Extraction, Immediate Placement, and Restoration of Maxillary Right Lateral Incisor Implant with an Integrated Abutment Crown™

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1.

First Clinical Visit: Preoperative radiograph of maxillary right lateral incisor.

2.

Preoperative view.

3.

Preoperative smile.

4.

Extracted maxillary right lateral incisor.

5.

Curette removing soft tissue remnants of periodontal ligament.

6.

Osteotomy being prepared with a 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 rotating at 50RPM without water irrigation.

9.

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

10.

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

11.

Harvested bone within the silver 4.5mm hand reamer.

12.

Harvested bone within the gold 5.0mm hand reamer.

13.

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

14.

A 5.0 x 8.0mm HA coated implant being inserted with an implant inserter/retriever.

15.

View of seated implant with cut polyethylene healing plug.

16.

Harvested bone being placed over the implant.

17.

Harvested bone placed over the implant.

18.

View of Bicon Resorbable Collagen Plug which was sutured in place to stabilize the clot after the two stage implant placement.

19.

Post-operative radiograph of a 5.0mm x 8.0mm HA coated implant.

20.

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

21.

Bonding material being applied.

22.

Light curing of bonding material.

23.

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

24.

Light curing of composite material.

25.

Additional composite material added to form a transitional prosthesis.

26.

Light curing of composite material.

27.

Transitional prosthesis being contoured.

28.

Transitional prosthesis being contoured.

29.

Polishing of bonded prosthesis with a pink silicone disc.

30.

View of finished transitional prosthesis.

31.

Post operative radiograph.

32.

Second Clinical Visit: Transitional prosthesis prior to its removal for the making of implant level transfer impression.

33.

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

34.

Incision being made for the uncovering of an implant.

35.

Healing plug being removed with healing plug removal instrument.

36.

Green 3.0mm impression post being inserted into the well of an integrated implant for the making of an implant level transfer impression.

37.

Green 3.0mm plastic impression post receiving its mandatory seating tap.

38.

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

39.

View of transitional prosthesis three weeks after the implant level transfer impression was taken.

40.

Third Clinical Visit: Well of implant being cleaned with alcohol on a cotton tipped applicator.

41.

Integrated Abutment Crown™ being inserted.

42.

Interproximal contact being adjusted with metal finishing strip.

43.

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.

44.

View of Integrated Abutment Crown™ immediately after being inserted.

45.

Post insertion radiograph.

46.

View of Integrated Abutment Crown™ five weeks post insertion.