Extraction, Two Stage Placement and Restoration of a Mandibular Lateral Incisor with Integrated Abutment Crown™

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1.

Pre-operative radiograph.

2.

Pre-operative site.

3.

Extraction of tooth with root resorption.

4.

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

5.

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

6.

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

7.

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

8.

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

9.

Harvested bone within the latch reamer.

10.

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

11.

Depth gauge confirming the appropriateness of the osteotomy.

12.

A 4.0mm x 8.0mm HA coated implant with a 2.0mm implant well is being inserted with the black polyethylene healing plug.

13.

Harvested bone being placed over the seated implant.

14.

Operative site immediately after the placement of 4.0mm x 8.0mm HA coated implant.

15.

Post-operative radiograph.

16.

Operative site at the patient’s second clinical visit three months after placement of the implant.

17.

Radiograph of integrated implant twelve weeks after implant placement.

18.

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

19.

Incision is being made to uncover the implant three months after the placement of the implant.

20.

Healing plug being removed from the well of the 4.0mm x 8.0mm HA coated implant.

21.

Healing plug being removed from the well of the 4.0mm x 8.0mm HA coated implant.

22.

Red 2.0mm impression reamer being inserted onto guide pin to remove any tissue which might inhibit the complete seating of an impression post.

23.

Red 2.0mm plastic impression post being inserted into the 2.0mm well of an integrated implant for the making of an implant level transfer impression.

24.

Red 2.0mm plastic impression post receiving its mandatory seating tap.

25.

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

26.

Integrated Abutment Crown™ on stone model.

27.

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

28.

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.

29.

View of Integrated Abutment Crown™.

30.

Red plastic healing abutment prior to its removal for the insertion of the Integrated Abutment Crown™.

31.

Red healing abutment being removed.

32.

View of implant well and soft tissue sulcus.

33.

Integrated Abutment Crown™ being inserted.

34.

Blanching of soft tissues with the initial seating of the Integrated Abutment Crown™.

35.

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

36.

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.

37.

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.

38.

Facial view immediately after definitive seating.

39.

Incisal view immediately after definitive seating.

40.

Post-insertion radiograph of Integrated Abutment Crown™.

41.

One week post-insertion image.

42.

Thirteen week post-insertion radiograph.

43.

Thirteen week post-insertion image.

44.

2.5 year post-insertion image.

45.

2.5 year post-insertion radiograph.