The laboratory in the digital age 27 June 2015

Author: Jean-Marc Etienne
Nobel Biocare Symposium - MONACO - 25 to 27 June 2015

In the plenary room, Jean-Marc Etienne illustrated his presentation "The laboratory in the digital age" with 3 clinical cases of screw-retained prostheses.

In a rallying speech, Jean-Marc Etienne linked Digital with "sharing and speed" emphasizing the need to use these new tools intelligently while striving for the excellence they can bring us nowadays, against some tendencies which tend to redefine "standards" in a more mediocre way...

The 3 cases:

1. Full-arch zirconia PIB (with contribution of pink ceramic).
2. Partial zirconia PIB: 4 maxillary incisors on 2 implants 12 and 22
3. Single Maxillary central incisor (project, planning, implementation): digital workflow

The "Smile design" concept: is it imperative to have a virtual project for all patients? Absolutely not!

Finally, Jean-Marc Etienne presented 3 solutions to screw-retained MOLARS:

1. ASC

A screw-retained ZIRCONIA prosthesis, homothetically scanned at the lab, covered with a custom-made laminate veneer, within which a metal adapter (Ti base, Nobel biocare) is placed to secure it to the implant.

Limited vertical space, small mouth opening, optimization of the occlusal function with the angulated screw channel. ASC (Angulated Screw Channel) up to 25° of angled channel.

The ASC abutment is only available with a conical connection (CC) and solely in zirconia on the NP-RP and from now on the WP platforms (diameter more adjusted to molars). Optimizing the emergence and anatomy profile and reproducing the real tooth more accurately.

An easily implemented , reliable and aesthetic solution (polyvalency of customized restorations) using the Omnigrip screwdriver.

2. FCZ

A full-contour screw-retained implant crown, it is CAD/CAM machined and made from monolithic zirconia. The complete shape is scanned: its replica is obtained in a non-laminated biocompatible material (available in 8 shades for all possible combinations, by surface colouring protected by a glaze).

Provided with a titanium metal adapter (Ti base, CC connection, Nobel Biocare), it retains the angled channel advantage (ASC) and offers high mechanical resistance.

3. Universal BASE :

A screw-retained crown made from lithium disilicate (E-Max) created using press-on technique, wax-up or machined CAD/CAM retained on a titanium abutment designed and approved by NobelBiocare (for the CC connection).

This solution allows the prosthetist to use the protocol that best suits him/her with the guarantee of a reliable implant connection thanks to the titanium abutment, available in 2 transmucosal heights.

To conclude, these 3 solutions offer complete maxilla restorations without sealing cement, optimising the choice of material and screwing angle.