This case demonstrates a mandibular ridge split, two stage placement and uncovering of four mandibular posterior implants as well as the implant level transfer impression for the insertion of Bicon Integrated Abutment Crowns™.
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View of bony ridge and the reflection of a full thickness mucoperiosteal flap.
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Crestal bony cut is being made with a thin fissure bur at high speed with external irrigation.
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Occlusal view of crestal cut.
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Labial view of a crestal, horizontal and two vertical bony cuts prior to soft tissue closure of the surgical site.
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Sutured site.
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Post-operative radiograph.
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Second Visit: – three weeks after previous visit Pre-operative site.
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Retraction suture placed.
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Minimal reflection of the labial mucosa.
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Osteotomy being prepared with 2.0mm pilot bur rotating at 1100RPM.
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Paralleling pin seated in pilot osteotomy indicating its trajectory.
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Paralleling pins in each pilot osteotomy indicating their trajectories.
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Osteotomy being enlarged with an olive green 2.5mm latch reamer rotating at 50RPM without water irrigation.
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A chisel being applied onto the crest without reflecting the buccal periosteum .
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Osteotomy being enlarged with blue 3.5mm hand reamer with hand reamer extension rotating at 50RPM without water irrigation.
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Osteotomy being enlarged with red 4.0mm hand reamer with hand reamer extension rotating at 50RPM without water irrigation.
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View of osteotomies.
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Osteotomy being enlarged with silver 4.5mm hand reamer with hand reamer extension rotating at 50RPM without water irrigation.
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Harvested bone in the flute of a silver 4.5mm hand reamer attached to the hand reamer extension.
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A 4.5mm x 8.0mm HA coated implant being inserted with the black polyethylene healing plug.
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A 4.5mm x 8.0mm HA coated implant being inserted with the black polyethylene healing plug.
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A 4.5mm x 8.0mm HA coated implant being inserted with the black polyethylene healing plug.
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A 4.5mm x 8mm HA coated implant being inserted with the black polyethylene healing plug.
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View of seated implants with polyethylene healing plugs.
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Implant being tapped into place.
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View of seated implants with polyethylene healing plugs.
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Trimmed polyethylene healing plug being inserted into the seated implant.
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View of seated implants with their cut black polyethylene healing plugs.
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SynthoGraft™, pure phase Beta-Tricalcium Phosphate, mixed with patient’s blood being placed over the implant.
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SynthoGraft™, pure phase Beta-Tricalcium Phosphate, mixed with patient’s blood being placed over the implant.
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Bicon resorbable collagen membrane cut to size and placed so that its margains extend onto surrounding bone on its mesial, distal, and apical borders.
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Sutured site.
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Post-operative radiograph.
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Third Visit: – Thirteen weeks after previous visit View of operative site prior to the two stage uncovering and the making of a full arch implant level transfer impression.
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Flap being reflected.
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Healing plug being removed with a healing plug removal instrument.
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Healing plug being removed with a healing plug removal instrument.
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Healing plug being removed with a healing plug removal instrument.
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Implants being tested with periotest to indicate their integration.
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Guide pins inserted into integrated implants.
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Green 3.0mm impression reamer inserted onto guide pin to remove any tissue which might inhibit the complete seating of an impression post.
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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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Integrated Abutment Crowns™ on stone model.
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View of Integrated Abutment Crowns™.
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Twenty months post-insertion radiograph.
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Twenty months post-insertion view of Integrated Abutment Crowns™.
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