Bicon Dental Implants
Friday, November 21st 2008 7:03PM EDT

Bicon Integrated Abutment Crowns™ : A Two Stage Placement of Mandibular Lateral Incisor Implants and their Restoration with Integrated Abutment Crowns™

This case demonstrates the extraction, two stage surgical placement of two 3.5mm x 11.0mm mandibular lateral incisor implants, implant level transfer impression, occlusal registration and the insertion of two 2 unit Integrated Abutment Crowns™.
     
First Visit:    


1. Pre-operative radiograph.


2. Pre-operative site.


3. Incision being made to facilitate the extraction of the mandibular anterior incisor.


4. Extraction of periodontally involved mandibular right lateral incisor.


5. Extraction of periodontally involved mandibular left lateral incisor.


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


7. Parallel pins seated in pilot osteotomies indicating their trajectories.


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


9. Osteotomy being enlarged with a blue 3.5mm latch reamer rotating at 50 RPM without water irrigation.


10. A 3.5mm x 11.0mm HA coated implant with a 2mm implant well being inserted with the black polyethylene healing plug.


11. A 3.5mm x 11.0mm HA coated implant with a 2mm implant well being inserted with the black polyethylene healing plug.


12. Black polyethylene healing plug being cut with a healing plug cutter for two stage implant placement.


13. Autogenous bone graft harvested during osteotomy being placed over the seated implants.


14. Sutured site.


15. Post operative radiograph.
Second Visit:    


16. Healing plug being removed from the well of the implant with a healing plug remover.


17. Healing plug removed from the well of the implant with a healing plug remover.


18. A 2.0mm guide pins inserted into the wells of the implants.


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


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


21. Red 2.0mm impression post receiving its mandatory seating tap.


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


23. Red 2.0mm impression post being modified for the making of an occlusal registration.


24. Red acrylic being injected onto the impression posts.


25. View of red acrylic on impression posts for the recording of an occlusal registration.


26. Occlusal registration being removed.


27. White healing abutment being inserted.
Third Visit:    


28. View of two cantilever crowns on stone model.


29. View of two cantilever crowns which will be bonded intraorally for the fabrication of a four-unit fixed prosthesis.


30. View of temporary healing abutment and 2.0mm healing abutment before the insertion of the Integrated Abutment Crowns™.


31. 2.0mm healing abutment being removed.


32. White healing abutment being removed.


33. A two-unit Integrated Abutment Crown™ being inserted.


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


35. A two-unit Integrated Abutment Crown™ being inserted.


36. Articulating paper being used to confirm contact.


37. Adjustment of interproximal contact, since a too tight interproximal contact would prevent the engagement of the locking taper and possibly result in the subsequent loosening of the prosthesis.


38. White healing abutment in a straight handle is being used to tap the prosthesis into the well of the implant.


39. View of two cantilevered Integrated Abutment Crowns™ which were subsequently bonded intraorally for the fabrication of a four-unit fixed prosthesis.


40. Post operative radiograph immediately after being intraorally bonded.


41. View of restorations one month after being inserted.
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