Bicon Dental Implants
Friday, November 21st 2008 2:43PM EDT

Immediate Stabilization and Function / Bicon Integrated Abutment Crowns™: Placement and Restoration of Immediately Functioning Maxillary Central Incisor Implant and Subsequent Placement and Restoration of the Adjacent Central Incisor Implant with Integrated Abutment Crown™
This case demonstrates the surgical placement and restoration of an immediately functioning maxillary central incisor implant and its restoration with an Integrated Abutment Crown™ as well as the subsequent restoration of the adjacent central incisor with an immediately functioning implant and an Integrated Abutment Crown™ by using the initially placed implant to stabilize its transitional restoration.

 

    


1. Pre-operative smile.


2. Pre-operative site.


3. Pre-operative radiograph.


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


5. Bonding primer agent being applied.


6. Bonding agent being applied.


7. Light curing of bonding agent.


8. Operative site.


9. Operative site.


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


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


12. Osteotomy being enlarged with a teal 3.0mm latch reamer bur rotating at 50RPM without water irrigation.


13. Osteotomy being enlarged with a 4.0mm latch reamer bur rotating at 50RPM without water irrigation.


14. A 4.0mm x 11.0mm HA coated implant being inserted into the osteotomy with the implant inserter/retriever device.


15. View of well of seated implant.


16. Post-insertion radiograph.


17. Shouldered depth gauge indicating that an abutment with a 4.0mm shoulder height would be appropriately positioned below the gingival crest.


18. Stealth shouldered abutment 5.0 mm wide with a shoulder height of 4.0mm is being inserted into the implant well with only finger pressure.


19. Short acrylic sleeve snapped on to stealth abutment.


20. Acrylic sleeve being adjusted for occlusal clearance.


21. Transitional composite material being added to acrylic sleeve to form a transitional prosthesis.


22. Transitional composite material being added to acrylic sleeve to form a transitional prosthesis.


23. Light curing of additional material.


24. Prosthesis prior to final polishing.


25. Polishing of transitional stabilizing prosthesis with a carbide finishing bur.


26. Polishing of bonded prosthesis with a soft white silicone disc.


27. Polishing with nylon bristle brush and water spray.


28. Polishing of bonded prosthesis with a soft white bristle brush.


29. Initially polished stabilizing splint.


30. Radiograph of immediately placed and functioning implant at the completion of the first clinical visit.


31. View of transitional prosthesis prior to its removal thirteen weeks after implant placement.


32. Facial view after the removal of transitional prosthesis.


33. Black 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.


34. Impression post being tapped into place to assure its proper seating.


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


36. Integrated Abutment Crown™ on stone model.


37. Mirror view of Integrated Abutment Crown™.


38. Pre-operative smile.


39. View of implant well after the removal of the transitional prosthesis and the stealth abutment.


40. Integrated Abutment Crown™ being inserted.


41. Radiograph two months after the insertion of the Integrated Abutment Crown™ and two weeks after the extraction of the right central incisor.


42. View of seated implant with polyethylene healing plug.


43. Shouldered depth gauge indicating that an abutment with a 3.5mm shoulder height would be appropriately positioned below the gingival crest.


44. Stealth shouldered abutment 4.0mm wide with a shoulder height of 3.5mm is being inserted into the implant well with only finger pressure.


45. Short acrylic sleeve being snapped on to stealth abutment.


46. Integrated Abutment Crown™ is being removed so that its implant may be used with a two unit transitional prosthesis to stabilize the right central incisor implant.


47. Occlusal view of acrylic sleeve, implant well and soft tissue sulcus.


48. Stealth shouldered abutment 5.0mm wide with a shoulder height of 2.0mm is being inserted into the implant well with only finger pressure.


49. Polyceramic material being added to acrylic sleeves to form a bonded strut between adjacent teeth.


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


51. Polyceramic material is being added to the labial aspect of the vacuum formed template.


52. Transitional stabilizing prosthesis being light cured.


53. Polishing of transitional stabilizing prosthesis with a carbide finishing bur.


54. Polishing of bonded prosthesis with a soft white silicone disc.


55. Polishing with nylon bristle brush and water spray.


56. View of transitional stabilizing prosthesis.


57. Radiograph of transitional stabilizing prosthesis for the right central incisor implant utilizing the left central incisor implant for its stability.


58. Bonded stabilizing prosthesis prior to its being removed at the patient’s second clinical visit.


59. View of the original left central incisor Integrated Abutment Crown™ after being reinserted into the well of its implant.


60. Black incisal marking of Integrated Abutment Crown™ against a black background facilitates determination of an appropriately aesthetic length.


61. Digital image being taken of shade guide against a black metal background to facilitate the fabrication of an aesthetic Integrated Abutment Crown™.


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


63. Red metal impression post receiving its mandatory seating tap.


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


65. Mirror view of reshaped Integrated Abutment Crown™.


66. Reshaped Integrated Abutment Crown™ on stone model.


67. Custom seating jig for facilitating the application of the engagement of the locking taper by directing the seating forces in the long axis of the implant well and abutment shaft.


68. Mirror view of Integrated Abutment Crown™.


69. View of transitional prosthesis prior to its removal for the insertion of the Integrated Abutment Crowns™.


70. View of transitional abutments after removal of splinted prosthesis.


71. View of implant wells and soft tissue sulci.


72. Integrated Abutment Crown™ being inserted.


73. Initial seating of Integrated Abutment Crown™.


74. Reshaped Integrated Abutment Crown™ being inserted.


75. 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.


76. Custom seating jig on a straight driver facilitating the application of the engagement of the locking taper by directing the seating forces in the long axis of the implant well and abutment shaft.


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


78. Facial view of seated Integrated Abutment Crowns™ immediately after being inserted.


79. Four-months post operative radiograph.


80. Four-months post operative image.
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