This case demonstrates the extraction of a mandibular first bicuspid, the immediate placement of an implant and the immediate stabilization of two implants. The case also shows an incorrect implant level impression transfer (impression post not fully seated into implant), occlusal registration, the insertion of two Integrated Abutment Crowns™ and the intra-oral addition of polyceramic material for the correction of a hypo-occlusion caused by the incorrect implant level impression transfer.
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View of failed root canal treated tooth after the removal of a failed three unit fixed bridge.
3.
Reamer being removed from second bicuspid osteotomy.
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Reamer rotating at 50RPM preparing first molar osteotomy.
5.
Reamer being inserted into second bicuspid osteotomy.
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Reamer with harvested bone being removed from bicuspid osteotomy.
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A 4.5mm x 8.0mm implant being transported with an implant inserter / retriever instrument.
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Molar implant being seated in osteotomy with an offset driver.
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A 5.0 x 8.0mm HA coated implant being transported into bicuspid osteotomy with an implant inserter / retriever instrument.
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Bicuspid implant being seated with an offset driver.
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Shoulder depth gauge seated in well of implant to facilitate the selection of an abutment with the appropriate shoulder height.
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Short one piece acrylic sleeve on a 5.0mm x 4.0mm shoulder abutment being inserted into bicuspid implant.
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Two short one piece acrylic sleeves on 5.0mm wide shouldered abutments.
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Transitional composite material being adapted around one piece acrylic sleeves within a vacuum formed template.
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Removal of transitional stabilization prosthesis and abutments for polishing.
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Insertion of polished transitional stabilization prosthesis, which includes a crown over molar tooth.
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Three unit transitional stabilization prosthesis in place.
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Radiograph revealing the failure of the 5.0mm x 4.0mm shouldered abutment to engage the implant well. A 5.0mm x 6.0mm shouldered abutment should have been used.
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View of implant wells and soft tissue sulci with the re-cemented molar crown, which was cut from failed three unit fixed bridge.
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Two 3.0mm white impression posts in implant wells.
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Impression material being injected around impression posts for the making of an implant level transfer impression.
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Impression posts remaining in implant wells for the recording of an occlusal registration.
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Red acrylic on white impression posts recording an occlusal registration.
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Occlusal registration being removed from implant wells.
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Shoulder depth gauge inserted into bicuspid implant indicating that a shoulder height of 4.0mm would be appropriately below the crest of soft tissue.
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Two plastic temporary shouldered abutments seated in implants.
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New transitional prosthesis incorporating one piece acrylic sleeves being inserted onto the plastic temporary shouldered abutments.
28.
Transitional prosthesis in place during the fabrication of the permanent Integrated Abutment Crowns™.
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Occlusal view of Integrated Abutment Crowns™ on stone model.
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Mirror view of two Integrated Abutment Crowns™.
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Buccal view of two Integrated Abutment Crowns™ on stone model.
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Removal of transitional crowns and plastic temporary shouldered abutments.
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View of 3.0mm implant wells and soft tissue sulci.
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Bicuspid Integrated Abutment Crown™ being transported to implant.
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Integrated Abutment Crown™ inserted into well of bicuspid implant.
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Molar Integrated Abutment Crown™ being seated into implant well.
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Buccal view of seated Integrated Abutment Crowns™ revealing the fact that there is no occlusal contact with the bicuspid Integrated Abutment Crown™.
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Hypo-occlusion of the bicuspid was most likely due to the failure to sufficiently tap the impression post into the well of the implant.
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Occlusal surface being roughened with fine micro-diamond bur.
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Surface being cleaned with 95% ethyl alcohol.
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Ceramo-coupler being applied to occlusal surface.
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Modeling liquid being applied to surface.
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Polyceramic material being added to occlusal surface.
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Newly added polyceramic material being light cured.
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Buccal view of two Integrated Abutment Crowns™ after the polishing of the newly added occlusal surface.
46.
Radiograph of the two properly seated Bicon Integrated Abutment Crowns™.
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