Extraction of a Maxillary Central Incisor and Restoration of an Immediately Placed and Functioning Short Implant with an Integrated Abutment Crown™

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1.

Pre-operative smile.

2.

Pre-operative site.

3.

Pre-operative radiograph.

4.

Extraction of tooth with internal resorption.

5.

Curette removing soft tissue remnants of periodontal ligament.

6.

Tissue being removed.

7.

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

8.

Parallel pin seated in pilot osteotomy indicating its trajectory.

9.

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

10.

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

11.

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

12.

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

13.

Harvested bone in a gold 5.0mm latch reamer.

14.

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

15.

A 5.0mm x 6.0mm HA coated implant being inserted into the osteotomy with an implant seating tip threaded on a straight driver.

16.

View of well of seated implant.

17.

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

18.

Radiograph of implant immediately after placement.

19.

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

20.

Tall acrylic sleeve being modified.

21.

A 5.0mm x 2.0mm stealth abutment with a modified acrylic sleeve being inserted into the well of the implant.

22.

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

23.

Bonding agent being applied.

24.

Light curing of bonding agent.

25.

Polyceramic material being added to acrylic sleeve to form a bonded strut between adjacent teeth.

26.

Light curing of polyceramic material that was applied over the acrylic sleeve.

27.

Additional material being added to prosthesis.

28.

Light curing of additional material.

29.

Polished prosthesis.

30.

Radiograph of immediately placed and functioning implant at the completion of the first clinical visit.

31.

Green 3.0mm plastic impression post being inserted into the 3.0mm well of an integrated implant for the making of an implant level transfer impression ten weeks after implant placement.

32.

Digital image being taken of shade guide against a black plastic background to facilitate the fabrication of an aesthetic Integrated Abutment Crown™.

33.

Integrated Abutment Crown™ on stone model.

34.

Integrated Abutment Crown™ on stone model with clear acrylic orientation jig.

35.

Integrated Abutment Crown™ on stone model with yellow thermoplastic seating jig which was fabricated on a crown alignment device to facilitate directing the seating forces in the long axis of the implant well and abutment post.

36.

View of Integrated Abutment Crown™.

37.

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

38.

Integrated Abutment Crown™ being inserted.

39.

Crestal relieving incision being made to facilitate the seating of the Integrated Abutment Crown™.

40.

View of Integrated Abutment Crown™ after the initial seating.

41.

Floss being used to confirm the fact that the inter-proximal contacts are passive and will not interfere with the engagement of the locking taper.

42.

Yellow thermoplastic custom seating jig which was formed in 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.

43.

View of Integrated Abutment Crown™ immediately after the insertion.

44.

Close-up view of Integrated Abutment Crown™.

45.

Close-up view of Integrated Abutment Crown™ in occlusion.

46.

Post-operative radiograph of seated Integrated Abutment Crown™.

47.

Integrated Abutment Crown™ one week after insertion.

48.

Patient’s smile.