Bicon Dental Implants
Friday, November 21st 2008 1:33PM EDT

Bicon Integrated Abutment Crowns™ / Ridge Split: Maxillary Ridge Split
, Two Stage Placement and Restoration of Left Lateral Incisor Implant

This case demonstrates a maxillary ridge split, two stage placement and uncovering of a left lateral incisor implant as well as the implant level transfer impression and insertion of a Bicon Integrated Abutment Crown™.

     


1. Pre-operative radiograph.


2. Pre-operative site.


3. Flap being reflected.


4. Retraction suture being placed.


5. View of ridge.


6. Ridge being initially split by the gentle tapping of a ridge splitting chisel.


7. Ridge being split by the use of successively larger chisels.


8. Ridge being split by the use of successively larger chisels.


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


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


11. Profile view of the trajectory of the osteotomy.


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


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


14. Osteotomy being enlarged with a blue 3.5mm hand reamer bur.


15. Harvested bone within the flute of blue 3.5mm hand reamer.


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


17. Osteotomy being enlarged with a silver 4.5mm hand reamer.


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


19. Clinician’s finger monitoring the buccal and palatal bone during the preparation of the osteotomy and the harvesting of bone with a gold 5.0mm hand reamer.


20. A 5.0mm x 8.0mm HA coated implant being inserted into the osteotomy with an implant seating tip threaded on a straight driver.


21. A 5.0mm x 8.0mm HA coated implant being inserted into the osteotomy with an implant seating tip threaded on a straight driver.


22. View of well of seated implant.


23. Implant seating tip attached to a straight handle is being tapped to seat implant farther into the osteotomy.


24. Cut polyethylene healing plug being inserted into the well of the implant.


25. View of seated implant with cut polyethylene healing plug.


26. View of the bone harvested during the osteotomy.


27. Harvested bone placed over the implant.


28. Sutured closure of flap.


29. View of transitional prosthesis bonded to adjacent teeth.


30. Post-operative radiograph.


31. View of transitional prosthesis prior to its removal nineteen weeks after implant placement.


32. Transitional prosthesis being removed for uncovering of the implant.


33. View of healing plug remover.


34. The trimmed polyethylene healing plug being removed from the well of the implant with a healing plug remover.


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


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


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


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


39. View of transitional crown.


40. Post-operative radiograph.


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. Integrated Abutment Crown™ on stone model.


43. View of Integrated Abutment Crown™.


44. View after removal of transitional stabilizing prosthesis two weeks after the implant level transfer impression was taken.


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


46. Abutment post being cleaned with alcohol wipe to remove any debris which would diminish the effectiveness of the locking taper connection.


47. Integrated Abutment Crown™ being inserted.


48. Floss being used to confirm the fact that the interproximal contacts are passive and will not interfere with the engagement of the locking taper.


49. Polishing strip being used to lighten the interproximal contact area eliminating the possibility that the contact may prevent the engagement of the locking taper connection.


50. Blue markings indicate contact on left canine.


51. Height of buccal gingiva being marked to facilitate the adjustment of the cervical aspect of the Integrated Abutment Crown™.


52. 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.


53. Integrated Abutment Crown™ one week after insertion.


54. Post-operative radiograph of seated Integrated Abutment Crown™ one week after insertion.


55. Facial view three weeks after insertion.


56. Right profile view three weeks after insertion.


57. Left profile view three weeks after insertion.
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