Placement of Seven Immediately Functioning Mandibular Implants and their Restoration with six Integrated Abutment Crowns™ and a Three Unit Fixed Polyceramic to Metal Bridge
This case demonstrates a patient’s attempt to solve his frustration with failed root canal and conventional restorative treatments by using plumber’s cement to rescue his mandibular fixed prosthesis as well as the insertion of seven implants and their restoration with six Integrated Abutment Crowns™ and a three unit fixed polyceramic to metal bridge.
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View of transitional stabilizing prosthesis in place.
42.
Radiograph of immediately placed and functioning implants with transitional stabilizing prosthesis.
43.
View of transitional prosthesis six months after implant placement and the removal of the most posterior right implant.
44.
View of transitional abutments after removal of splinted prosthesis.
45.
View of red acrylic resin on a green impression post recording the occlusal relationship while the transitional prosthesis is in place.
46.
Green 3.0 mm plastic impression post being inserted into the 3.0 mm implant well.
47.
Red acrylic on impression posts recording an occlusal registration.
48.
Occlusal registration being removed from implant wells.
49.
View of implant wells after the removal of the transitional prosthesis and the stealth abutments.
50.
Green 3.0 mm plastic impression post being inserted into the 3.0 mm implant well.
51.
Green 3.0 mm plastic impression post being inserted into the 3.0 mm implant well.
52.
View of seated impression posts after being tapped into the well of their implant.
53.
Impression material being injected around impression posts for the making of an implant level transfer impression.
54.
Impression post being tapped out of implant well.
55.
Transitional prosthesis being re-inserted.
56.
Milled abutments and occlusal registration rims on dental models.
57.
View of transitional abutments after removal of splinted prosthesis one month after the patient’s second visit.
58.
Milled posterior abutment being inserted into metal prosthesis.
59.
Prosthesis being used to position milled posterior abutment.
60.
Milled anterior abutment being inserted into metal prosthesis.
61.
Prosthesis being used to insert milled abutments into the well of their implants.
62.
Transitional stealth abutment being removed.
63.
An abutment prepared for an Integrated Abutment Crown™ being inserted into the well of an implant.
64.
An abutment prepared for an Integrated Abutment Crown™ being inserted into the well of an implant.
65.
Sulcus reamer being inserted into a seated guide pin to remove soft tissue and bony interference for the seating of a prepared Integrated Abutment Crown™ abutment.
66.
An abutment prepared for an Integrated Abutment Crown™ being inserted into the well of an implant.
67.
Occlusal registration rim being used to position cantilevered Integrated Abutment Crown™ abutment into the well of its implant.
68.
Occlusal registration and anterior aesthetic being established.
69.
Transitional prosthesis being re-inserted.
70.
Orientation jig on Integrated Abutment Crowns™ and three unit fixed prosthesis.
71.
Mirror view of Integrated Abutment Crowns™ and three unit fixed prosthesis.
72.
View of implant wells after the removal of the transitional prosthesis and the stealth abutments.
73.
Posterior milled abutment being inserted into prosthesis.
74.
Prosthesis being used to position milled abutment into the well of its implant.
75.
Three unit prosthesis preliminarily positioned with only posterior abutment.
76.
Integrated Abutment Crown™ being inserted to facilitate the positioning of adjacent three unit prosthesis.
77.
Anterior milled abutment being inserted into prosthesis.
78.
Prosthesis being used to position anterior abutment into the well of its implant.
79.
Dental floss indicates an inappropriately too tight interproximal contact.
80.
Prosthesis is being re-inserted with only the anterior abutment to facilitate establishing an appropriate interproximal relationship.
81.
Posterior abutment is being re-inserted after an appropriate anterior interproximal relationship was established.
82.
View of preliminarily positioned prosthesis prior to radiographic confirmation of its adaptation.
83.
Posterior abutment receiving a preliminary seating tap.
84.
Anterior abutment receiving a preliminary seating tap with the aid of an orientation jig.
85.
Anterior abutment receiving a definitive seating tap in the long axis of its implant well and abutment post.
86.
Re-inserted prosthesis reveals blanching of soft tissue beneath pontic.
87.
Crestal relieving incision being made to accommodate pontic.
88.
Integrated Abutment Crown™ being re-inserted after definitive seating of fixed posterior prosthesis.
89.
Orientation jig being used to facilitate positioning of Integrated Abutment Crown™.
90.
Polishing strip being used to adjust an inappropriately tight interproximal contact.
91.
A custom yellow seating jig is being used to direct the seating forces in the long axis of the implant well and abutment post.
92.
Integrated Abutment Crown™ being inserted.
93.
A custom yellow seating jig is being used to direct the seating forces in the long axis of the implant well and abutment post.
94.
Integrated Abutment Crown™ being inserted.
95.
Integrated Abutment Crown™ receiving a preliminary seating tap with the aid of an orientation jig.
96.
Integrated Abutment Crown™ being inserted.
97.
View of prostheses immediately after being seated.
98.
Post-operative radiograph of seated Integrated Abutment Crowns™ and three unit fixed prosthesis.
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