PART SELECTION PIB (Procera® Implant Bridge)
Intermediary abutment
The Procera implant bridge name would make it appear only Nobel Biocare
implants can be restored in this way and historically Nobel was the first company
to promote this style of restoration, almost any implant system can be restored in this way.
Regardless of the production method (wax up or CAD-CAM), if the implants are set very deep (more than 2mm) under the tissue it
becomes necessary to place intermediary abutments specially designed for
screw retained restorations. These abutments are already placed by the
restorative dentist and impressed with special impression copings or
the laboratory will select appropriate collar height abutments for
screw retained restorations. The UCLAs as well as the analogs for
screw retained abutments are designed differently than UCLAs that
screw directly to the implant or fixture level analogs and are not
interchangeable.
Non indexing UCLAs
A PIB frame has to be waxed and cast with non engaging UCLAs.
All plastic
or gold plastic combinations are utilized for this type of restoration.
All plastic parts are considerably cheaper but sacrifice the precision fit of
gold plastic combination UCLAs. Choose appropriate platform diameter
UCLAs from the implant manufacturer or clone parts.
Implant placement is critical in in the facial-lingual plane because the screw
access holes should come through the center of the occlusal surface for
posterior teeth and the lingual for anterior teeth. Implant placement in the
mesio-distal plane is less critical. Vertical clearance needs to be carefully
evaluated to leave enough room for the single cementable crowns.
Verification index
Modern CAD CAM technology enables the manufacture of titanium frame works
machined from one piece titanium disks without the purchase of UCLA abutments or
metal cost. As with a waxed frame work, the use of intermediary abutments may be
indicated. The abutment to implant interface is machined in a non engaging
fashion. A verification index
made with non engaging metal temporary abutments is highly recommended
because it is almost impossible to laser weld a titanium frame. The verification
index
needs to be tried in the patients mouth to ensure the working model
is accurate.
Laboratories with Procera® capabilities are able to copy
mill a bar design for Replace®, Active®, Branemark®
and a few select competitor implant brands. Process the mock up
with non engaging metal temporary abutments. Scan master
model and prototype mock up with a Forte scanner and transmit
data to Nobel Biocare.