Two Stage Placement of Two Maxillary Central Incisor Short Implants and their Restoration with Integrated Abutment Crowns™

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1.

First Clinical Visit: Pre-operative radiograph.

2.

Pre-operative site.

3.

View of extracted tooth.

4.

View of extracted tooth.

5.

Curette removing soft tissue remnants of periodontal ligament.

6.

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

7.

Parallel pin confirming appropriate trajectory and acting as a guide for subsequent osteotomy.

8.

Parallel pins seated in pilot osteotomies indicating their trajectories.

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 red 4.0mm latch reamer bur rotating at 50RPM without water irrigation.

13.

Osteotomy being enlarged with a silver 4.5mm hand reamer attached to a threaded straight handle.

14.

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

15.

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

16.

A 5.0mm x 6.0mm NanoTite™ implant being inserted into the osteotomy with the implant inserter/retriever.

17.

A 5.0mm x 6.0mm NanoTite™ implant being inserted into the osteotomy with the implant inserter/retriever.

18.

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

19.

View of seated implants with polyethylene healing plugs prior to their being cut.

20.

Trimmed polyethylene healing plug being inserted into the seated implant.

21.

View of Bicon Resorbable Collagen Plug being inserted.

22.

View of Bicon Resorbable Collagen Plug being inserted.

23.

Sutured site.

24.

Post-operative radiograph of 5.0mm x 6.0mm implants.

25.

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

26.

Bonding material being applied.

27.

Bonding material being applied.

28.

Light curing of bonding material.

29.

Transitional composite material, “Integrity” by Dentsply, being added to vacuum formed template to form a transitional stabilizing prosthesis.

30.

Transitional composite material, “Integrity” by Dentsply, being added to vacuum formed template to form a transitional stabilizing prosthesis.

31.

Additional transitional composite material, “Integrity” by Dentsply, in vacuum formed template being seated.

32.

Light curing of composite material.

33.

View of finished transitional stabilizing prosthesis.

34.

Post-operative radiograph.

35.

Second Clinical Visit: (Three months after previous visit) View of transitional prosthesis prior to its removal.

36.

Incision being made for the uncovering of an implant.

37.

Healing plug being removed from the well of the implant with a healing plug remover.

38.

Healing plug being removed from the well of the implant with a healing plug remover.

39.

View of 3.0mm guide pins seated into the well of the implants.

40.

A green 3.0mm titanium impression post being seated into the well of integrated implant.

41.

A green 3.0mm titanium impression post being seated into the well of integrated implant.

42.

A green 3.0mm impression post receiving its seating tap.

43.

A 3.0mm green plastic sleeve being seated onto the 3.0mm titanium impression post.

44.

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

45.

Short acrylic sleeve being seated onto the stealth abutment.

46.

Transitional composite material, “Integrity”, by Dentsply, being added to impression to form a transitional stabilizing prosthesis.

47.

Transitional composite material, “Integrity” by Dentsply, being added to acrylic sleeves to form a bonded strut between adjacent teeth.

48.

Additional transitional composite material in impression being added to the hardened strut for aesthetic contouring.

49.

View of transitional prosthesis seated onto shouldered abutments.

50.

Transitional prosthesis being removed for polishing.

51.

Polishing of bonded prosthesis with a silicone disc.

52.

Transitional prosthesis being polished with soft bristle brush.

53.

View of bonded transitional prosthesis.

54.

Third Clinical Visit: (One week after previous visit) Post operative radiograph.

55.

View of Integrated Abutment Crowns™ on stone model.

56.

Well of implants being cleaned with alcohol on cotton tipped applicators.

57.

Integrated Abutment Crown™ being inserted.

58.

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

59.

Integrated Abutment Crown™ being inserted.

60.

White healing abutment in a straight handle is being used to tap the Integrated Abutment Crown™ into the well of the implant.

61.

White healing abutment in a straight handle is being used to tap the Integrated Abutment Crown™ into the well of the implant.

62.

View of Integrated Abutment Crown™ immediately after being inserted.

63.

Post-insertion radiograph.

64.

Third Clinical Visit: Integrated Abutment Crowns™ four months after insertion.

65.

Four months post insertion radiograph.