Bone Grafting with SynthoGraft™, Two Stage Full Arch Placement of Nine Maxillary Implants, and their Restoration with Twelve Bicon Integrated Abutment Crowns™
This case demonstrates the use of Synthograft™, Pure Phase Beta-Tricalcium Phosphate, for bone grafting, two stage placement and restoration of nine implants, implant level transfer impression, occlusal registration, and insertion of nine Integrated Abutment Crowns™ including three two-unit Integrated Abutment Crowns™ for the intraoral fabrication of a four unit prosthesis and a three unit prosthesis.
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Pre-operative radiograph revealing severe bone loss.
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Pre-operative facial view.
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Pre-operative left profile view.
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Pre-operative right profile view.
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Post-operative radiograph after maxillary extractions.
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Incision being made for grafting procedure with Synthograft™, Pure Phase Beta-Tricalcium Phosphate.
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Small perforations being made in bone to enhance bleeding.
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Mixture of patient’s blood and Synthograft™, Pure Phase Beta-Tricalcium Phosphate, being placed.
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View of Synthograft™, Pure Phase Beta-Tricalcium Phosphate, in place.
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View of Bicon collagen membrane and Synthograft™, Pure Phase Beta-Tricalcium Phosphate, in place.
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Suture being placed.
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Sutured site.
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View of boney defect on the left maxillary ridge.
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Incision being made for grafting procedure with Synthograft™, Pure Phase Beta-Tricalcium Phosphate.
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Patient’s blood being collected from the operative site to be mixed with Synthograft™, Pure Phase Beta-Tricalcium Phosphate.
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Mixture of patient’s blood and Synthograft™, Pure Phase Beta-Tricalcium Phosphate, being placed.
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The graft material being packed with a cotton tip applicator.
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Bicon collagen membrane being placed over the graft material.
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View of Post-operative radiograph after the placement of nine maxillary implants.
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Healing plug being removed with a healing plug removal instrument.
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Healing plug removed with a healing plug removal instrument.
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Green 3.0mm guide pins seated into the wells of the implants.
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Green 3.0mm plastic impression post being inserted into the 3.0mm well of an integrated maxillary right central incisor implant for the making of an implant level transfer impression.
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Green 3.0mm plastic impression post being inserted into the 3.0mm well of an integrated maxillary right central incisor implant for the making of an implant level transfer impression.
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Green 3.0mm plastic impression post receiving its mandatory seating tap.
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Impression material being injected around the impression posts for the making of a full arch implant level transfer impression.
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View of occlusal bite registration rim with green 3.0mm plastic impression posts.
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Facial view of maxillary occlusal bite registration rim with white speckled plaster.
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Maxillary occlusal rim with white speckled plaster on the stone model.
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Maxillary occlusal rim with white speckled plaster being seated.
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View of seated maxillary occlusal rim.
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Functionally-derived registration being made.
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Note the reduction of white speckled plaster after the functionally-derived registration.
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View of achieved vertical dimension for the maxillary Integrated Abutment Crowns™.
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View of twelve maxillary Integrated Abutment Crowns™ and cantilever crowns.
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Facial view of twelve maxillary Integrated Abutment Crowns™ on stone model.
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Integrated Abutment Crowns™ on stone model with acrylic orientation jig.
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Integrated Abutment Crowns™ on stone model with yellow thermoplastic seating jigs, which were fabricated on a crown alignment device to facilitate directing the seating forces in the long axis of the implant well and abutment post.
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Occlusal view of Integrated Abutment Crowns™ on stone model.
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View of full maxillary arch with trimmed white healing abutments and green plastic impression posts.
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Trimmed white temporary abutment being removed.
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Integrated Abutment Crown™ with cantilever being inserted which will be intraorally bonded to adjacent teeth.
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Integrated Abutment Crown™ with distal cantilever being inserted.
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An orientation jig being used to initially position the Integrated Abutment Crowns™.
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Articulating paper being used to confirm interproximal contacts for the insertion of the Integrated Abutment Crown™.
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Interproximal contact being adjusted with metal finishing strip.
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Integrated Abutment Crown™ with cantilever being inserted.
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Integrated Abutment Crown™ being inserted.
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View of the Integrated Abutment Crown™ being modified with a pink acrylic polishing wheel.
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Articulating paper being used to confirm interproximal contacts.
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Red markings indicate excessive interproximal contact which must be adjusted to assure passive contact for the engagement of the locking taper connection. Interproximal contact being adjusted.
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Integrated Abutment Crown™ being inserted.
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White healing abutment in a straight handle is being used to tap the Integrated Abutment Crown™ into the well of the implant.
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White healing abutment in a straight handle is being used to tap the Integrated Abutment Crown™ into the well of the implant.
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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.
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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.
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.
58.
Facial view immediately after the initial insertion of Integrated Abutment Crowns™.
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Facial view immediately after the initial insertion of Integrated Abutment Crowns™.
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Post insertion radiograph of Integrated Abutment Crowns™ including three two-unit Integrated Abutment Crowns™ for the intraoral fabrication of a four unit prosthesis and a three unit prosthesis.
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