Bicon Dental Implants
Friday, November 21st 2008 2:15PM EDT

Immediate Stabilization and Function / Bicon Integrated Abutment Crowns™/ Polyceramic Material Fused to Metal: Extraction, Grafting, and Full Mouth Placement of Twenty-Three Two Stage, Immediately Stabilized and Functioning Implants, and their Restoration with Twenty-One Integrated Abutment Crowns™ and a Three Unit Polyceramic Material Fused to Metal Fixed Prosthesis. (Part Two)
This case demonstrates the sequencing of tooth extractions, bone grafting and two stage and immediately stabilized and functioning implant placement techniques for twenty-three implants as well as their restoration with twenty-one Integrated Abutment Crowns™ (IAC’s) and a three unit poly-ceramic to metal fixed prosthesis.

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

 

    


1. Twelve maxillary Integrated Abutment Crowns™.


2. Fabrication of custom thermoplastic seating jig.


3. Fabrication of custom thermoplastic seating jig.


4. Integrated Abutment Crowns™ on stone model with yellow thermoplastic seating jigs which were fabricated on a crown alignment device to facilitate directing the seating forces in the long axis of the implant well and abutment post.


5. Facial view of Integrated Abutment Crowns™ on stone model.


6. Palatal view of Integrated Abutment Crowns™ on stone model.


7. Blue acrylic placed on the Integrated Abutment Crowns™ for the
fabrication of an orientation jig.


8. Occlusal view of finished clear acrylic orientation jig seated on Integrated Abutment Crowns™.


9. Integrated Abutment Crowns™ on stone model with acrylic orientation jig.


10. Nine mandibular Integrated Abutment Crowns™ and a three unit prosthesis.


11. Fabrication of custom thermoplastic seating jig.


12. Fabrication of custom thermoplastic seating jig.


13. Integrated Abutment Crowns™ on stone model with yellow thermoplastic seating jigs which were fabricated on a crown alignment device to facilitate directing the seating forces in the long axis of the implant well and abutment post.


14. Facial view of Integrated Abutment Crowns™ on stone model.


15. Lingual view of nine Integrated Abutment Crowns™ and a three unit prosthesis on stone model.


16. Blue acrylic placed on the Integrated Abutment Crowns™ for the
fabrication of an orientation jig.


17. Occlusal view of finished clear acrylic orientation jig seated on Integrated Abutment Crowns™.


18. Nine Integrated Abutment Crowns™ and a three unit prosthesis on stone model with acrylic orientation jig.


19. Patient’s smile with transitional prostheses eleven months after first clinical visit.


20. View of twelve maxillary Integrated Abutment Crowns™ on stone model.


21. View of transitional abutments after removal of transitional stabilizing prosthesis.


22. View of implant wells and soft tissue sulci.


23. View of implant wells and soft tissue sulci.


24. Integrated Abutment Crown™ being inserted.


25. Palatal tissue is being excised to facilitate the seating of the
Integrated Abutment Crown™.


26. Integrated Abutment Crown™ being inserted.


27. Clear orientation jig is being tapped to initially engage the locking taper connection of the Integrated Abutment Crown™.


28. Integrated Abutment Crown™ being inserted.


29. 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.


30. Integrated Abutment Crown™ being inserted.


31. Palatal tissue being excised to facilitate the seating of the Integrated Abutment Crown™.


32. Palatal tissue being excised to facilitate the seating of the Integrated Abutment Crown™.


33. 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.


34. Articulating paper being used to confirm passive interproximal contacts.


35. White silicon polishing wheel adjusting the interproximal contacts of the Integrated Abutment Crown™.


36. A clear acrylic orientation jig is being used to initially position the Integrated Abutment Crown™.


37. View of seated Integrated Abutment Crowns™ immediately after their insertion.


38. Integrated Abutment Crown™ being inserted.


39. Blanching of soft tissues with the initial seating of the Integrated Abutment Crown™.


40. Incision being made to excise palatal tissue to facilitate the seating of the Integrated Abutment Crown™.


41. Excess palatal tissue being removed.


42. Reseated Integrated Abutment Crown™.


43. Transitional abutment being removed for seating of an Integrated
Abutment Crown™.


44. Stealth abutment being removed by tapping on the handle of forceps.


45. Integrated Abutment Crown™ being inserted.


46. Clear acrylic orientation jig is being used to initially position the Integrated Abutment Crown™.


47. Integrated Abutment Crown™ being inserted.


48. Clear acrylic orientation jig is being used to initially position the Integrated Abutment Crown™.


49. A red 2.0mm extended guide pin being inserted for use with a sulcus reamer.


50. 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™.


51. Integrated Abutment Crown™ with an extended post is being inserted.


52. Clear acrylic orientation jig being used to initially position the Integrated Abutment Crown™.


53. Transitional abutment being removed.


54. Integrated Abutment Crown™ being inserted.


55. Clear acrylic orientation jig being used to initially position the Integrated Abutment Crown™.


56. Integrated Abutment Crown™ being inserted.


57. View of seated maxillary Integrated Abutment Crowns™ immediately after their insertion.


58. View of nine mandibular Integrated Abutment Crowns™ and a three unit prosthesis on stone model.


59. Prosthesis being used to position milled abutment into the well of implant.


60. Prosthesis being used to position milled abutment into the well of implant.


61. Incision being made to excise crestal tissue to facilitate the seating
of the prosthesis.


62. Crestal tissue being removed to accommodate pontic.


63. Prosthesis being seated onto abutments.


64. Radiograph after the initial seating of the prosthesis to confirm its
adaptation prior to being cemented.


65. A red 3.0mm extended guide pin being inserted.


66. 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™.


67. A gold 5.0mm sulcus reamer being removed revealing excess bone.


68. Integrated Abutment Crown™ being inserted.


69. Clear acrylic orientation jig being used to initially position the Integrated Abutment Crown™.


70. Integrated Abutment Crown™ being inserted.


71. Lingual relieving incisions being made to facilitate the seating of the Integrated Abutment Crown™.


72. 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™.


73. Polishing strip being used to lighten the interproximal contact area to eliminate the possibility that the contact may prevent the engagement of the locking taper connection.


74. A 5.0 mm sulcus reamer is being rotated to remove any tissues that may interfere with the seating of the Integrated Abutment Crown™.


75. Integrated Abutment Crown™ being inserted.


76. Integrated Abutment Crown™ being inserted.


77. Transitional abutment being removed.


78. Clear acrylic orientation jig is being used to initially position the Integrated Abutment Crown™.


79. Integrated Abutment Crown™ being inserted.


80. A red 3.0mm extended guide pin being inserted.


81. 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™.


82. Integrated Abutment Crown™ being inserted.


83. 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.


84. Integrated Abutment Crown™ being inserted.


85. Integrated Abutment Crown™ being inserted.


86. View of seated Integrated Abutment Crowns™ and a three unit cemented prosthesis immediately after their insertion.


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


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


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


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


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


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


93. Yellow thermoplastic custom seating jig (formed in a crown alignment device) within a crown seating tip attached to a straight handle facilitate directing the tapping forces in the long axis of the abutment post and implant well.


94. Yellow thermoplastic custom seating jig (formed in a crown alignment device) within a crown seating tip attached to a straight handle facilitate directing the tapping forces in the long axis of the abutment post and implant well.


95. Yellow thermoplastic custom seating jig (formed in a crown alignment device) within a crown seating tip attached to a straight handle facilitate directing the tapping forces in the long axis of the abutment post and implant well.


96. Yellow thermoplastic custom seating jig being placed in a crown seating device.


97. Yellow thermoplastic custom seating jig (formed in a crown alignment device) within a crown seating tip attached to a straight handle facilitate directing the tapping forces in the long axis of the abutment post and implant well.


98. Yellow thermoplastic custom seating jig (formed in a crown alignment device) within a crown seating tip attached to a straight handle facilitate directing the tapping forces in the long axis of the abutment post and implant well.


99. Yellow thermoplastic custom seating jig (formed in a crown alignment device) within a crown seating tip attached to a straight handle facilitate directing the tapping forces in the long axis of the abutment post and implant well.


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


101. Clear acrylic orientation jig being used to initially position the Integrated Abutment Crown™.


102. 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.


103. Yellow thermoplastic custom seating jig (formed in a crown alignment device) within a crown seating tip attached to a straight handle facilitate directing the tapping forces in the long axis of the abutment post and implant well.


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


105. Integrated Abutment Crown™ being inserted.


106. Clear acrylic orientation jig being used to initially position the Integrated Abutment Crown™.


107. 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.


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


109. Integrated Abutment Crown™ being inserted.


110. A clear acrylic orientation jig is being used to initially position the Integrated Abutment Crown™.


111. White healing abutment in a straight handle is being used to tap the clear acrylic orientation jig to initially seat the Integrated Abutment Crowns™.


112. Integrated Abutment Crown™ being inserted.


113. View of prostheses immediately after their insertion.


114. Articulating paper being used to confirm occlusal contacts in all extreme excursions while the patient is clenching.


115. White silicon polishing wheel adjusting occlusal contacts.


116. Post-insertion radiograph of twenty-one Integrated Abutment Crowns™ and a three unit cemented fixed prosthesis eleven months after first clinical visit.


117. Post-insertion smile.


118. View of maxillary arch.


119. View of mandibular arch.


120. Left profile view.


121. Right profile view.


122. Post-insertion radiograph.


123. Post-insertion radiograph.


124. Post-insertion radiograph.


125. Post-insertion radiograph.


126. Post-insertion radiograph.


127. Post-insertion radiograph.


128. Post-insertion radiograph.


129. Post-insertion radiograph.


130. Post-insertion radiograph.


131. Post-insertion radiograph.


132. Post-insertion radiograph.


133. Patient’s smile two weeks after insertion.


134. Articulating paper being used to confirm occlusal contacts in all extreme excursions while the patient is clenching.


135. Red markings confirming appropriate occlusal contacts in all extreme excursions while the patient is clenching.


136. Facial view two weeks after insertion.


137. Left profile view two weeks after insertion.


138. Right profile view two weeks after insertion.


139. Facial view of the maxillary arch two weeks after insertion.


140. Occlusal view of maxillary arch two weeks after insertion.


141. Facial view of mandibular arch two weeks after insertion.


142. Occlusal view of mandibular arch two weeks after insertion.


143. Pre-operative radiograph.


144. Post-operative radiograph.


145. Pre-operative facial view.


146. Post-operative facial view.


147. Pre-operative smile.


148. Post-operative smile.

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

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