Extraction and Placement of Immediately Functioning Maxillary Right Central Incisor Implant and Restoration with an Integrated Abutment Crown™

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1.

Pre-operative radiograph of a failed endodontically treated maxillary incisor.

2.

Pre-operative smile.

3.

Pre-operative site.

4.

View of cracked root.

5.

Removal of cracked root.

6.

Note initial trajectory of pilot bur before its repositioning to a more upright position immediately after engagement of the palatal bone.

7.

Clinician’s finger monitoring the buccal bone during the preparation of the osteotomy and the harvesting of bone with a latch reamer rotating at 50RPMs.

8.

Clinician’s finger monitoring the buccal bone during the preparation of the osteotomy and the harvesting of bone with a latch reamer rotating at 50RPMs.

9.

Clinician’s finger monitoring the buccal bone during the preparation of the osteotomy and the harvesting of bone with a latch reamer rotating at 50RPMs.

10.

Clinician’s finger monitoring the buccal bone during the preparation of the osteotomy and the harvesting of bone with a latch reamer rotating at 50RPMs.

11.

Clinician’s finger monitoring the buccal bone during the preparation of the osteotomy and the harvesting of bone with a latch reamer rotating at 50RPMs.

12.

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

13.

5.0mm x 8.0mm HA coated Implant being inserted into osteotomy with an implant seating tip threaded on a straight driver.

14.

The well of seated implant.

15.

Implant being seated apically by the judicious tapping on the handle of the straight driver.

16.

Shoulder depth gauge seated in the well of the implant to facilitate the selection of a stealth abutment with an appropriate shoulder height.

17.

View of abutment seated with only finger pressure.

18.

Wide acrylic sleeve being placed onto stealth abutment.

19.

Acrylic sleeve snapped onto abutment.

20.

Adjacent tooth surface being prepared for bonding.

21.

Adjacent tooth surface being prepared for bonding.

22.

Adjacent tooth surface being prepared for bonding.

23.

Adjacent tooth surface being prepared for bonding.

24.

Adjacent tooth surface being prepared for bonding.

25.

Adjacent tooth surface being prepared for bonding.

26.

Polyceramic material being applied to the acrylic sleeve to initially form a strut.

27.

Polyceramic material being applied to the acrylic sleeve to initially form a strut.

28.

Light curing of initial material.

29.

Vacuum formed template being used to apply an additional polyceramic material for aesthetic contouring.

30.

Vacuum formed template being used to apply an additional polyceramic material for aesthetic contouring.

31.

Vacuum formed template being used to apply an additional polyceramic material for aesthetic contouring.

32.

Vacuum formed template being used to apply an additional polyceramic material for aesthetic contouring.

33.

Vacuum formed template being used to apply an additional polyceramic material for aesthetic contouring.

34.

Light curing of the aesthetic application.

35.

View of transitional stabilizing prosthesis for the immediate functioning of the implant.

36.

Post-operative radiograph of the immediately placed and functioning implant.

37.

Shouldered abutment after the removal of the transitional stabilizing prosthesis.

38.

View of implant well and sulcus.

39.

White 3.0mm impression post being inserted into the well of the implant.

40.

White impression post being definitively tapped into the well of the implant.

41.

Impression material being injected around the white impression post for the making of an implant level transfer impression.

42.

Digital image being taken for the recording of the desired shade against a black metallic background.

43.

Transitional crown seated onto the abutment.

44.

Integrated Abutment Crown™ on dental model.

45.

View of custom seating jig on dental model.

46.

Mirror view of Integrated Abutment Crown™.

47.

View of transitional crown prior to its removal for the insertion of the Integrated Abutment Crown™.

48.

Labial view of implant sulcus.

49.

Incisal view of implant well and sulcus.

50.

Integrated Abutment Crown™ being inserted.

51.

Initial seating of Integrated Abutment Crown™.

52.

Seating jig facilitating the application of the engagement of the locking taper by directing the seating forces in the long axis of the implant well and abutment shaft.

53.

Post-operative radiograph.

54.

Patient’s smile without Integrated Abutment Crown™.

55.

Patient’s smile with Integrated Abutment Crown™.

56.

Labial view of seated Integrated Abutment Crown™.

57.

Labial view of seated Integrated Abutment Crown™.

58.

Radiograph four-year post-insertion.

59.

Facial view four-year post-insertion.