A Two Stage Placement of Two Maxillary lateral Incisor 4.5mm x 6.0mm Short Implants and their Restoration with Integrated Abutment Crowns™

Click on an image to view it larger. Click on the right half of the large image to view the next image, click on the left half to view the previous image. You may also use the left and right arrow keys on your keyboard to navigate through the images. Click the ESC key to exit the slideshow.

Click "Switch View" below to change to a layout optimized for printing the case.

Switch Thumb

1.

Pre-operative view.

2.

Pre-operative radiograph of the maxillary right lateral incisor.

3.

Pre-operative radiograph of the maxillary left lateral incisor.

4.

Pre-operative smile.

5.

Pre-operative site.

6.

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

7.

Parallel pin seated in pilot osteotomy indicating its trajectory.

8.

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

9.

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

10.

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

11.

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

12.

A 4.5mm x 6.0mm HA coated short implant being inserted into the osteotomy on the right side with an implant seating tip threaded on a straight driver.

13.

Parallel pin seated in pilot osteotomy indicating its trajectory.

14.

Harvested bone within the olive green 2.5mm latch reamer.

15.

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

16.

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

17.

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

18.

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

19.

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

20.

A 4.5mm x 6.0mm HA coated short implant being inserted into the osteotomy on the left side with an implant seating tip threaded on a straight driver.

21.

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

22.

View of seated implants with polyethylene healing plugs.

23.

Post-operative radiograph.

24.

Post-operative radiograph.

25.

Trimmed polyethylene healing plug being inserted into the implant well for two stage placement.

26.

Trimmed polyethylene healing plug being inserted into the implant well for two stage placement.

27.

Transitional composite material is being injected into vacuum-formed template.

28.

Transitional prosthesis being formed.

29.

Transitional prosthesis being removed for polishing.

30.

Transitional prosthesis being polished.

31.

Etchant being applied to in preparation for the bonding of the left lateral incisor transitional stabilizing prosthesis.

32.

Bonding primer agent being applied.

33.

Bonding agent being applied.

34.

Light curing of bonding agent.

35.

Polyceramic material, “DiamondCrownTM”, being added to form a bonded strut between adjacent teeth.

36.

Transitional prosthesis formed in vacuum formed template being placed on the strut.

37.

Strut being light cured.

38.

Additional polyceramic material being applied.

39.

Etchant being applied in preparation for the bonding of the right lateral incisor transitional stabilizing prosthesis.

40.

Bonding primer agent being applied.

41.

Light curing of bonding agent.

42.

Polyceramic material, “DiamondCrownTM”, being added to form a bonded strut between adjacent teeth.

43.

Strut being light cured.

44.

Transitional prosthesis being contoured.

45.

Transitional prosthesis being contoured.

46.

Transitional prosthesis being polished with a white acrylic polishing wheel.

47.

Transitional prosthesis being polished with a white soft bristle brush.

48.

Radiograph of the seated right lateral 4.5mm x 6.0mm HA coated short implant with transitional prosthesis in place.

49.

Radiograph of the seated left lateral 4.5mm x 6.0mm HA coated short implant with transitional prosthesis in place.

50.

Integrated Abutment Crowns™ on stone model.

51.

Transitional prosthesis being removed for the insertion of the Integrated Abutment Crowns™ thirteen weeks after the implant placement and two weeks after the implant level transfer impression.

52.

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

53.

Integrated Abutment Crown™ being inserted.

54.

Integrated Abutment Crown™ being inserted.

55.

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.

56.

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.

57.

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

58.

Post-operative radiograph.

59.

Facial view one week post insertion.

60.

Facial view sixteen months post insertion.

61.

Right profile view sixteen months post insertion.

62.

Left profile view sixteen months post insertion.

63.

Patient’s smile sixteen months post insertion.

64.

Sixteen month post insertion radiograph.