Placement and Restoration of Two Implants and Crown Lengthening Surgery for Congenitally Missing Lateral Incisors

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1.

Smile revealing congenitally missing lateral incisors.

2.

Congenitally missing lateral incisors.

3.

Orthodontic appliance replacing lateral incisors.

4.

Pre-operative radiograph.

5.

Left profile revealing passive eruption.

6.

Right profile revealing passive eruption.

7.

Left profile revealing passive eruption.

8.

Right profile revealing passive eruption.

9.

Pre-operative labial view.

10.

Etchant being applied for bonding surfaces prior to surgery.

11.

Primer agent being applied for bonding.

12.

Bonding agent being applied.

13.

Bonding agent being light cured.

14.

Evaluation prior to crown lengthening and implant placement surgery.

15.

Initial incision.

16.

Reflection of palatal tissue.

17.

Evaluation for crown lengthening surgery.

18.

Osteotomy being prepared with 2.0mm pilot bur.

19.

Paralleling pins confirming trajectory of osteotomies.

20.

Osteotomy being prepared with a 3.5mm blue latch reamer rotating at 50RPM.

21.

A 3.5mm x 11mm HA coated implant being inserted into osteotomy.

22.

A 4.0mm x 3.5mm stealth abutment being inserted with only finger pressure into the implant.

23.

A tall 4.0mm acrylic sleeve being inserted onto the stealth abutment.

24.

Two acrylic sleeves on stealth abutments.

25.

Acrylic sleeve being reduced.

26.

Trimmed acrylic sleeve.

27.

Polyceramic material being added to acrylic sleeve to form a bonded strut between adjacent teeth.

28.

Additional polyceramic material in vacuum formed template being added to the hardened strut for aesthetic contouring.

29.

Polyceramic stabilization prostheses being light cured

30.

Two three-unit transitional stabilization prostheses in place.

31.

Right labial view after crown lengthening surgery.

32.

Left labial view after crown lengthening surgery.

33.

Smile immediately after implant placement.

34.

Radiograph of immediately stabilized implants.

35.

Stabilization prostheses seven weeks after implant placement.

36.

Two 4.0mm x 3.5mm stealth abutments after removal of stabilization prostheses.

37.

Implant wells and soft tissue sulci after removal of stealth abutments.

38.

A 2.0mm black plastic impression post being inserted into 2.0mm implant well.

39.

Impression post being fully seated into the well of the implant with multiple gentle taps.

40.

Two seated 2.0mm black impression posts.

41.

Impression material being injected around posts for the making of an implant level transfer impression.

42.

Digital photo being taken of shade guide against a black metallic background.

43.

Two Integrated Abutment Crowns™ on stone model with clear acrylic orientation jig.

44.

Mirror view of two Integrated Abutment Crowns™.

45.

Two 4.0mm stealth abutments prior to their being removed.

46.

Implant wells and sulci after removal of stealth abutments.

47.

Two guide pins seated in the implant wells indicating the trajectory of the implants.

48.

Right lateral incisor Integrated Abutment Crown™ being inserted.

49.

Orientation jig being stabilized with cotton rolls during initial placement of Integrated Abutment Crowns™.

50.

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

51.

Relieving incision being made leaving a thin piece of tissue along adjacent tooth.

52.

Orientation jig being used to initially seat right lateral incisor.

53.

Right lateral incisor being definitively seated with six taps with a white temporary abutment inserted into a straight driver.

54.

Left lateral incisor being initially seated with an orientation jig.

55.

White temporary abutment in a straight driver being used to definitively seat the Integrated Abutment Crown™ in the long axis of the implant well.

56.

Seated Integrated Abutment Crowns™.

57.

Radiograph of seated Integrated Abutment Crowns™.

58.

Six weeks after insertion of Integrated Abutment Crowns™.

59.

Six weeks after insertion of Integrated Abutment Crowns™.

60.

Restored congenitally missing lateral incisors six weeks after insertion of Bicon Integrated Abutment Crowns™.