Bicon Dental Implants
Friday, March 12th 2010 8:42AM EDT

Immediate Stabilization and Function / Bicon Integrated Abutment Crowns™: Extraction, Immediate Placement and Stabilization and Restoration of Maxillary lateral Incisor Implants with Integrated Abutment Crowns™
This case demonstrates the extraction of failed endodontically treated teeth and the immediate placement and stabilization of two 4.0mm x 11.0mm HA coated maxillary lateral incisor implants as well as their restoration with Bicon Integrated Abutment Crowns™.

 

    
First Clinical Visit:


1. Preoperative radiograph of maxillary right lateral incisor.


2. Preoperative radiograph of maxillary left lateral incisor.


3. Preoperative view.


4. Preoperative smile.


5. Extracted maxillary right lateral incisor.


6. Removed maxillary left lateral crown.


7. Extracted maxillary left lateral root.


8. Curette removing soft tissue remnants of periodontal ligament.


10. Socket being rinsed with chlorhexidine gluconate 0.12%.


11. Socket being rinsed with chlorhexidine gluconate 0.12%.


12. Osteotomy being prepared for the right lateral incisor implant with 2.0mm pilot bur rotating at 1100RPM with external irrigation.


13. Parallel pin seated in pilot osteotomy indicating its trajectory.


14. Osteotomy being prepared for the left lateral incisor implant with 2.0mm pilot bur rotating at 1100RPM with external irrigation.


15. Parallel pins seated in pilot osteotomies indicating their trajectories.


16. Osteotomy being enlarged with an olive green 2.5mm latch reamer rotating at RPM without water irrigation.


17. Osteotomy being enlarged with a teal 3.0mm latch reamer rotating at 50 RPM without water irrigation.


18. Osteotomy being enlarged with a blue 3.5mm latch reamer rotating at 50 RPM without water irrigation.


19. Osteotomy being enlarged with a red 4.0mm hand reamer.


20. Curette harvesting residual bone while confirming the integrity of the five bony walls of the osteotomy.


21. A 4.5 x 11.0mm HA coated implant being inserted into the right lateral osteotomy with an implant seating tip threaded on a straight driver.


22. A 4.5 x 11.0mm HA coated implant being inserted into the left lateral osteotomy with an implant seating tip threaded on a straight driver.


23. View of polyethylene healing plugs seated in the well of the implants.


24. Shoulder depth gauge seated in the well of the implant facilitating the selection of a stealth abutment with an appropriate shoulder height.


25. Tall acrylic sleeve being adjusted for occlusal clearance.


26. Modified acrylic sleeve and a 4.0 x 3.5mm stealth shouldered abutment being seated in the implant well.


27. Shoulder depth gauge seated in the well of the implant facilitating the selection of a stealth abutment with an appropriate shoulder height.


28. Modified acrylic sleeve and a 4.0 x 3.5mm stealth shouldered abutment being seated in the implant well.


29. Etchant being applied in preparation for the bonding of the transitional prosthesis.


30. Bonding material being applied.


31. Light curing of bonding material.


32. Composite material being added to form a strut between adjacent teeth.


33. Light curing of composite material.


34. Composite material being added.


35. Light curing of composite material.


36. Composite material being added.


37. Light curing of composite material.


38. Transitional prosthesis being contoured.


39. Polishing of bonded prosthesis with a pink silicone disc.


40. View of finished transitional prostheses.


41. Post operative radiograph.


42. Post operative radiograph.
Second Clinical Visit:


43. Transitional prostheses prior to their removal for the making of implant level transfer impression.


44. Transitional prosthesis being removed.


45. A 4.0 x 3.5mm stealth shouldered abutment being removed.


46. View of implant well after the removal of the transitional prosthesis and the stealth abutment.


47. Transitional prosthesis being removed.


48. Green 3.0mm impression reamer being inserted onto guide pin to remove any tissue which might inhibit the complete seating of an impression post.


49. Green 3.0mm plastic impression post being inserted into the 3.0mm well of an integrated implant for the making of an implant level transfer impression.


50. Green 3.0mm plastic impression post receiving its mandatory seating tap.


51. Green 3.0mm guide pin being inserted into the well of the implant.


52. Green 3.0mm impression reamer being inserted onto guide pin to remove any tissue which might inhibit the complete seating of an impression post.


53. Green 3.0mm plastic impression post being inserted into the 3.0mm well of an integrated implant for the making of an implant level transfer impression.


54. Green 3.0mm plastic impression post receiving its mandatory seating tap.


55. Impression material being injected around the impression post for the making of a full arch implant level transfer impression.


56. Maxillary implant level transfer impression.
Third Clinical Visit:


57. Integrated Abutment Crowns™ on stone model.


58. Bonded transitional stabilizing prostheses prior to their removal.


59. View of implant wells after the removal of the transitional prostheses.


60. Integrated Abutment Crown™ being cleaned with alcohol.


61. Integrated Abutment Crown™ being inserted.


62. Checking interproximal contact with dental floss since a too tight interproximal contact would prevent the engagement of the locking taper and possibly result in the subsequent loosening of the Integrated Abutment Crown™.


63. Interproximal contact being adjusted with metal finishing strip to achieve a passive contact.


64. Yellow thermoplastic custom seating jig, which was formed with a crown alignment device, in a crown seating tip attached to a straight handle facilitating directing the tapping forces in the long axis of the abutment post and implant well.


65. Well of implant being cleaned with alcohol on a cotton tipped applicator.


66. Integrated Abutment Crown™ being inserted.


67. Relieving incision being made to facilitate the seating of the Integrated Abutment Crown™.


68. Checking interproximal contact with dental floss since a too tight interproximal contact would prevent the engagement of the locking taper and possibly result in the subsequent loosening of the Integrated Abutment Crown™.


69. Interproximal contact being adjusted with metal finishing strip.


70. Yellow thermoplastic custom seating jig, which was formed with a crown alignment device, in a crown seating tip attached to a straight handle facilitates directing the tapping forces in the long axis of the abutment post and implant well.


71. View of Integrated Abutment Crowns™ immediately after being inserted.


72. Post insertion radiograph.


73. Post insertion radiograph.


74. View of Integrated Abutment Crowns™ seven months post insertion.


75. Left profile seven months post insertion.


76. Right profile seven months post insertion.
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