dedicated Slots For Implant Packaging That Facilitate Hands-Free Implant PlacementFor more information on how simple site preparation can be with the right surgical kit,please call your local BIOMET 3i Sales Representative.Anything Is Possible Providing You Work As A TeamTeam up with BIOMET 3i for a winning product portfolio for simpler restorations. The newaddition to BIOMET 3i ’s line of Provide ® Abutments is the Provide Temporary Cylinder.Available for single-unit and multi-unit cases, the Provide Temporary Cylinder allowsclinicians to temporize abutments with a provisional crown, providing the patient a fast,aesthetic solution. Made out of PEEK material (Polyetheretherketone), Provide TemporaryCylinders offer strength and longevity of up to 180 days in vivo use.This new option for provisionalization isavailable in two EP ® Profiles of 4.8mm and6.5mm and in one post height of 5.5mm. Thesingle-unit Provide Temporary Cylinder has ananti-rotational flat side.Start to finish, BIOMET 3i helps restorationsstay on track. For easy-to-use components,please call your local BIOMET 3i SalesRepresentative.Patients today demand aesthetic looking toothreplacements with short treatment times. Implantdesigns with enhanced surfaces and provisionalabutments provide clinicians with the ability toperform immediate implant placement andprovisionalization procedures in one appointment.The patient leaves the office with an aesthetic toothcoloredrestoration supported by a dental implant.New surface technology techniques allow thedeposition of individual nanometer-sized crystalsof calcium phosphate onto the proven OSSEOTITE ®Implant Surface. This is called Discrete CrystallineDeposition or DCD . This new NanoTite Implantfeaturing the DCD Surface may enhance outcomeswhen used for indications such as immediateextraction sockets. The speed to the definitiverestorative stage may enhance patient satisfactionand help build referrals from patients or dentists.The following Clinical Case Presentation demonstratesthe combined techniques of tooth extraction withimmediate placement of a NanoTite Certain PREVAIL ®Implant and immediate provisionalization with aPreFormance ® Post in one visit.A 57-year-old female presented with a fracturedall-ceramic crown on tooth #7. A post was in placewith much of the coronal tooth structure missing(Figure 1). Radiographic examination revealed thepresence of a short root with a post that was thickrelative to the diameter of the tooth root (Figure 2).Rather than attempting to remove the large postand risk weakening the remaining root further, thedecision was made to extract the root (Figure 3)and place an implant-supported restoration.Following careful extraction of the tooth root withperiotomes and without raising a soft-tissue flap,a 3.25mm diameter, 13mm length NanoTiteCertain PREVAIL Implant was placed. A PreFormancePost (made from PEEK— polyetheretherketone) with a6mm collar and a 3.4mm restorative seating platformwas placed into the internal interface of the CertainPlease Note: Not all products are available outside the U.S. Please contact your local BIOMET 3i Sales Representative for availability.4
T E C H N O L O G Y I N M O T I O NImmediate Implant Placement And ProvisionalizationWith A NanoTite Certain ® PREVAIL ® Implant And PreFormance ® PostImplant with an audible and tactile click to confirmproper seating. Minor modifications were performedintraorally with a coarse diamond and high-speedhandpiece using copious irrigation. Then, themodified post was removed for minor extraoraladjustments and polishing with a carbide bur andgreen stone on a slow speed handpiece (Figure 4).A polycarbonate crown shell was selected andrelined intraorally over the modified abutment.The abutment and crown were removed and themargins of the crown were refined extraorally. Afterpolishing, the PreFormance Post was placed backinto the implant and the abutment was securedwith an abutment screw tightened to 20Ncm. Thecrown was cemented with temporary cement anda periapical radiograph was taken to ensure therewas no remaining cement in the sulcus (Figure 5).The crown was adjusted out of occlusal andinterproximal contacts following the principlesfor immediate non-occlusal loading (Figure 6).Figure 1Figure 2Figure 7Figure 8After five weeks, the provisional crown wasremoved revealing healthy soft tissue surroundingthe PreFormance Post (Figure 7). The PreFormancePost was then removed and an Osstell Smartpeg was placed into the implant (Figure 8) to measurethe stability of the implant. An ISQ value of 70confirmed that the implant was very stable andcould therefore receive a definitive restoration.Figure 3Figure 9An Impression Coping 3.4mm(D) was placed(Figure 9) and an impression was made with afirm body impression material. An impressionof the opposing arch, a bite registration andshade were sent to the dental laboratory forfabrication of a custom abutment and a Captek crown. The PreFormance Post and provisionalcrown were replaced.Figure 4Figure 10Upon receipt of the definitive restoration from thelaboratory, the provisional crown was removed andthe custom abutment was placed into the internalinterface of the implant (Figure 10) with an audibleand tactile click to ensure complete seating. Aperiapical radiograph was also taken. The customabutment was then secured with a Gold-Tite ®Abutment Screw tightened to 20Ncm. The definitivecrown was tried in, followed by adjustment of theocclusion and interproximal contacts, then cementedwith Temrex ® Cement (Figure 11). The patient’streatment was concluded with a natural looking,implant-supported restoration in nine weeks afterextraction of the failed tooth (Figure 12).Figure 5Figure 11Figure 6Figure 125
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Winter 2007 - Biomet 3i

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