This case demonstrates the two-stage maxillary placement of four Bicon implants, uncovering, implant-level transfer impressions, the concept and clinical techniques for fabricating a maxillary and mandibular metal-free implant supported fixed TRINIA™ prosthesis on Bicon implants.
SURGICAL: Two Stage Uncovering
RESTORATIVE: Fixed
TOPICS: Impression TRINIA®
TAGS: Bicon Resorbable Collagen Membrane Metal-Free
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Second Visit: Maxillary placement. Pre-operative radiograph.
Pre-operative clinical image.
Initial incisions.
Mucosal flap reflection.
Pilot osteotomy being drilled with a 2.0mm pilot drill.
Paralleling pin seated in pilot osteotomy indicating its trajectory.
Harvested bone in the flute of an olive green 2.5mm latch reamer.
Osteotomy being enlarged with a teal 3.0mm hand reamer attached to a hand reamer extension.
Harvested bone in the flute of a blue 3.5mm hand reamer.
Osteotomy being enlarged with a magenta 4.0mm hand reamer attached to a hand reamer extension.
Osteotomy being enlarged with a gray 4.5mm hand reamer attached to a hand reamer extension.
Osteotomy being enlarged with a gold 5.0mm hand reamer attached to a hand reamer extension.
A 5.0 x 6.0mm Bicon implant being inserted into the osteotomy.
A 4.5 x 6.0mm Bicon implant with a 2.5mm well being inserted into the osteotomy.
Seated 5.0 x 6.0mm implant with polyethylene healing plug prior to the plug being cut.
Seated implants after polyethylene healing plugs have been cut.
Harvested bone being placed over the shoulder of an implant.
Bicon resorbable collagen membrane being placed over an implant and the bone.
Sutured surgical site.
Post-operative radiograph.
Third Visit: Three months after the placement of one maxillary 5.0 x 6.0mm and three 4.5 x 6.0mm implants. Radiograph prior to uncovering the implants.
View of surgical site prior to uncovering the implants.
Green 3.0mm impression posts in place before the making of a full arch implant level transfer impression.
Impression material being injected around the green impression sleeves for the making of a full arch implant level transfer impression.
Green impression sleeves within the full arch implant level transfer impression.
White healing abutment being tapped into place in the well of the implant.
White healing abutments seated in the implant wells.
View of surgical site prior to uncovering of the implants.
Uncovering a mandibular implant.
Black healing plug being removed.
Green 3.0mm and blue 2.5mm seated guide pins being used to assess the trajectory of the four integrated Bicon implants.
A blue 2.5mm titanium impression post with an acrylic sleeve being seated into an implant well.
Impression material being injected around the impression sleeves for the making of a full arch implant level transfer impression.
Green and blue impression sleeves within the full arch implant level transfer impression.
White healing abutment being inserted into the well of an implant.
White healing abutment being tapped into place.
White healing abutments seated in the implant wells.
Fourth Visit: Bite registration. White plastic healing abutment being removed.
Green 3.0mm impression post being placed into the implant well.
Green 3.0mm and blue 2.5mm impression posts in place.
View of wax rim prior to recording an occlusal registration.
Bite registration being made.
Bite registration being made.
Fifth Visit: Insertion. Mirrored view of the maxillary TRINIA™ fiber reinforced prosthesis prior to its being inserted.
Mirrored view of the maxillary ridge side of the TRINIA™ prosthesis.
Mirrored view of the mandibular TRINIA™ fiber reinforced prosthesis prior to its being inserted.
Mirrored view of the mandibular ridge side of the TRINIA™ prosthesis.
White plastic healing abutments being removed prior to the insertion of the mandibular TRINIA™ prostheses.
Vaseline™ being applied to stabilize the partially seated abutments within the prosthesis as they are transported intra-orally to their corresponding implant wells.
TRINIA™ prosthesis with four incompletely seated abutments being transported to the mouth.
Abutments being initially seated by tapping on the prosthesis with a white plastic healing abutment attached to a threaded straight handle.
View of four milled abutments after the removal of the TRINIA™ prosthesis.
A milled abutment being definitively seated into the well of its implant.
Vaseline™ being applied to the ridge area of the TRINIA™ prosthesis to facilitate the removal of any extraneous cement.
Minimal resin cement being applied to the bores of the mandibular TRINIA™ prosthesis.
Extraneous cement being removed.
Mandibular TRINIA™ prosthesis after being permanently cemented.
White plastic healing abutment being removed prior to the insertion of the maxillary TRINIA™ prosthesis.
A gold 5.0mm sulcus reamer being used to remove any excess tissue above the implant to facilitate the seating of the milled abutment.
TRINIA™ prosthesis with four incompletely seated abutments being transported to the mouth.
Abutments being initially seated by tapping on the prosthesis with a white plastic healing abutment attached to a threaded straight handle.
View of four milled abutments after the removal of the TRINIA™ prosthesis.
Minimal cement being applied to the bores of the mandibular TRINIA™ prosthesis.
Maxillary TRINIA™ prosthesis after being permanently cemented.
Facial view of TRINIA™ prostheses after being permanently cemented.
Post-insertion radiograph.
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