PIB (Procera® Implant Bridge)

A PIB restoration also falls in to the fixed detachable category and combines the esthetics and durability of a porcelain fused to metal bridge, with the serviceability of a hybrid denture. Implant placement in the mesio distal plane is not very critical and placement of the implants in the facial lingual plane is less critical than for a hybrid denture. Depending on the extent of the desired restoration a minimum of five implants should be placed. This type of restoration lends itself well if the patient presents with a considerable amount of bone loss.

Almost any implant brand can be restored in this fashion. A one piece frame is created either with the wax and cast technique or through CAD CAM technology. If CAD CAM technology is employed to manufacture the metal substructure a verification index needs to be made and passive fit confirmed in the patients mouth. The frame is designed as if individual teeth had been prepped for traditional crown and bridge restorations. The frames gingival portion is covered either with bake on pink porcelain or pink acrylic and individual crowns are cemented over the simulated crown preps of the frame. The restorative material for the individual crowns can be porcelain fused to metal restorations or any zirconia based material.

At the time of delivery the framework is screwed in to place and the individual crowns are cemented on to their respective simulated preparation. In case a porcelain fracture does occur on one of the crowns, only the affected crown needs to be remade without having to remove the whole restoration. The failed crown is simply cut off and an impression is taken over the simulated prep. Tutorial