Bicon Dental Implants
Thursday, March 11th 2010 8:17PM EDT

Full Arch / Short Implants / Immediate Stabilization and Function / Bicon Integrated Abutment Crowns™: Extraction, Two-Stage & Immediate Placement and Loading of Twenty-One Implants and their Restoration with Integrated Abutment Crowns™
This case demonstrates the two stage, immediate placement and loading of twenty one implants as well as their restoration with Integrated Abutment Crowns™ in four clinical visits during a period of twenty-two weeks.

(NOTE: This is Part Two of a two-part case. Click here to view Part One.)

 

   


1. View of transitional prostheses prior to its removal eleven weeks after implant placements.


2. View of transitional abutments after removal of splinted prostheses.


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


4. Cut polyethylene healing plug being removed from the well of the implant.


5. Cut polyethylene healing plug being removed from the well of the implant.


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


7. Cut polyethylene healing plug being removed from the well of the implant.


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


9. Cut polyethylene healing plug being removed from the well of the implant.


10. Red 2.0mm impression reamer inserted onto guide pin to remove any tissue which might inhibit the complete seating of an impression post.


11. Transitional abutments being removed.


12. View of implant wells after the removal of the transitional prosthesis and the stealth abutments


13. View of guide pins seated in the implant wells.


14. Profile view of guide pins seated in the implant wells.


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


16. Cut polyethylene healing plug being removed from the well of the implant.


17. Abutment being removed by gently tapping on the carbide tip forceps that is grasping the abutment.


18. View of implant wells after the removal of the transitional prosthesis and the stealth abutments.


19. View of green 3.0mm and red 2.0mm guide pins seated in the implant wells.


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


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


22. Red 2.0mm impression reamer inserted onto guide pin to remove any tissue which might inhibit the complete seating of an impression post.


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


24. 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.


25. Red 2.0mm plastic impression post being inserted into the 2.0mm well of an integrated implant for the making of an implant level transfer impression.


26. 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.


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


28. Red 2.0mm plastic impression post receiving its mandatory seating tap.


29. Red 2.0mm plastic impression post being adjusted to prevent contact with the adjacent impression post which would distort the trajectory of the impression analog.


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


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


32. Green 3.0mm plastic impression post being adjusted to prevent contact with the adjacent impression post which would distort the trajectory of the impression analog.


33. Facial view of maxillary and mandibular arches with seated green 3.0mm and red 2.0mm impression posts.


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


35. Impression tray filled with impression material being inserted.


36. Maxillary implant level transfer impression.


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


38. Mandibular implant level transfer impression.


39. Patient's smile with seated impression posts.


40. Aesthetic and functional evaluation of diagnostic prosthetic arrangement.


41. Aesthetic and functional evaluation of diagnostic prosthetic arrangement.


42. Aesthetic and functional evaluation of diagnostic prosthetic arrangement.


43. Red acrylic being injected onto the impression posts for occlusal registration.


44. Occlusal registration being marked to record the midline of the face, lip line and incisal length of anterior teeth.


45. Close-up view.


46. Post-operative radiograph.


47. Facial view of twenty-one Integrated Abutment Crowns™ on stone model prior to their being polished.


48. Occlusal view of twelve maxillary Integrated Abutment Crowns™ on stone model prior to their being polished.


49. Occlusal view of nine mandibular Integrated Abutment Crowns™ on stone model prior to their being polished.


50. Patient’s smile with transitional prosthesis prior to its removal for the insertion of the Integrated Abutment Crowns™ on the fourth clinical visit twenty-two weeks after the initial implant placement.


51. View of implant wells and soft tissue sulci.


52. Unpolished Integrated Abutment Crown™ being inserted initially to evaluate its appropriateness.


53. A green 6.5mm sulcus reamer being used to remove soft tissue and bone which might inhibit the complete seating of the Integrated Abutment Crown™.


54. Floss being used to confirm the fact that the inter-proximal contacts are passive and will not interfere with the engagement of the locking taper.


55. A gold 5.0mm sulcus reamer being used to remove soft tissue and bone which might inhibit the complete seating of the Integrated Abutment Crown™.


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


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


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


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


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


61. Crestal relieving incision being made to facilitate the seating of the Integrated Abutment Crown™.


62. Crestal relieving incision being made to facilitate the seating of the Integrated Abutment Crown™.


63. A gold 5.0mm sulcus reamer being used to remove soft tissue and bone which would inhibit the complete seating of the Integrated Abutment Crown™.


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


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


66. Floss being used to confirm the fact that the inter-proximal contacts are passive and will not interfere with the engagement of the locking taper.


67. Floss being used to confirm the fact that the inter-proximal contacts are passive and will not interfere with the engagement of the locking taper.


68. White healing abutment in a straight handle is being used to tap the Integrated Abutment Crown™ into the well of the implant.


69. Articulating paper being used to confirm appropriate incisal contacts in all extreme excursions while the patient is clenching.


70. Markings indicate the need for occlusal adjustments.


71. Adjustment of occlusal contacts with a #7408 carbide bur.


72. Patient’s smile indicates the need for aesthetic adjustments.


73. Black incisal marking helps to facilitate the evaluation of aesthetics.


74. Black incisal markings against a black plastic background to facilitate the evaluation of aesthetics.


75. Right profile view immediately after insertion of polished Integrated Abutment Crowns™.


76. Left profile view immediately after insertion of polished Integrated Abutment Crowns™.


77. Right side view.


78. Left side view.


79. Facial view.


80. Post-insertion radiograph of Integrated Abutment Crowns™.


81. Post-insertion radiograph of Integrated Abutment Crowns™.


82. Post-insertion radiograph of Integrated Abutment Crowns™.


83. Post-insertion radiograph of Integrated Abutment Crowns™.


84. Post-insertion radiograph of Integrated Abutment Crowns™.


85. Post-insertion radiograph of Integrated Abutment Crowns™.


86. Post-insertion radiograph of Integrated Abutment Crowns™.


87. Post-insertion radiograph of Integrated Abutment Crowns™.


88. Post-insertion radiograph of Integrated Abutment Crowns™.


89. Post-insertion radiograph of Integrated Abutment Crowns™.


90. Integrated Abutment Crown™ being removed for further aesthetic adjustment.


91. View of implant wells and soft tissue sulci.


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


93. View of seated maxillary right central incisor integrated abutment crown™.


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


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


96. Integrated Abutment Crown™ being inserted initially to evaluate its appropriateness.


97. Orientation jig being used to initially position the Integrated Abutment Crowns™.


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


99. Blue Markings indicate excessive interproximal contacts which must be adjusted to ensure the engagement of the locking taper connection.


100. Excessive interproximal contact being adjusted.


101. 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.


102. 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.


103. Integrated Abutment crown™ being inserted.


104. 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.


105. Markings indicate the need for incisal adjustment.


106. Occlusal markings.


107. Occlusal markings.


108. Occlusal contact is being reduced with #7408 carbide bur.


109. Incisal contact is being reduced with white acrylic polishing wheel.


110. View of sulci after the removal of three mandibular anterior Integrated Abutment Crowns™ for the addition of polyceramic material to close the space between the patient’s left mandibular canine and the Integrated Abutment Crown™.


111. Polyceramic material being added to the surface.


112. Additional material being light cured.


113. Polishing with a soft white silicone wheel.


114. Polishing with a nylon bristle brush wheel.


115. Integrated Abutment Crown™ being tapped into the implant.


116. Integrated Abutment Crown™ being reinserted.


117. Integrated Abutment Crown™ being tapped into the implant.


118. View of maxillary arch two months post insertion.


119. View of mandibular arch two months post insertion.


120. Facial view two months post insertion.


121. Right profile view two months post insertion.


122. Left profile view two months post insertion.


123. Right profile view of patient’s smile.


124. Left profile view of patient’s smile.


125. Patient’s smile.


126. Post-insertion radiograph.

(NOTE: This is Part Two of a two-part case. Click here to view Part One.)

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