Information provided by Straumann USA.

American Academy of Implant Dentistry (AAID)

, there are more than 30 million Americans that are missing all their teeth in one or both of their jaws. In a rapidly growing market where fully 

 are actively seeking out new treatment options online, the demand for implant-supported rehabilitation is at an all-time high. How will you support referring clinicians while maintaining the predictable, reliable and esthetic outcomes expected of you?

Straumann® Screw-Retained Abutment portfolio

 deliver a simple solution with excellent esthetics and dependable longevity. More than a treatment concept, 

 combines several treatment steps to reduce complexity without compromising the outcome. From treatment planning and implant placement to final, customized restorations, the entire process is seamless for the patient.

Patient situation at time of implant surgery. After consultation, patient elected for dual arch replacement therapy. Remaining teeth in both jaws to be extracted and restored with implant-supported dentures.


	The new Straumann® Screw-retained Abutment for 

 provides a wide range of prosthetic options for screw-retained restorations.
	Sleek Profile and a Simplified Portfolio:
	» Designed to provide optimal tissue management
	» Available for every restorative platform in the Bone Level Implant line
	» Angled abutments offer a choice of 17° and 30° with gingival heights of 2.5 mm and 4 mm
	» Straight abutments offer a choice of 1 mm, 2.5 mm and 4 mm gingiva heights
	» 

 provides precise guidance at assembly, ensuring the proper seating of the abutment with the sealed connection featuring a deep implant-abutment engagement

Block out technique over temporary copings.


	Straumann® delivers new CARES® Basic and Advanced Fixed Bar Solutions for fully edentulous patients that provide individual customization and treatment flexibility. Features include:
	» Individual customization on implant level and abutment level restorations
	» Basic Fixed Bar is cost-effective alternative to a ceramic veneered bridge
	» Ideal fixed solution for ongoing tissue management
	» Sandblasted service; wrapped in acrylic for reline if desired
	» Advanced Fixed Bar is partially wrapped in acrylic; intended for final tissue situations
	» Accessibility through in-lab scanners, 

Next page: how Straumann products are a perfect fit for all needs. 

“The system as it is right now works very, very well and I don’t think any technician that is familiar with these systems or this type of process would have any difficulty implementing it.”-Darrel Clark, CDT, 

The dental lab plays an integral role in the success of any edentulous case. Collaboration begins with conventional 2D imagery or 3D implant planning via 

. Through the coDiagnostiX software, a laboratory technician can select and place virtual abutment options through the overlaid diagnostic prosthesis so the desired result-a beautiful, long-lasting smile for the patient-can be visualized and planned prior to implant placement.  Any adjustments in selected components can be made in conjunction with the surgeon and restorative doctor. This team approach allows the laboratory technician to fabricate a temporary restoration so the patient may be able to leave the day of implant placement surgery with a brand-new smile.

Interim maxillary denture, post-operative, facial view.

More than a restoration. A perfect fit for all needs.

Straumann’s Roxolid® Bone Level Implants

, the new Straumann® Screw-Retained Abutments for Straumann® Bone Level Implants provide a wide range of prosthetic options for screw-retained restorations. Various angulations and gingival heights offer technicians the flexibility to create individualized patient solutions, including those involving posterior-tilted implants.

Creation of a milled bar in Straumann CARES software.

William F. Runyon, Jr., DDS, of Fort Worth Oral Surgery

 along with his laboratory partner Darrel Clark, CDT, of Clark Implant Solutions are early adopters of the new fixed edentulous solutions from Straumann. Both treatment team members are pleased with the results. Says Dr. Runyon: “This new screw-retained abutment, with multiple angle options and gingival heights, allows us to offer a Straumann product from top to bottom-from the implant, abutment, the connections, all the prosthetics, to include the bar. It’s going to be a great option for our patients.”

Next page: Looking at how CARES Bars are an excellent solution in challenging cases.

An excellent solution in challenging cases.

A diversified CARES® Bars platform offers fixed bar solutions for edentulous patients. The CARES® Basic Fixed Bar is a cost-effective solution that comes sandblasted and ready to be wrapped in acrylic, allowing for easy maintenance of the denture. The abutment-level connection is convenient for restoring cases with strongly diverging implants, as well as mixed abutment and implant-level restorations. A secondary abutment is not necessary. A new 

 for partially wrapped acrylics is also available.

After completing his first cases, Darrel Clark, CDT, Clark Implant Solutions, remarked that the components work well together-“everything went pretty much seamlessly with no issues”-and he was extremely pleased with the end result. Straumann’s open CAD/CAM platform accommodates every laboratory looking to provide bar solutions to their clients.

Image of CARES® Fixed Bar seated on the mandibular model.

Through the Straumann in-lab scanners or the laboratory-dedicated Scan & Shape Service, every dental lab can deliver 

Proper diagnosis and treatment planning, as well as an evidenced-based implant/prosthetic design, will help to result in a successful treatment. Together, these factors can significantly improve the patient’s quality of life.2 Remarks Dr. Runyon: “I think Straumann has brought to the market a whole new product line that is going to be extremely viable to allow us to treat a fixed hybrid solution.”

Patient post-treatment with final implant-supported dentures on both jaws.

Today’s dental patients desire an uncompromising quality of life that combines long-lasting functionality with a beautiful smile. Implant-supported dentures give patients back their confidence and let them eat, chew, talk and laugh naturally once again. Dr. Runyon believes the integrated solution from root to tooth, from treatment planning to the final restoration, is a step forward for fixed edentulous cases. “I feel very confident that with my lab support, we can transition these patients from a very compromised dental situation to an implant-supported fixed hybrid that they will be able to function with for years to come, with great success and comfort.”

1 http://www.aaid.com/about/Press_Room/Dental_Implants_FAQ.html. Dental Implants Facts and Figures. “More than 30 million Americans are missing all their teeth in one or both jaws.” Accessed May 19, 2014
	2 D. Wismeijer, P. Casentini, G. Gallucci, M. Chiapasco. Loading protocols in Implant Dentistry-Edentulous Patients. Patient Consideration. ITI Treatment Guide. 2010; 4:223

This article originally appeared in the November 2014 Dental Lab Products Buyer's Guide, in a special advertising section. For articles on other great lab products in action, 

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Articles

 According to the American Academy of Implant Dentistry (AAID), there are more than 30 million Americans that are missing all their teeth in one or both of their jaws. In a rapidly growing market where fully edentulous patients are actively seeking out new treatment options online, the demand for implant-supported rehabilitation is at an all-time high. How will you support referring clinicians while maintaining the predictable, reliable and esthetic outcomes expected of you?

Straumann's plan to bring patient-specific care to every lab [VIDEO]

 is a hybrid abutment with a titanium-alloy bonding base and customized zirconium dioxide coping, delivering the reliability of a titanium connection with the pleasing esthetics of a ceramic coping. The CARES Variobase Abutment can be used as a screw-retained, full-contour solution for your referring clinicians. The patented* engaging mechanism between the CARES Variobase coping and the CARES Variobase abutment offers reliability and efficiency when bonding the two components into a finished, one-piece CARES Variobase Abutment.  

Two restorative materials are available for a CARES Variobase Coping: zirconium dioxide zerion

 AE, a temporary material. The CARES Variobase Abutment can be used for single-tooth screw-retained or cement-retained restorations, or cement-retained bridges via a mesostructure. 

		Titanium-alloy bonding base with customized zirconium dioxide coping for individual patient situations 

		Precisely engineered engaging mechanism between the CARES Variobase Abutment and Coping is designed for a precise connection and optimal force distribution 

		Laser-etched Straumann logo indicating that it’s an original Straumann Abutment 

		Labs can create a CARES Variobase Abutment in three ways: Straumann’s in-lab CAD/CAM system; the CARES Prosthetic App for Dental Wings; or via the Scan & Shape online service from Straumann.

The Straumann® CARES® Variobase™ Abutment is a hybrid abutment with a titanium-alloy bonding base and customized zirconium dioxide coping, delivering the reliability of a titanium connection with the pleasing esthetics of a ceramic coping.

Quality, versatility and reliability with the Straumann CARES Variobase Abutment [VIDEO]

A 38-year-old healthy female patient presented with a chief complaint of dissatisfaction from the appearance of her smile because of multiple apparent gingival recession lesions. She recently completed orthodontic treatment and noticed an increase in recession over the 2-year treatment period. Upon examination, generalized recession ranging from 1 mm to 4 mm was observed (

). The tissue was of good quality with adequate attached and keratinized gingivae, with the exception of tooth No. 6 (

). A root coverage procedure was discussed with the patient, and informed consent was obtained.

The treatment plan included a coronally repositioned flap in conjunction with the application of Emdogain enamel matrix proteins from tooth No. 4 all the way across the midline to No. 13. Because of the thin tissue on the buccal aspect of No. 6, the simultaneous harvest and placement of an autogenous subepithelial connective graft was recommended for this specific site.

The patient was anesthetized using Lidocaine 2% with 1:100,000 epinephrine via buccal and palatal infiltration.

An intrasulcular incision was made on the buccal surface of the involved teeth. The incisions were connected via a split-thickness incision from line angle to line angle at the CEJ level of each tooth (

Once the incision line was completed, a partial-thickness flap was elevated beyond the mucogingival junction. Care was taken to not perforate the buccal flap during the sharp dissection. Any perforation can compromise the blood supply and risk the success of the procedure.

The denuded root surfaces were debrided with hand instruments to ensure the principle of a “receptive root.”

Periosteal release was performed from the inner aspect of the flap to allow for the coronal advancement of the flap.

The papillae were de-epithelialized to create a vascular surface for tissue incorporation.
	
	The flap was then mobilized coronally with tissue forceps to verify a tension-free eventual closure. At that point, the subepithelial connective tissue graft was harvested from the palatal aspect of tooth Nos. 3, 4 and 5.

The graft was placed on a cold surface and adjusted to fit the No. 6 recession site (

). Chemical root preparation followed thereafter with PrefGel® (24% EDTA) and was irrigated with sterile saline.

Emdogain was then applied to all exposed root surfaces (

), and the subepithelial connective tissue graft was sutured to the interproximal papillae of tooth No. 6 (

Additional Emdogain was applied on all other root surfaces of tooth No. 4 to No. 13, and the flap was coronally positioned using 5/0 Vicryl sutures (

Verification of tissue stability was done by lightly pulling on the lip and making sure there was no movement on the marginal gingival tissue.

Additional Emdogain was applied on the gingival margin and the sutures.

Post-operative instructions were given to the patient. A medication regimen of systemic antibiotics (Amoxicillin 500 mg TID for one week) and non-steroidal anti-inflammatory medication (Ibuprofen 600 mg to be used as needed for pain) was recommended to the patient. The healing was uneventful, and the sutures were removed two weeks after the surgery. Specific homecare instructions were given to the patient to prevent any trauma to the surgical site in the first 6-8 weeks of healing. These included an atraumatic brushing technique, and the patient was instructed to resume gentle flossing three weeks post-operatively. In this case, 3-month follow up showed excellent healing with almost 100% root coverage on all treated teeth, and the patient was satisfied with the final result (

This case report demonstrates treatment of multiple recession lesions in one appointment using the coronally positioned flap with a connective tissue graft and 

 Emdogain. The procedure was shown to be effective in achieving root coverage, with minimal morbidity for the patient and an excellent esthetic outcome.

Dr. Ziv Simon is a Diplomate of the American Board of Periodontology and maintains a practice in Beverly Hills, Calf., limited to periodontics, dental implants and reconstructive surgery.

A technique for treating patients with gingival recession.

How to: Treat gingival recession

Straumann® CARES® System 7.0 software gives users full flexibility to choose their workflow-validated or external (open)-through a single system. The validated workflow provides direct access to precise, high-quality materials and restorations through 

’s centralized milling facilities and pre-set design parameters. Customized abutments for Straumann bone level and tissue level implant platforms are available in Zr02 and Ti materials. Tooth-borne restorations in a wide range of materials including IPS e.max®, CAD, VITABLOCS® and 3M™ ESPE™ Lava™ Ultimate Restorative are available through the validated workflow offering. With software based on the 

Dental Wings Open Software (DWOS) design modules

, technicians working in the external workflow have the expanded flexibility of sending an open .STL file to almost any milling center to produce almost any restoration type from the material of their choice. More than just CAD/CAM, Straumann CARES System 7.0 is an integrated prosthetic digital design software, incorporating intraoral scan data, guided surgery planning and CAD/CAM design within a single interface. The software includes free online technical case support from Straumann’s trained CDTs. Equally powerful and flexible, the System 7.0 is designed to keep labs competitive for years to come.

		CAD/CAM system with both validated and external (open) workflows

		Validated workflow sends cases to Straumann for milling from materials including zirconia, IPS e.max CAD, VITABLOCS, Lava Ultimate Restorative and more

		External (open) workflow allows cases to be sent to any production facility that can accept .STL files

		Software is based on the Dental Wings Open Software (DWOS) design modules

		The Straumann Guarantee provides a limited warranty covering ceramic abutments for 5 years and titanium abutments for 10 years

		Incorporates intraoral scan data, guided surgery planning and dental CAD design within one software system

		Online support available from Straumann’s trained CDTs

		Onboard marketing support and training programs help bring laboratories up to speed

Straumann® CARES® System 7.0 software gives users full flexibility to choose their workflow-validated or external (open)-through a single system. The validated workflow provides direct access to precise, high-quality materials and restorations through Straumann’s centralized milling facilities and pre-set design parameters. Customized abutments for Straumann bone level and tissue level implant platforms are available in Zr02 and Ti materials.