digital precision for all indications nobelguide® · a retrospective study of edentulous patients...

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Digital precision for all indications NobelGuide® Guided pilot drilling also for edentulous patients

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Page 1: Digital precision for all indications NobelGuide® · A retrospective study of edentulous patients rehabilitated according to the ‘all-on-four’ or the ‘all-on-six’ immediate

Digital precision for all indicationsNobelGuidereg

Guided pilot drilling also for edentulous patients

NobelGuide is a complete treatment concept for diagnostics treatment planning and guided implant surgery ndash from a single missing tooth to an edentulous jaw

In the 10 years since its launch more than 40 publications have assessed the clinical application of NobelGuide reporting on its use with over 5900 Nobel Biocare implants in more than 950 patients

Key findings of the clinical studies arendash Higher accuracy and predictability of implant positions in comparison with freehand surgery1

ndash Excellent cumulative implant survival rates (CSR) of 968 weighted mean in 38 studies with guided surgery technique in up to seven years of follow-up2

ndash Significantly lower swelling edema and pain34 as well as use of analgesics534 with guided flapless surgery compared with freehand surgery

ndash Very high subjective patient satisfaction367 and high average VAS Visual Analogue Scale (1ndash100) scores of 992 regarding masticatory function and 981 for esthetics8

For accurate implant placement

Powerful diagnostics and treatment planningAvoid surprises during the treatment process through careful diagnosis and treatment planning with the user-friendly NobelClinician Software Safety margins and a warning system help to plan the safe placement of implants Visualizing prosthetics from the start minimizes restorative challenges

High accuracy and predictability of implant positions9 10 11 12

Using the custom-manufactured surgical templates turns your treatment plan into clinical reality Choose between guided pilot drilling with the first drill or fully guided implant insertion The latter leads to smaller deviations in entry point orientation and depth compared with freehand placement1 It is also proven to support precise implant placement in the planned position9 10 11 12

Implant positioning in NobelClinician software takes prosthetic requirements of the patient into account

Periapical radiograph after one year of function

Case courtesy of Dr Alessandro Pozzi

years NobelGuidereg consistent precision

Optimize your restorative outcomeOffer your patients optimized esthetics and function with a comprehensive range of prosthetic solutions Our restorations demonstrate high precision of fit13 mechanical stability14 and biocompatibility to provide years of safe and reliable function15 16

Enhanced patient satisfaction17

Involve patients in the treatment planning with the NobelClinician Software and improve their understanding of the treatment plan Interactive visual communication significantly increases patient satisfaction17 Optimized visualization and treatment planning with 3D software may reduce the need for bone augmentation procedures518 and treating the patient with flapless surgery cause less pain and discomfort5

Rely on high quality templates that fitEnsure the perfect fit We develop and produce templates according to Medical Devices Quality Management ISO 13485 and ISO 10993 Our processes are regularly audited by the notified body BSI and inspected by the FDA Plus every template you design is manually checked before production and verified for quality afterwards All this provides you with an exceptional product

Further enhance the fit before designing a surgical template with our unique (CB)CT calibration procedure Itrsquos strongly recom-mended for the radiographic-guide-based workflow

Patients are more satisfied with the outcome of their treatment after a discussion using visual tools to review the pre- and post-operative clinical pictures summarize the clinical steps and highlight the details of the restored region

Plt005

Before After

100

80

60

40

20

0

No

Do not know

Yes

7590

9

55

16

Every case you have is different Thatrsquos why NobelGuide offers you a choice of treatment workflows

Partially edentulous patients

Clinical diagnostics and treatment acceptance

Clinical diagnostics

Digitizing prosthetic information

Diagnostic tooth setup and fabrication of radiographic guide

3D diagnostics treatment planning and communication

Digitization with (CB)CT scan

Guided surgery

3D diagnostics treatment planning and patient communication

Guided surgery

Restoration Restoration

Edentulous patients

A seamless workflow for every case

Diagnose critical anatomical structures with the NobelClinician Software Take a definitive impression Obtain treatment acceptance before making further investments A (CB)CT scan can be taken at the first visit with no need to use a radiographic guide

Examine the patient Take an impression for study models and later the master cast

Collaborate with your lab technician and capture the soft tissue using the NobelProcera 2G Systemrsquos precise model scan Choose whether to include the diagnostic tooth setup

Fabricate and clinically validate the diagnostic tooth setup Transform the tooth setup into a radiographic guide ndash your prosthetic reference during planning

Visualize the patientrsquos (CB)CT data together with the intra-oral situation includ ing soft tissue and the diagnostic setup when you use NobelClinicianrsquos SmartFusion technology Effectively communicate the treatment plan to your patients using the Communicator iPad app

Make a (CB)CT scan of the patient and the radiographic guide following the double-scan protocol

Choose either guided pilot drilling or fully guided drilling and guided implant insertion using a custom-manufactured NobelGuide surgical template based on the treatment plan

Define implant positions from a clinical anatomical and prosthetic perspective by combining tooth setup with patient anatomy

Go for guided pilot drilling or fully guided drilling and guided implant insertion using a custom-manufactured NobelGuide surgical template based upon the treatment plan

1

1

2

2

3

3

4

4

5 6

5

Right from the start with guided pilot drilling

When therersquos no room for error Guided pilot drilling assists you in achieving the correct angulation direction and depth of the first drill when placing implants in narrow spaces or close to the inferior alveolar nerve

Your starting point for edentulous treatmentConfidently make use of all available bone and overcome challenges such as bone resorption Avoid critical anatomical structures and place implants deeper using the sleeve-offset function It supports bone reduction allowing for the initial treatment plan to remain unchanged

Design a surgical template for partially edentulous patients in just one click following a plan prepared with NobelClinicianrsquos SmartFusion function The result is a precise guide for predictable freehand implant placement The ready-to-use template safely guides your initial drill according to your NobelClinician plan

NobelActive NobelParallel Conical Connection

NobelReplace Conical Connection

Replace Select NobelSpeedy Braringnemark System exclusive Mk III TiUnite and Mk IV TiUnite

7937

9 A

Lot

ldquoU

S 1

509rdquo

Prin

ted

in U

SA

copy N

obel

Bio

care

US

A L

LC 2

015

All

right

s re

serv

ed

Nob

el B

ioca

re t

he N

obel

Bio

care

log

otyp

e an

d al

l oth

er t

rade

mar

ks a

re i

f no

thin

g e

lse

is s

tate

d or

is e

vide

nt f

rom

the

con

text

in a

cer

tain

cas

e t

rade

mar

ks o

f N

obel

Bio

care

Ple

ase

refe

r to

nob

elbi

ocar

eco

mt

rade

mar

ks f

or m

ore

info

rmat

ion

P

rodu

ct im

ages

are

not

nec

essa

rily

to s

cale

Dis

clai

mer

Som

e pr

oduc

ts m

ay n

ot b

e re

gul

ator

y cl

eare

dre

leas

ed f

or s

ale

in a

ll m

arke

ts P

leas

e co

ntac

t th

e lo

cal N

obel

Bio

care

sal

es o

ffice

for

cur

rent

pro

duct

ass

ortm

ent

and

avai

labi

lity

nobelbiocarecomnobelguide

NobelGuidereg for predictable outcomes

Periapical and (CB)CT radiograph revealed loss of most of the root structure The four maxillary incisors were considered hopeless

Implants in situ after removal of the insertion assembly

Visualization of patientrsquos anatomic structures and diagnostic wax-up using the SmartFusion Virtual placement of NobelActive NP for the lateral incisors and NobelActive RP for the central incisors

Two-year post-insertion periapical radiographs demonstrate precise implant placement and stable bone levels

Learn from the pioneersTo develop the knowledge and skills needed to achieve the best possible results with the NobelGuide treatment concept you need to learn from the best

Whether yoursquore an experienced clinician or at the beginning of your implant career we will find an implant course tailored to your experience level

Contact Nobel Biocare customer service to start with NobelGuidenobelbiocarecomcontact

The surgical template was seated immediately after atraumatic tooth extraction Implants were placed using a fully guided surgical template

Two-year post insertion clinical view demonstrates excellent soft tissue contours

Case courtesy of Dr Peter Woumlhrle USA

Dr Peter Woumlhrle USA

Clinical caseTwenty-year-old patient Non-smoker with no parafunctional habitsPatient presented with request for dental implant treatment subsequent to orthodontic therapy

Discover more NobelGuide clinical cases and videos at nobelbiocarecomnobelguide

ldquo Patients today are more esthetically demanding Placement of implants using guided surgery is crucial to routinely achieve the necessary precision resulting in treatment predictability And for me Predictability equals patient satisfactionrdquo

References 1 Tahmaseb A Wismeijer D Coucke W Derksen W Computer technology applications in surgical implant dentistry a systematic review Int J Oral Maxillofac Implants 201429 Suppl25-42 2 Integrated treatment workflow Diag-nostics treatment planning and guided surgery with NobelClinician and NobelGuide Nobel Biocare Services AG GMT79393 Science First 2015(3)2 3 Pozzi A Tallarico M Marchetti M Scarfo B Esposito M Computer-guided versus free-hand placement of immediately loaded dental implants 1-year post-loading results of a multicentre randomised controlled trial Eur J Oral Implantol 20147(3)229-42 4 Nkenke E Eitner S Radespiel-Troger M Vairak-taris E Neukam FW Fenner M Patientcentred outcomes comparing transmucosal implant placement with an open approach in the maxilla a prospective non-randomized pilot study Clin Oral Implants Res 200718(2)197-203 5 Bertossi D Gerosa R Schembri E Zanotti G Rossini N Colletti G et al NobelGuide influence in the perception of postoperative pain Minerva Stomatol 2013 6 Puig CP A retrospective study of edentulous patients rehabilitated according to the lsquoall-on-fourrsquo or the lsquoall-on-sixrsquo immediate function concept using flapless computer-guided implant surgery Eur J Oral Implantol 20103(2)155-63 7 Meloni SM De Riu G Pisano M Cattina G Tullio A Implant treat-ment software planning and guided flapless surgery with immediate provisional prosthesis delivery in the fully edentulous maxilla A retrospective analysis of 15 consecutively treated patients Eur J Oral Implantol 20103(3)245-51 8 Pozzi A Holst S Fabbri G Tallarico M Clinical Reliability of CADCAM Cross-Arch Zirconia Bridges on Immediately Loaded Implants Placed with Computer-AssistedTemplate-Guided Surgery A Retrospective Study with a Follow-Up between 3 and 5 Years Clin Implant Dent Relat Res 201517(S1)e86-e96 9 Vasak C Watzak G Gahleitner A Strbac G Schemper M Zechner W Computed tomo graphy-based evaluation of template (NobelGuide() )-guided implant positions a prospective radiological study Clin Oral Implants Res 201122(10)1157-63 10 Van Assche N van Steenberghe D Quirynen M Jacobs R Accuracy assessment of computer-assisted flapless implant placement in partial edentulism J Clin Periodontol 201037(4)398-403 11 Furhauser R Mailath-Pokorny G Haas R Busenlechner D Watzek G Pommer B Esthetics of Flapless Single-Tooth Implants in the Anterior Maxilla Using Guided Surgery Association of Three-Dimensional Accuracy and Pink Esthetic Score Clin Implant Dent Relat Res epub ahead 2014 12 Pettersson A Komiyama A Hultin M Nasstrom K Klinge B Accuracy of virtually planned and tem-plate guided implant surgery on edentate patients Clin Implant Dent Relat Res 2012 Aug14(4)527-37 13 Katsoulis J Mericske-Stern R Rotkina L Zbaumlren C Enkling N Blatz MB Precision of fit of implant-supported screw-re-tained 10-unit computer-aided-designed and computer-aided-manufactured frameworks made from zirconium dioxide and titanium an in vitro study Clin Oral Implants Res 2014 Feb25(2)165-74 14 Truninger TC Stawarczyk B Leutert CR et al Bending moments of zirconia and titanium abutments with internal and external implant-abutment connections after aging and chewing simulation Clin Oral Implants Res 201223(1)12-18 15 Zembic A Bosch A Jung RE Hammerle CH Sailer I Five-year results of a randomized controlled clinical trial comparing zirconia and titanium abutments supporting single-implant crowns in canine and posterior regions Clin Oral Implants Res 201324(4)384-90 16 Ozer F Mante FK Chiche G et al A retrospective survey on long-term survival of posterior zirconia and porcelain-fused-to-metal crowns in private practice Quintessence Int 201445(1)31-8 17 Imburgia M Coachman C Using digital devices to improve communications between clinicians and patients during implantprosthetic treatment a clinical study [519] 23rd Annual Scientific Meeting of the European Association for Osseointe-gration Rome Italy Wiley 2014 p 538 18 Scotti R Pellegrino G Marchetti C Corinaldesi G Ciocca L Diagnostic value of NobelGuide to minimize the need for reconstructive surgery of jaws before implant placement a review Quintessence Int 201041(10)809-14

Page 2: Digital precision for all indications NobelGuide® · A retrospective study of edentulous patients rehabilitated according to the ‘all-on-four’ or the ‘all-on-six’ immediate

NobelGuide is a complete treatment concept for diagnostics treatment planning and guided implant surgery ndash from a single missing tooth to an edentulous jaw

In the 10 years since its launch more than 40 publications have assessed the clinical application of NobelGuide reporting on its use with over 5900 Nobel Biocare implants in more than 950 patients

Key findings of the clinical studies arendash Higher accuracy and predictability of implant positions in comparison with freehand surgery1

ndash Excellent cumulative implant survival rates (CSR) of 968 weighted mean in 38 studies with guided surgery technique in up to seven years of follow-up2

ndash Significantly lower swelling edema and pain34 as well as use of analgesics534 with guided flapless surgery compared with freehand surgery

ndash Very high subjective patient satisfaction367 and high average VAS Visual Analogue Scale (1ndash100) scores of 992 regarding masticatory function and 981 for esthetics8

For accurate implant placement

Powerful diagnostics and treatment planningAvoid surprises during the treatment process through careful diagnosis and treatment planning with the user-friendly NobelClinician Software Safety margins and a warning system help to plan the safe placement of implants Visualizing prosthetics from the start minimizes restorative challenges

High accuracy and predictability of implant positions9 10 11 12

Using the custom-manufactured surgical templates turns your treatment plan into clinical reality Choose between guided pilot drilling with the first drill or fully guided implant insertion The latter leads to smaller deviations in entry point orientation and depth compared with freehand placement1 It is also proven to support precise implant placement in the planned position9 10 11 12

Implant positioning in NobelClinician software takes prosthetic requirements of the patient into account

Periapical radiograph after one year of function

Case courtesy of Dr Alessandro Pozzi

years NobelGuidereg consistent precision

Optimize your restorative outcomeOffer your patients optimized esthetics and function with a comprehensive range of prosthetic solutions Our restorations demonstrate high precision of fit13 mechanical stability14 and biocompatibility to provide years of safe and reliable function15 16

Enhanced patient satisfaction17

Involve patients in the treatment planning with the NobelClinician Software and improve their understanding of the treatment plan Interactive visual communication significantly increases patient satisfaction17 Optimized visualization and treatment planning with 3D software may reduce the need for bone augmentation procedures518 and treating the patient with flapless surgery cause less pain and discomfort5

Rely on high quality templates that fitEnsure the perfect fit We develop and produce templates according to Medical Devices Quality Management ISO 13485 and ISO 10993 Our processes are regularly audited by the notified body BSI and inspected by the FDA Plus every template you design is manually checked before production and verified for quality afterwards All this provides you with an exceptional product

Further enhance the fit before designing a surgical template with our unique (CB)CT calibration procedure Itrsquos strongly recom-mended for the radiographic-guide-based workflow

Patients are more satisfied with the outcome of their treatment after a discussion using visual tools to review the pre- and post-operative clinical pictures summarize the clinical steps and highlight the details of the restored region

Plt005

Before After

100

80

60

40

20

0

No

Do not know

Yes

7590

9

55

16

Every case you have is different Thatrsquos why NobelGuide offers you a choice of treatment workflows

Partially edentulous patients

Clinical diagnostics and treatment acceptance

Clinical diagnostics

Digitizing prosthetic information

Diagnostic tooth setup and fabrication of radiographic guide

3D diagnostics treatment planning and communication

Digitization with (CB)CT scan

Guided surgery

3D diagnostics treatment planning and patient communication

Guided surgery

Restoration Restoration

Edentulous patients

A seamless workflow for every case

Diagnose critical anatomical structures with the NobelClinician Software Take a definitive impression Obtain treatment acceptance before making further investments A (CB)CT scan can be taken at the first visit with no need to use a radiographic guide

Examine the patient Take an impression for study models and later the master cast

Collaborate with your lab technician and capture the soft tissue using the NobelProcera 2G Systemrsquos precise model scan Choose whether to include the diagnostic tooth setup

Fabricate and clinically validate the diagnostic tooth setup Transform the tooth setup into a radiographic guide ndash your prosthetic reference during planning

Visualize the patientrsquos (CB)CT data together with the intra-oral situation includ ing soft tissue and the diagnostic setup when you use NobelClinicianrsquos SmartFusion technology Effectively communicate the treatment plan to your patients using the Communicator iPad app

Make a (CB)CT scan of the patient and the radiographic guide following the double-scan protocol

Choose either guided pilot drilling or fully guided drilling and guided implant insertion using a custom-manufactured NobelGuide surgical template based on the treatment plan

Define implant positions from a clinical anatomical and prosthetic perspective by combining tooth setup with patient anatomy

Go for guided pilot drilling or fully guided drilling and guided implant insertion using a custom-manufactured NobelGuide surgical template based upon the treatment plan

1

1

2

2

3

3

4

4

5 6

5

Right from the start with guided pilot drilling

When therersquos no room for error Guided pilot drilling assists you in achieving the correct angulation direction and depth of the first drill when placing implants in narrow spaces or close to the inferior alveolar nerve

Your starting point for edentulous treatmentConfidently make use of all available bone and overcome challenges such as bone resorption Avoid critical anatomical structures and place implants deeper using the sleeve-offset function It supports bone reduction allowing for the initial treatment plan to remain unchanged

Design a surgical template for partially edentulous patients in just one click following a plan prepared with NobelClinicianrsquos SmartFusion function The result is a precise guide for predictable freehand implant placement The ready-to-use template safely guides your initial drill according to your NobelClinician plan

NobelActive NobelParallel Conical Connection

NobelReplace Conical Connection

Replace Select NobelSpeedy Braringnemark System exclusive Mk III TiUnite and Mk IV TiUnite

7937

9 A

Lot

ldquoU

S 1

509rdquo

Prin

ted

in U

SA

copy N

obel

Bio

care

US

A L

LC 2

015

All

right

s re

serv

ed

Nob

el B

ioca

re t

he N

obel

Bio

care

log

otyp

e an

d al

l oth

er t

rade

mar

ks a

re i

f no

thin

g e

lse

is s

tate

d or

is e

vide

nt f

rom

the

con

text

in a

cer

tain

cas

e t

rade

mar

ks o

f N

obel

Bio

care

Ple

ase

refe

r to

nob

elbi

ocar

eco

mt

rade

mar

ks f

or m

ore

info

rmat

ion

P

rodu

ct im

ages

are

not

nec

essa

rily

to s

cale

Dis

clai

mer

Som

e pr

oduc

ts m

ay n

ot b

e re

gul

ator

y cl

eare

dre

leas

ed f

or s

ale

in a

ll m

arke

ts P

leas

e co

ntac

t th

e lo

cal N

obel

Bio

care

sal

es o

ffice

for

cur

rent

pro

duct

ass

ortm

ent

and

avai

labi

lity

nobelbiocarecomnobelguide

NobelGuidereg for predictable outcomes

Periapical and (CB)CT radiograph revealed loss of most of the root structure The four maxillary incisors were considered hopeless

Implants in situ after removal of the insertion assembly

Visualization of patientrsquos anatomic structures and diagnostic wax-up using the SmartFusion Virtual placement of NobelActive NP for the lateral incisors and NobelActive RP for the central incisors

Two-year post-insertion periapical radiographs demonstrate precise implant placement and stable bone levels

Learn from the pioneersTo develop the knowledge and skills needed to achieve the best possible results with the NobelGuide treatment concept you need to learn from the best

Whether yoursquore an experienced clinician or at the beginning of your implant career we will find an implant course tailored to your experience level

Contact Nobel Biocare customer service to start with NobelGuidenobelbiocarecomcontact

The surgical template was seated immediately after atraumatic tooth extraction Implants were placed using a fully guided surgical template

Two-year post insertion clinical view demonstrates excellent soft tissue contours

Case courtesy of Dr Peter Woumlhrle USA

Dr Peter Woumlhrle USA

Clinical caseTwenty-year-old patient Non-smoker with no parafunctional habitsPatient presented with request for dental implant treatment subsequent to orthodontic therapy

Discover more NobelGuide clinical cases and videos at nobelbiocarecomnobelguide

ldquo Patients today are more esthetically demanding Placement of implants using guided surgery is crucial to routinely achieve the necessary precision resulting in treatment predictability And for me Predictability equals patient satisfactionrdquo

References 1 Tahmaseb A Wismeijer D Coucke W Derksen W Computer technology applications in surgical implant dentistry a systematic review Int J Oral Maxillofac Implants 201429 Suppl25-42 2 Integrated treatment workflow Diag-nostics treatment planning and guided surgery with NobelClinician and NobelGuide Nobel Biocare Services AG GMT79393 Science First 2015(3)2 3 Pozzi A Tallarico M Marchetti M Scarfo B Esposito M Computer-guided versus free-hand placement of immediately loaded dental implants 1-year post-loading results of a multicentre randomised controlled trial Eur J Oral Implantol 20147(3)229-42 4 Nkenke E Eitner S Radespiel-Troger M Vairak-taris E Neukam FW Fenner M Patientcentred outcomes comparing transmucosal implant placement with an open approach in the maxilla a prospective non-randomized pilot study Clin Oral Implants Res 200718(2)197-203 5 Bertossi D Gerosa R Schembri E Zanotti G Rossini N Colletti G et al NobelGuide influence in the perception of postoperative pain Minerva Stomatol 2013 6 Puig CP A retrospective study of edentulous patients rehabilitated according to the lsquoall-on-fourrsquo or the lsquoall-on-sixrsquo immediate function concept using flapless computer-guided implant surgery Eur J Oral Implantol 20103(2)155-63 7 Meloni SM De Riu G Pisano M Cattina G Tullio A Implant treat-ment software planning and guided flapless surgery with immediate provisional prosthesis delivery in the fully edentulous maxilla A retrospective analysis of 15 consecutively treated patients Eur J Oral Implantol 20103(3)245-51 8 Pozzi A Holst S Fabbri G Tallarico M Clinical Reliability of CADCAM Cross-Arch Zirconia Bridges on Immediately Loaded Implants Placed with Computer-AssistedTemplate-Guided Surgery A Retrospective Study with a Follow-Up between 3 and 5 Years Clin Implant Dent Relat Res 201517(S1)e86-e96 9 Vasak C Watzak G Gahleitner A Strbac G Schemper M Zechner W Computed tomo graphy-based evaluation of template (NobelGuide() )-guided implant positions a prospective radiological study Clin Oral Implants Res 201122(10)1157-63 10 Van Assche N van Steenberghe D Quirynen M Jacobs R Accuracy assessment of computer-assisted flapless implant placement in partial edentulism J Clin Periodontol 201037(4)398-403 11 Furhauser R Mailath-Pokorny G Haas R Busenlechner D Watzek G Pommer B Esthetics of Flapless Single-Tooth Implants in the Anterior Maxilla Using Guided Surgery Association of Three-Dimensional Accuracy and Pink Esthetic Score Clin Implant Dent Relat Res epub ahead 2014 12 Pettersson A Komiyama A Hultin M Nasstrom K Klinge B Accuracy of virtually planned and tem-plate guided implant surgery on edentate patients Clin Implant Dent Relat Res 2012 Aug14(4)527-37 13 Katsoulis J Mericske-Stern R Rotkina L Zbaumlren C Enkling N Blatz MB Precision of fit of implant-supported screw-re-tained 10-unit computer-aided-designed and computer-aided-manufactured frameworks made from zirconium dioxide and titanium an in vitro study Clin Oral Implants Res 2014 Feb25(2)165-74 14 Truninger TC Stawarczyk B Leutert CR et al Bending moments of zirconia and titanium abutments with internal and external implant-abutment connections after aging and chewing simulation Clin Oral Implants Res 201223(1)12-18 15 Zembic A Bosch A Jung RE Hammerle CH Sailer I Five-year results of a randomized controlled clinical trial comparing zirconia and titanium abutments supporting single-implant crowns in canine and posterior regions Clin Oral Implants Res 201324(4)384-90 16 Ozer F Mante FK Chiche G et al A retrospective survey on long-term survival of posterior zirconia and porcelain-fused-to-metal crowns in private practice Quintessence Int 201445(1)31-8 17 Imburgia M Coachman C Using digital devices to improve communications between clinicians and patients during implantprosthetic treatment a clinical study [519] 23rd Annual Scientific Meeting of the European Association for Osseointe-gration Rome Italy Wiley 2014 p 538 18 Scotti R Pellegrino G Marchetti C Corinaldesi G Ciocca L Diagnostic value of NobelGuide to minimize the need for reconstructive surgery of jaws before implant placement a review Quintessence Int 201041(10)809-14

Page 3: Digital precision for all indications NobelGuide® · A retrospective study of edentulous patients rehabilitated according to the ‘all-on-four’ or the ‘all-on-six’ immediate

Optimize your restorative outcomeOffer your patients optimized esthetics and function with a comprehensive range of prosthetic solutions Our restorations demonstrate high precision of fit13 mechanical stability14 and biocompatibility to provide years of safe and reliable function15 16

Enhanced patient satisfaction17

Involve patients in the treatment planning with the NobelClinician Software and improve their understanding of the treatment plan Interactive visual communication significantly increases patient satisfaction17 Optimized visualization and treatment planning with 3D software may reduce the need for bone augmentation procedures518 and treating the patient with flapless surgery cause less pain and discomfort5

Rely on high quality templates that fitEnsure the perfect fit We develop and produce templates according to Medical Devices Quality Management ISO 13485 and ISO 10993 Our processes are regularly audited by the notified body BSI and inspected by the FDA Plus every template you design is manually checked before production and verified for quality afterwards All this provides you with an exceptional product

Further enhance the fit before designing a surgical template with our unique (CB)CT calibration procedure Itrsquos strongly recom-mended for the radiographic-guide-based workflow

Patients are more satisfied with the outcome of their treatment after a discussion using visual tools to review the pre- and post-operative clinical pictures summarize the clinical steps and highlight the details of the restored region

Plt005

Before After

100

80

60

40

20

0

No

Do not know

Yes

7590

9

55

16

Every case you have is different Thatrsquos why NobelGuide offers you a choice of treatment workflows

Partially edentulous patients

Clinical diagnostics and treatment acceptance

Clinical diagnostics

Digitizing prosthetic information

Diagnostic tooth setup and fabrication of radiographic guide

3D diagnostics treatment planning and communication

Digitization with (CB)CT scan

Guided surgery

3D diagnostics treatment planning and patient communication

Guided surgery

Restoration Restoration

Edentulous patients

A seamless workflow for every case

Diagnose critical anatomical structures with the NobelClinician Software Take a definitive impression Obtain treatment acceptance before making further investments A (CB)CT scan can be taken at the first visit with no need to use a radiographic guide

Examine the patient Take an impression for study models and later the master cast

Collaborate with your lab technician and capture the soft tissue using the NobelProcera 2G Systemrsquos precise model scan Choose whether to include the diagnostic tooth setup

Fabricate and clinically validate the diagnostic tooth setup Transform the tooth setup into a radiographic guide ndash your prosthetic reference during planning

Visualize the patientrsquos (CB)CT data together with the intra-oral situation includ ing soft tissue and the diagnostic setup when you use NobelClinicianrsquos SmartFusion technology Effectively communicate the treatment plan to your patients using the Communicator iPad app

Make a (CB)CT scan of the patient and the radiographic guide following the double-scan protocol

Choose either guided pilot drilling or fully guided drilling and guided implant insertion using a custom-manufactured NobelGuide surgical template based on the treatment plan

Define implant positions from a clinical anatomical and prosthetic perspective by combining tooth setup with patient anatomy

Go for guided pilot drilling or fully guided drilling and guided implant insertion using a custom-manufactured NobelGuide surgical template based upon the treatment plan

1

1

2

2

3

3

4

4

5 6

5

Right from the start with guided pilot drilling

When therersquos no room for error Guided pilot drilling assists you in achieving the correct angulation direction and depth of the first drill when placing implants in narrow spaces or close to the inferior alveolar nerve

Your starting point for edentulous treatmentConfidently make use of all available bone and overcome challenges such as bone resorption Avoid critical anatomical structures and place implants deeper using the sleeve-offset function It supports bone reduction allowing for the initial treatment plan to remain unchanged

Design a surgical template for partially edentulous patients in just one click following a plan prepared with NobelClinicianrsquos SmartFusion function The result is a precise guide for predictable freehand implant placement The ready-to-use template safely guides your initial drill according to your NobelClinician plan

NobelActive NobelParallel Conical Connection

NobelReplace Conical Connection

Replace Select NobelSpeedy Braringnemark System exclusive Mk III TiUnite and Mk IV TiUnite

7937

9 A

Lot

ldquoU

S 1

509rdquo

Prin

ted

in U

SA

copy N

obel

Bio

care

US

A L

LC 2

015

All

right

s re

serv

ed

Nob

el B

ioca

re t

he N

obel

Bio

care

log

otyp

e an

d al

l oth

er t

rade

mar

ks a

re i

f no

thin

g e

lse

is s

tate

d or

is e

vide

nt f

rom

the

con

text

in a

cer

tain

cas

e t

rade

mar

ks o

f N

obel

Bio

care

Ple

ase

refe

r to

nob

elbi

ocar

eco

mt

rade

mar

ks f

or m

ore

info

rmat

ion

P

rodu

ct im

ages

are

not

nec

essa

rily

to s

cale

Dis

clai

mer

Som

e pr

oduc

ts m

ay n

ot b

e re

gul

ator

y cl

eare

dre

leas

ed f

or s

ale

in a

ll m

arke

ts P

leas

e co

ntac

t th

e lo

cal N

obel

Bio

care

sal

es o

ffice

for

cur

rent

pro

duct

ass

ortm

ent

and

avai

labi

lity

nobelbiocarecomnobelguide

NobelGuidereg for predictable outcomes

Periapical and (CB)CT radiograph revealed loss of most of the root structure The four maxillary incisors were considered hopeless

Implants in situ after removal of the insertion assembly

Visualization of patientrsquos anatomic structures and diagnostic wax-up using the SmartFusion Virtual placement of NobelActive NP for the lateral incisors and NobelActive RP for the central incisors

Two-year post-insertion periapical radiographs demonstrate precise implant placement and stable bone levels

Learn from the pioneersTo develop the knowledge and skills needed to achieve the best possible results with the NobelGuide treatment concept you need to learn from the best

Whether yoursquore an experienced clinician or at the beginning of your implant career we will find an implant course tailored to your experience level

Contact Nobel Biocare customer service to start with NobelGuidenobelbiocarecomcontact

The surgical template was seated immediately after atraumatic tooth extraction Implants were placed using a fully guided surgical template

Two-year post insertion clinical view demonstrates excellent soft tissue contours

Case courtesy of Dr Peter Woumlhrle USA

Dr Peter Woumlhrle USA

Clinical caseTwenty-year-old patient Non-smoker with no parafunctional habitsPatient presented with request for dental implant treatment subsequent to orthodontic therapy

Discover more NobelGuide clinical cases and videos at nobelbiocarecomnobelguide

ldquo Patients today are more esthetically demanding Placement of implants using guided surgery is crucial to routinely achieve the necessary precision resulting in treatment predictability And for me Predictability equals patient satisfactionrdquo

References 1 Tahmaseb A Wismeijer D Coucke W Derksen W Computer technology applications in surgical implant dentistry a systematic review Int J Oral Maxillofac Implants 201429 Suppl25-42 2 Integrated treatment workflow Diag-nostics treatment planning and guided surgery with NobelClinician and NobelGuide Nobel Biocare Services AG GMT79393 Science First 2015(3)2 3 Pozzi A Tallarico M Marchetti M Scarfo B Esposito M Computer-guided versus free-hand placement of immediately loaded dental implants 1-year post-loading results of a multicentre randomised controlled trial Eur J Oral Implantol 20147(3)229-42 4 Nkenke E Eitner S Radespiel-Troger M Vairak-taris E Neukam FW Fenner M Patientcentred outcomes comparing transmucosal implant placement with an open approach in the maxilla a prospective non-randomized pilot study Clin Oral Implants Res 200718(2)197-203 5 Bertossi D Gerosa R Schembri E Zanotti G Rossini N Colletti G et al NobelGuide influence in the perception of postoperative pain Minerva Stomatol 2013 6 Puig CP A retrospective study of edentulous patients rehabilitated according to the lsquoall-on-fourrsquo or the lsquoall-on-sixrsquo immediate function concept using flapless computer-guided implant surgery Eur J Oral Implantol 20103(2)155-63 7 Meloni SM De Riu G Pisano M Cattina G Tullio A Implant treat-ment software planning and guided flapless surgery with immediate provisional prosthesis delivery in the fully edentulous maxilla A retrospective analysis of 15 consecutively treated patients Eur J Oral Implantol 20103(3)245-51 8 Pozzi A Holst S Fabbri G Tallarico M Clinical Reliability of CADCAM Cross-Arch Zirconia Bridges on Immediately Loaded Implants Placed with Computer-AssistedTemplate-Guided Surgery A Retrospective Study with a Follow-Up between 3 and 5 Years Clin Implant Dent Relat Res 201517(S1)e86-e96 9 Vasak C Watzak G Gahleitner A Strbac G Schemper M Zechner W Computed tomo graphy-based evaluation of template (NobelGuide() )-guided implant positions a prospective radiological study Clin Oral Implants Res 201122(10)1157-63 10 Van Assche N van Steenberghe D Quirynen M Jacobs R Accuracy assessment of computer-assisted flapless implant placement in partial edentulism J Clin Periodontol 201037(4)398-403 11 Furhauser R Mailath-Pokorny G Haas R Busenlechner D Watzek G Pommer B Esthetics of Flapless Single-Tooth Implants in the Anterior Maxilla Using Guided Surgery Association of Three-Dimensional Accuracy and Pink Esthetic Score Clin Implant Dent Relat Res epub ahead 2014 12 Pettersson A Komiyama A Hultin M Nasstrom K Klinge B Accuracy of virtually planned and tem-plate guided implant surgery on edentate patients Clin Implant Dent Relat Res 2012 Aug14(4)527-37 13 Katsoulis J Mericske-Stern R Rotkina L Zbaumlren C Enkling N Blatz MB Precision of fit of implant-supported screw-re-tained 10-unit computer-aided-designed and computer-aided-manufactured frameworks made from zirconium dioxide and titanium an in vitro study Clin Oral Implants Res 2014 Feb25(2)165-74 14 Truninger TC Stawarczyk B Leutert CR et al Bending moments of zirconia and titanium abutments with internal and external implant-abutment connections after aging and chewing simulation Clin Oral Implants Res 201223(1)12-18 15 Zembic A Bosch A Jung RE Hammerle CH Sailer I Five-year results of a randomized controlled clinical trial comparing zirconia and titanium abutments supporting single-implant crowns in canine and posterior regions Clin Oral Implants Res 201324(4)384-90 16 Ozer F Mante FK Chiche G et al A retrospective survey on long-term survival of posterior zirconia and porcelain-fused-to-metal crowns in private practice Quintessence Int 201445(1)31-8 17 Imburgia M Coachman C Using digital devices to improve communications between clinicians and patients during implantprosthetic treatment a clinical study [519] 23rd Annual Scientific Meeting of the European Association for Osseointe-gration Rome Italy Wiley 2014 p 538 18 Scotti R Pellegrino G Marchetti C Corinaldesi G Ciocca L Diagnostic value of NobelGuide to minimize the need for reconstructive surgery of jaws before implant placement a review Quintessence Int 201041(10)809-14

Page 4: Digital precision for all indications NobelGuide® · A retrospective study of edentulous patients rehabilitated according to the ‘all-on-four’ or the ‘all-on-six’ immediate

Every case you have is different Thatrsquos why NobelGuide offers you a choice of treatment workflows

Partially edentulous patients

Clinical diagnostics and treatment acceptance

Clinical diagnostics

Digitizing prosthetic information

Diagnostic tooth setup and fabrication of radiographic guide

3D diagnostics treatment planning and communication

Digitization with (CB)CT scan

Guided surgery

3D diagnostics treatment planning and patient communication

Guided surgery

Restoration Restoration

Edentulous patients

A seamless workflow for every case

Diagnose critical anatomical structures with the NobelClinician Software Take a definitive impression Obtain treatment acceptance before making further investments A (CB)CT scan can be taken at the first visit with no need to use a radiographic guide

Examine the patient Take an impression for study models and later the master cast

Collaborate with your lab technician and capture the soft tissue using the NobelProcera 2G Systemrsquos precise model scan Choose whether to include the diagnostic tooth setup

Fabricate and clinically validate the diagnostic tooth setup Transform the tooth setup into a radiographic guide ndash your prosthetic reference during planning

Visualize the patientrsquos (CB)CT data together with the intra-oral situation includ ing soft tissue and the diagnostic setup when you use NobelClinicianrsquos SmartFusion technology Effectively communicate the treatment plan to your patients using the Communicator iPad app

Make a (CB)CT scan of the patient and the radiographic guide following the double-scan protocol

Choose either guided pilot drilling or fully guided drilling and guided implant insertion using a custom-manufactured NobelGuide surgical template based on the treatment plan

Define implant positions from a clinical anatomical and prosthetic perspective by combining tooth setup with patient anatomy

Go for guided pilot drilling or fully guided drilling and guided implant insertion using a custom-manufactured NobelGuide surgical template based upon the treatment plan

1

1

2

2

3

3

4

4

5 6

5

Right from the start with guided pilot drilling

When therersquos no room for error Guided pilot drilling assists you in achieving the correct angulation direction and depth of the first drill when placing implants in narrow spaces or close to the inferior alveolar nerve

Your starting point for edentulous treatmentConfidently make use of all available bone and overcome challenges such as bone resorption Avoid critical anatomical structures and place implants deeper using the sleeve-offset function It supports bone reduction allowing for the initial treatment plan to remain unchanged

Design a surgical template for partially edentulous patients in just one click following a plan prepared with NobelClinicianrsquos SmartFusion function The result is a precise guide for predictable freehand implant placement The ready-to-use template safely guides your initial drill according to your NobelClinician plan

NobelActive NobelParallel Conical Connection

NobelReplace Conical Connection

Replace Select NobelSpeedy Braringnemark System exclusive Mk III TiUnite and Mk IV TiUnite

7937

9 A

Lot

ldquoU

S 1

509rdquo

Prin

ted

in U

SA

copy N

obel

Bio

care

US

A L

LC 2

015

All

right

s re

serv

ed

Nob

el B

ioca

re t

he N

obel

Bio

care

log

otyp

e an

d al

l oth

er t

rade

mar

ks a

re i

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thin

g e

lse

is s

tate

d or

is e

vide

nt f

rom

the

con

text

in a

cer

tain

cas

e t

rade

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ks o

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obel

Bio

care

Ple

ase

refe

r to

nob

elbi

ocar

eco

mt

rade

mar

ks f

or m

ore

info

rmat

ion

P

rodu

ct im

ages

are

not

nec

essa

rily

to s

cale

Dis

clai

mer

Som

e pr

oduc

ts m

ay n

ot b

e re

gul

ator

y cl

eare

dre

leas

ed f

or s

ale

in a

ll m

arke

ts P

leas

e co

ntac

t th

e lo

cal N

obel

Bio

care

sal

es o

ffice

for

cur

rent

pro

duct

ass

ortm

ent

and

avai

labi

lity

nobelbiocarecomnobelguide

NobelGuidereg for predictable outcomes

Periapical and (CB)CT radiograph revealed loss of most of the root structure The four maxillary incisors were considered hopeless

Implants in situ after removal of the insertion assembly

Visualization of patientrsquos anatomic structures and diagnostic wax-up using the SmartFusion Virtual placement of NobelActive NP for the lateral incisors and NobelActive RP for the central incisors

Two-year post-insertion periapical radiographs demonstrate precise implant placement and stable bone levels

Learn from the pioneersTo develop the knowledge and skills needed to achieve the best possible results with the NobelGuide treatment concept you need to learn from the best

Whether yoursquore an experienced clinician or at the beginning of your implant career we will find an implant course tailored to your experience level

Contact Nobel Biocare customer service to start with NobelGuidenobelbiocarecomcontact

The surgical template was seated immediately after atraumatic tooth extraction Implants were placed using a fully guided surgical template

Two-year post insertion clinical view demonstrates excellent soft tissue contours

Case courtesy of Dr Peter Woumlhrle USA

Dr Peter Woumlhrle USA

Clinical caseTwenty-year-old patient Non-smoker with no parafunctional habitsPatient presented with request for dental implant treatment subsequent to orthodontic therapy

Discover more NobelGuide clinical cases and videos at nobelbiocarecomnobelguide

ldquo Patients today are more esthetically demanding Placement of implants using guided surgery is crucial to routinely achieve the necessary precision resulting in treatment predictability And for me Predictability equals patient satisfactionrdquo

References 1 Tahmaseb A Wismeijer D Coucke W Derksen W Computer technology applications in surgical implant dentistry a systematic review Int J Oral Maxillofac Implants 201429 Suppl25-42 2 Integrated treatment workflow Diag-nostics treatment planning and guided surgery with NobelClinician and NobelGuide Nobel Biocare Services AG GMT79393 Science First 2015(3)2 3 Pozzi A Tallarico M Marchetti M Scarfo B Esposito M Computer-guided versus free-hand placement of immediately loaded dental implants 1-year post-loading results of a multicentre randomised controlled trial Eur J Oral Implantol 20147(3)229-42 4 Nkenke E Eitner S Radespiel-Troger M Vairak-taris E Neukam FW Fenner M Patientcentred outcomes comparing transmucosal implant placement with an open approach in the maxilla a prospective non-randomized pilot study Clin Oral Implants Res 200718(2)197-203 5 Bertossi D Gerosa R Schembri E Zanotti G Rossini N Colletti G et al NobelGuide influence in the perception of postoperative pain Minerva Stomatol 2013 6 Puig CP A retrospective study of edentulous patients rehabilitated according to the lsquoall-on-fourrsquo or the lsquoall-on-sixrsquo immediate function concept using flapless computer-guided implant surgery Eur J Oral Implantol 20103(2)155-63 7 Meloni SM De Riu G Pisano M Cattina G Tullio A Implant treat-ment software planning and guided flapless surgery with immediate provisional prosthesis delivery in the fully edentulous maxilla A retrospective analysis of 15 consecutively treated patients Eur J Oral Implantol 20103(3)245-51 8 Pozzi A Holst S Fabbri G Tallarico M Clinical Reliability of CADCAM Cross-Arch Zirconia Bridges on Immediately Loaded Implants Placed with Computer-AssistedTemplate-Guided Surgery A Retrospective Study with a Follow-Up between 3 and 5 Years Clin Implant Dent Relat Res 201517(S1)e86-e96 9 Vasak C Watzak G Gahleitner A Strbac G Schemper M Zechner W Computed tomo graphy-based evaluation of template (NobelGuide() )-guided implant positions a prospective radiological study Clin Oral Implants Res 201122(10)1157-63 10 Van Assche N van Steenberghe D Quirynen M Jacobs R Accuracy assessment of computer-assisted flapless implant placement in partial edentulism J Clin Periodontol 201037(4)398-403 11 Furhauser R Mailath-Pokorny G Haas R Busenlechner D Watzek G Pommer B Esthetics of Flapless Single-Tooth Implants in the Anterior Maxilla Using Guided Surgery Association of Three-Dimensional Accuracy and Pink Esthetic Score Clin Implant Dent Relat Res epub ahead 2014 12 Pettersson A Komiyama A Hultin M Nasstrom K Klinge B Accuracy of virtually planned and tem-plate guided implant surgery on edentate patients Clin Implant Dent Relat Res 2012 Aug14(4)527-37 13 Katsoulis J Mericske-Stern R Rotkina L Zbaumlren C Enkling N Blatz MB Precision of fit of implant-supported screw-re-tained 10-unit computer-aided-designed and computer-aided-manufactured frameworks made from zirconium dioxide and titanium an in vitro study Clin Oral Implants Res 2014 Feb25(2)165-74 14 Truninger TC Stawarczyk B Leutert CR et al Bending moments of zirconia and titanium abutments with internal and external implant-abutment connections after aging and chewing simulation Clin Oral Implants Res 201223(1)12-18 15 Zembic A Bosch A Jung RE Hammerle CH Sailer I Five-year results of a randomized controlled clinical trial comparing zirconia and titanium abutments supporting single-implant crowns in canine and posterior regions Clin Oral Implants Res 201324(4)384-90 16 Ozer F Mante FK Chiche G et al A retrospective survey on long-term survival of posterior zirconia and porcelain-fused-to-metal crowns in private practice Quintessence Int 201445(1)31-8 17 Imburgia M Coachman C Using digital devices to improve communications between clinicians and patients during implantprosthetic treatment a clinical study [519] 23rd Annual Scientific Meeting of the European Association for Osseointe-gration Rome Italy Wiley 2014 p 538 18 Scotti R Pellegrino G Marchetti C Corinaldesi G Ciocca L Diagnostic value of NobelGuide to minimize the need for reconstructive surgery of jaws before implant placement a review Quintessence Int 201041(10)809-14

Page 5: Digital precision for all indications NobelGuide® · A retrospective study of edentulous patients rehabilitated according to the ‘all-on-four’ or the ‘all-on-six’ immediate

Right from the start with guided pilot drilling

When therersquos no room for error Guided pilot drilling assists you in achieving the correct angulation direction and depth of the first drill when placing implants in narrow spaces or close to the inferior alveolar nerve

Your starting point for edentulous treatmentConfidently make use of all available bone and overcome challenges such as bone resorption Avoid critical anatomical structures and place implants deeper using the sleeve-offset function It supports bone reduction allowing for the initial treatment plan to remain unchanged

Design a surgical template for partially edentulous patients in just one click following a plan prepared with NobelClinicianrsquos SmartFusion function The result is a precise guide for predictable freehand implant placement The ready-to-use template safely guides your initial drill according to your NobelClinician plan

NobelActive NobelParallel Conical Connection

NobelReplace Conical Connection

Replace Select NobelSpeedy Braringnemark System exclusive Mk III TiUnite and Mk IV TiUnite

7937

9 A

Lot

ldquoU

S 1

509rdquo

Prin

ted

in U

SA

copy N

obel

Bio

care

US

A L

LC 2

015

All

right

s re

serv

ed

Nob

el B

ioca

re t

he N

obel

Bio

care

log

otyp

e an

d al

l oth

er t

rade

mar

ks a

re i

f no

thin

g e

lse

is s

tate

d or

is e

vide

nt f

rom

the

con

text

in a

cer

tain

cas

e t

rade

mar

ks o

f N

obel

Bio

care

Ple

ase

refe

r to

nob

elbi

ocar

eco

mt

rade

mar

ks f

or m

ore

info

rmat

ion

P

rodu

ct im

ages

are

not

nec

essa

rily

to s

cale

Dis

clai

mer

Som

e pr

oduc

ts m

ay n

ot b

e re

gul

ator

y cl

eare

dre

leas

ed f

or s

ale

in a

ll m

arke

ts P

leas

e co

ntac

t th

e lo

cal N

obel

Bio

care

sal

es o

ffice

for

cur

rent

pro

duct

ass

ortm

ent

and

avai

labi

lity

nobelbiocarecomnobelguide

NobelGuidereg for predictable outcomes

Periapical and (CB)CT radiograph revealed loss of most of the root structure The four maxillary incisors were considered hopeless

Implants in situ after removal of the insertion assembly

Visualization of patientrsquos anatomic structures and diagnostic wax-up using the SmartFusion Virtual placement of NobelActive NP for the lateral incisors and NobelActive RP for the central incisors

Two-year post-insertion periapical radiographs demonstrate precise implant placement and stable bone levels

Learn from the pioneersTo develop the knowledge and skills needed to achieve the best possible results with the NobelGuide treatment concept you need to learn from the best

Whether yoursquore an experienced clinician or at the beginning of your implant career we will find an implant course tailored to your experience level

Contact Nobel Biocare customer service to start with NobelGuidenobelbiocarecomcontact

The surgical template was seated immediately after atraumatic tooth extraction Implants were placed using a fully guided surgical template

Two-year post insertion clinical view demonstrates excellent soft tissue contours

Case courtesy of Dr Peter Woumlhrle USA

Dr Peter Woumlhrle USA

Clinical caseTwenty-year-old patient Non-smoker with no parafunctional habitsPatient presented with request for dental implant treatment subsequent to orthodontic therapy

Discover more NobelGuide clinical cases and videos at nobelbiocarecomnobelguide

ldquo Patients today are more esthetically demanding Placement of implants using guided surgery is crucial to routinely achieve the necessary precision resulting in treatment predictability And for me Predictability equals patient satisfactionrdquo

References 1 Tahmaseb A Wismeijer D Coucke W Derksen W Computer technology applications in surgical implant dentistry a systematic review Int J Oral Maxillofac Implants 201429 Suppl25-42 2 Integrated treatment workflow Diag-nostics treatment planning and guided surgery with NobelClinician and NobelGuide Nobel Biocare Services AG GMT79393 Science First 2015(3)2 3 Pozzi A Tallarico M Marchetti M Scarfo B Esposito M Computer-guided versus free-hand placement of immediately loaded dental implants 1-year post-loading results of a multicentre randomised controlled trial Eur J Oral Implantol 20147(3)229-42 4 Nkenke E Eitner S Radespiel-Troger M Vairak-taris E Neukam FW Fenner M Patientcentred outcomes comparing transmucosal implant placement with an open approach in the maxilla a prospective non-randomized pilot study Clin Oral Implants Res 200718(2)197-203 5 Bertossi D Gerosa R Schembri E Zanotti G Rossini N Colletti G et al NobelGuide influence in the perception of postoperative pain Minerva Stomatol 2013 6 Puig CP A retrospective study of edentulous patients rehabilitated according to the lsquoall-on-fourrsquo or the lsquoall-on-sixrsquo immediate function concept using flapless computer-guided implant surgery Eur J Oral Implantol 20103(2)155-63 7 Meloni SM De Riu G Pisano M Cattina G Tullio A Implant treat-ment software planning and guided flapless surgery with immediate provisional prosthesis delivery in the fully edentulous maxilla A retrospective analysis of 15 consecutively treated patients Eur J Oral Implantol 20103(3)245-51 8 Pozzi A Holst S Fabbri G Tallarico M Clinical Reliability of CADCAM Cross-Arch Zirconia Bridges on Immediately Loaded Implants Placed with Computer-AssistedTemplate-Guided Surgery A Retrospective Study with a Follow-Up between 3 and 5 Years Clin Implant Dent Relat Res 201517(S1)e86-e96 9 Vasak C Watzak G Gahleitner A Strbac G Schemper M Zechner W Computed tomo graphy-based evaluation of template (NobelGuide() )-guided implant positions a prospective radiological study Clin Oral Implants Res 201122(10)1157-63 10 Van Assche N van Steenberghe D Quirynen M Jacobs R Accuracy assessment of computer-assisted flapless implant placement in partial edentulism J Clin Periodontol 201037(4)398-403 11 Furhauser R Mailath-Pokorny G Haas R Busenlechner D Watzek G Pommer B Esthetics of Flapless Single-Tooth Implants in the Anterior Maxilla Using Guided Surgery Association of Three-Dimensional Accuracy and Pink Esthetic Score Clin Implant Dent Relat Res epub ahead 2014 12 Pettersson A Komiyama A Hultin M Nasstrom K Klinge B Accuracy of virtually planned and tem-plate guided implant surgery on edentate patients Clin Implant Dent Relat Res 2012 Aug14(4)527-37 13 Katsoulis J Mericske-Stern R Rotkina L Zbaumlren C Enkling N Blatz MB Precision of fit of implant-supported screw-re-tained 10-unit computer-aided-designed and computer-aided-manufactured frameworks made from zirconium dioxide and titanium an in vitro study Clin Oral Implants Res 2014 Feb25(2)165-74 14 Truninger TC Stawarczyk B Leutert CR et al Bending moments of zirconia and titanium abutments with internal and external implant-abutment connections after aging and chewing simulation Clin Oral Implants Res 201223(1)12-18 15 Zembic A Bosch A Jung RE Hammerle CH Sailer I Five-year results of a randomized controlled clinical trial comparing zirconia and titanium abutments supporting single-implant crowns in canine and posterior regions Clin Oral Implants Res 201324(4)384-90 16 Ozer F Mante FK Chiche G et al A retrospective survey on long-term survival of posterior zirconia and porcelain-fused-to-metal crowns in private practice Quintessence Int 201445(1)31-8 17 Imburgia M Coachman C Using digital devices to improve communications between clinicians and patients during implantprosthetic treatment a clinical study [519] 23rd Annual Scientific Meeting of the European Association for Osseointe-gration Rome Italy Wiley 2014 p 538 18 Scotti R Pellegrino G Marchetti C Corinaldesi G Ciocca L Diagnostic value of NobelGuide to minimize the need for reconstructive surgery of jaws before implant placement a review Quintessence Int 201041(10)809-14

Page 6: Digital precision for all indications NobelGuide® · A retrospective study of edentulous patients rehabilitated according to the ‘all-on-four’ or the ‘all-on-six’ immediate

7937

9 A

Lot

ldquoU

S 1

509rdquo

Prin

ted

in U

SA

copy N

obel

Bio

care

US

A L

LC 2

015

All

right

s re

serv

ed

Nob

el B

ioca

re t

he N

obel

Bio

care

log

otyp

e an

d al

l oth

er t

rade

mar

ks a

re i

f no

thin

g e

lse

is s

tate

d or

is e

vide

nt f

rom

the

con

text

in a

cer

tain

cas

e t

rade

mar

ks o

f N

obel

Bio

care

Ple

ase

refe

r to

nob

elbi

ocar

eco

mt

rade

mar

ks f

or m

ore

info

rmat

ion

P

rodu

ct im

ages

are

not

nec

essa

rily

to s

cale

Dis

clai

mer

Som

e pr

oduc

ts m

ay n

ot b

e re

gul

ator

y cl

eare

dre

leas

ed f

or s

ale

in a

ll m

arke

ts P

leas

e co

ntac

t th

e lo

cal N

obel

Bio

care

sal

es o

ffice

for

cur

rent

pro

duct

ass

ortm

ent

and

avai

labi

lity

nobelbiocarecomnobelguide

NobelGuidereg for predictable outcomes

Periapical and (CB)CT radiograph revealed loss of most of the root structure The four maxillary incisors were considered hopeless

Implants in situ after removal of the insertion assembly

Visualization of patientrsquos anatomic structures and diagnostic wax-up using the SmartFusion Virtual placement of NobelActive NP for the lateral incisors and NobelActive RP for the central incisors

Two-year post-insertion periapical radiographs demonstrate precise implant placement and stable bone levels

Learn from the pioneersTo develop the knowledge and skills needed to achieve the best possible results with the NobelGuide treatment concept you need to learn from the best

Whether yoursquore an experienced clinician or at the beginning of your implant career we will find an implant course tailored to your experience level

Contact Nobel Biocare customer service to start with NobelGuidenobelbiocarecomcontact

The surgical template was seated immediately after atraumatic tooth extraction Implants were placed using a fully guided surgical template

Two-year post insertion clinical view demonstrates excellent soft tissue contours

Case courtesy of Dr Peter Woumlhrle USA

Dr Peter Woumlhrle USA

Clinical caseTwenty-year-old patient Non-smoker with no parafunctional habitsPatient presented with request for dental implant treatment subsequent to orthodontic therapy

Discover more NobelGuide clinical cases and videos at nobelbiocarecomnobelguide

ldquo Patients today are more esthetically demanding Placement of implants using guided surgery is crucial to routinely achieve the necessary precision resulting in treatment predictability And for me Predictability equals patient satisfactionrdquo

References 1 Tahmaseb A Wismeijer D Coucke W Derksen W Computer technology applications in surgical implant dentistry a systematic review Int J Oral Maxillofac Implants 201429 Suppl25-42 2 Integrated treatment workflow Diag-nostics treatment planning and guided surgery with NobelClinician and NobelGuide Nobel Biocare Services AG GMT79393 Science First 2015(3)2 3 Pozzi A Tallarico M Marchetti M Scarfo B Esposito M Computer-guided versus free-hand placement of immediately loaded dental implants 1-year post-loading results of a multicentre randomised controlled trial Eur J Oral Implantol 20147(3)229-42 4 Nkenke E Eitner S Radespiel-Troger M Vairak-taris E Neukam FW Fenner M Patientcentred outcomes comparing transmucosal implant placement with an open approach in the maxilla a prospective non-randomized pilot study Clin Oral Implants Res 200718(2)197-203 5 Bertossi D Gerosa R Schembri E Zanotti G Rossini N Colletti G et al NobelGuide influence in the perception of postoperative pain Minerva Stomatol 2013 6 Puig CP A retrospective study of edentulous patients rehabilitated according to the lsquoall-on-fourrsquo or the lsquoall-on-sixrsquo immediate function concept using flapless computer-guided implant surgery Eur J Oral Implantol 20103(2)155-63 7 Meloni SM De Riu G Pisano M Cattina G Tullio A Implant treat-ment software planning and guided flapless surgery with immediate provisional prosthesis delivery in the fully edentulous maxilla A retrospective analysis of 15 consecutively treated patients Eur J Oral Implantol 20103(3)245-51 8 Pozzi A Holst S Fabbri G Tallarico M Clinical Reliability of CADCAM Cross-Arch Zirconia Bridges on Immediately Loaded Implants Placed with Computer-AssistedTemplate-Guided Surgery A Retrospective Study with a Follow-Up between 3 and 5 Years Clin Implant Dent Relat Res 201517(S1)e86-e96 9 Vasak C Watzak G Gahleitner A Strbac G Schemper M Zechner W Computed tomo graphy-based evaluation of template (NobelGuide() )-guided implant positions a prospective radiological study Clin Oral Implants Res 201122(10)1157-63 10 Van Assche N van Steenberghe D Quirynen M Jacobs R Accuracy assessment of computer-assisted flapless implant placement in partial edentulism J Clin Periodontol 201037(4)398-403 11 Furhauser R Mailath-Pokorny G Haas R Busenlechner D Watzek G Pommer B Esthetics of Flapless Single-Tooth Implants in the Anterior Maxilla Using Guided Surgery Association of Three-Dimensional Accuracy and Pink Esthetic Score Clin Implant Dent Relat Res epub ahead 2014 12 Pettersson A Komiyama A Hultin M Nasstrom K Klinge B Accuracy of virtually planned and tem-plate guided implant surgery on edentate patients Clin Implant Dent Relat Res 2012 Aug14(4)527-37 13 Katsoulis J Mericske-Stern R Rotkina L Zbaumlren C Enkling N Blatz MB Precision of fit of implant-supported screw-re-tained 10-unit computer-aided-designed and computer-aided-manufactured frameworks made from zirconium dioxide and titanium an in vitro study Clin Oral Implants Res 2014 Feb25(2)165-74 14 Truninger TC Stawarczyk B Leutert CR et al Bending moments of zirconia and titanium abutments with internal and external implant-abutment connections after aging and chewing simulation Clin Oral Implants Res 201223(1)12-18 15 Zembic A Bosch A Jung RE Hammerle CH Sailer I Five-year results of a randomized controlled clinical trial comparing zirconia and titanium abutments supporting single-implant crowns in canine and posterior regions Clin Oral Implants Res 201324(4)384-90 16 Ozer F Mante FK Chiche G et al A retrospective survey on long-term survival of posterior zirconia and porcelain-fused-to-metal crowns in private practice Quintessence Int 201445(1)31-8 17 Imburgia M Coachman C Using digital devices to improve communications between clinicians and patients during implantprosthetic treatment a clinical study [519] 23rd Annual Scientific Meeting of the European Association for Osseointe-gration Rome Italy Wiley 2014 p 538 18 Scotti R Pellegrino G Marchetti C Corinaldesi G Ciocca L Diagnostic value of NobelGuide to minimize the need for reconstructive surgery of jaws before implant placement a review Quintessence Int 201041(10)809-14