Bicon Dental Implants
Friday, November 21st 2008 1:01PM EDT

Immediate Stabilization and Function / All-Ceramic Crowns: Two Extra-orally Cemented Crowns
This case demonstrates the immediate placement, stabilization, and implant level impression transfer of two maxillary bicuspid implants as well as the extra-oral cementation of two all-ceramic crowns.
     


1. Pre-operative radiograph.


2. Final reamer being removed from second bicuspid osteotomy.


3. View of two prepared bicuspid osteotomies.


4. Implant inserter / retriever instrument transporting a 5mm x 8.0mm HA coated implant into first bicuspid osteotomy.


5. Implant being tapped into position with implant seating tip on straight driver.


6. Shoulder depth gauge seated in implant well facilitating the selection of an abutment with an appropriate shoulder height relative to the soft tissue crest.


7. A 5.0mm x 2.0mm shouldered abutment is being inserted into a tall one piece acrylic sleeve.


8. Tall one piece acrylic sleeve and abutment being inserted into well of implant.


9. Height of tall one piece acrylic sleeve being reduced.


10. Tall one piece acrylic sleeve and a 4.0mm x 1.5mm abutment being inserted into well of second bicuspid implant.


11. View of two one piece acrylic sleeves.


12. Bonding agent being applied to one piece acrylic sleeves.


13. Light curing of bonding agent.


14. A strut of transitional composite material being formed between the two sleeves prior to their being incorporated into the transitional stabilization prosthesis.


15. Removal of transitional stabilization prosthesis for polishing.


16. Flowable composite material being added to voids in stabilization prosthesis.


17. Acid etching of enamel for the bonding of stabilization prosthesis.


18. Bonding agent being applied.


19. Light curing of bonding agent.


20. Bonded transitional stabilization prosthesis.


21. Radiograph of a 4.0mm x 1.5mm and a 5.0mm x 2.0mm shouldered abutment supporting the bonded transitional stabilization prosthesis.


22. Two implant sulci after the removal of the stabilization splint eleven weeks after the placement of the implants.


23. Second white 3.0mm impression post being inserted into second bicuspid implant.


24. Impression posts after having been tapped for definitive seating into their implant wells.


25. Impression material being injected around white posts for the making of an implant level transfer impression.


26. White impression posts in soft tissue model prior to being replaced with actual titanium shouldered abutments.


27. Soft tissue model after the removal of the impression posts and prior to the insertion of two titanium shouldered abutments.


28. Two all-ceramic crowns on soft tissue model.


29. Mirror view of two all ceramic crowns revealing their aluminum oxide cores.


30. Initial seating of first bicuspid all-ceramic crown confirming appropriateness of color and morphology.


31. Removal of plastic temporary abutment which was maintaining the soft tissue sulcus after the removal of transitional prosthesis.


32. Occlusal view of all-ceramic crown and 3.0mm implant well with soft tissue sulcus.


33. Second bicuspid all-ceramic crown being inserted for confirmation seating.


34. Metalic coupler being applied to 4.0mm wide shouldered abutment.


35. Ceramo-coupler being applied to aluminum oxide core of all-ceramic crown.


36. Bonding agent being applied to shouldered abutment.


37. Bonding agent being applied to aluminum oxide sleeve.


38. Cement being applied to shouldered abutment.


39. Extraneous cement being removed from the extra-orally cemented all-ceramic crown with a cotton applicator.


40. Extra-orally cemented all-ceramic crown being inserted into well of implant.


41. Extra-orally cemented all-ceramic crown being tapped for definitive seating into the well of the implant.


42. Two all-ceramic maxillary bicuspid crowns in occlusion.


43. Radiograph of two extra-orally cemented all-ceramic crowns.


44. Labial view of two all-ceramic crowns.
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