Two Stage Placement of Maxillary Left Lateral Incisor Implant and its Restoration with an Integrated Abutment Crown™ in a Single Clinical Visit

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1.

Pre-operative radiograph of fractured endodontically treated left maxillary lateral incisor.

2.

Pre-operative site.

3.

Periotome being used to initiate the extraction.

4.

Periotome being used on the palatal side to initiate the extraction.

5.

Extraction of fractured endodontically treated tooth.

6.

Fractured half of the root being elevated from the socket.

7.

Maxillary left lateral root being extracted.

8.

Curette removing soft tissue remnants.

9.

Shoulder depth gauge being used to measure the level of facial bone.

10.

Soft tissue remnants being removed.

11.

View of socket after extraction.

12.

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

13.

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

14.

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

15.

Osteotomy being enlarged with a blue 3.5mm latch reamer rotating at 50 RPM without water irrigation.

16.

Osteotomy being enlarged with a red 4.0mm latch reamer rotating at 50 RPM without water irrigation.

17.

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

18.

Harvested bone within the flute of silver 4.5mm hand reamer.

19.

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

20.

A 4.5mm x 8.0mm NanoTite™ implant being inserted into the osteotomy with an implant seating tip threaded on a straight driver.

21.

Post-operative radiograph.

22.

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

23.

View of titanium impression post seated in the well of integrated implant.

24.

A green 3.0mm plastic sleeve being snapped onto the 3.0mm titanium impression post.

25.

View of seated green 3.0mm plastic sleeve.

26.

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

27.

Full arch implant level transfer impression being made.

28.

View of maxillary full arch implant level transfer impression and a titanium impression post seated into the green impression sleeve with in the impression.

29.

A view of seated plastic stealth shouldered abutment with only finger pressure for the fabrication of transitional prosthesis.

30.

An acrylic sleeve being seated onto the plastic stealth abutment.

31.

View of transitional prosthesis being fabricated

32.

View of impression with seated 3.0mm titanium impression post with the green 3.0mm implant analog.

33.

Soft tissue material being placed around the seated impression post and implant analog.

34.

Impression being poured with dental stone.

35.

Abutment being prepared with a carbide bur.

36.

View of prepared abutment on model.

37.

Abutment being sandblasted with 50 micron alumina oxide.

38.

Shofu M.L. primer agent for bonding resin to metal.

39.

Primer being applied to the abutment for the bonding of resin.

40.

Ceramage® pre-opaque is being applied prior to being light cured.

41.

Ceramage® opaque paste.

42.

Ceramage opaque paste is being applied to the pre-opaque abutment.

43.

Composite material being applied to the abutment.

44.

Confirming the shade of the crown of the extracted lateral incisor with the shade guide.

45.

Dentin composite material being applied to the abutment.

46.

View of composite material being light cured.

47.

Matching the shade of the extracted lateral incisor with the shade of the composite material of the Integrated Abutment Crown™ restoration.

48.

Composite material being applied.

49.

Incisal composite material being applied.

50.

Different shades of composite material are being used for the characterization.

51.

Composite material being added onto the lingual surface of the maxillary lateral incisor.

52.

Light cured Integrated Abutment Crown™ is being trimmed with the pink acrylic polishing wheel.

53.

View of red articulating paper being used to check the occlusion of an Integrated Abutment Crown™.

54.

Integrated Abutment Crown™ is being trimmed with a diamond bur.

55.

View of Integrated Abutment Crown™ being polished with the nylon bristle brush.

56.

View of Integrated Abutment Crown™ being polished with a buff cloth wheel.

57.

Etchant being applied in preparation for the bonding of the Integrated Abutment Crown™ for stability.

58.

Bonding material being applied.

59.

Light curing of bonding material.

60.

View of slightly roughened proximal surface of Integrated Abutment Crown™.

61.

Bonding material being applied.

62.

Light curing of bonding material.

63.

Composite material being added to the mesial surface of left maxillary canine for the intra oral bonding of the Integrated Abutment Crown™.

64.

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

65.

Integrated Abutment Crown™ being inserted.

66.

White healing abutment in a straight handle is being used to tap the Integrated Abutment Crown™ into the well of the implant.

67.

Added composite material being light cured.

68.

View of the Integrated Abutment Crown™ being finished with a pink acrylic polishing wheel.

69.

View of bonding material being polished with the nylon bristle brush.

70.

View of seated Integrated Abutment Crown™ immediately after its insertion and bonding to adjacent canine for stability.

71.

Post insertion radiograph.