The Direct Abutment System ......................4Keeping the Simple Case Simple ..............6Chronicle of Documentation ......................9

Astra Tech Implants Placed in Dog ..........10Education Program 2003 ......................14Creating Perfectly Sculptured Soft Tissues..16

Introducing theDirect AbutmentIntroducing theDirect Abutment

Volume 6. No 1. 2003

# 6:1

As simple as crown and bridgeAs simple as crown and bridge

Three simple steps. Page 4

PublisherThe Astra Tech Insight is published and distrib-uted worldwide by Astra Tech AB, P.O. Box 14,SE-431 21 Mölndal, Sweden. Astra Tech is acompany in the AstraZeneca Group.

Editor-in-chiefMia Jensen, DDSClinical Information Manager, DentalAstra Tech AB

Associate editorAnders Holmén, DDSMedical Director, DentalAstra Tech AB

Contact usEditors can be reached at the above address and at

editor.insight@astratech.com

Please mail your questions, opinions andthoughts on the Astra Tech Insight.

SubscriptionContact your local office or the Astra Tech mainoffice directly on the above mentioned address.

CopyrightAll rights reserved, including that of translationinto other languages. No part of this publica-tion may be reproduced or transmitted in anyform or by any means, electronic or mechan-ical, including photocopying, recording or anyinformation storage or retrieval system, withoutpermission in writing from Astra Tech AB.

Editorial contentAlthough great care has been taken in compil-ing and checking the information given in thispublication to ensure it is accurate, the publishershall not be held responsible for the continuedcurrency of the information or for any errors,omissions or inaccuracies in this publication.

The opinions expressed in this publication arenot necessary those of the publisher or editor-in-chief.

Submitted material will be stored electronicallyfor the possibility of publication on the Internet,reprints and in other manners.

Editorial content developed in conjunction withAdis International Limited, Chowley Oak Lane,Tattenhall, Chester, CH3 9GA, UK.

Layout Layout developed with assistance of theadvertising agency Explicit & Partners, Göteborg, Sweden.

PrintingPrinted in Sweden by Alfredssons Offset AB.

ContentsThe Future Belongs to Us ........................................3Dynamic development is taking place due to increasing demands for the Astra Tech Dental Implant System.

The Direct Abutment System ....................................4A simple and flexible system with conventional procedures for cemented constructions with an esthetic result.

Keeping the Simple Case Simple ..............................6Clinical experience from developing and working with the Direct Abutment, interview with Dr Mastrovich, USA.

Chronicle of Documentation ....................................9Discover the new browser for scientific documentation on your own computer.

Man’s Best Friend – Astra Tech Implants Successfully Placed in Dog ........10As the first utility dog in the world a young German shepherdreceives Astra Tech Implants and a crown.

Welcome to the International Education Program for 2003 ................................14Read more on all the international courses available from Astra Tech.

Creating Perfectly Sculptured Soft Tissues ................16For individualized esthetics with screw-retained constructions, use the new ProHeal Cap System.

Get on-line ........................................................17Find out what the Astra Tech website can offer to you.

Successful Design of Implant Education Program in Bilbao ................................................18A year-long program gives dentists a thorough knowledge and clinical skills in implant treatment.

Join Astra Tech at 2003 Congresses! ......................19Read more on the upcoming congresses in 2003.

Cover: The Direct Abutment System allows for conventional crownand bridge technique to be used with cemented constructions.

INSIGHT #6:1:2003 3INSIGHT #6:1:2003 3

Astra Tech is part of the AstraZenecagroup. AstraZeneca is one of theworld’s leading pharmaceutical com-panies; it has over 54,000 employeesand has products marketed in over100 countries. Importantly,AstraZeneca invests USD 10 millionevery working day in research anddevelopment activities.

Astra Tech is the only companywithin the AstraZeneca group whichspecializes in the field of medicaldevices. Our close connection to thepharmaceutical industry has a signi-ficant impact on the way we developand market our products. We havean extensive international programfor clinical investigations and followthe same strict protocols that areapplied in pharmaceutical trials inorder to base our marketing claimson solid documentation. This hasmade the Astra Tech Dental Implant

System one of the best-documentedimplant systems in the world.

Our design, originating in theearly 1980s, has excellent performanceand we have seen one competitorsystem after another trying to copyour results. With over 20 years ofexperience from our Conical SealDesign™ and more than 10 years fromour rough surface TiOblast™ and theunique MicroThread™, it is reward-ing to see the former leaders withinthe field now falling in behind us.

Our product development doesnot blindly aim to increase ourrevenue and cut costs but rather toenhance the performance of oursystem, proving ourselves worthy ofthe trust of our clients. The ongoinglaunch of the Fixture MicroThread is supported by over 10 years of ex-perience and 5 years of publishedclinical data. The aim is to establish

the Astra Tech Dental Implant Systemas the new gold standard withindental implantology.

We want to offer our clients a“total product” consisting of ourwell-designed system, support fromcompetent and dedicated staff, soliddocumentation and high qualitytraining and education. This offer, incombination with serious and ethicalmarketing is for us, the key tosuccess.

The FutureBelongs to Us

Astra Tech of today is a company undergoing dynamic development. All over the world our sales are growing rapidly, and at a rate at

least double that of our major competitors. We are currently buildingour organization in order to meet this increasing demand and to

ensure a high level of service for our clients.

I N T R O D U C T I O N

Björn Delin, DDSProduct Group & Marketing

Director, DentalAstra Tech AB

Photo:Sofia Sabel

4 INSIGHT #6:1:2003

Kent Engström, DDSTherapy Manager Prosthetics, DentalAstra Tech AB

P R O D U C T P R E S E N TAT I O N T H E D I R E C T A B U T M E N T S Y S T E M

4 INSIGHT #6:1:2003

The Direct Abutment System offers a simplified restorative protocol forimplant-supported constructions.This gives the clinician the unrivalledpossibility of recreating the patient’snatural smile and appearance.

Conventional prosthetic procedureThe Direct Abutment is a pre-preparedsolid core abutment designed to allowfor conventional crown and bridgeprocedures, but easier. The coronaland restorative margin mimics theconfiguration of prepared naturalteeth in different positions. The abut-ments are available in four verticalheights from the fixture to the restor-ative margin (0.5, 1, 2.5 and 4 mm)and three widths at the shoulder

(4, 5 and 6 mm). This offers a uniquefreedom to choose an ideal size fornatural esthetics.

In total, there are 12 different kitseach containing a Direct Abutmentwith carrier, Impression Pick-up, andtwo Healing Cap/Burnout Cylinders.The kits provide control of the in-ventory and the components followthe patient through the restorativeprocess.

Design featuresThe Direct Abutment System hasseveral features which make it aconvenient standard procedure. TheDirect Abutment is designed with:• Pre-prepared configuration whichfits the majority of cases.

• Snap-on groove situated directlyover the restorative margin – provid-ing retention for the Impression Pick-up, Healing Cap/Burnout Cylinder.• Laser-etched indication at 1 mmfrom the top – allowing for custom-ization via occlusal reduction.• Hex hole at the top – giving optionsfor carrying, seating and retrieval.• Flat surface – providing indexingand anti-rotation of the crown. Thereare also two ST-types of Direct Abut-ments providing anti-rotation in the4.5/5.0 fixture.

Snap-on for easy handling• The Direct Abutment Carrier isdesigned for friction fit to the abut-ment. It offers tight connection, easycarrying and quick seating of theabutment. It is designed with verticalgrooves providing grip for the newTorque Wrench.• The Snap-on function of the DirectAbutment Impression Pick-up makesimpression-taking very simple andaccurate. It provides distinct seatingand perfect capturing of the restor-ative margin. The raised dot indicates

The

Direct Abutment– as Simple as Crown and Bridge

The Direct Abutment System was developed for cemented constructionsand provides esthetic solutions in most cases without the need for custom-ization.

SummaryA system with pre-prepared abutmentsallows for conventional crown and bridgetechnique when performing cementedconstructions. The 12 different abutmentsvary in height and width covering mostclinical situations and rendering excellentesthetic results.

The simple-to-use Process Kit contains allnecessary parts for the dentist and tech-nician: Direct Abutment, Carrier, snap-onImpression Pick-up, Replica and HealingCap/Burnout Cylinder.

the indexing flat surface of the abut-ment. The Pick-ups are color-coded.• The Direct Abutment Replica con-tains a laser-etched indication allow-ing for occlusal reduction.• The Direct Abutment Healing Cap/Burnout Cylinder functions as tissuesupport and protection during heal-ing with a snap-on function and canbe used as a base for temporisations.It is also used as a wax-up and burn-out coping.• The Process Kit contains all neces-sary components and no additionalinstrumentation is needed.

Restorative protocolThe restorative protocol is very simple and mimics conventionalcrown and bridge technique. Thefirst step is to measure the soft tissueheight (Fig. 1), and decide whichabutment to use, taking into accountthe width and cervical height. Theabutment is mounted with the carriereither by hand (Fig. 2) or by usingthe Torque Wrench. The snap-onImpression Pick-up is seated on theabutment (Fig. 3). The impression istaken using a closed tray and elasto-meric impression material (Fig. 4),and is sent to the laboratory togetherwith the replica and the BurnoutCylinder.

The dentist completes his work byplacing the Healing Cap or by usingit as a base for a provisional. In thelaboratory, the final construction iscompleted following conventionallaboratory protocol.

As mentioned before, this systemoffers the possibility of reducing theheight by 1 mm by preparing downto the laser-etched indication that isavailable on both the abutment andthe replica. For more extensive indi-vidualization, we recommend use ofour customized abutments such asProfile BiAbutment or Cast-to Abut-ment. If you choose to do prepara-tion on the Direct Abutment, it is, ofcourse, possible with conventionalimpression technique without usingthe Pick-up.

The Direct Abutment System willgive you the possibility of perform-ing your cement-retained implantrestorations using conventionalcrown and bridge technique. Thewide variety of heights and dia-meters makes this the ideal systemusing pre-prepared abutments.

Direct Abutment Impression Pick-up Burnout Cylinder/Healing CapCarrier Abutment Replica

INSIGHT #6:1:2003 5INSIGHT #6:1:2003 5

1. Measure the thickness of soft tissue with the Tissue Depth Gaugemm. Use the gauge which matchesfixture 3.5, 4.0 ST and 4.5/5.0 ST,respectively.

2. Deliver the abutment to the fixture and tighten firmly. Apply 15 Ncm using the Torque Wrench.

3. Align the flat surface of the abut-ment with the raised dot on theImpression Pick-up and seat firmlyuntil snap.

4. Use a closed tray and elasto-meric impression material. Note:Impression Pick-up cannot be usedwhen occlusal reduction is morethan 1 mm, or the tapered aspector shoulder have been customized.

6 INSIGHT #6:1:2003

1 What is the key to simplifyingimplant treatment?

There are several key factors inattaining this coveted designation of“easy”. First and foremost, as inother phases of dentistry, often timesthe clinical situation dictates thelevel of complexity because not allcases are created equal. Practitionereducation and experience can pre-identify case complexity allowing forproperly diagnosed and coordinatedcase planning from initial consulta-tion through treatment execution.

Of course, simplicity is not justcase-dependent but also system-dependent. Working with Astra Tech

in the development of the DirectAbutment, I have been impressedwith how much effort is directedtoward delivering components witha range of functionality and proce-dural simplicity without sacrificingclinical stability or over-complicatingthe system. I believe the DirectAbutment System will now meet this requirement of helping to keep thesimple case simple by providing a verystable platform for cement-retainedrestorations when there is no specificneed for custom abutment fabrica-tion. In other words, let’s do thepreparing in the machine shopwhenever possible.

Keepingthe Simple Case SimpleDevelopment and Clinical Experience of the Direct Abutment

Dr Mastrovich has experience with the Astra Tech Dental ImplantSystem since the early 90s. Over the years, Dr Mastrovich has providedvaluable information and novel ideas, which played an important rolein the development of the Direct Abutment System.

Dr Charlie MastrovichProsthodontistEscondido, CA, USA

I N T E R V I E W

SummaryDr Mastrovich explains his views on how to simplify prosthetic procedure andminimize the need for customized abut-ments with the Direct Abutment System.Easy abutment insertion and dimensionalflexibility in vertical and horizontal

aspects result in a standardized crownand bridge protocol, which is easier andmore cost effective.

Unique freedom to choose the idealsize for natural esthetics.

Interview performed by PR-team, Astra Tech Inc.

INSIGHT #6:1:2003 7

2 You have been involved in the development and clinical

evaluation of the Direct AbutmentSystem. Which clinical aspects havebeen the focus and have been incor-porated into the design?The primary mission in developmentwas to create an easy-to-use cement-retained abutment system, whichcould alleviate the need for customi-zed abutments in many cases when acement-retained option was prefer-able. The application would of coursesave precious chair time and expense,plus provide for expanded clinicalfunctionality as in immediately pro-visionalized or loaded cases.

Along the development road,there have been many clinical aspects,which have driven the design of thisnew abutment system. To address thenumerous aspects involved, I wouldlike to describe the clinical and labor-atory phases illustrating the pointswith photographs from three cases.

The first case restores the easy abut-ment insertion, without fear of tissueimpingement. Until experienced, theprofound simplification this has oneveryday implant dentistry is hard toappreciate (Figs. 1 and 2). The arrayof Direct Abutments gives the clini-cian dimensional flexibility in verticaland horizontal aspects to control abut-ment height and emergence diameterfor maximum flexibility, withouthaving to resort to custom preparedor wax-and-cast options (Fig. 3). Thesimplicity of the transfer system (Fig.4), with identically sized abutmentsand replicas, translates into identicalsnap fits for both impression takingand replica insertion.

When there is no indication fortemporary replacement, a snap-onHealing Cap is provided for tissuecontrol and patient comfort (Fig. 5).If provisionals are needed, the cap

doubles as a provisional base. Bypicking up the Healing Cap in a pre-fabricated provisional shell or vacu-um form matrix, the fit and margindetail will automatically be com-plete*. This leaves only the refiningof emergence contour to efficientlycomplete the provisional. In the labo-ratory, wax-up on the other HealingCap/Burnout Cylinder can proceedimmediately once the master cast isarticulated. No die spacing is neces-sary, as this space has already beenbuilt into the tolerance fit of theBurnout Cylinder. Once the restora-tion is cast, the metal copings do notrequire internal relief, as the reten-tive features of the abutment are notengaged in the waxing sleeve. Bothof these features save time for thetechnician, and truly make implantsupported crown fabrication in thelaboratory as straightforward as anyother PFM restoration. Once deliv-ered, the crown will have the samefeel on the abutment as it did on thereplica in the lab (Fig. 6).* There are two Healing Caps in each kit and one isused as a Burnout Cylinder.

3 Is there any other feature orclinical aspect that you believe

should be highlighted?Without shifting the focus away fromthe main topic of installing andimpressioning abutments simply with-out preparing, there are scenarioswhen some modification to the abut-ment will expand its clinical useful-ness. I see these modifications fallinginto two basic categories: modifica-tions involving the margin, and thosethat only involve the abutmentabove the margin. If the modificationis confined above the margin, aswhen a limited vertical space dictatesa shorter clinical abutment height,the abutments (and replicas) can

1. The case as returned from the sur-geon with standard healing abutmentsin place.

2. Healing abutments removed, priorto abutment insertion.

3. Direct Abutments installed.

4. Intraoral view of transfers in placeprior to impression.

5. Intraoral view of HealingCaps/Burnout Cylinders installed.

8 INSIGHT #6:1:2003

easily be reduced using the laser lineguide. This allows use of the sametransfer system (avoiding needlessduplication of additional compo-nents). If the need arises for angula-tion or draw modifications, either clinically or in the laboratory phase,the previously described protectivecaps also double as pre-made reduc-tion copings. Modification of themargin to adapt accurately to tissuecontour introduces the need to trans-fer this information into the lab. Ihave used two techniques to accom-plish this quite easily: the prepableProfile BiAbutments, and the Cast-toAbutments. In the first technique, themodified abutment can simply becaptured with standard impressiontechniques, bypassing the transfercoping. In the second technique, Irecover the modified abutment andimpress for a die extraorally (Figs. 7and 8). The abutment is reinsertedand a full arch impression is com-pleted, generally without the impres-sion coping. However, in the illus-trated modified Direct Abutment 4 inFig. 8, the impression was createdwith the transfer, and an epoxy diewas poured and inserted into theimpression as a custom replica (Figs.9 and 10). Initially this techniquesounds complicated. However, due to the ease by which abutments canbe inserted, tissue packing avoidedand impressions attained with fast-set polyvinyl, the technique takes nomore chair time than an intraoralimpression.

4 What is your clinical experi-ence of the current Direct

Abutment line and clinical concept?Of course, I have a rather biasedopinion, clouded by a significantamount of experience with thevarious prototypes and prototyping

steps generated to create the currentDirect Abutment line. This systemallows me to choose abutments andeasily restore when the clinical situa-tion allows. I have found a very highpercentage of the posterior casesadapt easily to the Direct Abutment,but a lower percentage in the anteriorregion where tissue contour tends tobe more scalloped, especially insingle tooth scenarios. That is what isgreat about the system: a fixturelevel impression can be made as easyas an abutment level impression. Ifnecessary, a custom abutment can befabricated, using laboratory time inlieu of additional clinical chair time.

5 What restorative protocol can please all parties involved

– surgeon, restorative dentist, tech-nician and patient?I don’t think I can be specific exactlyin those terms. I believe the caseshould drive the restorative protocol.With that said, when there is a treat-ment planning choice, generallysimple is better than complex. TheDirect Abutment System with itsclinical flexibility is a good exampleof confining an implant case to astandard crown and bridge protocolthat is easier and more cost effective.

6. Completed crowns seated on themaster cast.

7. Extraoral box impression of modi-fied abutment.

8. Transfer seated intraorally on modi-fied Direct Abutment 4.

9. Epoxy die generated from extraoralimpression.

10. Epoxy die inserted into full archimpression as a custom replica.

Research results are made public inmany ways, the most common andimportant being through publicationin scientific journals. Our experienceis that sometimes much of the scien-tific literature is difficult to get to.Therefore, the design of a tool for thepresentation of scientific documentsis a delicate task. For the activeresearcher, it is evident that there ismuch to find in the documentationand so we have tried to extract theessence of our articles into brief sum-maries to highlight important matters.

Simple and factualToday, the majority of researchershave access to computers which iswhy we wanted to use this new tech-nology to present our documents.We have created a CD, a Chroniclecovering the documentation of AstraTech Implants. The literature hasbeen categorized and summarizedfor the convenience of the user. Wehave endeavored to produce a sim-plified process and stepwise catego-rization of documents while trying tocreate a mind map to help navigatethe flood of facts.

Easy navigationBehind the door to the vault wherewe keep the Documentation, with amouse click, you will find documen-tation on a variety of topics. Eachtopic provides a list of references andthe individual scientific article issummarized in a one-page printout.The navigation map looks like a tree,one stem with four major branches:Methods, Indications, ParticularTopics and the System Key Features.Each branch then has a number oftwigs with more sub-groups on the

branch topic. The user can navigateup and down the tree as he or shepleases.

The Chronicle of Documentationis a pioneer production, please doenjoy it!

To get your Chronicle of Docu-mentation on CD, please contactyour local Astra Tech representative!

INSIGHT #6:1:2003 9

Chronicle of Documentation-CD

Astra Tech’s ambitions include intense front-line research to provide thebest solution for each patient. Implant treatment has become the firstchoice for a growing number of indications and we know that we canfurther improve the quality of life of our patients by continuous research.

D O C U M E N TAT I O N

Johan RoosMedical Manager, DentalAstra Tech AB

Root Menu for Indications, Methods, KeyFeatures and Topics.

Example of a submenufor Indications (Single,Partial or Edentulism).

1

2

To print out the currentabstract, use the button athotspot 3. 3

To print out a list of references,use the button at hotspot 4.4

To return to the Root Menu,use the button at hotspot 5.5

SummaryThe CD Chronicle of Documentation is a new powerful tool of scientific docu-mentation on implant treatment. Topicsinclude various aspects of Astra TechImplants and are presented in a simple

and easy-to-navigate manner. TheChronicle allows fast access to scientificliterature and will be very useful for busyresearchers and clinicians.

10 INSIGHT #6:1:2003

Taiko, a male utility dog in training,lost his first molar tooth in the rightmandible when he was 9 months old.This carnassial tooth is essential forchewing, and if it is missing Taiko willprimarily chew with his teeth on theopposite side. This means that dentalplaque will be accumulating on theremaining teeth on the side of themissing tooth, increasing the risk ofdeveloping periodontitis.

A crucial factor to the owner aswell as the dog is that the missingtooth reduces Taiko’s value as a utility

dog. It will be difficult for the dog toretain the decoy during protectiontraining, which often means earlyretirement of the dog. There is nodoubt that Taiko enjoys the trainingactivities very much and that hisquality of life would be reduced if heno longer could take part in them. Itwas therefore decided that Taiko betreated with an Astra Tech implantreplacing the lost molar, to examinewhether Astra Tech implants couldsuccessfully be used in rehabilitationin dogs.

Man’s Best FriendUtility Dog Rehabilitated with Implants

A young German shepherd, Taiko, is the first documented utility dog inthe world to receive a crown on a dental implant for rehabilitation. Thesuccessful treatment received medial acclaim in Denmark, as the treatmentwith Astra Tech implants on dogs that have lost a tooth may turn out to berevolutionary. This case report is a summary of an article to be publishedin the Journal of Veterinary Dentistry.

SummaryA young German shepherd trained as a utility dog, regains full value andenjoys his training after having beenrehabilitated with Astra Tech dentalimplants. After extraction, three implantswere placed, a customized abutmentattached and a PFM crown cemented.

21 months later, the dog functionsnormally. This revolutionary case mayprove to be a new field of treatment.

C A S E R E P O R T

Tom Olsen, DDS, MD, Private practioner Skovlunde, Denmark

Jens Ruhnau, DVM, Veterinarian and animaldentist at several clinicsin Denmark and Sweden.

Summary performed by Hilda Zollitsch Grill

INSIGHT #6:1:2003 11

Dogs have previously been used asmodels 1-4 but there are no knownstudies where the dog subsequentlyhas been exposed to normal loadssuch as those seen in play and intakeof food. As the first in the world, the authors want to demonstrate thedurability of the implants in a dogthat uses his teeth actively for protec-tion training. The teeth are therebysubjected to extreme loading and toexcessive tear.

Canine teethAs is the case in man, dogs haveboth primary and secondary teeth.The full permanent dentition has 42 teeth. Each quadrant has threeincisors, one canine, four premolarsand two molars in the maxilla butthree molars in the mandible. The

carnassial teeth have both shearingcusps and a smaller surface forocclusion. With the carnassial teeth,the dog tears and shreds his foodinto smaller pieces, and will chewwith one side at a time. The chewingpressure in a big dog like the Germanshepherd is 2–3 times that of ahuman 5,6. The axial pressure follow-ing from the load on the molar teethis up to 3000 kg/m2 7,8. The horizon-tal load when dragging an item suchas a rope is up to 114 kg on the car-nassial teeth 9.

Case reportThe German shepherd Taiko wasborn on May 11, 2000. Apart fromthe dental problem, the dog has hadno known disorders. All dental treat-ment of the dog is carried out under

general anesthesia. Preoperative painrelief was ensured prior to each stageof the treatment.

02.27.2001Taiko has his carnassial tooth ex-tracted due to extensive dental caries,probably the result of a congenitalenamel defect.

04.24.2001Clinical examination reveals goodcondition of the mucosa and softtissue (Fig. 1). Intraoral X-ray showsa very fine healing.

After standard surgical uncoveryof soft tissue and mucosa, a 25 mmdiastema appears. Three fixtures ST4.5 are chosen. The middle implant isplaced and the direction is chosen inorder to obtain maximum axial loadon the implants. Note that the dog’socclusion curve in this region is verycurvilinear as opposed to humans’.The direction and the placement ofthe three implants is controlled (Fig.2). As it turned out, there was roomfor two 15 mm mesial implants andone distal 13 mm implant.

06.14.2001During check-up 2 months later itappears that the two distal implantcover screws have been exposed tothe oral cavity. During the healingperiod, the dog has not spared thearea, neither during play, protectiontraining or food intake. This mechan-ical impact is probably the most sig-nificant cause of exposure.

The implants are surgicallyuncovered, showing a very smallresorption of the marginal bonearound the 2 distal implants (Fig. 3).

An impression is made (Fig. 4)and the restoration with the indi-vidually adapted Cast-to Abutmentsis now fabricated. Three Cast-toAbutments are connected togetherwith a cast-on alloy. This becomes acustomized abutment supported by3 fixtures. A metal framework is castin a precious metal alloy with highpalladium content in order to pro-vide strength and hardness. It isshaped to function as a normal toothif ceramics were to break off from themetal framework. The functionality

Taiko, a 2-year-old German Shepherdwho is the first documented dog in theworld to receive implant treatment inorder to be able to continue his work asa utility dog.

12 INSIGHT #6:1:2003

of the tooth has received higher prior-ity than the esthetic aspects (Fig. 5).

06.27.2001During the healing period, Taiko hasbeen wearing Healing Abutments. In

less than two weeks, perfect healingis seen in the region. The restorationwith the individually adapted Cast-to Abutments is screwed in to thefixtures (Fig. 6), and the PFM crownis cemented.

08.30.2001Check-up after 2 months: a happydog with a perfect tooth and com-pletely normal conditions around theimplant crown (Fig. 7).

12.27.2001The dog is taken acutely to theVeterinary Hospital in Copenhagenwith halitosis and a slight bloodyflux from the oral cavity. On clinicalexamination it appears that there isan infection in the region of theimplants. Diagnosis: acute lacerationfollowing from bite activity or impacton a foreign object. The trauma is not caused by peri-implantitis sinceall that is missing is facial bone.

01.04.2002On clinical check-up the woundshows fine gingival healing.

DiscussionAfter 21 months Taiko still functionswith his implant crown. The ownerstates that the dog functions normal-ly and appears to chew with equalforce on both sides of the mouth. Asregards the protection training inconnection with his work as a utilitydog, the decoy is of the opinion thatTaiko bites with balanced occlusalforce. At the clinical examination the dog shows no signs whatsoeverof being inconvenienced by the tooth during bite activity or foodintake. X-ray shows full osseo-integration and no signs of peri-implantitis.

The treatment itself is not asso-ciated with any risks, but at everytreatment the dog will need to beanesthetized, which may carry aslight risk. In this case the dog wassubjected to anesthesia three times,which represents only a minor risk to a healthy dog.

5. The customized Cast-to Abutments andthe crown on the working model.

6. The customized restoration is screwedinto place.

7. Final restoration in function. 8. X-ray at 10-month follow-up.

1. Fine healing of mucosa after extrac-tion of carnassial tooth due to extensivecaries.

2. X-ray of Fixtures ST 4.5 installed.

3. Some resorption of the marginal bonesurrounding the two distal implants isnoted due to oral exposition during heal-ing.

4. Fixture Pick-ups mounted for oralimpression.

References

1. Arvidson A, Bystedt H, Ericsson I.Histometric and ultrastructural studies of tissues surrounding Astra Dental implants in dogs.Int J Oral Maxillofacial Impl 1990; 5: 127-33

2. Gotfredsen K, Nimb L, Hjørting-Hansen E,et al. Histomorphometric and removal torqueanalysis for TIO2-blasted titanium implants.An experimental study on dogs. Clin Oral Impl Res 1992; 3: 77-84

3. Abrahamsson I, Berglundh T, Wennstrøm J,et al. The peri-implant hard and soft tissues atdifferent implant systems. Clin Oral Impl Res 1996; 7: 212-9

4. Moon IS, Berglundh T, Abrahamsson I, et al.The barrier between the keratinized mucosaand the dental implant. An experimental studyin the dog. J Clin Periodontol 1999; 26: 658-63

5. Bakke M, Holm B, Jensen BL, et al.Unilateral isometric bite force in 8 68-year-oldwomen and men related to occlusal factors.Scand J Dent Res 1990; 98: 149-58

6. Lindner DL, Marretta SM, Pijanowaki GJ, etal. Measurement of bite force in dogs: a pilotstudy. J Vet Dent 1995; 12: 49-52

7. Eisenmenger E, Zetner K. VeterinaryDentistry, Philadelphia; Lea & Febiger; 1985: 2

8. Wiggs RB, Lobprise HB. In: Wiggs RB,Lobprise HB, Veterinary Dentistry – Principles& Practice, 1st ed. Lippincott-Raven, 1997; 79

9. Hamel L, Le Brech C, Besnier NJ, et al.Measurement of biting-pulling strength developon canine teeth of military dogs. J Vet Dent 1997; 14: 57-60

Choosing this particular dog, wherethe subsequent load in connectionwith bite activities would be extens-ive, has shown that the durability ofthe implant structure is highly satis-factory as measured over a period of21 months (Fig. 8). This new field oftreatment with Astra Tech implantson dogs may turn out to be revo-lutionary.

“I would use it for myself”Dr Bruno Collaert from Belgium is the winner of the MicroThread com-petition “Taking Technology to the Top” on the special Astra Tech Internetsite, focused on Fixture MicroThread. Dr Collaert displayed an indepthknowledge of the Fixture MicroThread™ and explained why he wouldtreat his best friend with dental implants from Astra Tech by stating “Iwould use it for myself”. What better motivation can you have being anexperienced implant user as well as a scientist?

CongratulationsWe would like to congratulate Dr Collaert on winning a trip to the Ice-hotel in Jukkasjärvi, Lapland. Dr Collaert works as a periodontist in theClinic of Periodontology and Implantology in Brussels, Belgium. He isalso Associate Professor at the University of Malmö, Sweden. In the fieldof implantology, Dr Collaert has published several articles about earlyloading, one-stage surgery and patient opinion. In next issue of Insight wewill publish an interview with the winner.

Clever reasonsOur competition raised a great deal of interest with many competitorstaking part and giving good reasons as to why you should treat your bestfriend with the Astra Tech Dental Implant System. The reasons were all of high quality, including for example, “You’re simply the best – betterthan all the rest” and “To have a friend, be a friend. Give your best andnothing less”.

Stay on the lookoutIf you participated in the competition and did not win, you will stillreceive an IceLight pen. Make sure to stay on the lookout for more com-petitions from Astra Tech with fine prizes in the future. This was our firstbut not our last Internet-based competition.

Mia Jensen, DDSClinical Information Manager, Dental

Astra Tech AB

Winnerin the MicroThread Competition

INSIGHT #6:1:2003 13

14 INSIGHT #6:1:2003

Welcome to the International

It is with great pleasure we present the internationaleducation program for year 2003, covering a varietyof interesting fields within implant rehabilitation.

The program is mainly composed of courses aimed at the

clinician with experience of implant rehabilitation who

wishes to extend his knowledge and experience. One

basic course is provided for the clinician with no experi-

ence who is starting treatment with the Astra Tech Dental

Implant System. Take the opportunity to enhance your

knowledge to ensure clinical success in oral rehabilitation

with implants, and to exchange experience with colleagues

and skilled lecturers.

To complement the international education program,we provide a new education program for the Swedishimplant team. Focusing on basic and step-two courses insurgery, prosthetics as well as laboratory work, the clinicianwith some or no experience in implant rehabilitation willbe provided with a solid base for future clinical work andtraining. For the dental assistant there are courses focus-ing on both surgical and prosthetic treatment.

FOR THE CLINICIAN WITH MINOR OR NO EXPERIENCE INIMPLANT REHABILITATION

Basic Implant Treatment Course – Options & Methods (3 days)

This is a course that provides theoretical and clinicalfoundation for oral rehabilitation with implants, coveringtreatment options and treatment planning as well as bio-logical, physiological and mechanical considerations.Case presentations together with patient demonstrationsand hands-on training will illustrate treatment proce-dures with the Astra Tech Dental Implant System.

In-Clinic Training ProgramThe course takes place in your own practice, targeting allmembers of the team in preparation for the first AstraTech Dental Implant case. The education session consistsof a tailor-made theoretical part on products and proce-dures as well as hands-on training. This course entitlesthe team to enrolment in the Astra Tech Warranty Program.

FOR THE CLINICIAN WITH SOME EXPERIENCE IN IMPLANTREHABILITATION

Implant Treatment Course – Dental Implants and Esthetics (1,5 days)

Through case presentations, participants will be able tofollow the systematic treatment strategy from treatmentplanning to the final result. Possibilities and limitations in the surgical as well as in the prosthetic phase focusingon biology, function and esthetics will be presented anddiscussed.

Special Program – Clinical and Research Observations on Implants (2 days)

The course focuses on treatment planning and live surgery.Research results on implant treatment and implants arepresented and discussed.

Clinical Training Course – Advanced Prosthetic Procedures(2 days)

This is an overview of prosthetic solutions in a variety ofimplant cases accompanied by a patient demonstration,which will illustrate the different stages of treatment pro-cedures in complex cases. Mechanical and biomechanicalconsiderations are in focus, and the importance of closeteamwork is emphasized.

Ingrid Johnsson,Manager Training and Support, DentalAstra Tech AB

E D U C AT I O N P R O G R A M

INSIGHT #6:1:2003 15

Clinical Training Course – Implant Treatment in Difficult Cases (2 days)

The course focuses on solving difficult cases with con-ventional surgical and prosthetic treatment procedures.Two course concepts are available with one clinicalcourse focusing on implant surgery. The other is a theo-retical course covering both implant surgery techniquesand prosthetic restorations. After agreement this coursemay be followed by a special clinical session.

FOR THE EXPERIENCED CLINICIAN

Clinical Training Course – Advanced Implant Surgery (2,5 days)

This is the most advanced course on implant rehabilita-tion. Live surgery and follow-up of various bone-graftingprocedures will be presented and discussed, as well asexperimental and clinical studies on the subject. Bonesubstitutes are discussed, and in some courses may bedemonstrated in live surgery sessions.

FOR THE DENTAL TECHNICIAN WITH SOME EXPERIENCEIN IMPLANT REHABILITATION

Dental Technician Course – Laboratory Procedures (1,5 days)

This course is aimed at the dental technician and the clinician with an interest in laboratory procedures. Thefocus is on design, investing and casting techniques forsuprastructures. The advantages and potential with theAstra Tech Dental Implant System are presented anddiscussed. Workshops will guide participants through the procedures.

Dental Technician Course – Esthetic Solutions (2 days)

The course is arranged in collaboration with IvoclarVivadent. The fundamentals of implant-supported restora-tions will be discussed with focus on esthetic implant

crown design. Special attention will be paid to the use of customized components such as Temporary Abutment,Profile BiAbutment, Cast-to Abutment and CeramicAbutment in conjunction with IPS Empress2.

SPECIAL PROGRAMS

Special Program – Customized ProgramVisit a qualified Astra Tech Dental Implant user toexchange knowledge and experience on different aspectsof implant rehabilitation. Or, visit Astra Tech AB inMölndal, Sweden for a customized program adapted toyour specific request.

Special Program – International SeminarsWell-known and experienced lecturers will present thelatest data on implant research as well as the latest clinicaltechniques within implant rehabilitation.

The Astra Tech Dental Implant course program hascreated a lot of interest among implant users. In order toensure high quality courses, the number of participantson each course is limited. To guarantee your place, werecommend you to send/fax your registration form assoon as possible to: Astra Tech AB, Dental Department,P.O. Box 14, SE-431 21 Mölndal, SwedenPhone: +46 31 776 30 00; fax: +46 31 776 30 10.E-mail education.dental@astratech.com

For further information, please contact your local AstraTech dental representative or Astra Tech AB, Sweden.

Education Program for 2003

16 INSIGHT #6:1:2003

Ideal soft tissue sculpturingThe ProHeal Cap system consists ofthree different sizes of sterile healingcaps. A tissue sculpturing healingcap is placed on the UniAbutmentduring the healing period and con-trols and shapes the surrounding softtissue. In addition, it protects theconical top surface and the screwentrance on the UniAbutment fromplaque and tissue overgrowth. Thematerial, design and surface textureof the healing caps provide smoothfeeling, tissue health and patientcomfort.

Creating perfect impressionThe Abutment Impression Pick-ups,which correspond to the different

ProHeal Caps, simplify the impres-sion taking and are the key to accu-rate impressions. The AbutmentImpression Pick-up is a two-com-ponent pick-up shaped specificallyto mimic the ProHeal Cap and usedfor taking impressions on the Uni-Abutment. The novel healing andtissue sculpturing system also in-cludes the Guide Pin Hex which rep-resents a new type of guide pin witha knurled top and hexagonal open-ing for improved handling.

If you want to give your patientsan esthetic and natural-looking resultwith screw-retained prosthetics, usethe ProHeal Cap system in combina-tion with the corresponding Abut-ment Impression Pick-ups.

For further information on theProHeal Cap System, contact yourlocal Astra Tech representative.

Creating Perfectly Sculptured Soft Tissues

Kent Engström, DDSTherapy Manager, Proshtetics, DentalAstra Tech AB

P R O D U C T N E W S

With the ProHeal Cap system you can create individual esthetics whenworking with screw-retained prosthetic solutions. The ProHeal Cap offersflexibility and easy clinical procedures for sculpturing the peri-implantsoft tissue. For perfect registration of the soft tissue at impression taking,use the Abutment Impression Pick-up.

1. The ProHeal Caps in place. 2. Sculptured papillas and softtissue after healing.

3. The corresponding AbutmentImpression Pick-ups installed.

ProHeal Cap 20 in 3 different heights:4.3 mm, 5.5 mm and 5.5 mm Long.

An Abutment ImpressionPick-up 20 5.5 mm, whichcorresponds to the ProHealCap 20 5.5 mm and givesa correct impression of thesculptured soft tissue.

INSIGHT #6:1:2003 17

Brand new homepage releasedThe new homepage was launchedlast year and is continuously under-going improvements and updates.Here you canfind a Profes-sional Center forthe dentist andthe dental tech-nician, while thePatient Centerinforms patients about implant treatment.

Informing your patientsFor the patient it is important to havefull understanding of the implant pro-cedure and today’s patient demandsto be thoroughly informed. The treat-ment procedure is described andillustrated, advantages with implantsexplained in conjunction with testi-monials from 5 patients, all success-fully treated with Astra Techimplants.

A large section on frequently asked questions (FAQ) addresses thecommon concerns and worries ofmany patients.

A patient who is familiar with thetreatment procedures and who knowswhat to expect is much more likelyto co-operate with instructions andbe more satisfied with both the treat-ment and the outcome. Recommend

your patients to enter the patientsection on the Astra Tech website sothey can learn at home about implantsand come back to you with specific

questions regarding theirindividual situation.

For the dentistIn the System section, youcan read about the well-documented features of the

Astra Tech Dental Implant System.Look under Products and find outabout all the components availablefor dentists as well as for dental tech-nicians. Through easy navigationyou will quickly find what you arelooking for.

Increase your knowledgeWatch out for the net version of theInternational Training & Educationprogram 2003. In the Services sectionyou will find all necessary courseinformation. Take this chance to im-prove your skills and reserve a seaton one of our popular courses.

If you would like to increase yourknowledge on-line, look in the Library

section where you will find a lot of pdf-files for download, such as the Documentation Summarieswhere you find the articles one byone. Read the latest on your topic ofinterest.

Astra Tech is engaged inmany different con-gresses throughoutthe world. Maybethere is somethinghappening close to you,take a look in the events section.

FAQFor questions on the Astra Techsystem, look under FAQ where youwill find answers to many frequentlyasked questions concerning surgical,prosthetic and laboratory issues.

Get on-lineKeep visiting the Astra Tech home-page and stay up to date with thelatest news. Get on-line and find outmore.

Welcome!

Get on-line

Mia Jensen, DDSClinical Information Manager, DentalAstra Tech AB

I N T E R N E T

Have you had the opportunity to visit the new Astra Tech homepage?Simply choose your own country to find the latest news, as well as aworld of information on the Astra Tech Dental Implant System.

The course program has been devel-oped jointly by Professor FranciscoDonate Oliver (Head of Departmentof Neuroanatomy, University ofBilbao), Professor Karl-Erik Kahnberg

(Head of Department of Oral andMaxillofacial Surgery, GöteborgUniversity) and Dr Manuel Gomez(Associate Professor and privatepractitioner, Bilbao).

The program lasts for about 1year and graduation took place atthe end of 2001 and 2002. The courseis held one weekend a month (Fridayand Saturday) in order not to inter-fere with the participants’ weeklywork schedule.

This extended program consistsof ten modules and will give the par-ticipants a basic theoretical know-ledge in implantology as well as theskills to perform practical clinicalwork in surgical and prosthetic areasincluding treatment planning. Theimplant course is run at the University

of Bilbao as well as in private hospi-tals. Participating lecturers includeinternational as well as local speakers,such as Professor Lyndon Cooper(USA), Dr Michael Norton (UK), Pro-fessor Juan Pi Urgell and ProfessorEcheverria Garcia (both from Spain).

The ten modules are composed as below.

Closing session“We have received a lot of positivefeedback so far and some of the first-year attendants returned for theexamination of the ten delegates from2002,” concludes Professor Kahnberg.

18 INSIGHT #6:1:2003

New Successful

Education Program

Mia Jensen, DDSClinical Information Manager, DentalAstra Tech AB

I M P L A N T E D U C AT I O N P R O G R A M

A new implant education program has been developed in Bilbao, Spain,by the European Association of Oral Implantology (EAOI), a joint col-laboration between the University of Bilbao and the Department of Oraland Maxillofacial Surgery, Göteborg University. Astra Tech, Spain is theindustrial collaborator in the program.

1. Basic oral implantology: bone bio-logy, anatomy, principles of osseo-integration and overview of treatmentapplications.

2. Basic implant surgery: surgicaltechniques and precautions, survey ofcomplications associated with surgery(including practical demonstrations).

3. Soft tissue management andperiodontal considerations: implantsurgery aspects focusing on the perio-dontally-involved dentition and theesthetic zone.

4. Surgical practice on corpses:practical training on different graftingtechniques especially from themandible and hip region, histologicalpresentation of osseointegration fix-tures in bone tissue sections.

5. Clinical surgery I: supervisedimplant surgery on selected patients.

6. Clinical surgery II: lectures and livedemonstration of advanced implantsurgery showing bone grafting tech-niques in combination with ortho-gnathic surgery or onlay technique.

7. Implant-supported prosthesis I:impression techniques and planningof prosthetic procedures and dentallaboratory aspects (including practi-cal training).

8. Implant-supported prosthesis II:prosthetics (including supervised prac-tical treatment of implant patients).

9. Esthetics in oral implantology:prosthetic and surgical aspects ofesthetics, including the use of lasersurgery and continued live implantsurgery.

10. Multidisciplinary restorativetherapy: therapy planning and estheticaspects of implant rehabilitation.

At the end of the course, each par-ticipant is assessed based on oralpresentations of literature reviews ondefined areas.

Course participants during clinical treatment(supervised by Dr Gomez).

INSIGHT #6:1:2003 19INSIGHT #6:1:2003 19

Many interesting congresses will take place in Europe and theUS during 2003. Astra Tech will be present at several of thesewith our own workshops, exhibitions and activities.

Europerio 4 in BerlinWhy not take the opportunity to combine a trip to the excitingcity of Berlin with a visit to the highly scientific Europerio periodontology congress? The congress takes place betweenJune 19–21 at the International Congress Center in Berlin.

Astra Tech will be participating in the congress as a GoldSponsor and has organised a workshop on the theme “AstraTech Implants – The Predictable Choice” on Thursday June 19th

from 3.30 to 5.30 pm. The speakers are Professor Jan EirikEllingsen (Norway), Dr Michael Norton (UK), Dr Florian Müllner(Germany) and Dr Anders Holmén (Astra Tech, Sweden).

IADR in Gothenburg For everyone interested in the latest odontological scientificadvances, a visit to the 81st General Session of IADR/AADR(International and American Associations for Dental Research) isa must. This year it will be held in central Gothenburg, Sweden,where you will be within walking distance of the city and itsattractions, and June is the most beautiful time to visit Gothen-burg! During the meeting the IADR Implantology Researchgroup will set up a half-day implant symposium “Importance ofImplant Surface Structure on Early Bone Bonding”.

On the morning of June 25th, from 9.00 to 12.00 am, AstraTech invites you to a workshop titled “Clinical Relevance ofScientific Advances with Astra Tech Dental Implant System”.Listen to the views of Dr Lyndon Cooper (USA), Professor ClarkStanford, (USA), Dr Denis Cecchinato (Italy) and Dr AndersHolmén (Astra Tech, Sweden). The workshop will be followedby lunch for all pre-registered participants.

Visit Vienna and EAO in OctoberAt the beautiful imperial Hofburg Palace, the EuropeanAssociation of Osseointegration (EAO) will hold its 12th AnnualScientific Congress on October 9–11. The magnificent formerresidence of the Habsburg family in conjunction with the highquality scientific sessions will make this a memorable congress.The focus this year is on different aspects of regeneration.

The Astra Tech Gold Sponsor Course entitled “EvidenceBased Protocols for Clinical Success” will be held on October 10,from 2.00 to 6.00 pm. Speakers include Assoc. Professor Lars

Rasmusson (Sweden), Dr Helmut Steveling (Germany),Professor Tord Berglundh (Sweden) and Dr Anders Holmén(Astra Tech Sweden).

Join Astra Tech at these important congresses and increase yourknowledge. We look forward to meeting you all; welcome!

Join Astra Tech at 2003 Congresses!

MAY 9-10 ADI, International two Day CongressImplantology TeamworkBirmingham, UK

MAY 16-18 California Society of PerioSanta Barbara, CA, USA

JUNE 19-21 Europerio 4Berlin, Germany

JUNE 25-28 IADR, International Association of Dental ResearchGöteborg, Sweden

SEPTEMBER 21-24 AAP 85th Annual MeetingSan Francisco, CA, USA

OCTOBER 8-11 ACP, American College of ProsthodontistsAnnual SessionDallas, Tx, USA

OCTOBER 9-11 EAO, European Association forOsseointegrationVienna, Austria

OCTOBER 17 UNC 3rd International SymposiumChapel Hill, NC, USA

DECEMBER 5-6 AAOMS, American Association of Oral- and Maxillofacial Surgeons DentalImplant ConferenceChicago, IL, USA

Calendar 2003Insight Vol. 6, Iss. 1

www.hofburg.com

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Send for the Astra TechDental Implant Educationprogram 2003.

Astra Tech AB, P.O. Box 14, SE-431 21 Mölndal, Sweden. Tel: +46 31 776 30 00. Fax: +46 31 776 30 10. www.astratech.com

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304Denmark

Astra Tech A/S, Husby Allé 19, DK-2630 Taastrup.Tel: +45 43 71 33 77. Fax: +45 43 71 78 65.

FinlandAstra Tech Oy, PL 96, FI-022301 Espoo.Tel: +358 9 8676 1626. Fax: +358 9 8044 128.

FranceAstra Tech France, Groupe Pharmaceutique AstraZeneca7, rue Eugène et Armand PeugeotTSA 90002, 92563 Rueil Malmaison CedexTél. : 01 41 39 97 35 - Fax : 01 41 39 97 42

GermanyAstra Tech GmbH, An der kleinen Seite 8, DE-65604 Elz.Tel: +49 6431 9869 0. Fax: +49 6431 9869 500.

ItalyAstra Tech S.p.AVia M. Luther King n. 38/2, IT-40132 Bologna Tel: +39 051 641 6511. Fax. +39 051 641 7742.

The NetherlandsAstra Tech BV, Signaalrood 55, NL-2718 SG Zoetermeer.Tel: +31 79 360 1950. Fax: +31 79 362 3748.

NorwayAstra Tech AS, Postboks 160, NO-1471 Lørenskog.Tel: +47 67 92 05 50. Fax: +47 67 92 05 60.

SpainAstra Tech S.A., Calle Ciencias nº 73 derecha. Nave 9, PolígonoIndustrial Pedrosa, ES-08908 L´Hospitalet de Llobregat.Tel. Servicio al cliente: +34.902.101.558.Tel: +34.932.643.560. Fax: +34.933.363.231.

SwedenAstra Tech AB, P.O. Box 14, SE-431 21 Mölndal.Tel: +46 31 776 30 00. Fax: +46 31 776 30 10.

United KingdomAstra Tech Ltd., Brunel Way, Stonehouse, Glos GL10 3SX.Tel: +44 1453 791763. Fax: +44 1453 791001.

USAAstra Tech Inc. 430 Bedford Street, Suite 100, Lexington, MA 02420.Tel: +1 781 861 7707. Fax: +1 781 861 7787.

JapanAstra Tech Division,AstraZeneca K.K. Tokyo Regional OfficeKoraku Mori Bldg. 11F, 1-4-14, KorakuBunkyo-ku, Tokyo 112-0004.Tel: +81 3 5840 1113. Fax: +81 3 5840 1160.

Other MarketsAstra Tech AB, Export Department, P.O. Box 14, SE-431 21 Mölndal, Sweden.Tel +46 31 776 30 00. Fax +46 31 776 30 23.

Local Astra Tech Companies

editor.insight@astratech.com

+46 31 776 30 12

The Insight EditorAstra Tech ABP.O. Box 14SE-431 21 Mölndal, Sweden

Introducing theDirect AbutmentIntroducing theDirect Abutment

Direct Abutment – Simple, Fast and Esthetic

Snap-on andtake impression.

Carry and seatthe abutment.

Fabricate andinstall restoration.

1. 2. 3.

The pre-prepared Direct Abutment mimics the crownpreparation you’d make on a natural tooth, helping youprepare your implant restorations in a way that is famil-iar, simple, fast and esthetic.

Available in four diameters and heights to deal witha variety of clinical situations, the Direct Abutmentsnap-on coping makes it easy to take the accurate

impressions needed to ensure the best possiblerestorative esthetic result.

The Direct Abutment Process Kit includes allcomponents necessary for both the clinical and

laboratory procedures.This makes it easier than ever to work in harmony

with your technician to produce implant restorations thatgive you the most elusive of emotions: job satisfaction.

With the Complete Simple-to-use Process Kit

As simple as crown and bridge