Clinical applications of TiUltra™ implants and Xeal™ abutments in full-arch and individual restorations
Dr. Nader Salib
Patient: 73-year-old, male.
Clinical situation: Currently retired. Previous fixed bridge work failing. Patient is very esthetically conscious and desired a fixed, immediate, graftless solution for his maxilla and replacement of 3 missing mandibular teeth.
Surgical solution: Remaining teeth were extracted and infection cleared. 6 maxillary implants (NobelActive® TiUltra™) and 3 mandibular implants (NobelParallel™ CC TiUltra™) were placed. A temporary fixed prosthesis was delivered the same day.
Restorative solution: A fixed ceramic prosthesis was made for the maxillary arch, seated on Multi-unit Abutments Xeal, and screw retained abutment/crowns were fabricated for the mandibular teeth.
Surgery date: December 1, 2020.
Total treatment time: 4.5 months.
Tooth position: Full maxillary arch; #36, #45, #46.
Maxillary arch: Multiple decayed, non-restorable teeth. Multiple abscesses in bone. Mandibular arch: Multiple missing teeth.
CBCT: Pano view illustrating clinical situation (left).
Photo showing multiple decayed teeth (right).
CBCT: Pano view maxillary arch (left).
Intraoral photos demonstrating oral health (right).
Digital treatment planning with DTX Studio™ Implant software.
CBCT (left).
CBCT and patient’s intraoral scan (center)
Final plan with implants and template shown (right).
Digital treatment planning with DTX Studio Implant software.
CBCT (first image from left).
CBCT and intraoral scan (second image from left).
CBCT, intraoral scan and teeth mockup (second image from right).
Final plan with implants and template shown (first image from right).
Mandibular arch: 3D view of proposed implant placement with DTX Studio Implant software.
3D view: All implants planned for screw-retained restorations with access through central fossa.
Mandibular arch: Sagittal view of proposed implant placement (NobelParallel CC TiUltra).
#46 (left), #45 (center), #36 (right).
Planning to execution.
Maxillary and mandibular templates shown respectively (left).
PO Pano X-ray demonstrating implant placement (right).
Maxillary ridge reduction and implant placement.
Mandibular implant placement. Surgical placement of NobelParallel CC TiUltra implant.
Mandibular implant evaluation.
Intraoperative photo of NobelParallel CC TiUltra implant placement (left).
4-month PO check – maxillary treatment (center and right).
4-month PO check – maxillary treatment.
Intraoperative: Xeal Multi-unit Abutment placement (left).
4-month PO evaluation and integration check demonstrating gingival health around Multi-unit Abutments with Xeal surface (right).
4-month PO check – maxillary treatment.
Before: Preoperative photo demonstrating gingival health (left).
After: 4-month PO evaluation and integration check demonstrating healthy well healed soft tissue around the Multi-unit Abutments with Xeal surface (right).
Temporary restorative work performed in collaboration with Dr. Dave Eggleston, prosthodontist.
Before treatment (left).
After treatment (right).
Final restorative work performed in collaboration with Dr. Dave Eggleston, prosthodontist.
Before treatment (left).
After treatment (right).
-
NobelActive®An implant like no other.
-
NobelParallel™ Conical ConnectionProven performance, enhanced esthetics.
-
Multi-unit AbutmentKey to the original All-on-4® treatment concept.
-
Xeal™ and TiUltra™Welcome to the Mucointegration™ era. Surface chemistry cells can’t resist.
Share this clinical case
Sign up for our blog update
Get the latest clinical cases, industry news, product information and more.
© Nobel Biocare Services AG, 2021. All rights reserved. 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. Please contact the local Nobel Biocare sales office for current product assortment and availability. Caution: Federal (United States) law restricts this device to sale by or on the order of a dentist 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. Dr. Salib 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.