Two Stage Placement of Mandibular Left First Molar with a 6.0mm x 5.7mm Short Implant and its Restoration with an Integrated Abutment Crown™

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1.

First Clinical Visit: Pre-operative radiograph.

2.

Pre-operative site.

3.

A straight elevator is being used to gently luxate the tooth.

4.

Periotome being used to facilitate the extraction.

5.

Periotome being used to facilitate the extraction.

6.

A straight elevator being used to initiate the extraction.

7.

A forceps is being used to gently luxate the tooth.

8.

Hemisectomy is being performed.

9.

A straight elevator is being used to gently luxate the hemisected root.

10.

A straight elevator is being used to gently luxate the hemisected root.

11.

Hemisected root being extracted.

12.

Hemisected root being extracted.

13.

Sutured site.

14.

Post-operative radiograph.

15.

Second Clinical Visit: (Two months after previous visit) View of operative site prior to the implant placement, 8 weeks after extraction.

16.

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

17.

Paralleling pin seated in pilot osteotomy indicating its trajectory.

18.

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

19.

Osteotomy being enlarged with a silver 4.5mm latch reamer rotating at 50RPM without water irrigation.

20.

Osteotomy being enlarged with a gold 5.0mm latch reamer rotating at 50RPM without water irrigation.

21.

Osteotomy being enlarged with a blue 5.5mm latch reamer rotating at 50RPM without water irrigation.

22.

View of harvested bone in the flute of a green 6.0mm latch reamer.

23.

Curette removing residual bone while confirming the integrity of the five bony walls of the osteotomy.

24.

A 6.0 x 5.7mm short implant being inserted into the osteotomy with an implant seating tip threaded on a straight driver.

25.

Trimmed polyethylene healing plug being inserted into the seated implant.

26.

Harvested bone being placed over the shoulder of the implant.

27.

Sutured site.

28.

Post-operative radiograph.

29.

Third Clinical Visit: (Three months after previous visit) View of operative site prior to the making of an implant level transfer impression.

30.

Healing plug being removed with a healing plug removal instrument.

31.

Healing plug being removed with a healing plug removal instrument.

32.

View of Green 3.0mm titanium impression post being seated into the 3.0mm well of an integrated implant for the making of an implant level transfer impression.

33.

View of Green 3.0mm titanium impression post with plastic sleeve seated into the 3.0mm well of an integrated implant for the making of an implant level transfer impression.

34.

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

35.

View of non-shouldered abutment in stone model.

36.

Non-shouldered abutment being modified while being held in an abutment prep holder.

37.

Hemispherical base of prepared abutment covered with wax, prior to its being sand blasted.

38.

View of prepared non-shouldered abutment being ultrasonically cleaned in 95% ethyl alcohol.

39.

View of One-Step® Universal Dental Adhesive and prepared abutment.

40.

One-Step® Universal Dental Adhesive being applied to the prepared non-shouldered abutment.

41.

Adhesive being light cured.

42.

Adhesive being light cured.

43.

Tescera™ light opaquer.

44.

Prepared abutment with opaque layer being light cured.

45.

View of opaquer being applied to the prepared non-shouldered abutment.

46.

View of prepared non-shouldered abutment with indirect composite resin seated in the stone model.

47.

View of prepared non-shouldered abutment with indirect composite resin seated in the stone model.

48.

View of prepared non-shouldered abutment with indirect composite resin seated in the stone model.

49.

View of contours being adjusted.

50.

Contacts being checked with articulating paper.

51.

Integrated Abutment Crown™ being polished with pink acrylic polishing wheel.

52.

Integrated Abutment Crown™ being polished with bristle brush.

53.

Integrated Abutment Crown™ being polished with nylon soft bristle brush.

54.

View of Integrated Abutment Crown™ on stone model.

55.

View of Integrated Abutment Crown™ .

56.

View of Integrated Abutment Crown™ .

57.

Fourth Clinical Visit: (Two days after previous visit) View of transitional abutment prior to their removal for the insertion of Integrated Abutment Crowns™.

58.

View of the soft tissue sulci and implant well.

59.

Abutment post receiving its mandatory alcohol wipe to remove any contaminants that would reduce the effectiveness of its locking taper engagement.

60.

Integrated Abutment Crown™ being inserted.

61.

Crestal relieving incision being made to facilitate the seating of the Integrated Abutment Crown™ .

62.

View of Integrated Abutment Crowns™ immediately after insertion.

63.

Post-operative radiograph.

64.

View of seated Integrated Abutment Crown™ one week post insertion.