Placement of Immediately Stabilized and Functioning Maxillary Right Canine Implant for a Congenitally Missing Maxillary Right Lateral and its Restoration with Bicon Integrated Abutment Crown™

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1.

First Clinical Visit: Pre-operative radiograph.

2.

Pre-operative smile.

3.

View of pre-operative site.

4.

Parallel pin seated in pilot osteotomy indicating its trajectory. Note: retraction suture.

5.

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

6.

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

7.

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

8.

Osteotomy being enlarged with a red 4.0mm hand reamer.

9.

Harvested bone within the silver 4.5mm hand reamer.

10.

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

11.

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

12.

View of polyethylene healing plug seated in the well of the implant.

13.

Post-operative radiograph.

14.

Tall acrylic sleeve being modified for occlusal clearance.

15.

Modified acrylic sleeve and a 4.0 x 3.5mm 0°stealth shouldered abutment being seated in the implant well.

16.

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

17.

Bonding material being applied.

18.

Light curing of bonding material.

19.

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

20.

Light curing of composite material.

21.

Composite material being added.

22.

Composite material being added.

23.

Light curing of composite material.

24.

Transitional prosthesis being contoured.

25.

View of transitional prosthesis.

26.

Polishing of bonded prosthesis with a pink silicone disc.

27.

View of finished transitional prosthesis.

28.

Post operative radiograph.

29.

Second Clinical Visit: Transitional prosthesis prior to their removal for the making of implant level transfer impression.

30.

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

31.

Green 3.0mm plastic impression post being inserted into the 3.0mm well of an integrated implant for the making of an implant level transfer impression.

32.

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

33.

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

34.

Third Clinical Visit: Integrated Abutment Crown™ on stone model.

35.

Integrated Abutment Crown on stone model with yellow occlusal orientation jig which is used to facilitate the initial positioning of the Integrated Abutment Crown™.

36.

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

37.

View of Integrated Abutment Crown™.

38.

Bonded transitional stabilizing prosthesis prior to its removal for the insertion of the Integrated Abutment Crown™.

39.

Transitional prosthesis being removed.

40.

An oblique crestal relieving incision is being made to facilitate the seating of the ideally contoured Integrated Abutment Crown™.

41.

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

42.

Integrated Abutment Crown™ being inserted.

43.

View of Integrated Abutment Crown™ after initial insertion.

44.

Diamond finishing strip being used to lighten the interproximal contact area eliminating the possibility that the contact may prevent the engagement of the locking taper connection.

45.

Yellow thermoplastic custom seating jig, which was formed with a crown alignment device, in a crown seating tip attached to a straight handle facilitates directing the tapping forces in the long axis of the abutment post and implant well.

46.

Post insertion radiograph.

47.

View of Integrated Abutment Crown™ one month post insertion.

48.

View of Integrated Abutment Crown™ one month post insertion.

49.

Facial view of Integrated Abutment Crown™ one month post insertion.

50.

View of patient's smile one month post insertion.