Bicon Dental Implants
Friday, November 21st 2008 4:37PM EDT

Immediate Stabilization and Function / Bicon Integrated butment Crowns™ : Extraction of a Maxillary Central Incisor and Restoration of an Immediately
Placed and Functioning Implant with an Integrated Abutment Crown™
This case demonstrates the extraction of a maxillary left central incisor with internal resorption, immediate placement, transitional stabilization, implant level transfer impression, and insertion of immediately stabilized or loaded maxillary left central incisor implant as well as the insertion of an Integrated Abutment Crown™ with a seating jig.
     


1. Pre-operative smile.


2. Pre-operative site.


3. Pre-operative radiograph.


4. Extraction of tooth with internal resorption.


5. Close-up view of the extracted tooth.


6. Curette removing soft tissue remnants of periodontal ligament.


7. Pilot bur initiating osteotomy by having a trajectory that is more perpendicular to the palatal wall of the socket which will allow for its engagement. Immediately upon its engagement, the pilot bur will be up righted to a trajectory parallel to the adjacent teeth.


8. Osteotomy being prepared with 2.0mm pilot bur rotating at 1100RPM with external irrigation.


9. Osteotomy being enlarged with an olive green 2.5mm latch reamer bur rotating at 50RPM without water irrigation.


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


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


12. Osteotomy being enlarged with a red 4.0mm latch reamer bur rotating at 50RPM without water irrigation.


13. Osteotomy being enlarged with a silver 4.5mm latch reamer bur rotating at 50RPM without water irrigation.


14. Osteotomy being enlarged with a gold 5.0mm latch reamer bur rotating at 50RPM without water irrigation.


15. Harvested bone within the gold 5.0mm latch reamer.


16. Curette removing residual bone while confirming the integrity of the five bony walls of the osteotomy.


17. A 5.0mm x 11.0mm HA coated implant being inserted into the osteotomy with an implant inserter instrument.


18. Implant inserter instrument attached to a straight handle being used to seat implant farther into the osteotomy.


19. View of seated implant with polyethylene healing plug.


20. Harvested bone being placed over implant.


21. 5.0mm wide Stealth shouldered abutment with a shoulder height of
4.0mm is being inserted into the implant well with only finger pressure.


22. Short acrylic sleeve being modified.


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


24. Bonding agent being applied.


25. Light curing of bonding agent.


26. Polyceramic material being added to acrylic sleeve to form a bonded strut between adjacent teeth.


27. Light curing of polyceramic material that was applied over the acrylic sleeve.


28. Additional polyceramic material is being added to the hardened strut for aesthetic contouring.


29. Polishing of bonded prosthesis with a soft white silicone disc.


30. Polishing of bonded prosthesis with a nylon bristle brush.


31. Smile at completion of first clinical visit.


32. Radiograph of immediately placed and functioning implant at the completion of the first clinical visit.


33. Bonded stabilizing prosthesis prior to its being removed at the patient’s second clinical visit eight weeks after the implant placement.


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


35. 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.


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


37. Impression material being injected around the impression post for the making of an implant level transfer impression.


38. Digital image being taken of shade guide against a black plastic background to facilitate the fabrication of an aesthetic Integrated Abutment Crown™.


39. Post-operative radiograph.


40. Integrated Abutment Crown™ on stone model.


41. Integrated Abutment Crown™ on stone model with yellow thermoplastic seating jig which was fabricated on a crown alignment device to facilitate directing the seating forces in the long axis of the implant well and abutment post.


42. View of Integrated Abutment Crown™.


43. Integrated Abutment crown™ being inserted initially to evaluate its appropriateness.


44. Clear acrylic orientation jig being used to initially align Integrated Abutment Crown™.


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


46. View of seated Integrated Abutment Crown™ immediately after insertion.


47. Post-operative radiograph.


48. Right profile view one month post-insertion.


49. Left profile view one month post-insertion.


50. Facial view one month post-insertion.


51. Patient’s smile.
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