1. Facing the challenges of multi-unit restorations with the new Multi-unit Abutment Plus
GMT © Nobel Biocare Services AG, All rights reserved. Nobel Biocare, the Nobel Biocare logotype and all other trademarks are, if nothing else is stated or is evident from the context in a certain case, trademarks of Nobel Biocare. Please refer to nobelbiocare.com/trademarks for more information. Product images are not necessarily to scale. Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. For prescription use only. Caution: Federal (United States) law restricts this device to sale by or on the order of a licensed dentist. See Instructions for Use for full prescribing information, including indications, contraindications, warnings and precautions.

2. Information for the sales force
This Sales Rep Module is intended to be used by the sales force with the customer
Hands-on material
Drill model with implant and Multi-Unit Abutment
Additional information
Leaflet: Multi-unit Abutment Plus Product Overview (ref 80561)
Brochure: Abutments for all indications (ref A)
Manual:
NobelEsthetics Manual GB (ref L)
Denture conversion manual (GMT 46774)
Quickguide: Multi-unit Abutment plus - conversion of existing denture (ref 80390)
Presentation: Impression taking on Conical Connection (via Speaker Portal)
Presentation: Impression taking on implants (GMT 29255)
Animations: Multi-unit Abutment Plus
Other SRM
TorqTite screws (GMT 47836)
Restoration for Edentulous patients (GMT 45577)

3. Nobel Biocare can reduce the challenges for multi-unit restorations
Time-consuming handing of screws
Access to the screw hole
Retrievability
Screw-loosening
Bacteria / infections
Seating the restoration on implants
Large forces in the posterior region
Cantilever
Restorative procedures
Anatomy of patient
Limited space in the posterior region
Passive fit of the abutments
Vertical mouth opening

4. Treatment of edentulous and soon-to-be edentulous patient
Nobel Biocare provides the broadest and most compelling offering
in the industry for the edentulous patient!
All-on-4
Overdenture + Locators
Bridge implants
Bar + implants
Bridge implants

5. The All-on-4® treatment concept
The All-on-4® treatment concept is a cost-efficient, graftless solution that provides patients with a fixed full-arch provisional prosthesis on the day of surgery 
Only four implants for full-arch rehabilitation
Graftless procedure
Immediate Function (fixed-acrylic bridge)
Minimally invasive
Flap or flapless surgical approach
Up to 45º tilting of the posterior implants
All-on-4 is an efficient treatment for the fully edentulous patients, developed by Nobel Biocare in
collaboration with Dr Paulo Malo, MaloClinic, Portugal. The All-on-4 solution is also a well documented solution with excellent study results and is today world-wide spread.
Prerequisite – 30 degree angulated abutments
Cost effective with acrylic bridges
Scientific evidence– A number of publications support the concept and has been publiched over the years. 10 year results in the mandible just resently published. 5 year data for maxilla in preparation.
Many ways of selling this product.
Decreased number of implants resulting in reduced costs for patients
Flapless procedure for the TSP or not so trained dentists
Graftless procedure resulting in less patients and costs for the patients
Immediate function for soon to be edentulous patients. They don’t have to walk out without teeth
45º tilting of the posterior implants allow to place implants in anterior bone when no posterior bone is available
45º tilting of the posterior implants allows to reduce cantilever and provide 12 teeth
Tilting of implants increase the Bone to implant contact resulting in the bi-cortical anchorage of the apex in the hard bone
Note: Image shows the Multi-unit Abutment

6. The All-on-4® treatment concept - Benefits for the clinician
Treatment option for edentulous patients and soon-to-be edentulous
High esthetics, function and hygiene maintenance capability1,2
Clinically validated and scientifically proven with 34 clinical studies (clinical case reports excluded) with 2000 patients
Simple surgical and prosthetic procedure to allow more dentists to perform the treatment
Many ways of selling this product.
Decreased number of implants resulting in reduced costs for patients
Flapless procedure for the TSP or not so trained dentists
Graftless procedure resulting in less patients and costs for the patients
Immediate function for soon to be edentulous patients. They don’t have to walk out without teeth
45º tilting of the posterior implants allow to place implants in anterior bone when no posterior bone is available
45º tilting of the posterior implants allows to reduce cantilever and provide 12 teeth
Tilting of implants increase the Bone to implant contact resulting in the bi-cortical anchorage of the apex in the hard bone
1: Mozzati M, Arata V, Gallesio G, Mussano F, Carossa S. Immediate postextractive dental implant placement with immediate loading on four implants for mandibular full-arch rehabilitation: a retrospective analysis. Clin Implant Dent Relat Res 2013;15: // 2: Weinstein R, Agliardi E, Fabbro MD, Romeo D, Francetti L. Immediate rehabilitation of the extremely atrophic mandible with fixed full-prosthesis supported by four implants. Clin Implant Dent Relat Res 2012;14:434-41

7. The All-on-4® treatment concept - Benefits for the patient
Rapid improvement in quality of life A fixed full-arch prosthesis on the day of surgery quickly leads to improved patient satisfaction with regards to function, esthetics, sense, speech and self-esteem.1,2 Shorter treatment times Tilting of the posterior implants avoids the need for time-consuming bone grafting procedures, while immediate loading shortens time-to-teeth. 1,2 Lower costs The concept is the least costly in comparison with conventional implant treatment modalities of the edentulous and soon-to-be edentulous jaw.3
Many ways of selling this product.
Decreased number of implants resulting in reduced costs for patients
Flapless procedure for the TSP or not so trained dentists
Graftless procedure resulting in less patients and costs for the patients
Immediate function for soon to be edentulous patients. They don’t have to walk out without teeth
45º tilting of the posterior implants allow to place implants in anterior bone when no posterior bone is available
45º tilting of the posterior implants allows to reduce cantilever and provide 12 teeth
Tilting of implants increase the Bone to implant contact resulting in the bi-cortical anchorage of the apex in the hard bone
1: Mozzati M, Arata V, Gallesio G, Mussano F, Carossa S. Immediate postextractive dental implant placement with immediate loading on four implants for mandibular full-arch rehabilitation: a retrospective analysis. Clin Implant Dent Relat Res 2013;15: // 2: Weinstein R, Agliardi E, Fabbro MD, Romeo D, Francetti L. Immediate rehabilitation of the extremely atrophic mandible with fixed full-prosthesis supported by four implants. Clin Implant Dent Relat Res 2012;14: // 3: Babbush CA, Kanawati A, Kotsakis GA, Hinrichs JE. Patient-related and financial outcomes analysis of conventional full-arch rehabilitation versus the All-on-4 concept: A cohort study. Implant Dent 2014;23:218–24

8. Shorter time-to-teeth with All-on-4® treatment concept
Same day
1 2
4 5
3 months
6 months
9 months
Conventional treatment
Progressive treatment
7 8
11 months 10
Patients increasingly expect (provisional) teeth when they leave immediately after treatment
“Time-to-teeth” is a differentiating factor for rapidly growing practices
Hundreds of thousands of patients have been treated with the All-on-4® treatment concept using Nobel Biocare implants

9. Choose a precision-manufactured NobelProcera restoration
Broad choice of cost-effective fixed-removable bars and high-end fixed solutions like zirconia implant bridges.
Choose to restore on implant or abutment level. 
NobelProcera solutions are precision manufactured, providing consistent precision of fit and exceptional product quality.
NobelProcera restorations are backed by a comprehensive five-year product warranty

10. Multi-unit Abutment Plus – snap function
Radical simplification of chairside denture conversion by avoiding the use of screws
No need for screw fixation during try-in and adjustment phase
Reduces chair and lab time
Add clinician comment on “Time saving” chairside

11. Multi-unit Abutment Plus
Accommodates wide variability in placement angles
Short cone to facilitate limited interocclusal space
Wide shoulder for easy positioning
Accommodates varying tissue heights
Straight Abutments
Margin Heights: 1.5 to 4.5 mm
Angled Abutments
Angle Correction: 17° and 30°
Margin Heights: 2.5 to 4.5 mm
Rotational locking for
easy repositioning

12. Multi-unit Abutment Plus
Save time with snap function design - no need for screw fixation during try-in and adjustment phase
Pre-mounted holder
for easy handling
Made from a Titanium alloy for high strength
Compared to titanium screws, Nobel Bicoare TorqTite screws deliver higher joint compression and their preload does not decrease with the number of torque cycles1.
Note: Image shows the Multi-unit Abutment.
1: Vizer T, Maia C, Fuchs F, Liechti M, Heuberger P. Development of a test model to evaluate the pre-load of screw-retained dental implant systems. European Cells and Materials 2014;27( Suppl. 2):16

13. Wide and flat abutment shoulder
Provides the necessary positive vertical stop for the restoration
Allows minor adjustment of restoration placement on top of implant
Limited gap to bacteria
Note: Image shows the Multi-unit Abutment

14. Made from a titanium alloy for high strength
A step fatigue test simulating half of an All-on-4® treatment concept with a 30º tilted implant was performed. The cantilever on the bar was loaded in 1 million cycle steps with increasing load until failure was induced.
The failure mode was fracture of the front prosthetic screw due to tension. There was no failure of the posterior implant or abutment.1
The load level at fracture was well above the maximum bite force measured in young male patients by Blamphin et al.2
Step fatigue test1
Maximum Load lbf (N)
Minimum Load lbf
No. of cycles
110 (488) 11
1,000,000
130 (578) 58
150 (667) 67
170 (756) 78
190 (844) 19
353,900
Lbf = Pound Force
Right Molar
Mean Maximum Bite Force
Young Male
522 N
Mature Female
251 N
2:Blamphin CNJ, Brafield TR, Jobbins B, Fisher J. A simple instrument for the measurement of maximum occlusal force in the human dentition. J Engrg in Med 1990;204(2):
1: Test by Mr. Steve Hurson - AAOMS 2012 – Mr. Steve Hurson, Session 3
accessed May 2015

15. Accommodates wide variability in placement angles
Having a wide angle on the cone accommodates a higher variation in implant placement angles than a narrow cone.
22° cone taper allows for an additional 22° angulation correction
+22°
2 x (30° angulation + 22° cone taper) =
104° *
* Maximum possible divergence. Angle to be decided by clinician based on individual patient case.

16. Facilitate limited interocclusal space and varying heights
The cone on the abutment is necessary to provide the internal threads for the prosthetic screw
Desirable to keep this cone as short as possible so that it does not impinge on the interocclusal space
Having the abutments available in multiple heights allows adjustment to each individual patient based on their anatomy

17. Delivered with a patented pre-mounted holder
Simple placement of the Multi-unit Abutment
Excellent handling, especially in the posterior region
Allows placement even in small interocclusal spaces
Intuitive color coding matching the connection size
Guide to check abutment angulation

18. Simplified restorative procedure
Same components for straight and angled Multi-unit Abutments Plus, for all three platforms
Impression coping open-tray
Impression coping closed-tray
Prosthetic screw Multi-unit
Healing caps
Special Multi-unit Driver as part of the prosthetic kit

19. Avoid issues by using only original components (1/2)
System performance is key for biological system integration, reduced complication rates and for predictable clinical longevity
Manual adjustments can damage perfectly engineered implant-abutment interfaces and introduce uncontrolled risks
A tightly connected system helps aiding soft tissue integrity and minimizes risk of reduction of crestal bone levels.
The Nobel Biocare Warranty Program only covers implants restored with original Nobel Biocare components. For more detailed information, visit nobelbiocare.com/warranty

20. Avoid issues by using only original components (2/2)
Manual manufacturing, adjusted components or incongruent system components can result in uncontrolled peak loads which can lead to implant failure and other complications

21. Each design feature plays a crucial role in the overall system performance
Optimized preload (i.e. clamping force) increases mechanical stability
Optimized connection designed for tight connection to minimize risk of peri-implant complications
Predictable mechanical system performance
Optimized preload preserves components from fatigue
Source: Science First (2015) Individualized CAD/CAM restoration. Nobel Biocare.; 3(1):5-16

22. We got you and your patient covered
Nobel Biocare products and solutions offer predictable safety and performance
NobelProcera provides assurance with an extensive warranty. Restorations and implants, including non-Nobel Biocare implants, are all covered.
The NobelProcera authentication tool allows you to quickly check you’ve received a genuine NobelProcera product

23. Overview of components
Product list
Conical connection
Multi-unit Abutment
straight, 17° and 30°
Includes abutment screw
Prosthetic screw Multi-unit
Impression coping
closed tray Multi-unit
open tray Multi-unit
Abutment replica
Healing cap

24. Next steps Plan and treat a patient with Multi-unit Abutments Plus
Inform your treatment partners
Share your experiences in your local Study Club
Expand your knowledge by attending a course on implant prosthetics
Learn about more advanced procedures with the Multi-unit Abutment Plus such as the All-on- 4® Treatment Concept

25. Questions?

26. Multi-unit Abutment Plus
New straight and angled Multi-unit Abutments Plus for conical connection
New Temporary Snap Coping
Updated Protection Analogs and Abutment Replicas
Straight and Angled Multi-unit Abutments Plus
Temporary Snap Coping and Drill Guide for MUA Plus
New Multi-unit Abutments Plus are compatible with the previous Temporary Copings
New Temp Snap Copings are NOT compatible with the previous Multi-unit Abutments
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