Extraction and Immediate Placement of a Maxillary Anterior Implant and its Restoration with an Integrated Abutment Crown™

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1.

First Visit: Ridge split and implant placement. Pre-operative radiograph.

2.

Pre-operative site.

3.

View of extracted tooth.

4.

The extraction site being carefully curetted to remove granulation tissue and soft tissue tags.

5.

Pilot hole being drilled with a 2.0mm Bicon Pilot Drill.

6.

Paralleling pin seated in the pilot osteotomy indicating its trajectory.

7.

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

8.

Osteotomy being enlarged with a teal 3.0mm latch reamer.

9.

Harvested bone within the flute of a blue 3.5mm latch reamer.

10.

Harvested bone within the flute of a red 4.0mm latch reamer.

11.

Curette being used to remove residual bone while confirming the integrity of the five bony walls of the osteotomy.

12.

Harvested bone within the flute of a silver 4.5mm hand reamer attached to a straight handle.

13.

Harvested bone within the flute of a gold 5.0mm hand reamer attached to a straight handle.

14.

Curette being used to remove residual bone while confirming the integrity of the five bony walls of the osteotomy.

15.

A 5.0mm x 8.0mm implant being inserted with an inserter retriver instrument on a straight handle.

16.

Trimmed polyethylene healing plug being inserted into well of the seated implant.

17.

Harvested bone being placed over the implant.

18.

View of Bicon Resorbable Collagen Plug being inserted.

19.

Sutured implant site.

20.

View of bonded transitional prosthesis.

21.

Post operative radiograph.

22.

Second Visit: Four months after previous visit. Bonded prosthesis prior to its removal.

23.

Site after removal of transitional prosthesis.

24.

Healing plug being removed with removal instrument.

25.

A green 3.0mm titanium impression post being seated into the well of the implant with only seating pressure.

26.

A green 3.0mm plastic sleeve being inserted onto the 3.0mm titanium impression post.

27.

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

28.

View of transfer impression with 3.0mm green plastic sleeve.

29.

Third Visit: Two weeks after previous visit. View of Integrated Abutment Crown™.

30.

Occlusal view of implant well and sulcus prior to the seating of the Integrated Abutment Crown™.

31.

Labial view of implant sulcus.

32.

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

33.

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

34.

Integrated Abutment Crown™ being inserted.

35.

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

36.

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.

37.

Blue markings indicate the need for occlusal adjustment.

38.

Polishing with a pink silicone disc.

39.

Polishing with bristle brush.

40.

Seated Integrated Abutment Crown™ immediately after its insertion.

41.

Post-insertion radiograph.

42.

Fourth Visit: Two weeks after previous visit. Right profile view two-weeks post insertion.

43.

Left profile view two-weeks post insertion.

44.

Facial view two-weeks post insertion.

45.

Patient's smile.

46.

Two weeks post-insertion radiograph.