With the connection outside the tissues it is simple.

There are at least three reasons to consider the Prama implant as a more effective tool for complex rehabilitations of a dental arch

  1. The respect of crestal bone anatomy
  2. The conical emergence adaptation to bone irregularities
  3. No need to use intermediate angled abutments

This means a minimally invasive surgery, faster healing and still there is the possibility to insert the implants in an angled position.

The rehabilitation of a dental arch on Prama implants allows the clinician to set the prosthetic structure at a distance of at least 2.8 mm from the osseointegration area, thereby forming a gingival protection area and a soft tissue support capable of guaranteeing easy cleaningand aesthetic stability over time.

Moreover, combining the gingival healing potential of the conivsl neck with the use of modern connective membranes, now it is possible to fabricate prostheses which are 'ALL WHITE' or with a minimal share of pink, without excessively invasive operations.

Dr. Giuseppe Vignato and Dr. Costantino Vignato

Clinical case 1

Male 63-year-old patient with removable prosthesis in the upper arch and a removable partial dentures with hooks connected with 6 dental elements in the lower arch. The treatment plan consists in the complete rehabilitation of both arches with Toronto type prosthesisdirectly screw-retained on Prama implants fabricated in zirconium-ceramic: six Prama RF implants are inserted in the upper arch, the dental elements from 3.3 to 4.3 are removed from the lower arch and five Prama and Prama RF implants are inserted.

Initial situation with prosthesis and without prosthesis
Initial X-ray.
Post-extraction surgery with open flaps for the insertion of six Prama RF implants in the upper jaw and five in the lower jaw.
Gingival situation of the upper and lower arch 3 months after surgery.
Upper and lower final prosthesis.
Final prosthesis in zirconium-ceramic in articulator
Gingival situation of the upper and lower arch at the delivery of the final prosthesis. The soft tissues seem healed and healthy.
Final prosthesis
X-ray at delivery of the final prosthesis

Clinical case 2

Male patient with severe bone resorptionin both arches.
The treatment planned consists of a complete rehabilitation of both arches with a composite Toronto prosthesis directly screw-retained on Prama implants. Following the extraction of the damaged teeth, five Prama RF implants are inserted in the upper arch while five Prama and Prama RF implants are inserted in the lower arch.

Initial situation: bone resorption is evident both in the maxilla and mandible
Occlusal view of the preoperative case in which the resorption, both vestibular and lingual, of the lower arch is evident. The movement of elements 24 and 26, following the loss of 25, also is noticeable.
Open tray impression with Pick-up transfer.
Clinical follow up 3 months after surgery in the upper and lower arch.
Final situation.
Final X-ray.