This case demonstrates a mandibular ridge split, a two stage implant placement with implant level transfer impression of two left mandibular molar and premolar implants, and their restoration with Integrated Abutment Crowns™.
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View of corticotomy with two vertical cuts and one horizontal and crestal cut.
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View of horizontal bony cut being made with a fissure bur.
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View of corticotomy site.
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Post-operative site – to be closed for three weeks.
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Post-operative radiograph.
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Second Visit: View of operative site prior to the implant placement, three weeks after ridge split.
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A chisel being applied onto the crest without reflecting the buccal periosteum.
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Pilot bur preparing osteotomy at 1,100 RPM with water irrigation.
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Paralleling pins in each pilot osteotomy.
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Osteotomy being enlarged with an olive green 2.5mm latch reamer bur rotating at 50RPM without water irrigation.
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Osteotomy being enlarged with a teal 3.0mm latch reamer bur rotating at 50RPM without water irrigation.
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Osteotomy being enlarged with a blue 3.5mm latch reamer bur rotating at 50RPM without water irrigation.
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Harvested bone within the flute of a blue 3.5mm latch reamer bur.
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Harvested bone within the flute of a red 4.0mm hand reamer bur with hand reamer extension.
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Curette removing residual bone while confirming the integrity of the five bony walls of the osteotomy.
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Osteotomy being enlarged with a silver 4.5mm hand reamer bur with hand reamer extension without water irrigation.
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Harvested bone within the flute of a silver 4.5mm latch reamer bur.
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Depth gauge seated in the osteotomy to facilitate the selection of an implant with an appropriate length.
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A 5.0mm x 8.0mm implant being inserted into the osteotomy.
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A 4.5mmx 8.0mm implant being inserted into the osteotomy.
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Offset driver being tapped to definitively seat a 5.0mm x 8.0mm implant into its osteotomy.
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Trimmed polyethylene healing plug being inserted into the seated implant.
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View of harvested bone in dappen dish.
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Harvested bone being placed over implants.
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View of Bicon Resorbable Collagen Plug being inserted.
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Sutured site.
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Post-operative radiograph.
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Third Visit: View of operative site prior to the making of an implant level transfer impression.
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A crestal incision being made.
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Polyethylene healing plug being removed with a #110 reamer bur.
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View of two 3.0mm guide pins seated in the wells of the implants.
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Impression reamer being used to remove soft tissue and bone prior to seating impression posts.
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Green 3.0mm plastic impression post being inserted into the 3.0mm well of an integrated implant for the making of an implant level transfer impression.
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Green 3.0mm plastic impression post receiving its mandatory seating tap.
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Impression material being injected around the impression posts for the making of a full arch implant level transfer impression.
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White healing abutments inserted into implant wells.
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Fourth Visit: Post of Integrated Abutment Crown™ receiving its mandatory alcohol wipe for the removal of any contaminants that may interfere with the engagement of its locking taper connection.
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Integrated Abutment Crown™ being inserted initially to evaluate its appropriateness.
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Integrated Abutment Crown™ being inserted initially to evaluate its appropriateness.
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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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White healing abutment in a straight handle is being used to tap the Integrated Abutment Crown™ into the well of the implant.
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White healing abutment in a straight handle is being used to tap the Integrated Abutment Crown™ into the well of the implant.
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Definitive seating of the restoration and engagement of its locking taper connection is being achieved by occlusal pressure on a cotton applicator.
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Articulating paper being used to check interproximal contacts between Integrated Abutment Crowns™ .
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Interproximal contacts being adjusted.
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View of seated Integrated Abutment Crowns™ immediately after their insertion.
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Post-operative radiograph after the insertion of Integrated Abutment Crowns™
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View of Integrated Abutment Crowns™ two weeks post insertion.
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