Two Stage Placement of Three Mandibular Incisor Implants and their Restoration with Integrated Abutment Crowns™

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1.

First Clinical Visit: Pre-operative radiograph.

2.

Pre-operative site.

3.

Pre-operative smile.

4.

Periotome being used to initiate the extraction.

5.

Periotome being used to initiate the extraction.

6.

Periotome being used to initiate the extraction.

7.

View of extracted tooth.

8.

View of extracted tooth.

9.

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

10.

View of paralleling pin seated in the initial osteotomy confirming its appropriate trajectory.

11.

Paralleling pins confirming appropriate trajectories and acting as guides for subsequent osteotomy.

12.

Paralleling pins seated in pilot osteotomies indicating their trajectories.

13.

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

14.

Harvested bone within the flute of an olive green 2.5mm latch reamer.

15.

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

16.

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

17.

Harvested bone within the flute of a teal 3.0mm latch reamer.

18.

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

19.

Harvested bone within the flute of a blue 3.5mm latch reamer.

20.

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

21.

Harvested bone within the flute of a blue 3.5mm latch reamer.

22.

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

23.

Harvested bone within the flute of a blue 3.5mm latch reamer.

24.

Currette being used to confirm the integrity of the five walls of the osteotomy.

25.

Currette being used to harvest the bone.

26.

A 3.5mm x 11.0mm HA coated implant being inserted into the osteotomy with a black polyethylene healing plug.

27.

A 3.5mm x 11.0mm HA coated implant being inserted into the osteotomy with a black polyethylene healing plug.

28.

A 3.5mm x 11.0mm HA coated implant being inserted into the osteotomy with a black polyethylene healing plug.

29.

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

30.

Harvested bone collected in the silicon dappen dish.

31.

Harvested bone being placed over the implants.

32.

View of harvested bone being packed with a cotton tip applicator.

33.

View of Bicon Resorbable Collagen Plug being inserted.

34.

Suture being placed.

35.

Sutured site.

36.

Post-operative radiograph.

37.

Second Clinical Visit: (Four months after previous visit) View of operative site, 3 months after implant placement, prior to the two stage uncovering and the making of an implant level transfer impression.

38.

Healing plug being removed with a healing plug removal instrument.

39.

Healing plug being removed with a healing plug removal instrument.

40.

A 2.0mm titanium impression post with red 2.0mm plastic sleeve being seated into the well of an integrated implant for the making of an implant level transfer impression.

41.

A 2.0mm titanium impression post with red 2.0mm plastic sleeve being seated into the well of an integrated implant for the making of an implant level transfer impression.

42.

A 2.0mm titanium impression post with red 2.0mm plastic sleeve being seated into the well of an integrated implant for the making of an implant level transfer impression.

43.

View of seated 2.0mm titanium impression posts with red 2.0mm plastic sleeves.

44.

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

45.

Third Clinical Visit: (Six weeks after previous visit) View of Integrated Abutment Crowns™ on the stone model.

46.

View of Integrated Abutment Crowns™.

47.

View of transitional prosthesis prior to its removal, 3 weeks after the taking of an implant level transfer impression.

48.

Transitional prosthesis being removed.

49.

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

50.

Integrated Abutment Crown™ being inserted.

51.

Integrated Abutment Crown™ being inserted.

52.

Integrated Abutment Crown™ being inserted.

53.

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

54.

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

55.

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

56.

View of seated Integrated Abutment Crowns™ immediately after insertion.

57.

Post insertion radiograph.

58.

Four month post insertion facial view of Integrated Abutment Crowns™.

59.

Four month post insertion radiograph.

60.

One year post insertion facial view of Integrated Abutment Crowns™.