Guided Surgery with Two-Stage Technique for the Restoration of a 5.0 x 8.0mm Bicon SHORT® Implant for a Mandibular Right First Molar with an Integrated Abutment Crown™ (IAC)
Using the Bicon Guided Surgery Technique, a 5.0 x 8.0mm Bicon SHORT® Implant was placed with a two-stage surgery for a mandibular right first molar and restored with an Integrated Abutment Crown™ (IAC). This technique employs a Spade Drill to initially establish the osteotomy to the diameter of the intended implant. Subsequently, the osteotomy was deepened using incrementally longer Guided Surgery Reamers through the orifice of a 5.0mm Guide Ring until the length of the intended implant was achieved. The top of the Guide Ring was designed to be 15.0mm above the top of the implant when the implant is placed 2.0 to 3.0mm below the alveolar crest of bone.
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Initial incision being made three months after the extraction.
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Flap being reflected.
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Occlusal view of a custom surgical guide with a gold 5.0mm-diameter Guide Ring to facilitate the placement of a 5.0 x 8.0mm Bicon SHORT® Implant 2.0 to 3.0mm below the alveolar crest of bone.
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Custom surgical guide positioned on the adjacent teeth with its 5.0mm Guide Ring over the intended implant site. The top of the Guide Ring will be 15.0mm above the top of the implant when it is positioned 2.0 to 3.0mm below the alveolar crest of bone.
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View of a Bicon 5.0mm Guided Surgery Kit.
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5.0mm Guided Spade Drill being inserted into the Guide Ring to initiate the osteotomy to the 5.0mm width of the intended implant.
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5.0mm Guided Spade Drill being rotated at 400 to 600RPM with external irrigation to remove the cortical layer of crestal bone.
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Gold 5.0 x 5.0mm Guided Surgery Reamer being inserted into the Guide Ring.
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Gold 5.0 x 5.0mm Guided Surgery Reamer being rotated to lengthen the osteotomy to a depth of 8.0mm below the crest of bone.
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Bone and tissue collected in the flute of the gold 5.0 x 5.0mm Guided Surgery Reamer.
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Gold 5.0 x 6.0mm Guided Surgery Reamer being inserted into the Guide Ring.
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Gold 5.0 x 6.0mm Guided Surgery Reamer being rotated to lengthen the osteotomy to a depth of 9.0mm below the crest of bone.
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Gold 5.0 x 8.0mm Guided Surgery Reamer being inserted into the Guide Ring.
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Gold 5.0 x 8.0mm Guided Surgery Reamer being rotated to lengthen the osteotomy to a depth of 11.0mm to accommodate the placement of the intended 8.0mm-long implant to be 2.0 to 3.0mm below the crest of bone.
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Black 3.0mm Healing Plug Inserter being removed from its 5.0 x 8.0mm Bicon SHORT® Implant and its sterile packaging.
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Gold 5.0 x 3.0mm Guided Inserter being placed into the well of the implant to transport it from its sterile packaging to the prepared osteotomy.
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Gold 5.0 x 3.0mm Guided Inserter being used to insert the 5.0 x 8.0mm Bicon SHORT® Implant into its prepared osteotomy through the Guide Ring.
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Knob of a gold 5.0 x 3.0mm Guided Inserter being gently turned to release it from the placed implant.
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Gold 5.0 x 3.0mm Guided Inserter being removed from the surgical guide.
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View of the implant seated 2.0 to 3.0mm below the crest of bone.
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Healing Plug Inserter being cut with a Healing Plug Cutter.
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View of the cut healing plug.
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Healing plug being transported to its implant with a periodontal probe.
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View of the sutured site.
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Post-operative radiograph of the 5.0 x 8.0mm Bicon SHORT® Implant positioned 2.0 to 3.0mm below the crest of bone.
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Six-month post-operative radiograph of the 5.0 x 8.0mm Bicon SHORT® Implant prior to its uncovering.
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Clinical view prior to the implant's uncovering.
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5.0mm Guided Tissue Punch being used to initiate a circular incision through the Guide Ring.
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Partial view of a circular incison.
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Circular piece of keratinized tissue being removed.
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Tissue over the implant being removed with an Angled Curette.
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Healing plug being removed from its implant with an endodontic file.
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Green 3.0mm Guide Pin seated in the well of its implant to confirm its osseointegration and trajectory.
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Threaded Knob attached to a green 6 Series Sulcus Former seated on a Guide Pin being used to remove excess tissue from the implant's sulcus.
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Green Impression Sleeve seated on its corresponding 3.0mm Impression Post in the well of the implant for the making of a full arch implant-level transfer impression.
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Impression material being injected around the Impression Post and Sleeve.
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Green Impression Sleeve captured within a full arch implant-level transfer impression.
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6.5 x 5.0mm Healing Abutment being inserted into the well of the implant.
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Standard Seating Tip attached to a Threaded Offset Handle being used to gently tap the Healing Abutment.
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View of an Integrated Abutment Crown™ (IAC).
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View of the Healing Abutment prior to its removal for the insertion of the IAC.
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Relieving incision being made to remove any soft tissue interference.
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IAC being inserted into its implant with finger pressure.
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IAC being seated with occlusal pressure from a cotton swab.
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Articulating paper being used to mark the occlusal contacts.
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Blue ink indicating appropriate occlusal contacts while the interproximal contacts are being checked with dental floss.
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Post-insertion clinical view of the definitively seated IAC.
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Post-insertion radiograph of the IAC with its 5.0 x 8.0mm Bicon SHORT® Implant.
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One-month post-insertion clinical view of the IAC and the surrounding tissues.
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