A Two Stage Placement of Mandibular First Molar Short Implant and its Restoration with an Integrated Abutment Crown™

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1.

View of periodontally involved mandibular first molar.

2.

Radiograph of periodontally involved mandibular first molar.

3.

Pre-operative radiograph.

4.

View of socket thirteen weeks after extraction of mandibular first molar.

5.

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

6.

Parallel pin seated in pilot osteotomy indicating its trajectory.

7.

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

8.

Osteotomy being enlarged with a silver 4.5mm latch reamer bur rotating at 50RPM without water irrigation.

9.

Osteotomy being enlarged with a light blue 5.5mm latch reamer bur rotating at 50RPM without water irrigation.

10.

Osteotomy being enlarged with a green 6.0mm latch reamer bur rotating at 50RPM without water irrigation.

11.

A 6.0mm x 5.7mm HA coated implant being inserted into the osteotomy with the implant inserter/retriever device.

12.

A 6.0mm x 5.7mm HA coated implant being inserted into the osteotomy with the implant inserter/retriever device.

13.

Implant seating tip attached to an offset handle is being tapped to seat implant farther into the osteotomy.

14.

View of implant well immediately after being tapped into its osteotomy.

15.

Operative site immediately after the placement of a 6.0 mm x 5.7 mm HA coated short implant.

16.

Radiograph immediately after placement of the 6.0 mm x 5.7mm HA coated short implant.

17.

Radiograph fourteen weeks after implant placement on the day of its uncovering.

18.

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

19.

Integrated Abutment Crown™ on stone model.

20.

Integrated Abutment Crown™.

21.

White healing abutment prior to its removal for the insertion of the Integrated Abutment Crown™.

22.

Integrated Abutment crown™ being inserted initially to evaluate its appropriateness.

23.

Incision being made to excise “lingual” tissue to facilitate the seating of the Integrated Abutment Crown™.

24.

Excess lingual tissue being removed.

25.

Excess lingual tissue being removed.

26.

A 7.5 mm sulcus reamer attached to a threaded knob is being inserted onto a guide pin.

27.

A 7.5 mm sulcus reamer is being rotated to remove any tissues that may interfere with the seating of the Integrated Abutment Crown™.

28.

Guide pin being removed from implant revealing bone chips that were loosened with the sulcus reamer.

29.

Bone chips being removed with a curette.

30.

View of prepared sulcus prior to the insertion of the Integrated Abutment Crown™.

31.

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

32.

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.

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.

Plastic temporary abutment mounted in an offset handle to seat the Integrated Abutment Crown™ in the long axis of the abutment shaft and implant well to engage the locking taper.

35.

Blue markings indicate excessive contact on the distolingual cusp.

36.

Five weeks post insertion radiograph.

37.

Five weeks post insertion image.