Bicon Dental Implants
Monday, March 15th 2010 5:23AM EDT

Bicon Integrated Abutment Crowns™ / Congenitally Missing Laterals: Two Stage Placement of Two Implants and their Restoration with Integrated Abutment Crowns™ for Two Congenitally Missing Lateral Incisors
This case demonstrates the two stage placement of two implants, temporization, uncovering, implant level transfer impression, and their restoration with Bicon Integrated Abutment Crowns™ for two congenitally missing lateral incisors.
     

First Visit:

    


1. Pre-operative radiograph of missing maxillary right lateral incisor.


2. Pre-operative radiograph of missing maxillary left lateral incisor.


3. View of preoperative sites after the removal of prostheses.


4. Patients smile after the removal of prostheses.


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


6. Parallel pin confirming appropriate trajectory of the osteotomy.


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


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


9. Osteotomy being prepared with a teal 3.0mm bone expander.


10. Osteotomy being prepared with a blue 3.5mm bone expander.


11. Curette harvesting residual bone while confirming the integrity of the five bony walls of the osteotomy.


12. A 3.5mm x 8.0mm HA coated implant being inserted into the osteotomy with an implant-seating tip threaded on a straight driver.


13. Cut polyethylene healing plug being inserted into the well of the implant.


14. Suture being placed.


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


16. Paralleling pin confirming appropriate trajectory of the osteotomy.


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


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


19. Osteotomy being prepared with a teal 3.0mm bone expander.


20. Osteotomy being prepared with a blue 3.5mm hand reamer.


21. A 3.5mm x 8.0mm HA coated implant being inserted into the osteotomy with an implant-seating tip threaded on a straight driver.


22. Implant seating tip attached to a straight handle being tapped to seat implant farther into the osteotomy.


23. Cut polyethylene healing plug being inserted into the well of the implant.


24. Sutured sites.


25. Post-operative radiograph.


26. Post-operative radiograph.

Second Visit: – four months after previous visit


27. Bonded transitional prostheses prior to their removal for the making of implant level transfer impression.


28. Polyethylene plug being removed from the well of the implant using healing plug remover.


29. Polyethylene plug being removed from the well of the implant using healing plug remover.


30. View of seated 2.0mm titanium impression posts with red 2.0mm plastic sleeves.


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

Third visit: – six weeks after previous visit


32. View of transitional prostheses prior to their removal for the insertion of Integrated Abutment Crowns™.


33. View of after removal of transitional prostheses for the insertion of Integrated Abutment Crowns™.


34. Re-inserted polyethylene healing plug being removed from the maxillary right lateral incisor implant well with a healing plug removal instrument.


35. Abutment post receiving its mandatory alcohol wipe to remove any contaminants that would reduce the effectiveness of its locking taper engagement.


36. Well of implant being cleaned with alcohol on a cotton tipped applicator.


37. Integrated Abutment Crown™ being inserted.


38. Well of implant being cleaned with alcohol on a cotton tipped applicator.


39. Re-inserted polyethylene healing plug being removed from the maxillary left lateral incisor implant well with a healing plug removal instrument.


40. Diamond finishing strip being used to lighten the interproximal contact area eliminating the possibility that the tight contact may prevent the engagement of the locking taper connection.


41. Diamond finishing strip being used to lighten the interproximal contact area eliminating the possibility that the tight contact may prevent the engagement of the locking taper connection.


42. Yellow thermoplastic custom seating jig, which was formed with a crown alignment device, in a crown seating tip attached to a straight handle facilitates directing the tapping forces in the long axis of the abutment post and implant well.


43. Yellow thermoplastic custom seating jig, which was formed with a crown alignment device, in a crown seating tip attached to a straight handle facilitates directing the tapping forces in the long axis of the abutment post and implant well.


44. Facial view of Integrated Abutment Crowns™ immediately after insertion.


45. View of Integrated Abutment Crown™ immediately after insertion.


46. View of Integrated Abutment Crown™ immediately after insertion.


47. View of patient’s smile immediately after insertion.


48. Post insertion radiograph.


49. Post insertion radiograph.


50. One month post insertion view.


51. View of Integrated Abutment Crown™ one month post insertion.


52. View of Integrated Abutment Crown™ one month post insertion.


53. View of patient’s smile one month post insertion.
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