Bicon Dental Implants
Friday, November 21st 2008 1:22PM EDT

Immediate Stabilization and Function / All-Ceramic Crown: Maxillary Second Bicuspid Restored with an Extra-orally Cemented Crown
This case demonstrates: the placement, transitional stabilization, implant level transfer impression and extra-oral cementation of an all-ceramic crown on an immediately placed and loaded maxillary second bicuspid.
     


1. Radiograph of failed root canal treated tooth.


2. Occlusal view of failed root canal treated tooth.


3. Failed root canal treated tooth with periapical granuloma.


4. Paralleling pin in pilot osteotomy.


5. Reamer preparing osteotomy.


6. Implant being inserted into osteotomy with black polyethylene healing plug handle.


7. 5.0mm wide shouldered abutment placed with only finger pressure into well of implant for the transitional stabilization of the immediately loaded implant.


8. Tall one piece acrylic sleeve on shouldered abutment.


9. Transitional composite material "Integrity" by Dentsply being injected onto one piece acrylic sleeve for the stabilization of the immediately loaded implant.


10. Transitional crown prior to being removed for polishing.


11. Composite crown being removed for polishing.


12. Acid etching of adjacent teeth for the cement bonding of transitional stabilization prosthesis.


13. Bonding material being applied to etched tooth surface.


14. Bonding cement being applied to transitional crown.


15. Shouldered abutment prior to insertion of transitional crown.


16. Light curing of bonding cement.


17. Radiograph of splinted transitional prosthesis.


18. Transitional prosthesis prior to its removal for the making of an implant level transfer impression.


19. White 3.0mm impression post being inserted into the well of the implant.


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


21. A white acrylic temporary abutment as been modified to provide more space for the development of a wider distal inter-dental papilla while the all-ceramic crown is being fabricated.


22. Aluminum oxide sleeve on white abutment transfer die in stone model.


23. Digital photograph being taken of shade guide against a black background for transmission to a technician.


24. Occlusal view of modified white acrylic temporary abutment.


25. Occlusal view of implant well and soft tissue sulcus with tear of palatal mucosa.


26. All-ceramic crown seated on shouldered abutment being inserted into implant to confirm appropriateness of shade and morphology.


27. Metalic coupler being applied to 5.0mm x 2.0mm shouldered abutment.


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


29. Light curing of bonding agent on abutment post and aluminum oxide core.


30. Polyceramic bonding cement being applied to abutment.


31. Shouldered abutment with cement being inserted into all-ceramic crown.


32. All-ceramic crown extra-orally cemented on titanium shouldered abutment.


33. Extraneous cement being removed with a cotton applicator.


34. Extra-orally cemented crown and abutment being inserted into implant well.


35. Blue acrylic incisal orientation jig facilitates the appropriate placement of the extra-orally cemented all-ceramic crown.


36. The extra-orally cemented all-ceramic crown is being tapped for its final seating.


37. Labial view of all-ceramic immediately after being tapped into the implant.


38. Labial view of seated all-ceramic crown in occlusion.


39. Radiograph of extra-orally cemented all-ceramic crown and a 5.0mm x 8.0mm immediately placed and immediately loaded or stabilized implant.
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