A Two Stage Placement of Mandibular Left Central Incisor Implant and its Restoration with an Integrated Abutment Crown™

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1.

First Clinical visit: Preoperative radiograph.

2.

Preoperative radiograph.

3.

Pre-operative view.

4.

Pre-operative site after the removal of transitional prosthesis.

5.

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

8.

Harvested bone within the olive green 2.5mm latch reamer.

9.

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

10.

Harvested bone within a blue 3.5mm latch reamer.

11.

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

12.

View of seated implant.

13.

View of seated implant. Note retraction suture.

14.

Harvested bone being placed over the implant.

15.

Sutured site.

16.

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

17.

Bonding material being applied.

18.

Composite material being added to form a strut between adjacent teeth.

19.

Light curing of composite material.

20.

Composite material being added.

21.

Light curing of composite material.

22.

Transitional prosthesis being polished.

23.

View of bonded transitional prosthesis.

24.

Post operative radiograph.

25.

Second Clinical visit: View of transitional prosthesis prior to its removal three months after implant placement.

26.

View after removal of transitional prosthesis prior to the uncovering of the implant and the making of a full arch implant level transfer impression.

27.

Incision being made for the uncovering of the implant.

28.

View of trimmed black polyethylene healing plug seated in the well of the implant.

29.

Healing plug remover being used to remove the cut polyethylene plug from the well of the implant.

30.

Black polyethylene plug removed from the well of the implant using a healing plug remover.

31.

View of the 2.0mm prototype titanium impression post with prototype plastic sleeve and red 2.0mm plastic impression post.

32.

2.0mm prototype titanium impression post with a prototype plastic sleeve being seated into the well of an integrated implant for the making of an implant level transfer impression.

33.

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

34.

View of implant level transfer impression incorporating the prototype plastic sleeve.

35.

2.0mm prototype titanium impression post being removed from the well of the implant.

36.

2.0mm prototype titanium impression post inserted into the plastic sleeve within the mandibular implant level impression.

37.

Third Clinical visit: Bonded transitional stabilizing prosthesis prior to its removal.

38.

A stealth transitional abutment being removed.

39.

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

40.

Integrated Abutment Crown™ being inserted.

41.

View of Integrated Abutment Crown™ immediately after being inserted.

42.

View of Integrated Abutment Crown™ with blue markings indicating incisal contact.

43.

View of Integrated Abutment Crown™ immediately after being inserted.

44.

Post insertion radiograph.

45.

View of Integrated Abutment Crown™ one week post insertion.

46.

View of Integrated Abutment Crown™ six months post insertion.