Bicon Dental Implants
Wednesday, August 27th 2008 7:04PM EDT
 

Immediate Stabilization and Function / Bicon Integrated Abutment Crowns™: An Aesthetic Resolution of a Metallic Gingival Margin
This case demonstrates the immediate placement and loading, implant level transfer impression, and the restoration of a maxillary left first bicuspid with an Integrated Abutment Crown™ as well as the ease with which a metallic gingival margin resulting from a tear of the buccal mucosa on a one-year old Integrated Abutment Crown™ can be aesthetically improved.
     


1. Pre-operative view.


2. Pre-operative radiograph.


3. Osteotomy being enlarged with a gold 2.5mm hand reamer bur.


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


5. 5.0mm x 8.0mm TPS coated implant being inserted into the osteotomy with an implant seating tip threaded on a straight driver. Note tear of buccal mucosa which will subsequently result in gingival recession.


6. Implant seating tip attached to a straight handle is being tapped to seat implant farther into the osteotomy. Note tear of buccal mucosa which will subsequently result in gingival recession.


7. View of seated implant with a polyethylene healing plug.


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


9. Bonding primer agent being applied. Note tear of buccal mucosa which will subsequently result in gingival recession.


10. Bonding agent being applied. Note tear of buccal mucosa which will subsequently result in gingival recession.


11. Light curing of bonding agent.


12. Shoulder depth gauge seated in the well of the implant facilitates the selection of a stealth abutment with an appropriate shoulder height. Note tear of buccal mucosa which will subsequently result in gingival recession.


13. Short one-piece acrylic sleeve snapped onto a stealth shouldered abutment 4.0mm wide with a shoulder height of 3.5mm are being inserted into the implant well with only finger pressure.


14. Polyceramic material being added to acrylic sleeve to form a bonded strut between adjacent teeth. Note tear of buccal mucosa which will subsequently result in gingival recession.


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


16. Transitional prosthesis being contoured. Note tear of buccal mucosa which will subsequently result in gingival recession.


17. Radiograph thirteen weeks after implant placement prior to the making of a full arch implant level transfer impression.


18. Green 3.0mm metal impression post receiving its mandatory seating tap. Note: The metal impression posts are no longer available.


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


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


21. View of seated Integrated Abutment Crown™ on the day of its insertion. Note gingival recession most likely from initial tear of buccal mucosa.


22. Post insertion radiograph.


23. View of Integrated Abutment Crown™ one year after insertion. Note the gingival recession and ease with which it will be corrected.


24. Implant well and soft tissue sulcus after the removal of the Integrated Abutment Crown™.


25. View of seated plastic healing abutment.


26. Laboratory bur is used to prepare the cervical portion of a Bicon abutment by cutting a groove into the surgical grade titanium alloy.


27. View of prepared Integrated Abutment Crown™ in a red wax holding device.


28. After sandblasting with 50 micron alumina and ultrasonically cleaning in 95% ethyl alcohol, the prepared groove is coated with a metallic coupling agent.


29. Integrated Abutment Crown™ with a metallic coated prepared groove is placed in an oven at 120°C for five minutes.


30. Metal opaque powder and liquid being mixed on a glass slab.


31. A layer of neutral metal opaque powder is applied onto the prepared groove.


32. Restoration with opaque layer is placed into an oven for five minutes at 120°C for five minutes under vacuum.


33. View of the restoration after an application and light curing of modeling liquid, and polyceramic opaque dentin.


34. A layer of polyceramic opaque dentin material is being applied.


35. Opaque dentin is being light cured for 3 minutes.


36. View of the restoration and incisal white.


37. Incisal white being applied.


38. Light curing of incisal white.


39. Polishing with a pink silicone disc.


40. Polishing with a nylon bristle brush.


41. Polishing with a soft bristle brush and a polishing paste.


42. Final buffing with cloth wheel.


43. Steam cleaning of Integrated Abutment Crown™.


44. View of plastic healing abutment prior to the insertion of the Integrated Abutment Crown™ with an aesthetic gingival margin.


45. Integrated Abutment Crown™ being re-inserted.


46. Seated Integrated Abutment Crown™ immediately after its insertion.


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


48. One-week post insertion view of the Integrated Abutment Crown™ with an aesthetically improved gingival margin.
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