Two Maxillary Central Incisors

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1.

Radiograph prior to extraction of failed root canal treated maxillary right central incisor.

2.

Radiograph of 3 year old implant prior to extraction of failed root canal treated maxillary left central incisor.

3.

Radiograph of implant with temporary abutment.

4.

View of 5.0 mm x 2.0 mm x 3.0 mm shouldered abutment after it has been seated into the 3.0 mm well of the implant.

5.

A 5.0 mm short one-piece acrylic sleeve being placed onto the shouldered abutment.

6.

One-piece acrylic sleeve seated on abutment prior to its being incorporated into transitional resin crown. If necessary, it could have been adjusted to assure ideal emergence profile.

7.

Vacuum-formed template placed to confirm appropriate fit with one-piece sleeve.

8.

Composite resin being injected around one-piece sleeve. With some composites, it may be advisable to roughen the surface of sleeve and add a bonding agent prior to adding the composite resin.

9.

Composite resin filling vacuum formed template with excess escaping out incisal weep hole.

10.

Transitional crown being removed for polishing.

11.

Transitional crown being trimmed of excess material.

12.

Transitional crown being polished confluent with one-piece acrylic sleeve.

13.

Polished transitional crown being snapped onto shouldered abutment.

14.

Transitional crown snapped onto shouldered abutment.

15.

Impression material being injected around one-piece acrylic sleeve for the making of a transfer impression.

16.

One piece sleeve incorporated in transfer impression.

17.

Transfer die being inserted into one-piece sleeve.

18.

White transfer die in soft-tissue stone model.

19.

Aluminum oxide sleeve being placed on transfer die.

20.

Mirror view of all-ceramic crown revealing internal aspect of aluminum oxide sleeve.

21.

All-ceramic crown being inserted onto shouldered abutment.

22.

Distal contact being checked.

23.

Distal contact being adjusted.

24.

Incisal contact being checked – When checking excessive contact, patient should be instructed to maintain maximum contact as they move their mandible.

25.

Metallic coupler bonding cement is being applied to shouldered abutment.

26.

Ceramic coupler is being applied to aluminum oxide sleeve of all-ceramic crown.

27.

Bonding agent being applied to shouldered abutment.

28.

Bonding agent being applied to aluminum oxide sleeve.

29.

Light coating of Vaseline being applied to cervical area of crown to facilitate removal of extraneous cement.

30.

Minimal amount of cement being applied to internal cervical aspect of crown.

31.

Cemented porcelain fused to metal crown and a cemented all-ceramic crown.

32.

Radiographic comparison of a non-shouldered abutment with a 2.0 mm shaft and a porcelain fused to metal crown and a shouldered abutment with a 3.0 mm shaft and an all-ceramic crown.

33.

Palatal view of a porcelain fused to metal crown and an all-ceramic crown.