Extraction, Placement and Restoration of Immediately Placed and Functioning Maxillary Central and Left Lateral Incisor Implants with Integrated Abutment Crowns™

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1.

Pre-operative radiograph.

2.

Pre-operative site.

3.

Pre-operative site.

4.

Extraction of maxillary right central incisor.

5.

Extraction of maxillary left lateral incisor.

6.

Post-insertion radiograph.

7.

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

8.

Bonded stabilizing prosthesis prior to its being removed at the patient’s second clinical visit.

9.

View of transitional abutments after removal of splinted prosthesis.

10.

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

11.

A gold 5.0mm sulcus reamer being used to remove soft tissue and bone.

12.

3.0mm guide pin being removed revealing excess bone.

13.

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.

14.

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.

15.

Green plastic impression post receiving its mandatory seating tap.

16.

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

17.

Integrated Abutment Crowns™ on stone model.

18.

Integrated Abutment Crowns™ on dental model with acrylic orientation jig.

19.

Mirror view of Integrated Abutment Crowns™.

20.

A gold 5.0mm sulcus reamer being used to remove soft tissue and bone which might inhibit the complete seating of the Integrated Abutment Crown™. Note soft tissue sinus tract and inflammation caused by the mobility of the transitional prosthesis’ abutment.

21.

A gold 5.0mm sulcus reamer being used to remove soft tissue and bone which might inhibit the complete seating of the Integrated Abutment Crown™.

22.

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

23.

Integrated Abutment Crown™ being inserted initially to evaluate its appropriateness.

24.

A clear acrylic orientation jig is being used to initially position the Integrated Abutment Crown™.

25.

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.

26.

Polishing strip being used to lighten the interproximal contact area eliminating the possibility that the contact may prevent the engagement of the locking taper connection.

27.

Clear orientation jig is being tapped to initially engage the locking taper connection of the Integrated Abutment Crown™.

28.

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.

29.

Excess palatal tissue being removed.

30.

Integrated Abutment crown™ being inserted initially to evaluate its appropriateness.

31.

Polishing strip being used to lighten the interproximal contact area eliminating the possibility that the contact may prevent the engagement of the locking taper connection.

32.

Clear orientation jig is being tapped to initially engage the locking taper connection of the Integrated Abutment Crown™.

33.

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.

34.

Integrated Abutment Crown™ being inserted initially to evaluate its appropriateness.

35.

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

36.

Clear acrylic orientation jig is being used to initially position the Integrated Abutment Crown™.

37.

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.

38.

Adjustment of interproximal contact since a too tight interproximal contact will prevent the engagement of the locking taper and possibly result in subsequent loosening of the Integrated Abutment Crown™.

39.

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.

40.

Polishing strip being used to lighten the interproximal contact area eliminating the possibility that the contact may prevent the engagement of the locking taper connection.

41.

Clear orientation jig is being tapped to initially engage the locking taper connection of the Integrated Abutment Crown™.

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.

Adjustment of interproximal contact since a too tight interproximal contact will prevent the engagement of the locking taper and possibly result in subsequent loosening of the Integrated Abutment Crown™.

44.

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.

45.

Chlorhexidine irrigation of implant sulcus and sinus tract.

46.

Facial view of three Integrated Abutment Crowns™ immediately after their having been definitively seated.

47.

Radiograph of seated Integrated Abutment Crowns™.

48.

One week post-insertion view of seated Integrated Abutment Crowns™.

49.

Three weeks post-insertion view of seated Integrated Abutment Crowns™.

50.

Facial view nine weeks after insertion.

51.

Facial view nine weeks after insertion.

52.

Facial view nine weeks after insertion.

53.

Right profile view nine weeks after insertion.

54.

Left profile view nine weeks after insertion.