This case demonstrates the two-stage placement, uncovering, implant-level transfer impression, and restoration of a congenitally missing left lateral incisor with a Bicon Integrated Abutment Crown™.
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First Visit: Implant Placement. Pre-operative radiograph.
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Pre-operative site.
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Incision being made.
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Operative site.
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Osteotomy being prepared with a 2.0mm pilot drill rotating at 1100RPM with external irrigation.
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Paralleling pin seated in the pilot osteotomy indicating its position and trajectory.
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Osteotomy being enlarged with an olive green 2.5mm hand reamer attached to a threaded straight handle.
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Osteotomy being enlarged with a teal 3.0 mm hand reamer attached to a threaded straight handle.
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Osteotomy being enlarged with a blue 3.5mm hand reamer attached to a threaded straight handle.
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View of the 3.5mm osteotomy.
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Osteotomy being enlarged with a magenta 4.0mm hand reamer attached to a threaded straight handle.
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Harvested bone within the flute of a magenta 4.0mm hand reamer.
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View of the 4.0mm osteotomy.
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A 4.0 x 8.0mm Integra-CP™ implant with a 2.5mm well attached to its black polyethylene healing plug handle being inserted into the osteotomy.
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View of the implant with black healing plug after being inserted into the osteotomy prior to the removal of the healing plug handle.
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A blue 2.5mm seating tip on threaded straight handle is being used to fully seat the implant into its osteotomy.
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A blue 2.5mm seating tip being used to fully seat the implant.
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Implant seated subcrestally in its osteotomy.
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Cut polyethylene healing plug on a periodontal probe being inserted into the 2.5mm well of the implant.
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Subcrestally seated implant after insertion of the polyethylene healing plug.
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Harvested bone being placed over the shoulder of the implant.
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Harvested bone over the shoulder of the implant.
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Surgical site after insertion of the implant and prior to being sutured.
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Sutured surgical site.
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Post-operative radiograph.
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Second Visit: Three months after the placement of a 4.0 x 8.0mm Integra-CP™ implant. Three month post insertion radiograph prior to the uncovering of the implant.
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Bonded temporary prosthesis prior to the uncovering of the implant.
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Temporary prosthesis being removed.
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View of surgical site prior to crestal incision.
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Crestal incision being made for removal of the healing plug.
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Integrated implant with healing plug.
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Healing plug being removed with a #110 endodontic file.
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Blue 2.5mm guide pin indicating the trajectory of the integrated 4.0 x 8.0mm implant.
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Blue 2.5mm titanium Impression post with corresponding acrylic blue sleeve being inserted for the making of a full arch implant level impression.
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Impression material being injected around the blue impression sleeve for the making of a full arch implant level transfer impression.
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Blue 2.5mm impression sleeve within the full arch implant level transfer impression.
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2.5mm titanium impression post in place after the making of a full arch implant level impression.
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White healing abutment being seated in the well of the implant.
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Modifying the white healing abutment with a #7408 carbide bur prior to its insertion.
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Modified white healing abutment prior to being inserted.
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Modified white healing abutment seated in implant well.
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Modified healing abutment after being inserted with only finger pressure.
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White healing abutment being gently tapped into the well of the implant with a seating tip attached to a threaded straight handle.
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Modified white healing abutment seated in the well of the implant.
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Third Visit: Insertion of IAC two weeks after the uncovering and full arch implant level transfer impression of the 4.0 x 8.0mm Integra-CP™ implant. IAC on stone model.
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Mirror view of the Integrated Abutment Crown™.
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Temporary prosthesis prior to its removal.
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Modified white healing abutment being removed from the well of the implant.
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View of the well of the implant after the removal of the white healing abutment.
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Integrated Abutment Crown™ being inserted.
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Yellow thermoplastic custom seating jig being used to facilitate directing the tapping forces in the long axis of the abutment post and implant well.
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Floss being used to confirm the fact that the interproximal contacts are passive and will not interfere with the engagement of the locking taper.
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Blue articulating paper being used to indicate the contact area.
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Facial view immediately after the insertion of the Integrated Abutment Crown™.
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Post-Insertion radiographs.
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Fourth Visit: One month after insertion. Facial view of Integrated Abutment Crown™.
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Radiograph one month after insertion.
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Fifth Visit: Four months after insertion. Facial view of Integrated Abutment Crown™.
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