Two Maxillary Central Incisors

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1.

Pre-operative radiograph of two failed endodontically treated teeth.

2.

Periotome being used to facilitate the extraction of the two failed endodontically treated teeth.

3.

Extracted left central incisor.

4.

Extracted right central incisor.

5.

Guide pin placed into pilot osteotomy of left central incisor.

6.

Pilot osteotomy being prepared with a 2.0mm twist drill.

7.

Osteotomy being enlarged with a latch reamer bur.

8.

Bone being harvested from osteotomy with a curette.

9.

A 5.0mm x 8.0mm HA coated implant being inserted into the right central osteotomy with an implant inserter/retriever instrument.

10.

A 5.0mm x 8.0mm HA coated implant being inserted into the left central osteotomy with an implant inserter/retriever instrument.

11.

View of the two implant wells.

12.

Straight handle driver being used to further seat the implant into the bone.

13.

Shouldered abutment depth gauge being used to confirm appropriate axial seating of the implant.

14.

Further seating of the implant is accomplished by tapping the straight handled instrument with a 3.0mm seating tip.

15.

Shouldered abutment depth gauge confirms the appropriate axial seating of the implant.

16.

View of the implant wells of the fully seated immediately placed implants.

17.

A 5.0mm x 4.0mm shouldered abutment is being placed with only finger pressure into the well of the right central implant.

18.

A 5.0mm x 4.0mm shouldered abutment being placed into the well of the left central implant.

19.

A short one-piece acrylic sleeve is being snapped onto the 5.0mm wide shouldered abutment.

20.

One-piece acrylic sleeve is being reduced with a carbide finishing bur to facilitate the seating of an acrylic vacuum formed template.

21.

View of the facially reduced one-piece acrylic sleeves.

22.

A composite acrylic strut is being formed with the material Integrity by Dentsply.

23.

Holes are being drilled into the template to prevent the entrapment of air.

24.

Template being inserted over the composite strut to confirm fit.

25.

Composite material Integrity by Dentsply being inserted only into the incisal portion of the template.

26.

Thin coating of Integrity being applied onto the hardened composite strut.

27.

Template with minimal composite material is being inserted onto the strut.

28.

Newly formed transitional prosthesis is being removed for polishing.

29.

Mesial aspect of adjacent teeth being acid-etched for the bonding of the transitional splint prosthesis.

30.

Bonding material being applied.

31.

Light curing of the bonding material.

32.

Polished transitional prosthesis being inserted to confirm proper fit.

33.

Bonding material being applied to the splint prosthesis.

34.

Bonding material being applied to lateral incisor teeth.

35.

Light curing of material to achieve immobility of the immediately placed and stabilized implants.

36.

Labial view of the transitional splinted prosthesis at the conclusion of the patient's first treatment visit.

37.

Radiograph at the conclusion of the patient's first treatment visit revealing the immediately placed and stabilized implants.

38.

Labial view of transitional splint prosthesis ten weeks after implant placement.

39.

View of shouldered abutments after the removal of splint prosthesis.

40.

Shouldered abutment being removed from right central implant ten weeks after its placement.

41.

View of implant wells ten weeks after their placement.

42.

Patient's smile.

43.

A white 3.0mm impression post being inserted into an implant well.

44.

Mandatory tapping of the impression post to insure its proper axial seating.

45.

Impression material being injected around the white impression post for the recording of an implant level transfer impression.

46.

Digital photo being taken of appropriate shade for transmission to dental technician.

47.

Digital photo of a second shade being taken.

48.

Transitional splint being used to orientate the seating of the left shouldered abutment.

49.

Transitional splint prosthesis after the recording of an implant level impression.

50.

Integrated Abutment Crowns™ with yellow incisal seating jig.

51.

Mirror view of Integrated Abutment Crowns™.

52.

Transitional prosthesis prior to the insertion of the permanent Integrated Abutment Crowns™.

53.

View of implant wells prior to the insertion of the Integrated Abutment Crowns™.

54.

Crestal relieving incision being made to facilitate tissue displacement with the insertion and seating of the Integrated Abutment Crowns™.

55.

View of the palatally placed crestal relieving incisions.

56.

Right Integrated Abutment Crown™ being inserted.

57.

Inserted Integrated Abutment Crown™.

58.

Yellow incisal orientation jig being used to confirm appropriate positioning.

59.

Left Integrated Abutment Crown™ being inserted.

60.

Thirteen week radiograph of two immediately placed and immediately loaded implants restored with Integrated Abutment Crowns™.

61.

Right profile view.

62.

Labial view.

63.

Labial view.

64.

Right profile view.

65.

Labial view revealing the superior gingival aesthetics that were achieved with the Bicon Integrated Abutment Crowns™.

66.

Radiograph six years post insertion.

67.

Right profile view six years post insertion.

68.

Left profile view six years post insertion.

69.

Facial view six years post insertion.