1. Restorations for edentulous patients
Zurich, 2016
GMT45577 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. 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.

2. Key messages
Edentulous or partially edentulous patients can benefit from our versatile portfolio of implant bridges and implant bars.
Depending on the indication and planned treatment, both implant bridges and implant bars can offer the optimal restoration.
Related material
Brochure: GMT Rehabilitation concepts for edentulous patients. Pretreatment guidelines and considerations for an improved quality of life.
T&E presentation - GMT NobelProcera® restorations for edentulous cases
Study Cub – GMT XXXX Restoring an edentulous case with Locator® R-Tx abutments
Grip stock material to use
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3. Agenda Welcome and introduction Business opportunity
Clinical and restorative challenges
Overview of full-arch restorations
Some selection criteria
Ordering full-arch restoration

4. What makes Nobel Biocare’s multiple implant restoration offering…
versatile
Restoration types for all indications
highly efficient
Production process, CAD workflow, dental lab workflow
flexible
Design efficiently solutions for many edentulous indications
such an optimized fit
Milling precision, systematic quality control, medical device
biocompatible and strong
Surgical grade titanium and Zirconia monoblocs
optimized for supporting soft tissue
High polishing quality on tissue surfaces
easy to trace and long-lasting support
Access to the original design even after several years

5. Agenda Welcome and introduction Business opportunity
Clinical and restorative challenges
Overview of full-arch restorations
Some selection criteria
Ordering full-arch restoration

6. Multiple implant restorations: Opportunity for practices and labs
Growing number of patients
All patients with two or more implants.
6-10% of the world’s population is edentulous.
More than 40 million people in the Western world and 250 million in Asia are edentulous. Many more are partially edentulous.
Increased awareness
It is well-documented that dental implants improve patients’ quality of life.2
Growing awareness that edentulous patients seem to be at risk from multiple systematic disorders if left untreated.3
Source: WHO and Nobel Biocare (2013) for more details. //2. Curtis et al (2008) The use of dental implants to improve quality of life for edentulous patients. J Calif Dent Assoc Apr;36(4): // 3. Pavel et al. (2012) Dental implants and improvement of oral health-related quality of life.. Community Dent Oral Epidemiol Feb;40 Suppl 1:65-70

7. Opportunity with Nobel Biocare for practices and labs
Nobel Biocare’s acknowledged expertise with 42%* global market share in CAD/CAM implant bar market.
Conversion from Isus bar in 2008 to 85% NobelProcera in 2013.
Growth from $120,000 (2008) to $900,000 (2013).
New business from $0 (2010) to 80’000 (2013).
Currently produces 260 IBO / year.
*: iData (2014) US and European market for overdentures, iData Research Inc., October 2014, pp.6

8. CAD/CAM multiple implant restorations: Opportunity for labs
Traditional Process
Dentist
Dental Laboratory
Veneering
Model
Wax-Up
Finishing
Investing
Casting
Preparation
Impression
NobelProcera Production
Courier
Internet
transfer
Scanning of model
CAD
CAD/CAM Process
New technology efficiency
Efficient CAD/CAM workflow to receive multiple implant restorations.
Convenient access to CAD/CAM restorations through lab service or in-lab scan & design for full control.
Compared to a conventional workflow, with a CAD/CAM system, the lab can focus more on planning with his customer, designing and finalizing the case.

9. Agenda Welcome and introduction Business opportunity
Clinical and restorative challenges
Some selection criteria
Overview of full-arch restorations
Ordering full-arch restoration

10. Clinical and restorative challenges - Consequences of bone loss
Bone loss affects the esthetic appearance
Bone loss decreases masticatory abilities
Increased bone loss can lead to the irritation of mandibular nerve
Likely to require a restoration which maintains soft and hard tissue as well as teeth
Long-term edentulism leads to false posture, which sometimes leads to the need to restore the occlusal plane 3 3 2 1 4
Hard tissue
Occlusal height
Mandibluar nerve
Soft tissue
Impact of bone resorption levels
Maintenance of hard tissue with implant treatment – loss of tissue / atrophy without implants
With advanced atrophy denture might put pressure on mandibluar nerve
Occlusal height: With advanced atrophy prosthetic reconstruction becomes more demanding – compensation of bone loss / height with prosthetic reconstruction needed
Extra-oral physiognomy in edentulous patients (e.g. lack of tissue support)

11. Clinical and restorative challenges - Bone resorption patterns
Development of bone resorption (A-E) in the maxilla and mandible after tooth loss registered according to Lekholm & Zarb.1
Also decreasing besides the quantity of bone is the quality of bone, meaning the bone density starts to change as well.1
Reference: 1. Lekholm, U. and G.A. Zarb, Patient selection and preparation. In tissue-integrated prosthesis: Osseointegration in clinical dentistry., ed. P.-I. Brånemark, G.A. Zarb, and T. Albreksson. 1985, Chicago: Quintessence Publ Co
Various stages (A-E) of atrophy of the maxilla and mandible after tooth lossIs registered according to Lekholm & Zarb(ref)
A = Most of the alveolar ridge is present
B = Moderate residual ridge resorption has occurred
C = Advanced residual ridge resorption has occurred and only basal bone remains
D = Some resorption of the basal bone has started
E = Extreme resorption of the basal bone has taken place

12. Clinical and restorative challenges - Bone resorption pattern
Case with limited resorption
Case with moderate maxilla bone resorption
Case with extreme maxilla bone resorption

13. Clinical and restorative challenges
- Bone resorption = determining factor
Fixed restoration for case with limited space
Fixed/Fixed-removable restorations for compensation
High vertical spread
High sagittal spread

14. Other factors influencing selection of fixed vs
Other factors influencing selection of fixed vs. fixed-removable implant restoration
Medical status
Previous illnesses (e.g. cancer)
Diabetes (if not controlled)
Medication
Smoker
Ability to maintain oral hygiene/compliance
Financial situation
Complete treatment cost incl. surgery and restoration (maintenance costs)
Insurance reimbursement conditions
Patient contribution

15. Agenda Welcome and introduction Business opportunity
Clinical and restorative challenges
Overview of full-arch restorations
Some selection criteria
Ordering full-arch restoration

16. Implant Bar Overdenture
Treatment options for every clinical situation
NEW
Implant Bridge
Implant Bar Overdenture
Abutments
Fixed removable
Dolder Bar
Hader Bar
Paris Bar
Round Bar
Free Form Milled Bar
Fixed
Fixed
Implant-retained
Hybrid
Wrap-around Bar
NobelProcera
Implant Bridge Zirconia
NobelProcera
Implant Bridge Titanium
Montreal Bar
Locator R-Tx
abutment
Montreal Bar with metallic lingual
Ball
abutment
From left to right
Patient with no bone loss  implant bridge or overdenture on locators
Patient with limited bone loss  PIB with gingival mask
Patient with advanced bone loss  implant bridge or fixed-removable implant bar (All-on-4)
Patinet with severe bone loss  implant bar (All-on-4)
Locator® R-Tx is a registered trademark of Zest IP Holdings, LLC

17. Abutment edentulous solutions
NEW
Ball abutment
Locator R-Tx
Overdenture with attachments helps to replace soft and hard tissues (mild and moderate bone resorption only)
Reduces the need for extensive vertical bone augmentation
Replace of both hard & soft tissue hiding the transition zone
Locator® R-Tx is a registered trademark of Zest IP Holdings, LLC

18. NobelProcera ® edentulous solutions - broad portfolio to treat a wide range of patient needs
Fixed
Fixed-removable
Replacement of white and pink tissues (teeth, teeth & tissue or teeth, tissue and bone)
Choice Zr or Ti depending on patients budgetary needs
Restorative options with different design supporting material e.g. veneering of implant bridge, acrylic of overdenture
Replacement of white and pink tissue (teeth & tissue or teeth, tissue and bone)
Reduces the need for extensive vertical bone augmentation
Replacement of both hard & soft tissue hiding the transition zone

19. NobelProcera ® edentulous solutions - broad portfolio to treat a wide range of patient needs
Fixed
Fixed-removable
Maximizing esthetic results through use of Zirconia
Excellent restorative compatibility with the All-on-4 treatment concept
Easier maintenance - removable overdenture is easier for patient to clean than fixed screw retained restoration
Allows long-term adjustments to be made to support oral tissues
Routine maintenance needed e.g. replacement of attachment
Excellent restorative compatibility with the All-on-4 treatment concept

20. Fixed implant restorations
- Wrap around vs Titanium exposed to soft tissue
Titanium base in contact with oral mucosa
High-polished titanium base supports easy hygiene by the patient and reduces the risk of plaque accumulation on the framework.
Fixed implant bars can be either fully wrapped in acrylic or have a high-shine polished titanium surface in contact with the oral mucosa.
In case of tissue recession, pink acrylic can be easily added to the fixed implant bar fully wrapped in acrylic.
Acrylic denture wraps around the implant bar 20

21. Fixed-removable implant restorations - Attachments
Features & benefits
All attachments are screwed into the bar and can be easily replaced if needed.
Different retention/separating forces are available as metal or nylon inserts.
Metal attachment don’t wear as fast as plastic attachments.
Plastic attachments offer multiple specific retention forces.

22. Fixed-removable implant restorations - Attachments
Rigid non-resilient attachments (metal clips, gold riders)
Limited movement occurs between the attachment and the bar.1
The implant receives 100 % of the chewing force, providing no relief to the supporting implants.1
Restricted vertical resilient attachments (plastic attachments)
This type of attachment provides 5-10 % load relief to the supporting implants.1
The prosthesis can move up and down with no lateral, tipping or rotary movement.1
Source: 1. Hamid R. et al (2007) Clinical and laboratory manual of implant overdentures, Blackwell Munksgaard, pp

23. NobelProcera® Patient and Guarantee Card
Patient will receive this card with the implant bar overdenture
The card gives information on:
File number of restoration
Dentist
Dental laboratory
Duration of warranty 23

24. NobelProcera® Authenticity labels and extensive warranty
Benefits
Proof of genuine NobelProcera product, verify under
Long-term traceability
Available for all materials
Full coverage
Warranty extends to non-Nobel Biocare implant systems (implant and prosthetic components replacement).

25. Agenda Welcome and introduction Business opportunity
Clinical and restorative challenges
Some selection criteria
Overview of full-arch restorations
Ordering full-arch restoration

26. Resorption patterns Replacement of teeth
Limited interocclusal space allows implant bridges and fixed restorations
For optimized esthetic result the replacement of teeth, soft tissue and hard tissue is needed
Replacement of soft and hard tissue

27. Clinical situation 1 No tissue resorption
Replacement required:
Teeth
Available restorations:
Implant Bridge (Zirconia, Titanium)

28. Clinical situation 2 Mild tissue resorption
NEW
Replacement required:
Teeth
Minimal hard and soft tissue
Available restorations:
Implant Bridge
Hybrid
Wrap-around Bar
Montreal Bar
Overdenture with ball/Locator R-Tx
Locator® R-Tx is a registered trademark of Zest IP Holdings, LLC

29. Clinical situation 3 Moderate tissue resorption
NEW
Replacement required:
Teeth
Hard and soft tissue
Available restorations:
Implant Bridge
CAD/CAM Free Form Milled Bar
Paris Bar
Dolder Bar
Hader Bar
Montreal Bar
Wrap-around Bar
Hybrid
Overdenture with ball/Locator R-Tx
Locator® R-Tx is a registered trademark of Zest IP Holdings, LLC

30. Clinical situation 4 Advanced tissue resorption
Replacement required:
Teeth
Hard and soft tissue
Available restorations:
Implant Bridge
CAD/CAM Free Form Milled Bar
Paris Bar
Dolder Bar
Hader Bar
Hybrid

31. Costs/benefit considerations
Costs can vary on patient and clinician preferences
Costs/benefit considerations
NEW
Surgical
Prosthetics
Treatment cost
- NobelZygoma straight or angled
- NobelSpeedy
NobelProcera ® Implant Bridge
NobelProcera ® Implant Bar
Overdenture
Any Nobel Biocare Implant System
NobelProcera ® Implant Bridge
NobelProcera ® Implant Bar
Overdenture
Any Nobel Biocare Implant System, All-on-4 ® treatment concept
NobelProcera ® Implant Bridge
NobelProcera ® Implant Bar
Overdenture
Any Nobel Biocare Implant System
NobelProcera ® Implant Bar
Overdenture
Any Nobel Biocare Implant System
Ball abutmemnts
Locator ® R-Tx Abutments
Benefit
Locator® is a registered trademark of Zest Anchors Inc.

32. Hygiene requirements (patient)
Patient ability to maintain hygiene
Fixed implant bar or implant bridge
Bar structure with mucosa contact
Bar structure without mucosa contact
Implant-retained denture
Complexity of hygiene

33. Maintenance requirements (clinician)
Time for maintenance
Fixed-removable bar overdenture. with riders e.g. nylon clip
Fixed implant bar
or Titanium implant bridge
Fixed-removable bar overdenture with attachments e.g. Locators®
Zirconia implant bridge
Zirconia implant bridge rarely require maintenance, however in case of porcelain chipping, the framework will require costly repairs. These repairs mostly need to be done by the dental technician and can’t be done chairside.
Titanium implant bridge or fixed implant bar rarely require maintenance, however in case of composite/acrylic fracture, the repair can be done chairside
Fixed-removables have a higher likelihood of repair required, due to the need for need for the replacement of the female component in the overdenture e.g. clips. Repair can be done chairside or depending on complexity by the dental technician.
Cost

34. Restoration of Function
Other selection criteria for full arch treatment options
Reasonable
Excellent
Good
Restoration of Function
Advanced
Medium
Advanced1
Surgical complexity
Expert
Advanced
Basic
Medium
Restorative complexity2
Excellent
Low-High3
Medium-High4
Material support
Esthetics for patient
Very high
Zirconia bridges
Titanium bridges
High
Fixed bars
Fixed-removable bars
High
High
Attachments
Good
1: excluding bone reduction surgery // 2: complexity for the dental technician // 3: Support depending on secondary structure // 4: High with NobelProcera hybrid restoration // 5: All material in the overdenture except the framework e.g. Ceramic for implant bridge. Acrylic, denture teeth, etc for bars

35. Agenda Welcome and introduction Business opportunity
Clinical and restorative challenges
Overview of full-arch restorations
Ordering full-arch restoration

36. With NobelProcera System With Scan & Design Service
Order multiple implant restoration? - Choose from In-lab scan & design or our scan & design service
With NobelProcera System
In-lab scan & design
With Scan & Design Service
Ship casted model & order
Implant bridges on:
Nobel Biocare implant and multi-unit abutments
Implant bars on:
Straumann Octagon and Bone Level
Excellent CAD software with
intuitive flow, flexibility and high
control of the design
Implant bars on:
Nobel Biocare implants
Over 170 other major implant manufacturers (Straumann, 3i, Zimmer, Astra,…)
nobelproceraservices.com

38. Back up

39. & consistent quality of
Benefits of CAD/CAM NobelProcera® Implant Bar Portfolio 2
Platform support 4
Screws included 6
Affordability
1. Restorative flexibility: choice between 12 fixed and fixed-removable options covering the vast majority of restorations.
2. Available on all Nobel Biocare and major 3rd party platforms
4. Clinical screws included with Nobel Biocare platforms
6. Efficient and affordable solution for many edentulous patients 1
Flexibility 3
Trusted quality 5
Ready-to-use
& consistent quality of
fit
3. High quality level based on Medical Device standards applied in development, production and quality control.
5. Implant bars are delivered highly polished, ready-to-use and milled from solid monobloc.

40. Clinical situation 1 No tissue resorption
Replacement required:
Teeth
Available restorations:
Implant Bridge (Zirconia, Titanium)

41. Fixed implant restorations - NobelProcera implant bridge (titanium)
Features & benefits
Lightweight.
Mechanical strength to support long-term performance and stability
Choice of framework design for direct veneering and for cementable crown
Implant bar design for optimized support of the veneering material for a long- term restoration
Screw-retained implant suprastructures allow access to the implant at any time. …
Implant bridge Titanium 41

42. Fixed implant restorations - NobelProcera implant bridge (titanium)
Features & benefits …
CAD/CAM-based milling milled from a monobloc to ensures consistent precision of (marginal) fit.
Can be veneered with composite or porcelain.
Software supports optimized design for individual soft tissue and veneering.
Available on implant or abutment (Multi-unit abutment) level, and combination of thereof.
(Available from two units to full-arch restorations at abutment and implant levels)
Implant bridge Titanium 42

43. Fixed implant restorations NobelProcera implant bridge (titanium)
Implant level and abutment level
NobelReplace (NP, RP, WP, 6.0)
Brånemark System (NP, RP, WP)
Conical Connection (NP, RP)
Abutment level only
Straumann Bone Level (NC, RC)
Straumann Standard/Standard Plus (4.8, 6.5)
AstraTech (Yellow, Aqua, Lilac)
AstraTech (ST 3.5, ST 4.0, ST 4.5/5.0)
Camlog (3.3, 3.8, 4.3, 5.0/6.0)
Ankylos (3.5, 4.5, 5.5, 7.0)
Straumann® is a registered trademark of Institut Straumann AG, AstraTech® is a registered trademark of AstraTech Group, Camlog® is a registered trademark of Camlog Biotechnologies Group, Ankylos® is a registered trademark of Dentsply Friadent Group.
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.

44. Fixed implant restorations - NobelProcera implant bridge (zirconia)
Features & benefits
Highly esthetic solution
Mechanical strength to support long-term performance and stability
Choice of framework design for direct veneering and for cementable crown
Screw-retained implant bridge allows access to the implant at any time.
Industrial shading guarantees consistent color …
Implant bridge Zirconia 44

45. Fixed implant restorations - NobelProcera implant bridge (zirconia)
Features & benefits …
High mechanical strength as design constraints are controlled by CAD (e.g. connector size, cantilever length) and the implant bridge is milled from a solid homogenous monobloc.
Software supports optimized design for individual soft tissue and veneering.
Available on implant or abutment (Multi-unit abutment) level, and combination of thereof.
(Available from two units to full-arch restorations at abutment and implant levels)
Implant bridge Zirconia 45

46. Fixed implant restorations NobelProcera implant bridge (zirconia)
Implant level and abutment level
NobelReplace (NP, RP, WP, 6.0)
Brånemark System (NP, RP, WP)
Conical Connection (NP, RP)
Abutment level only
Straumann Bone Level (NC, RC)
Straumann Standard/Standard Plus (4.8, 6.5)
AstraTech (Yellow, Aqua, Lilac)
AstraTech (ST 3.5, ST 4.0, ST 4.5/5.0)
Camlog (3.3, 3.8, 4.3, 5.0/6.0)
Ankylos (3.5, 4.5, 5.5, 7.0)
Straumann® is a registered trademark of Institut Straumann AG, AstraTech® is a registered trademark of AstraTech Group, Camlog® is a registered trademark of Camlog Biotechnologies Group, Ankylos® is a registered trademark of Dentsply Friadent Group.

47. Clinical situation 2 Mild tissue resorption
Replacement required:
Teeth
Minimal hard and soft tissue
Available restorations:
Implant Bridge
Hybrid
Wrap-around Bar
Montreal Bar
Overdenture with ball/Locator R-Tx

48. Implant-supported restorations - Locators R-Tx abutment
NEW
Features & benefits
All-in-one packaging (Abutment, Denture Attachment Housing, Retention Inserts, Block-out Spacer).
Angle correction up to 30° per implant & 60° between implants.
TiCN – Titanium Carbon Nitride coating for wear resistance and esthetic pink tone.
Identify retention levels with easier terminology: zero, light, medium, high.
“Self-Locating” alignment that allow the patient to easily align and seat the overdenture
Laboratory benefits:
Time efficient fixed restorative solution:
Full CAD workflow, with easy to use, sophisticated software tools enabling great design flexibility in order to support the acrylic for optimal results
Cost efficient fixed solution
Clinical benefits:
Cost-effective, affordable fixed solution for treating edentulous patients
Enhance fixed restoration design to better support acrylic, reducing the need for chair side repair
Additional restorative option for All-on-4 cases 48
Locator® R-Tx is a registered trademark of Zest IP Holdings, LLC

49. Implant-supported restorations - Ball abutment
NEW
Features & benefits
Allows for implant angle divergence of maximum 30° and 60° between implants
Available in multiple heights for varying tissue levels
Biocompatible and strong – made of surgical grade titanium alloy
Laboratory benefits:
Time efficient fixed restorative solution:
Full CAD workflow, with easy to use, sophisticated software tools enabling great design flexibility in order to support the acrylic for optimal results
Cost efficient fixed solution
Clinical benefits:
Cost-effective, affordable fixed solution for treating edentulous patients
Enhance fixed restoration design to better support acrylic, reducing the need for chair side repair
Additional restorative option for All-on-4 cases 49
Locator® R-Tx is a registered trademark of Zest IP Holdings, LLC

50. Fixed implant restorations - Hybrid restoration
Features & benefits
This design combines the features of a wrap-around bar and an implant bridge.
Bar design with the highest support for denture teeth.
Ideal restorative solution if there is limited vertical space.
Round shape – shape the tissue side of the bar individually.
Available with acrylic denture wraps around the entire implant framework.
Also available with high-shine polished titanium base which can be in contact with the oral mucosa.
Hybrid restoration
Laboratory benefits:
Time efficient fixed restorative solution:
Full CAD workflow, with easy to use, sophisticated software tools enabling great design flexibility in order to support the acrylic for optimal results
Cost efficient fixed solution
Clinical benefits:
Cost-effective, affordable fixed solution for treating edentulous patients
Enhance fixed restoration design to better support acrylic, reducing the need for chair side repair
Additional restorative option for All-on-4 cases 50

51. Fixed implant restorations - Hybrid restoration
Anterior fingers
Ensure optimized support and longevity of the veneering material (acrylics / composite).
Posterior retentive elements
Ability to maximize the retention surface without compromising esthetics.
Individually define the number, design and position of retention elements.
Retention elements are an integral part of the milled bar, i.e. not screwed on.
Laboratory benefits:
Time efficient fixed restorative solution:
Full CAD workflow, with easy to use, sophisticated software tools enabling great design flexibility in order to support the acrylic for optimal results
Cost efficient fixed solution
Clinical benefits:
Cost-effective, affordable fixed solution for treating edentulous patients
Enhance fixed restoration design to better support acrylic, reducing the need for chair side repair
Additional restorative option for All-on-4 cases 51

52. Fixed implant restorations - Wrap-around bar
Features & benefits
The acrylic denture wraps around the entire bar.
Dentures can easily be adjusted/relined by adding or removing acrylic.
Simple implant bar design together with denture teeth offering a cost- effective solution
Among implant bars, this design is optimized for cases with no to mild tissue resorption (limited vertical height)
Wrap-around Bar 52

53. Fixed implant restorations - Montreal bar
Features & benefits
Montreal Bar combines the key features of the wrap-around and the Montreal lingual (esthetic and hygienic).
The titanium base offers a clean transition line between the acrylic and the titanium.
Polished titanium base reduces plaque adhesion and bacterial intrusion
Metal base follows the soft tissue contour.
Montreal Bar 53

54. Fixed implant restorations - Montreal bar with metallic lingual
Features & benefits
Design similar to the Montreal Bar where the polished base extends into the lingual aspect of the implant bar
Retention of the denture teeth and acrylic is supported by retention pins
Patient-friendly hygiene maintenance as all parts in contact with the tissue are metallic. …
Montreal Bar with metallic lingual 54

55. Fixed implant restorations - Montreal bar with metallic lingual
Features & benefits …
No acrylic in the lingual aspect of the bar
Limited esthetic result as metal part is visible on the lingual side.
High smile line patients might see the overdenture line show.
Reduced ability to reline implant bar due to metallic base
Montreal Bar with metallic lingual 55

56. Clinical situation 3 Moderate tissue resorption
Replacement required:
Teeth
Hard and soft tissue
Available restorations:
Implant Bridge
CAD/CAM Free Form Milled Bar
Paris Bar
Dolder Bar
Hader Bar
Montreal Bar
Wrap-around Bar
Hybrid

57. NobelProcera® fixed-removable implant overdenture - Free milled bar
Features & benefits
Individually shaped with taper on buccal and lingual walls 0º - 10º (0.5º increments)
Minimum bar size required to screw an attachment into the bar is 2.5 mm x 2.5mm
Volume consideration needed as the design is more bulky
Ideal for cases with advanced bone resorption
Attachments
All attachments are parallel and aligned on the bar.
Milled Bar with Locators® 57

58. NobelProcera® fixed-removable implant overdenture - Paris bar
Features & benefits
Removable prosthesis that looks like a fixed restoration.
Polished titanium base reduces plaque adhesion and bacterial intrusion
Design flexibility:
Adapt implant base to tissue contour
Lingual and buccal margin offer a clean line between the overdenture and the implant bar …
Paris Bar with Ball Attachments 58

59. NobelProcera® fixed-removable implant overdenture - Paris bar
Features & benefits …
Individually shaped with taper on buccal and lingual walls 0º - 10º
Volume consideration needed as the design is more bulky
Attachments
Ball attachments
Paris Bar with Ball Attachments 59

60. Clinical situation 4 Advanced tissue resorption
Replacement required:
Teeth
Hard and soft tissue
Available restorations:
Implant Bridge
CAD/CAM Free Form Milled Bar
Dolder Bar
Hader Bar
Paris Bar
Hybrid

61. NobelProcera® fixed-removable implant overdenture - Round bar
Features & benefits
Option for limited vertical space as well as advanced bone resorption level
Easy for patient to remove for cleaning
Pleasant feel for patient
Delicate, particularly at the cantilevers
Metal attachments
Less frequent changes (change of clip is work intensive) and have more wear resistance compared to plastic clips.
Round Bar with Metal Clips
Features & benefits
Among IBO types, Round Bar is an option for limited vertical space. However the design is delicate, in particular with long cantilevers.
The overdenture can be removed easily by patient for cleaning
Pleasant feel for patient
Delicate, in particularly high on cantilevers
Attachments
2 different type of clips can be used:
Metal attachment need less frequent changes (change of clip is work intensive) and have more wear resistance compared to plastic clips. The bar dimension can be smaller with metal clips
Plastic clips are more cost effective, and easier to change in the overdenture. However, plastic clips are more delicate if overdenture is clipped with an angle, as plastic bar of the clip can be pinched. These clips need to be replaced more often than metal clips. 61

62. NobelProcera® fixed-removable implant overdenture - Round bar
Plastic attachments
Cost effective and easy to change plastic inserts
Options to have inserts with different retention strengths
Important to seat denture in an even motion
Need to be replaced more often than metal attachments
If denture is not seated evenly, the plastics may need increased replacement
Easy for patient to remove for cleaning
Round Bar with Metal Clips
Features & benefits
Among IBO types, Round Bar is an option for limited vertical space. However the design is delicate, in particular with long cantilevers.
The overdenture can be removed easily by patient for cleaning
Pleasant feel for patient
Delicate, in particularly high on cantilevers
Attachments
2 different type of clips can be used:
Metal attachment need less frequent changes (change of clip is work intensive) and have more wear resistance compared to plastic clips. The bar dimension can be smaller with metal clips
Plastic clips are more cost effective, and easier to change in the overdenture. However, plastic clips are more delicate if overdenture is clipped with an angle, as plastic bar of the clip can be pinched. These clips need to be replaced more often than metal clips. 62

63. NobelProcera® fixed-removable implant overdenture - Hader bar
Features & benefits
Round bar with higher rigidity
Option to adjust the gingival part, fit to gum and distance to tissue
4.5 mm maximum height
Easy for patient to remove for cleaning
Metal attachments
Less frequent changes (change of clip is work intensive) and have more wear resistance compared with plastic clips.
Hader Bar with Nylon Clips
Features & benefits
Round bar with higher rigidity.
Option to adjust the gingival part, a fit to gum and distance to tissue
4.5 mm maximum height
Easy to remove by patient for cleaning
Pleasant feel for patient
Attachments
Metal attachment need less frequent changes (change of clip is work intensive) and have more wear resistance compared to plastic clips. The bar dimension can be smaller with metal clips
Plastic clips are more cost effective, and easier to change in the overdenture. However, plastic clips are more delicate if overdenture is clipped with an angle, as plastic bar of the clip can be pinched. These clips need to be replaced more often than metal clips. 63

64. NobelProcera® fixed-removable implant overdenture - Hader bar
Plastic attachments
Cost effective and easy to change plastic inserts
Options to have inserts with different retention strengths
Important to seat denture in an even motion
Need to be replaced more often than metal attachments
If denture is not seated evenly, the plastics may need increased replacement
Easy for patient to remove for cleaning
Hader Bar with Nylon Clips
Features & benefits
Round bar with higher rigidity.
Option to adjust the gingival part, a fit to gum and distance to tissue
4.5 mm maximum height
Easy to remove by patient for cleaning
Pleasant feel for patient
Attachments
Metal attachment need less frequent changes (change of clip is work intensive) and have more wear resistance compared to plastic clips. The bar dimension can be smaller with metal clips
Plastic clips are more cost effective, and easier to change in the overdenture. However, plastic clips are more delicate if overdenture is clipped with an angle, as plastic bar of the clip can be pinched. These clips need to be replaced more often than metal clips. 64

65. NobelProcera® fixed-removable implant overdenture - Dolder bar
Features & benefits
Seating of overdenture is easy and self-engaging
Very good retention
Separating forces can be individually adjusted to patients
Design flexibility - Dolder bar available in 4 types
4.5 mm maximum height (Macro)
3.5 mm maximum height (Micro) …
Dolder Bar with Gold Riders
Features & benefits
Clipping of overdenture is easy and is self-driven. Very good retentions (by friction). Separating forces can be individually adjusted to patients
The rider is self-driven, only valid with 2 implants
Design flexibility - Dolder bar available in 4 types
4.5 mm maximum height (Macro)
3.5 mm maximum height (Micro)
Micro/Marco rigid design is the standard – resilient bar has less friction with attachment compared to conventional overdenture.
Restoration allows movement of the prosthesis from lingual to buccal
Available on implant and Multi-unit Abutment level and combination of thereof
Attachments
Attachments , Gold rider
Clip last 5-10 years without adjustment or replacement. Replacement is work intensive. 65

66. NobelProcera® fixed-removable implant overdenture - Dolder bar
Features & benefits …
Micro/Macro rigid design is the standard – resilient bar has less friction with attachment compared to conventional overdenture.
Restoration allows movement of the prosthesis from lingual to buccal.
Attachments
Gold rider
Dolder Bar with Gold Riders
Features & benefits
Clipping of overdenture is easy and is self-driven. Very good retentions (by friction). Separating forces can be individually adjusted to patients
The rider is self-driven, only valid with 2 implants
Design flexibility - Dolder bar available in 4 types
4.5 mm maximum height (Macro)
3.5 mm maximum height (Micro)
Micro/Marco rigid design is the standard – resilient bar has less friction with attachment compared to conventional overdenture.
Restoration allows movement of the prosthesis from lingual to buccal
Available on implant and Multi-unit Abutment level and combination of thereof
Attachments
Attachments , Gold rider
Clip last 5-10 years without adjustment or replacement. Replacement is work intensive. 66

67. General references from Science First

68. General references from Science First

69. References