Prama

BE UNIQUE.
BE PRAMA.
THE ONE AND ONLY INTRAMUCOSAL IMPLANT
Convergent portion UTM Surface

More space for Allows great
soft tissue adherence of the
collagen fibers
Cylindrical portion
To manage the
irregularities of
bone crest
THE IMPLANT
Prama W implants are available in two endosseous shapes,

cylindrical and tapered.
The cylindrical morphology of Prama W implants, with over 20 years of

clinical experience, allows the ability to take advantage of the implant
design according to the site and the most appropriate use.
In particular, the cylindrical body facilitates insertion in the mandibular

bone, which is often poorly vascularized and highly corticalized. Moreover,
it ensures the maximum surface for BIC (Bone-to-Implant-Contact)
percentage which can be obtained.
Prama W RF (Root Form) has a tapered morphology, and it is recommended

for the insertion in a poorly mineralized bone, where the RF implant
reaches the maximum stability. The markedly rounded apex of this implant
makes it safe and reliable in the cases of maxillary sinus elevation.
The endosseous body of the implant has the typical sand-blasted acid
etched ZirTi surface, and the degree of roughness can remarkably increase
the bone-implant contact area, thus promoting osseointegration.
PRAMA W RF PRAMA W
PRAMA W. UNIQUE BECAUSE...
ZIRTI SURFACE
The ZirTi body is sand-blasted with zirconium oxide and etched with mineral acids. This treatment gives to the surface a characteristic micromorphology capable of
significantly increasing the bone-to-implant contact area, promoting osseointegration and guaranteeing a great primary stability.
Roughness of the surfaces - Conclusions of the 2nd Consensus Conference EAO (European Association for Osseointegration), held in Monaco in 2009:
“This review concludes that rough and moderately rough surfaces support a correct osseointegration. The highest level of BIC is associated with moderately rough
surfaces (Sa value between 1 and 2 μm).”
The roughness of ZirTi surface, with its Sa medium value of 1.4- 1.7 μm, is considered ideal to achieve osseointegration. Recent histologies in humans show at 8 weeks
an excellent mineralization directly onto the ZirTi surface also in scarcely mineralized bone.*
* Amari Y., Piattelli A., Apaza Alccayhuaman K.A., Mesa N.F., Ferri M., Iezzi G., Botticelli D.; Bone healing
at non-submerged implants installed with different insertion torques: a split-mouth histomorphometric
randomized controlled trial. Int J Implant Dent. 2019 Dec 5;5(1):39. doi: 10.1186/s40729-019-0194-2.
Image of a portion of ZirTi surface obtained Magnifications of primary osteoblasts on ZirTi surface: the intimate adaptation of one cell onto the characteristic peaks of the ZirTi is visible,
using a confocal microscope thanks to a section obtained with FIB (Focused Ion Beam).
Image courtesy of Prof. G. M. Macaluso, University of Parma, Medicine and surgical department - Dentistry centre.
4
THE UTM SURFACE TREATMENT OF THE NECK

(Ultrathin Threaded Microsurface)
Implant surfaces not only are the substrate with which the biological structures
interact after the insertion of the fixture, but also activate the signals that cause
a different response in terms of proliferation and cellular organization.
This concept, very much discussed in the literature as in regards to hard tissues,
is now also considered important for soft tissues.
With these premises, Sweden & Martina has developed the UTM (Ultrathin
Threaded Microsurface) treatment: a microthread that runs all along the neck of
the implant and that offers a guide to the unidirectional fibroblast movement for
all the length of the intramucosal portion.
The biological benefit consists in a rapid cellular activity with low energy
consumption, thanks to the contact guidance concept. The acceleration of the
healing process and the long term preservation of stable and healthy tissues is
the clinical benefit, which is quite impressive when using Prama W implants.
SEM (Scanning Electron Microscope) image of Arrangement of murine myofibroblasts on

the UTM neck. the UTM surface after 72 hours and observed
with fluorescence microscopy - in vitro study.
Thanks to the kind concession of the Dentistry
Department of the University of Parma.
5
LOOK AT THE EFFECT ON SOFT TISSUES!
Courtesy of Davide Guglielmi Courtesy of Marco Gargari Courtesy of Andrea Di Domenico Courtesy of Andrea Di Domenico
Courtesy of Ignazio Loi Courtesy of Ruggero Bertolini Courtesy of Fabio Gorni Courtesy of Dentisti Vignato
Courtesy of Luigi Canullo Courtesy of Giuseppe Pellitteri Courtesy of Fortunato Alfonsi Courtesy of Stefano Conti
Prama W implants may be released in many countries with the UTM gold anodized neck and in other countries with UTM non anodized neck.
6
MORE SPACE FOR SOFT TISSUES
The convergent morphology of the Prama W neck permits the soft tissue to thicken in the area that a traditional transgingival implants or a bone level implant with a
divergent abutment would fill with titanium.
The convergence of the Prama W implant neck makes it possible for the clot to fill the coronal periimplant portion.
The clot is rich in important growth factors, which will turn into thick and functional soft tissues.
The thickening of the gingiva around the Prama W neck represents an undoubted benefit, especially in patients with a thinner biotype, in which this innovative implant
helps thickening soft tissues with no need of regenerative therapies.
DIVERGENT PROFILE
CONVERGENT PROFILE OF TRADITIONAL
OF PRAMA W IMPLANT TRANSGINGIVAL IMPLANTS OR
BONE LEVEL IMPLANTS WITH
DIVERGENT ABUTMENTS
7
CONNECTIVE TISSUE CORONAL MIGRATION
The morphology of the part of the implant-prosthesis assembly which comes into direct contact with soft tissue plays an extremely important role in the quality of
healing. The contraction of myofibroblasts and collagen fibers entails a migration of the tissues towards the narrowest diameter, so the convergent morphology of
the Prama W neck enables a growth of the soft tissues towards the most coronal part, which will stabilize and support the healing and the consequent maintenance
and coronal growth of hard tissues.
Finding a situation favourable to its regeneration, the connective tissue will progressively thicken thereby creating around the neck of the Prama W implant a high and
vascularized transgingival area that, besides its function of bone support, will also contribute to obtaining an excellent aesthetic result.
Around traditional transgingival implants with a divergent neck collagen fibers migrate towards the narrowest diameter, but in this case they shift in the apical direction,
considerably limiting the soft tissue regenerating process.
Prama W implant Transgingival implant
8
CIRCULAR FIBERS
A recent histological research in humans has confirmed the presence of circular collagen fibers bundles, arranged around the intramucosal neck of the implant and
longitudinal parallel fibers.
It is also possible to identify bundles of fibers that, from the periphery, are directed towards the surface of the implant by connecting with the structure of circular/longi-
tudinal fibers.
This arrangement explain why thick soft tissues around Prama W remain stable over time.
Histology at 6 months in human: complete view (A), detail (B).

Courtesy of Antonio Rocci and Marco Gargari
9
TRY AND PROBE!
Collagen fibers migrate towards the narrower part of the converging neck.
The convergent morphology of the neck of Prama W implants allows an excellent

adhesion of the collagen fibers with a resulting coronal migration of the
connective tissue. Thanks to this rearrangement of the peri-implant soft tissues
a seal at the prosthetic sulcus is created: this results in a short and horizontal
probing of the sulcus, that leads to a high aesthetic value with stable and
functional tissues.
Courtesy of Guillermo Cabanes Gumbau
10
HORIZONTAL AND VERTICAL

PLATFORM SWITCHING
For many years scientific literature has been dealing with the concept of Platform
Switching, the restorative prosthetic technique involving the use of posts with
a smaller diameter than the implant platform with the aim of improving the
biomechanical distribution of the prosthetic loading, and mainly to plan the
prosthetic connection at a distance from the cervical bone, thus moving away
from the bone the critical point of bacterial infiltration from bone.
From this experience, the idea of maximizing the Platform Switching mismatching
with Prama W implants was developed, taking advantage of both its vertical and
its horizontal dimensions. Another great benefit of the shape of the
Prama W implant neck is the possibility to include the implant-post interface
inside the crown, thus protecting the connection from bacterial infiltration and
Courtesy of Fabio Gorni Courtesy of Dentisti Vignato
avoiding the risk of peri-implant infections.
11
PROSTHETIC PLANNING AND INTRAMUCOSAL POSITIONING
Prama W is an implant for which an accurate

prosthetic planning is very important for the
aesthetic and functional result.
Planning is facilitated 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.
12 12
When planning the prosthesis, the implant placement should be planned according to:
Prosthetic axis: any disparallelisms can be balanced Height of the parabolas of the adjacent teeth: the In distal sectors, single crowns must be ferulized on
by a deeper and more lingual positioning, closing connection platform must be at least 1 mm deeper the implant neck in order to increase the resistance
the prosthesis on the abuments or at the level of the than the level of the parabola of the contralateral to the masticatory loads typical of the molars.
connection platform. When a screw retained crown is element.
chosen, it is possible to use components that allow
for the orientation of the hole of the prosthetic screw
palatally for a more aesthetic result.
In case of immediate post extraction sockets with In the presence of thin soft tissues a deeper
different bucco lingual and/or mesio distal bony positioning is recommended.
peaks, normally the connection platform must be
Available vertical space according to the occlusal positioned at the level of the lingual peak. The ZirTi
plane, also considering the space required for the surface portion must be placed into the bone, the
screw head, inserting the implant deeper, when UTM portion can indifferently be placed in contact
necessary. with both hard and soft tissues.
13
LOOK AT THE EFFECT ON HARD TISSUES!
Courtesy of Guillermo Cabanes Gumbau Courtesy of Guillermo Cabanes Gumbau Courtesy of Berta Garcia Mira Courtesy of Marco Csonka
Courtesy of Gioacchino Cannizzaro Courtesy of Paolo Nardinocchi Courtesy of Ignazio Loi Courtesy of Luigi Canullo
Courtesy of Dentisti Vignato Courtesy of Luigi Canullo Courtesy of Andrea Di Domenico Courtesy of Luigi Canullo
14
UTM IN CONTACT WITH HARD TISSUES
UTM finishing, the micro-thread that

runs all along the implant neck, has
proved to be an excellent substrate
both for fibroblasts and
osteoblasts, showing a perfect
osseointegration from both a
histological and a radiographic point
of view.
The histological research conducted

first in animals and then in humans,
shows at 3 months not only the
presence of mineralized bone tissue
in contact with the cylindrical portion
of the Prama W neck, but also an
osteoblastic advancement front that
proceeds in a coronal direction, both in
case of scarcely mineralized bone and
in case of hard bone.
Courtesy of Antonio Rocci Courtesy of Antonio Rocci

Histological image of a Prama W implant in
and Marco Gargari and Marco Gargari
human at 3 months.
15
ASYMMETRIC CREST?
TAKE ADVANTAGE OF IT!
The experience of the clinicians has shown that in immediate post-extraction

procedures it is possible to preserve the bone peaks of the alveoli because the
convergent neck facilitates the maintenance of thick and healthy tissues.
The hyperbolic reverse cone shape allows the preservation of all the
circumferential bone and leaves space for the clot, while the UTM (Ultrathin
POST-EXTRACTION
SOCKET Threaded Microsurface) surface of the neck ensures optimal stabilization and
organization of the fibers, which accelerates the healing process.
All these aspects contribute to the natural regeneration of the

circumferential bone despite initial deficit, showing that the surgical and
morphological characteristics of Prama W implants play a primary role in
reaching the excellent biological and aesthetic results to which Prama W users
have been accustomed.
HEALING
Bone-level implant Prama W implant
16
IF THE THREADS ARE NOT EXPOSED,

WHY SHOULD YOU REGENERATE?
BONE-LEVEL IMPLANTS PRAMA W IMPLANTS

Inserting an implant in thin crests
can be difficult, especially when the
endosseous threads naturally emerge
from the geometry and volumes of
the receiving bone. In these cases it
is usually necessary to graft material
to cover the exposed threads, then
protecting the site with membranes
and suturing to allow primary healing.
Prama W implants, thanks to
particular morphology of their necks,
can be placed, submerging the entire
treated surface, thus placing the
threads completely into the bone,
where there is a suitable thickness
to cover them: the convergent portion
of the neck will fit different anatomies
of the bone, allowing more space
to soft tissues, in a single surgical
procedure.
Simulation on pig’s mandible with bone level implants Simulation on pig’s mandible with Prama W implants
Courtesy of Marco Csonka Courtesy of Marco Csonka
17
CREST LEVELLING OR PEAKS PRESERVATION?
BONE-LEVEL IMPLANTS PRAMA W IMPLANTS

In post-extractive procedures with
Prama W implants clinical experience
has shown that it is possible to
preserve bone peaks between alveoli,
since the convergent neck does not
interfere with the correct positioning
of the rough portion inside the bone
crest and at the same time it leaves
room for the clot, facilitating the
maintenance of thick and healthy
tissues.
Therefore why sacrifice bone when it

can be a resource?
The osteotomy generate a contraction of tissues volumes in the end Bone peaks preservation helps maintaining bone and soft tissues
Courtesy of Dentisti Vignato volumes supporting the prosthetic rehabilitation
Courtesy of Dentisti Vignato
18
PRAMA W AND GUIDED SURGERY: A WINNING STRATEGY
Sweden & Martina can assist you from the design to the production of the
surgical guide, model and temporary prosthesis. Sweden & Martina’s expertise
and its dedicated assistance will make the correct positioning of Prama W even
easier. The possibility of a flapless approach will result in a significantly shorter
procedure with less pain and swelling during the healing phase for the patient.
To perform a guided surgery with Prama W implants, two complete and ergonomic
kits have been designed that includes all the instruments required to carry out an
entirely computer-assisted surgery.
Courtesy of Berta García Mira
19
ALL ON PRAMA
When a completely edentulous arch is restored with traditional submerged

implants, it is necessary to use intermediate abutments both on the angled distal
implants and on the straight mesial implants. Moreover the distal margin of the
angled implants has to be submerged, with a resulting crestal bone loss and with
difficulties due to the very deep position of the implant connection.
However, by using intramucosal Prama W implants it is possible to avoid the use

intermediate abutments in the anterior sector, positioning only the pre-angled
ones on the distal implants. Moreover the conformation of the convergent neck
allows for the ability to position the distal margin of the tilted implants at crestal
level and the mesial margin at intramucosal level, thereby avoiding the need to
use a bone profiler.
Courtesy of Marco Csonka
20
DIRECT TORONTO BRIDGES ON IMPLANTS
Prama W implant, thanks to its ability to adapt to irregular ridges and to respect
bone anatomy, has proved to be an effective tool for complex rehabilitations
of dental arches, which can be finalized in less time and with minimally invasive
surgery.
In cases of complete rehabilitations on Prama W implants, the neck allows

distances the prosthetic platform, and thus the prosthetic structure, from the
osseointegration area, favoring the formation of a layer of soft tissues which
guarantees easy cleaning and aesthetic stability over time.
It is also possible to make properly shaded toth prostheses with a minimal

amount of pink without resorting to excessively invasive operations but exploiting
the gingival healing potential of Prama W neck.
21
THE MARGIN WHERE YOU WANT IT, AT 360°
Rehabilitations on Prama W implants take

advantage of the total absence of margins or
prosthetic chamfers and the vertical morphology
of the post ensures continuity with the neck of the
implant.
This absence of margins allows the soft tissues to

run on the titanium surface without obstacles and
to obtain the desired adaptation profile set by the
restoring doctor.
Furthermore the restoring doctor can place

the prosthetic crown margin at any level of the
intramucosal position, thus managing the different
anatomical and/or clinical situations of the patient.
22
FULL RANGE OF PROSTHETIC OPTIONS
Prama W prosthetic offerings allows

the application of different excellent
rehabilitation protocols, from screw-
retained to cemented, from analogic to
digitally designed prosthesis.
Go to the prosthetic manual to explore

the full range of Prama W prosthetic
possibilities.
STANDARD AND PRAMA IN PLAIN ABUTMENTS P.A.D. ABUTMENTS PRE-MADE STRAIGHT
HEALING ABUTMENTS (Disparallel Screwed Prosthesis) POSTS
SOLUTIONS FOR OVERDENTURE SOLUTIONS FOR CUSTOM-MADE REHABILITATIONS WITH CAD-CAM TECHNIQUE
LOCATOR ABUTMENTS AND BALL ATTACHMENTS TEMPORARY POSTS SCANBODIES AESTETHIC CUSTOM-MADE
LUTED SOLUTIONS PROSTHESIS
23
ONE CONNECTION, ONE KIT – ALL DIAMETERS,

ALL LENGHTS, TWO SHAPES
Prama W implants are available in 3 sizes, 3.80 mm, 4.25 mm and 5.00 mm; all of
them have the same 3.40 mm connection.
The available lengths range between 8.50 mm and 15.00 mm.
The whole range can be inserted with the same small and practical Prama W
surgical kit, as it includes all the instruments needed for the surgical preparation
phase and the screwdrivers for the rehabilitation phase.
The kit contains also the Easy Insert drivers, for the optimal insertion of the
implants, and the “REPLY” pins, made of Gr. 5 titanium, very useful for a proper
preparation of the site for the Prama W RF tapered implants.
24
THE RANGE
Prama W Prama W RF
Range of the Prama W and Prama W RF heights
ø implant heights
3.80 mm 8.50 mm, 10.00 mm, 11.50 mm, 13.00 mm, 15.00 mm
4.25 mm 8.50 mm, 10.00 mm, 11.50 mm, 13.00 mm, 15.00 mm
5.00 mm 8.50 mm, 10.00 mm, 11.50 mm, 13.00 mm, 15.00 mm
25
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BE UNIQUE.
BE PRAMA.
rev. 02-20
Sweden & Martina S.p.A. Sweden & Martina Inc. Sweden & Martina Mediterranea S.L. - España
Via Veneto, 10 Distributor for U.S. info.pes@sweden-martina.com
35020 Due Carrare (PD), Italy 637 S. 48th St. - Suite 21 Sweden & Martina Lda - Portugal
Tel. +39.049.9124300 Tempe, AZ 85281 info.pt@sweden-martina.com
Fax +39.049.9124290 Toll free 1-844-8MARTINA (1-844-862-7846) Sweden & Martina Ltd. - United Kingdom
info@sweden-martina.com info.us@sweden-martina.com info.uk@sweden-martina.com
www.sweden-martina.com www.sweden-martinainc.com
The implants, standard prosthetic components and surgical instruments contained in this catalogue are Medical devices and are manufactured by Sweden & Martina S.p.A. They conform to the ISO 9001 and ISO 13485 standards and are certified with
the CE Mark (Class I) and CE 0476 mark (Class IIA and class IIB) in compliance with Regulation (EU) Medical Devices n. 745/2017. They are conform to the QSR and 21 CFR part 820 and are approved by FDA. Prama W implants are pending FDA approval.
Some products may not be regulatory/released for sale in all markets.

All trademarks here in are the property of Sweden & Martina S.p.A. unless otherwise indicated.
This material is intended for laboratories and clinicians and is not intended for patient distribution.
This material is not to be redistributed, duplicated, or disclosed without the express written consent of Sweden & Martina S.p.A.
For additional product information, including indications, contraindications, warnings, precautions, and potential adverse effects, see Sweden & Martina S.p.A. website.
The contents are updated at the time of publication. Check with the company for any subsequent updates.

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BE UNIQUE.

Convergent portion UTM Surface

Prama W implants are available in two endosseous shapes,

The cylindrical morphology of Prama W implants, with over 20 years of

In particular, the cylindrical body facilitates insertion in the mandibular

Prama W RF (Root Form) has a tapered morphology, and it is recommended

THE UTM SURFACE TREATMENT OF THE NECK

SEM (Scanning Electron Microscope) image of Arrangement of murine myofibroblasts on

LOOK AT THE EFFECT ON SOFT TISSUES!

MORE SPACE FOR SOFT TISSUES

CONNECTIVE TISSUE CORONAL MIGRATION

Prama W implant Transgingival implant

Histology at 6 months in human: complete view (A), detail (B).

TRY AND PROBE!

The convergent morphology of the neck of Prama W implants allows an excellent

Courtesy of Guillermo Cabanes Gumbau

HORIZONTAL AND VERTICAL

PROSTHETIC PLANNING AND INTRAMUCOSAL POSITIONING

Prama W is an implant for which an accurate

Planning is facilitated by:

LOOK AT THE EFFECT ON HARD TISSUES!

UTM IN CONTACT WITH HARD TISSUES

UTM finishing, the micro-thread that

The histological research conducted

Courtesy of Antonio Rocci Courtesy of Antonio Rocci

The experience of the clinicians has shown that in immediate post-extraction

All these aspects contribute to the natural regeneration of the

Bone-level implant Prama W implant

IF THE THREADS ARE NOT EXPOSED,

BONE-LEVEL IMPLANTS PRAMA W IMPLANTS

CREST LEVELLING OR PEAKS PRESERVATION?

BONE-LEVEL IMPLANTS PRAMA W IMPLANTS

Therefore why sacrifice bone when it

PRAMA W AND GUIDED SURGERY: A WINNING STRATEGY

Courtesy of Berta García Mira

When a completely edentulous arch is restored with traditional submerged

However, by using intramucosal Prama W implants it is possible to avoid the use

Courtesy of Marco Csonka

DIRECT TORONTO BRIDGES ON IMPLANTS

In cases of complete rehabilitations on Prama W implants, the neck allows

It is also possible to make properly shaded toth prostheses with a minimal

Courtesy of Dentisti Vignato

THE MARGIN WHERE YOU WANT IT, AT 360°

Rehabilitations on Prama W implants take

This absence of margins allows the soft tissues to

Furthermore the restoring doctor can place

Courtesy of Dentisti Vignato

FULL RANGE OF PROSTHETIC OPTIONS

Prama W prosthetic offerings allows

Go to the prosthetic manual to explore

ONE CONNECTION, ONE KIT – ALL DIAMETERS,

The available lengths range between 8.50 mm and 15.00 mm.

Range of the Prama W and Prama W RF heights

Launch the Tap the video

Some products may not be regulatory/released for sale in all markets.

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