CLINICIAN > HOW MUCH IS THE FREEDOM OF ACTION?
PROSTHETIC PLANNING AND INTRAMUCOSAL POSITIONING
​
Prama is an implant for which an accurate prosthetic planning is very important for the aesthetic and functional result.
Planning is facilitate by:
​
​
-
the possibility of inserting the implant at different depths;
-
the versatility and variety of prosthetic solutions;
-
the possibility of closing the prosthesis on the implant neck or on the prosthetic abutment or at the level of the connection platform.
When planning the prosthesis, the implant placement should be planned according to:
Prosthetic axis: any disparallelisms can be balanced by closing the prosthesis on the abutment or resting on the prosthetic platform, thus using Short Neck or Regular Neck implants, but with a deeper and more lingual positioning. When a screw-reatined crown is choosen, it is possible to use components that allow to orient the hole of the prosthetic screw palatally for a more aesthetic result.
Available vertical space according to the occlusal plane, also considering the space required for the screw head, choosing a Short Neck implant or PROPERLY insert the Regular Neck deeper.
Height of the parabolas of the adjacent teeth: based on the biotype and the presence of bone peaks and papillae, the possibility to choose between three different heights of the intramucosal neck and to use Prama IN or Prama FIT components allows you to always position the margin of the prosthetic crown at least 1 mm deeper than the level of the parabola of the contralateral element.the connection platform must be at least 1 mm deeper than the level of the parabola of the contralateral element.
In case of immediate post-extraction sockets with different bucco-lingual and/or mesio-distal bony peaks, normally the connection platform must be positioned at the level of the lingual peak. The ZirTi surface portion must be placed into the bone, the UTM portion can indifferently be placed in contact with both hard and soft tissues. Also in this case the availability of three different heights of the intramucosal neck always compensates for the discrepancy between the peaks.
In distal sectors, single crowns must be ferulized on the implant neck in order to increase the resistance to the masticatory loads typical of the molars. Short Neck implants are dedicated to aesthetic sectors and multiple rehabilitations, therefore prosthetic solutions that close on the neck are not available.
In the presence of thin soft tissues, the use of Short Neck implants or Regular Neck implants but with a deeper positioning is indicated. If the neck is positioned too exposed, the Prama Designer software allows the anatomical emergence profile of a screw-retained single crown to be modulated without constraints and to recover any excessively emerged positioning.