Extractions, Six Implants, and Six Crowns in Three Patient Visits

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1.

First Patient Visit: Removal of existing prosthesis.

2.

Four carious roots of previously root canal treated teeth prior to their being extracted.

3.

The insertion of a 6.0mm x 5.7mm implant.

4.

The insertion of a 3.5mm x 11.0mm implant.

5.

The first 5.0mm wide stealth shouldered abutment seated into an implant.

6.

Five emergence cuffs snapped onto the 5.0mm wide stealth shouldered abutments.

7.

One acrylic sleeve snapped onto an emergence cuff.

8.

Five sleeves snapped onto emergence cuffs and one sleeve placed on the 3.5mm wide stealth shouldered abutment prior to being incorporated into transitional splint.

9.

Transitional prosthesis being fabricated in a vacuum formed template incorporating the plastic components of the stealth abutment system.

10.

Radiograph of immediately loaded implants with transitional acrylic prosthesis.

11.

Second Patient Visit: Healed tissue around transitional prosthesis at the patient's second clinical visit.

12.

Stealth shouldered abutments after the removal of transitional prosthesis.

13.

Occlusal view of six stealth shouldered abutments.

14.

Six aluminum oxide sleeves seated on abutments prior to being withdrawn in a transfer impression.

15.

Aluminum oxide sleeve seated on a stealth shouldered abutment.

16.

Impression material being injected around aluminum oxide sleeves. A preferable way of making the transfer impression would be to use the one-piece acrylic sleeves.

17.

When using the aluminum oxide sleeves for the transfer impression care must be taken not to displace the sleeve with the impression material.

18.

Impression with withdrawn sleeves prior to the insertion of abutment analogs into the sleeves for the pouring of a stone model.

19.

Two two-piece sleeves snapped onto abutments for the making of an occlusal registration.

20.

Height of sleeves has been reduced.

21.

Acrylic has been added to record opposing dentition.

22.

Material for soft tissue model being injected around abutment analogs.

23.

Stone model being poured.

24.

Models being indexed with occlusal registration.

25.

Model with three all-ceramic crowns.

26.

Mirror view of six all-ceramic crowns revealing the internal aspect of the aluminum oxide sleeves on which the crowns were made.

27.

Occluso-lingual view of six all-ceramic crowns.

28.

Ceramic crown on 5.0mm abutment analog.

29.

Third Patient Visit: Mirror view of 3.5mm stealth shouldered abutment and all-ceramic crown prior to their being extra-orally cemented.

30.

Emergence cuffs being used as corrective copings to reduce the height of two abutments prior to cementing the all-ceramic crowns

31.

Radiograph after the cementation of all-ceramic crowns.

32.

Lingual view of six all-ceramic crowns at time of placement.

33.

Facial view of six all-ceramic crowns at time of placement.

34.

Radiograph sixteen months after implant placement. Note the level and density of bone.

35.

Completed restoration.

36.

Radiograph seven years after implant placement. Note the level and density of bone.