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