Two Stage Placement and Restoration of a Congenitally Missing Maxillary Left Lateral Incisor Implant with an Integrated Abutment Crown™

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1.

First Visit: Pre-operative radiograph.

2.

Pre-operative site.

3.

Pre-operative smile.

4.

Osteotomy being prepared with 2.0mm pilot bur rotating at 1100RPM with external irrigation.

5.

Paralleling pin confirming appropriate trajectory of the osteotomy.

6.

Osteotomy being enlarged with an olive green 2.5mm latch reamer bur rotating at 50RPM without water irrigation.

7.

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

8.

Osteotomy being enlarged with a blue 3.5mm hand reamer.

9.

Harvested bone within the flute of blue 3.5mm hand reamer.

10.

A 3.5mm x 8.0mm HA coated implant being inserted with an implant seating tip threaded on a straight driver.

11.

Cut polyethylene healing plug being inserted into the well of the implant.

12.

Sutured site.

13.

Post-operative radiograph.

14.

Second Visit: – four months after previous visit. View of operative site prior to the two stage uncovering four months after the implant placement.

15.

Healing plug being removed with a healing plug removal instrument.

16.

Note the trajectory of the implant.

17.

View of seated 2.0mm titanium impression post with red 2.0mm plastic sleeve.

18.

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

19.

Third Visit: – six weeks after previous visit. View of transitional removable prosthesis.

20.

Site after removal of transitional prosthesis.

21.

Healing plug being removed with healing plug removal instrument.

22.

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

23.

Integrated Abutment Crown™ being inserted.

24.

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.

25.

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.

26.

Integrated Abutment Crown™ being modified with 7408 carbide finishing bur.

27.

Facial view immediately after the definitive seating of the Integrated Abutment Crown™.

28.

Post insertion radiograph.

29.

View of Integrated Abutment Crown™ one month post insertion.

30.

Facial view one month post insertion.

31.

Patient’s smile one month post insertion.

32.

View of Integrated Abutment Crown™ five months post insertion.

33.

Left profile view five months post insertion.

34.

Patient’s smile five months post insertion.