Prama is een uniek implantaat, er is geen ander implantaat op de markt wat hier op lijkt en toch is het concept zo logisch en simpel. Misschien is ‘simpel’ lichtelijk overdreven want het concept is doordacht en goed ontwikkeld met als basis de B.O.P.T.
Wat is B.O.P.T.? Dit staat voor:
Een techniek die in de afgelopen jaren is toegepast en geperfectioneerd door Dr. Ignazio Loi. Hij maakte deze verticale preparatie al verscheidenen jaren in zijn praktijk voordat het concept werd omgezet naar een implantaat. Hij verteld het hier zelf:
PRAMA. UNIQUE BECAUSE…
“Perhaps we can open up a new world in which the fit is outside the tissues, it is transgingival, it is convergent, we can apply all the prosthetic philosophy we have seen today and most of all we can move the bacteria’s operating zone in a much safer area.
I would have expected everything in life except that a Premium Day would be dedicated almost exclusively to this implant, because I would never have hoped so. I have kept it jealously treasured for some time after my experiences with the first vertical abutment… I was scared also to show it to my close friends. […] I was a bit frightened then in the end we managed to find a solution together with Sweden & Martina and I chose Sweden not by chance, but because implants are the core business of this company. […] When I met Dr. Martina and I asked him “But when will you create the implant for me?” lui mi ha risposto “Well, yesterday!”
This is the birth of Prama, they asked me to talk about the birth today, while tomorrow you will see its development as the use of this implant has allowed us to think about other things that go beyond B.O.P.T. on implants.
I did not think that this implant would develop as it has been…”
“The characteristic conical shape of the neck of the Prama implant has Break down the walls imposed by the implant systems of companies, brands and multinational companies that, compared one to the other, are all very similar. The conical morphology comes from years of application of B.O.P.T. with exciting results.
To be able to move from a predefined “margin line” to a “margin area” that also gives chance the choose the margin on implant prosthesis is a real gift for surgeons and prosthodontists. Prama already claims a substantial scientific background in which the biological advantages are described, but it is daily use that makes us appreciate the prosthetic specificity of the platform. The use for immediate loading combined with the Flapless technique represents at the same time what is most modern and conservative in the implant rehabilitation therapies scenario. The 2.8 mm height of the conical neck allows a visual check during insertion since in most cases the connection emerges at gingival level, it does not sink into the alveolus and the gingival tissue firmly surrounds the platform; indeed it is better to insert a healing abutment so as to keep an alveolar access for the prosthesis insertion. The impression phase is simplified by the dry bloodless environment and the posts or the transfers engage without having to pass through the mucosa. The geometry of the gingival tissue does not depend on the healing but remains stable and this is the only condition that allows to place immediately the final prosthesis. The volume and the morphology of the biological space to be restored are delegated to the technician, who will determine where and how much to “move” the soft tissue modeling it through the crown. If we think that the desirable anatomy is the compromise between width and depth, it seems evident how favourable a closure area of almost three millimeters where to choose to position the emergence profile is. If we carefully observe the implant neck shape at gingival level, we recognize the characteristics of an one piece implant with clear biological advantages. The implant-abutment connection often is out of the soft tissue thanks to the conservative control of the insertion procedure with the Flapless technique. For the same reason important advantages have been noticed with Toronto Bridge restorations. The geometry of the implant with prosthetic connection outside the gingiva and flapless surgery contribute to obtain a transgingival seal which is considerable and stable over time. The association of Prama with Flapless surgery has produced some truly significant results from every point of view: surgical, biological and prosthetic, but most of all it has fostered the passionate side of this work freeing us from some constraints and giving us the opportunity to carry out a subjective interpretation that we were missing a little.
A brilliant idea!!!”
“Prama is part of a new generation of implants.
It consists of the perfect combination, in a single piece, of a rough surface suitable for osseointegration and of a conical micro-lined geometry capable of supporting the healing of soft tissues. […] The two parts together set a delicate biological environment favourable for bone cells, the periosteum, the connective tissue and the epithelium.
This new vision is called the ‘conical revolution’ and the gingival anatomy that we manage to reconstruct houses the prosthetic element and becomes an aesthetic shape itself, protecting the integration of the implant over time. ”
“The PRAMA implant is giving me great satisfaction […] This is an implant that in my opinion is very “biological”, indeed it is evident how it greatly facilitates firstly osteoblastic and then osteocytic activities, also in its smooth part that has always been considered a very risky area for the maintenance of the bone crest.
The credit for this nice biological healing and for this total lack of inflammation of the tissues around the neck of the implant certainly is not mine but, analyzing things well, it is of the structure that Sweden & Martina has designed to create an extremely tight connection between the extraosseous part (smooth neck and implant head) and the prosthetic post. Indeed, tightening to 25 Ncm, the head of the post, which in all its circumference has an inclination of 2 degrees on the surface of the implant, creates such a tight connection that I almost feel like calling it a “cold welding”.
Given the clinical and radiological images that we have after 2 years, I can affirm that in these cases the Prama implant guarantees an almost total absence of bacterial activity in its connection.
[…] The Prama implant is simplistically considered a transgingival implant, in the following cases I will show how the specific implant architecture adapts perfectly to be placed both with the smooth neck above the bone crest, and with all its structure completely into the bone.”
“The reason why I choose Prama, especially in the aesthetic anterior areas, is that the convergent neck allows a new prosthetic approach: the emergence profile of the restoration (post and crown) can be modulated depending on the prosthetic requirements, positioning it at different levels of the transgingival path following the different anatomical and clinical situations. This also has a positive effect on the soft tissue: a greater three-dimensional space available for soft tissues allows them to thicken, specially when compared with an implant with a predefined cylindrical or divergent neck.”
“The Prama implant does not have a single margin line, but a margin surface, a margin area. The biological advantage is that of a juxta-gingival position that allows us to position the prosthetic margin at different levels because there is an area on which the closure can be done and not a precise and inevitable line as with the traditional “tissue level” implants. And it is not the only advantage. […] with Prama the thickness of the cervical soft tissues is objectively greater, especially as regards the connective tissue component. Therefore a tissue collar practically forms, giving the whole implant-prosthetic structure a great stability. Finally, Prama offers a vaster opportunity of counterbalancing malpositionings: one of the problems in the aesthetic area is an implant placed too vestibular; if I place a traditional transgingival implant in that position I will certainly have big problems. With Prama I can manage it way better.”
“Why use a Prama implant?
In my opinion the question should be: why not use it??
The Prama implant is:
AESTHETIC (less titanium volume in the transgingival portion results in thicker and more stable soft tissues);
BIOLOGICAL (the microgap is far from the bone crest, thus avoiding premature crestal bone resorption);
VERSATILE (the UTM conical neck allows totally or partially submerged transgingival positioning, very useful in case of tilted implants);
CONSERVATIVE (the machined neck, left deliberately exposed in case of thin crests in the most coronal section, avoid many horizontal GBR procedures).
Therefore……why not use it?”
“The new Prama implant, starting from the principles of B.O.P.T. technique on natural teeth, enables me to exploit its design features during the surgical phases. Its conical UTM neck allows to place the implant exploiting the anatomical conditions of soft tissues, with variable thickness compared to hard tissues. Therefore, the possibility of managing the insertion level diversifies the surgical strategy and, consequently, the following prosthetic phases. This creates the conditions for a perfect clinical outcome, respecting the biology of soft and hard tissues . The integration between the implant and the prosthetic crown creates a natural area, maintaining the rehabilitation over time. Anatomical and esthetic stability are the aim of my rehabilitations, and the Prama implant allows “odontological pragmatism” without any sacrifice.”