Extraction, Two Stage Placement and Restoration of Maxillary Lateral Incisor Implants with Integrated Abutment Crowns™

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1.

First visit: Pre-operative radiograph of maxillary right lateral incisor.

2.

Pre-operative radiograph of maxillary left lateral incisor.

3.

Pre-operative site.

4.

Pre-operative view of maxillary right lateral incisor

5.

Pre-operative view of maxillary left lateral incisor.

6.

Pre-operative smile.

7.

Post extraction site.

8.

Post extraction site.

9.

Second visit: Pre-operative sites two weeks after the first visit.

10.

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

11.

Parallel pin seated in the pilot osteotomy indicating its trajectory.

12.

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

13.

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

14.

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

15.

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

16.

Osteotomy being enlarged with a silver 4.5mm hand reamer.

17.

Osteotomy being enlarged with a silver 4.5mm hand reamer.

18.

Harvested bone within the flute of a silver 4.5mm hand reamer.

19.

A 4.5mm x 11.0mm HA coated implant being inserted into the osteotomy with an implant seating tip threaded on a straight driver.

20.

A 4.5mm x 11.0mm HA coated implant being inserted into the osteotomy with an implant seating tip threaded on a straight driver.

21.

Harvested bone being placed over the shoulder of the seated stealth abutment.

22.

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

23.

Bonding material being applied.

24.

Light curing of bonding material.

25.

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

26.

Light curing of composite material.

27.

Light curing of composite material.

28.

Transitional stabilizing prosthesis bonded to adjacent teeth.

29.

Patient's smile at completion of second clinical visit.

30.

Post operative radiograph.

31.

Post operative radiograph.

32.

Third visit: Digital image being taken of shade guide against a black plastic background to facilitate the fabrication of aesthetic Integrated Abutment Crowns™.

33.

View of implant wells after the removal of the transitional prosthesis and the stealth abutments.

34.

Green 3.0mm impression reamer being inserted onto guide pin to remove any tissue which might inhibit the complete seating of an impression post.

35.

Green 3.0mm plastic impression post being inserted into the 3.0mm implant well.

36.

Green 3.0mm plastic impression post being inserted into the 3.0mm implant well.

37.

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

38.

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

39.

Integrated Abutment Crowns™ on stone model.

40.

Integrated Abutment Crowns on stone model with yellow thermoplastic seating jigs which were fabricated on a caliper like device to facilitate directing the seating forces in the long axis of the implant well and abutment post.

41.

View of Integrated Abutment Crown™.

42.

View of Integrated Abutment Crown™.

43.

View of implant wells and sulci.

44.

View of implant wells and sulci.

45.

Integrated Abutment Crown™ being inserted.

46.

Integrated Abutment Crown™ being inserted.

47.

Post operative view immediately after insertion of Integrated Abutment Crowns™.

48.

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

49.

Facial view after the initial insertion of Integrated Abutment Crowns™.

50.

Yellow thermoplastic custom seating jig which was formed with 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.

51.

Yellow thermoplastic custom seating jig which was formed with 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.

52.

View of definitively seated Integrated Abutment Crowns™.

53.

View of seated Integrated Abutment Crowns™ in occlusion.

54.

Post-operative radiograph.

55.

Patient's smile one month post-insertion.

56.

View of the maxillary right lateral incisor Integrated Abutment Crown™ one month post-insertion.

57.

View of the maxillary left lateral incisor Integrated Abutment Crown™ one month post-insertion.

58.

Facial view of Integrated Abutment Crowns™ one month post-insertion.

59.

Patient’s smile three and a half years post-insertion.

60.

View of the maxillary right lateral incisor Integrated Abutment Crown™ three and a half years post-insertion.

61.

View of the maxillary left lateral incisor Integrated Abutment Crown™ three and a half years post-insertion.

62.

Facial view of Integrated Abutment Crowns™ three and a half years post-insertion.