This case demonstrates the use of Synthograft™, Pure Phase Beta-Tricalcium Phosphate, for bone grafting, two stage placement and restoration of nine implants, implant level transfer impression, occlusal registration, and insertion of nine Integrated Abutment Crowns™ including three two-unit Integrated Abutment Crowns™ for the intraoral fabrication of a four unit prosthesis and a three unit prosthesis.
Categories: Bicon Integrated Abutment Crowns™Full Arch
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1. | Pre-operative radiograph revealing severe bone loss. |
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2. | Pre-operative facial view. |
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3. | Pre-operative left profile view. |
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4. | Pre-operative right profile view. |
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5. | Post-operative radiograph after maxillary extractions. |
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6. | Incision being made for grafting procedure with Synthograft™, Pure Phase Beta-Tricalcium Phosphate. |
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7. | Small perforations being made in bone to enhance bleeding. |
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8. | Mixture of patient’s blood and Synthograft™, Pure Phase Beta-Tricalcium Phosphate, being placed. |
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9. | View of Synthograft™, Pure Phase Beta-Tricalcium Phosphate, in place. |
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10. | View of Bicon collagen membrane and Synthograft™, Pure Phase Beta-Tricalcium Phosphate, in place. |
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11. | Suture being placed. |
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12. | Sutured site. |
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13. | View of boney defect on the left maxillary ridge. |
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14. | Incision being made for grafting procedure with Synthograft™, Pure Phase Beta-Tricalcium Phosphate. |
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15. | Patient’s blood being collected from the operative site to be mixed with Synthograft™, Pure Phase Beta-Tricalcium Phosphate. |
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16. | Mixture of patient’s blood and Synthograft™, Pure Phase Beta-Tricalcium Phosphate, being placed. |
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17. | The graft material being packed with a cotton tip applicator. |
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18. | Bicon collagen membrane being placed over the graft material. |
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19. | View of Post-operative radiograph after the placement of nine maxillary implants. |
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20. | Healing plug being removed with a healing plug removal instrument. |
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21. | Healing plug removed with a healing plug removal instrument. |
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22. | Green 3.0mm guide pins seated into the wells of the implants. |
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23. | Green 3.0mm plastic impression post being inserted into the 3.0mm well of an integrated maxillary right central incisor implant for the making of an implant level transfer impression. |
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24. | Green 3.0mm plastic impression post being inserted into the 3.0mm well of an integrated maxillary right central incisor implant for the making of an implant level transfer impression. |
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25. | Green 3.0mm plastic impression post receiving its mandatory seating tap. |
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26. | Impression material being injected around the impression posts for the making of a full arch implant level transfer impression. |
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27. | View of occlusal bite registration rim with green 3.0mm plastic impression posts. |
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28. | Facial view of maxillary occlusal bite registration rim with white speckled plaster. |
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29. | Maxillary occlusal rim with white speckled plaster on the stone model. |
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30. | Maxillary occlusal rim with white speckled plaster being seated. |
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31. | View of seated maxillary occlusal rim. |
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32. | Functionally-derived registration being made. |
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33. | Note the reduction of white speckled plaster after the functionally-derived registration. |
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34. | View of achieved vertical dimension for the maxillary Integrated Abutment Crowns™. |
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35. | View of twelve maxillary Integrated Abutment Crowns™ and cantilever crowns. |
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36. | Facial view of twelve maxillary Integrated Abutment Crowns™ on stone model. |
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37. | Integrated Abutment Crowns™ on stone model with acrylic orientation jig. |
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38. | Integrated Abutment Crowns™ on stone model with yellow thermoplastic seating jigs, which were fabricated on a crown alignment device to facilitate directing the seating forces in the long axis of the implant well and abutment post. |
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39. | Occlusal view of Integrated Abutment Crowns™ on stone model. |
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40. | View of full maxillary arch with trimmed white healing abutments and green plastic impression posts. |
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41. | Trimmed white temporary abutment being removed. |
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42. | Integrated Abutment Crown™ with cantilever being inserted which will be intraorally bonded to adjacent teeth. |
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43. | Integrated Abutment Crown™ with distal cantilever being inserted. |
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44. | An orientation jig being used to initially position the Integrated Abutment Crowns™. |
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45. | Articulating paper being used to confirm interproximal contacts for the insertion of the Integrated Abutment Crown™. |
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46. | Interproximal contact being adjusted with metal finishing strip. |
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47. | Integrated Abutment Crown™ with cantilever being inserted. |
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48. | Integrated Abutment Crown™ being inserted. |
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49. | View of the Integrated Abutment Crown™ being modified with a pink acrylic polishing wheel. |
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50. | Articulating paper being used to confirm interproximal contacts. |
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51. | Red markings indicate excessive interproximal contact which must be adjusted to assure passive contact for the engagement of the locking taper connection. Interproximal contact being adjusted. |
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52. | Integrated Abutment Crown™ being inserted. |
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53. | White healing abutment in a straight handle is being used to tap the Integrated Abutment Crown™ into the well of the implant. |
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54. | White healing abutment in a straight handle is being used to tap the Integrated Abutment Crown™ into the well of the implant. |
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55. | 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. |
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56. | 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. |
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57. | 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. |
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58. | Facial view immediately after the initial insertion of Integrated Abutment Crowns™. |
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59. | Facial view immediately after the initial insertion of Integrated Abutment Crowns™. |
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60. | Post insertion radiograph of Integrated Abutment Crowns™ including three two-unit Integrated Abutment Crowns™ for the intraoral fabrication of a four unit prosthesis and a three unit prosthesis. |