Immediate implant placement and function in the anterior region (cement-retained) – Hands-on presentation Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. 

Drilling and GBR/GTR training model with indications Extractable tooth – immediate implant Socket with buccal defect – GBR +/- immediate implant Sinus with membrane – Sinus lift Thread Narrow healed site – 3.0 implant placement Narrow ridge – GBR Healed sites – Regular platform implant placement Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. 

Drilling and GBR/GTR training model with indications Extractable tooth – immediate implant Socket with buccal defect – GBR +/- immediate implant Sinus with membrane – Sinus lift Thread Narrow healed site – 3.0 implant placement Narrow ridge – GBR Healed sites – Regular platform implant placement Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. 

Materials overview Drilling and GBR/GTR training model Scalpel handle and 15c blade Periotome kit Forceps for upper incisors Lucas curette Periodontal probe Dummy NobelActive® Int RP Osseocare™ drill motor and hand-piece NobelActive® Surgery Training Kit NobelActive® Surgical Driver Example surgical kit (Hu Friedy® or Aesculap®) Dummy NobelActive® Int RP 4.3 x 13 mm Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. 

Materials overview Healing abutment (ex: Ø3.6x5 mm) Demo hands-on bone powder and saline solution Bone plugger Prosthetic kit Handle for Protection Analogs and Protection Analog Immediate Temporary Abutment and Plastic Coping Polycarbonate crowns Composite resin and composite resin spatula Dental curing light Tungsten carbide cone bur and rubber polishing bur Micromotor Demo hands-on bone powder Handle for protection analog with protection analog Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. 

Steps Atraumatic tooth extraction Verification of integrity of buccal bone wall Removal of granulation tissue NobelActive® drill protocol Implant placement Grafting of buccal gap Temporary crown fabrication

Speaker Slide Speaker Slide For the purpose of the clinical procedure covered in this presentation, a tooth has been added in position of the left central incisor to simulate a single edentulous space. However, please note that The Drilling and GBR/GTR training model originally presents an edentulous space in the position of left central incisor and an extractable tooth in the position of the right central incisor. Speaker Slide Training model with the left central incisor in place Original Drilling and GBR/GTR training model

1. Atraumatic tooth extraction Dissection of supracrestal fibers Perform careful luxation of tooth with the use of a periotome With 15c blade and handle, dissect supracrestal fibers circumferentially Frontal view of model. The tooth to be extracted is the right central incisor

1. Atraumatic tooth extraction Tooth extraction with forceps Perform careful extraction with forceps Frontal view of model after tooth extraction

2. Verification of integrity of buccal bone wall Occlusal view Perform apicocoronal sounding of the buccal bone wall to verify its anatomy

3. Removal of granulation tissue With the use of a curette, perform thorough removal of all remaining tissue in the socket

4. NobelActive® drill protocol Continue with Twist Step Drill diameter Ø 2.4/2.8 mm Continue with Twist Drill with tip Ø 2 mm Perform precision drilling on the palatal wall of the socket Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. 

Speaker Slide Speaker Slide Enhancement of this section This section could be enhanced by adding the following module: NobelActive® drill protocol Speaker Slide

5. Implant placement Unpacking of implant Packed dummy implant 1 2 3 4 Packed dummy implant Remove clear plastic cover and gray cap Extract metallic cylinder 4, 5, 6. With the use of the Implant Driver, carefully extract the implant from the cylinder 6 5 Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. 

5. Implant placement With the use of the Nobel Biocare Surgical Driver, adjust implant position during insertion for optimal prosthetic orientation Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. 

5. Implant placement Tightening with manual torque wrench Occlusal view of implant in place. Note the palatal position and the direction of the implant Tighten to a maximum of 70 Ncm with a manual torque wrench Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. 

Place a Ø3.6mm Healing Abutment with Screwdriver Manual Unigrip™ 6. Grafting of buccal gap Placement of healing abutment Place a Ø3.6mm Healing Abutment with Screwdriver Manual Unigrip™ Occlusal view with Healing Abutment in place Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. 

6. Grafting of buccal gap Insertion of biomaterial With the use of a bone plugger, fill the buccal gap with demo hands-on bone powder (previously hydrated in saline solution) up to the implant platform but not coronal to it Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. 

7. Temporary crown fabrication Placement of provisional temporary abutment View of Immediate Temporary Abutment, plastic coping and screw driver With use of a Machine Multi-Unit Driver and torque wrench, tighten Immediate Temporary Abutment to 35Ncm Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. 

7. Temporary crown fabrication Try-in of acrylic shell Select a polycarbonate crown and place a small amount of composite resin inside Place plastic coping onto abutment Place crown over plastic coping and light cure composite resin

7. Temporary crown fabrication Try-in of acrylic shell Plastic coping should come out inside temporary crown. Note the remaining gap around it Remove temporary crown from Immediate Temporary Abutment Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. 

7. Temporary crown fabrication Shaping of emergence profile with composite resin Fill the gap with composite resin and a spatula, shaping the emergence profile Light cure composite resin Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. 

7. Temporary crown fabrication Surface polishing Remove excess with hand-piece and tungsten carbide cone bur Polish surface with rubber polishing bur View of temporary crown and emergence profile

7. Temporary crown fabrication Insertion of temporary crown Add a small quantity of temporary cement inside plastic coping, place over Immediate Temporary Abutment and wait for setting to occur View of temporary crown in place Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability.