Currently, we are aware that there is excellent tissue response to highly polished zirconia surfaces and we are leaving tissue surface of Zr restorations on high polish without glaze to hope that sulcus forms hemidesmosomes like structures to restoration surfaces. Question: would polishing help with tissue response? Other than helping abutments look good. Recently, it has been noticed that Neobiotech TiN surfaces exhibit high shine without delamination or color changes during polishing (unlike certain famous European brand that changes color during polishing) Polished and unpolished abutments comparison. Care has been taken not to polish connection surfaces.

2 neobiotech IS II Active fixtures were placed in immediate implantation 4 months ago in #24,#25 region. During 2nd stage surgery, implants were uncovered and attempted to counter torqued to 30ncm. #25 implant was not stable and was easily removed during removal of cover screw. Note bone attached to fixture at top 1/3 of fixture. Concluded graft failure due to residual granulation tissue around implant Site debrided and large socket of healthy bone was created. Labial fenestration after curettage. Depth probe from Master KIT is helpful in dragging out granulation tissue from sockets, especially helpful in small drill osteotomy diameters. As mesial distal bone volume is insufficient, we could not use a larger diameter fixture to engage the socket walls. Sinus Floor is targeted for apical engagement of fixture to inferior wall of sinus using sinus all kit Initial preparation with Lindemann drill with drill stoppers deviated. Osteotomy position corrected and preparation into sinus floor with S reamers Apical fenestration and socket of implant grafted with allograft

Usually, issuing a bridge with deep sulcus is difficult due to divergent path of insertion of implant connections. Sometimes the bridges fit on the model but is impossible to fit onto the mouth since the technician works with a gingival mask and removes it during fitting as they would over contour the emergence profile to give the restoration a natural form. The deep sulcus also presents an obstruction to the abutment connections directly to the fixture connection. To overcome this issue, multi unit abutments are placed on dental implant fixtures to bring the prosthetic platform to 1mm below the sulcus. Master impression utilizing open tray copings note narrow emergence profile of copings to avoid interference with adjacent bony protrusions 17 degree multi unit abutment placed to correct screw channel direction 14 to 24 bridge issued with 4 multi unit abutments easily fitted and issued. Unfortunately patient enjoys chewing on nuts. Subsequently patient returned with screw loosening and fracture of abutment screw on multi units. Screw fracture inside muli units easily resolved by removing multi unit abutments and removal of broken screw extra- orally. (will share photos later)

Healthy gingival tissues around implant bridges has always been crucial for survivability of dental implant fixtures long term. ( some clinical photos are not available at the moment and will be added in next few days) Patient presented with failing bridge and would like to replace with fixed restorations. Abutment teeth cannot provide sufficient support for fixed bridge due to severe caries and mobility on tooth #13 Treatment plan: Removal of tooth #13, 23, 24, 25 Installation of 7 fixtures, internal sinus lift on 24, 25 with neobiotech sinus all kit Fitting of Multi unit abutments on 24, 25, 26. Surprisingly 24, 25, 26 had good initial stability(more than 50ncm) due to engagement to cortical plate on sinus floor and precise matching of reamer drill diameter to fixture wall Final xray of upper zirconia bridge Good co adaption of soft tissues to zirconia bridge during issue.

Neobiotech prosthetic connection allows for 20 degrees divergence between implants. We decided to test it out with 8 units neobiotech IS II active fixtures splinted together. Implants installed Impression taken using PVS (I-Sil spident) Open tray non hexed impression coping used. It seems to work well. With UCLA casted bridge framework. Compliments to MR YANG Huei Jung from Trione lab

Patient had 6 upper implants installed and temporized and returned to clinic after 3 years absence. Patient expectation: Remove lower mobile teeth replace with implants Treatment plan: CBCT scan, plan for implantation of 7 implants using neobiotech Naviguide system Multi unit abutments fitted to facilitate passive seat of upper bridge. upper tempories replaced with full zirconia monolithic screw retained bridge

Patient presented with shaky bridge and would like immediate replacement of shaky teeth with fixed dentition. Patient refused denture as she has to lecture extensively. Treatment plan: Temporisation with temporary bridge Final issue with screw retained zirconia bridge

Patient presented with all teeth exhibiting mobility from periodontal disease Lower anterior teeth extracted and implants placed. Tent screw placement Ti enforced Ptfe membrane placement followed by bone packing below PTFE membrane Note cover cap of tent screw claps down on membrane and imobilises the membrane. 2 tent screws total immobilises membrane in vertical dimension and eliminates graft mobility in grafted site. Bone graft particles are packed tightly underneath membrane and tent screw. lateral sinus lift on Q1 above existing teeth

Patient presented with failing dentition on upper maxilla Patient laments that his denture has compromised his remaining dentition and would like to have a fixed restoration. hygenic pontic design