Placement and Restoration of a 4.0 x 8.0mm Bicon SHORT® Implant for a Maxillary Left Central Incisor in a 17-Year-Old Female Adolescent
Posted on February 3, 2020
This treatment demonstrates the placement and restoration of a 4.0 x 8.0mm Bicon SHORT® Implant for a female adolescent’s maxillary left central incisor, including the full-arch implant-level transfer impression, laboratory fabrication, insertion, and intraoral modification of an Integrated Abutment Crown™ (IAC), and post-insertion labial frenectomy.
RESTORATIVE: Integrated Abutment Crowns™ TOPICS: Adolescent Patients Impression TAGS: Laboratory fabrication
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1. Pre-operative radiograph of a non-restorable maxillary left central incisor.
2. Pre-operative radiograph two-and-a-half months after extraction.
3. Patient's pre-operative smile.
4. FIRST VISIT: Pre-operative site.
5. View of the initial papilla-sparing incision.
6. Patient's blood being collected for later use.
7. 2.0mm Pilot Drill being used to intiate the osteotomy.
8. 2.0mm Paralleling Pin seated in the pilot osteotomy, indicating the position and trajectory of the intended implant.
9. Bone collected in the flute of a light yellow 2.5mm Hand Reamer attached to a Threaded Instrument Adapter.
10. Bone collected in the flute of a teal 3.0mm Hand Reamer attached to a Threaded Instrument Adapter.
11. Bone collected in the flute of a blue 3.5mm Hand Reamer attached to a Threaded Straight Handle.
12. Magenta 4.0mm Bone Expander being inserted into the osteotomy to expand the labial bone.
13. Bone collected in the flute of a magenta 4.0mm Hand Reamer attached to a Threaded Straight Handle.
14. 4.0 x 8.0mm Bicon SHORT® Implant being transported to its prepared osteotomy with a blue 2.5mm Inserter/Retriever instrument.
15. Blue 2.5mm Implant Seating Tip being inserted into the well of the implant to definitively seat it.
16. Blue 2.5mm Guide Pin seated in the well of the implant, indicating its trajectory.
17. Trimmed polyethylene healing plug being inserted into the well of the implant.
18. Harvested autogenous bone being placed over the implant.
19. Facial view of the sutured site.
20. Post-operative radiograph of the 4.0 x 8.0mm Bicon SHORT® Implant.
21. SECOND VISIT: Four-month post-operative radiograph of the 4.0 x 8.0mm Bicon SHORT® Implant with its winged temporary TRINIA® prosthesis.
22. View of the retrieved healing plug on a Healing Plug Removal Instrument.
23. Blue 2.5mm Guide Pin seated in the well of the implant, confirming its osseointegration and trajectory.
24. Magenta 4 Series Sulcus Former being rotated on the Guide Pin to remove tissue and shape the implant's sulcus.
25. Blue 2.5mm Impression Post seated in the well of the implant for the making of a full-arch implant-level transfer impression.
26. Blue Impression Sleeve seated on its corresponding Impression Post.
27. Impression material being injected around the Impression Post and Sleeve.
28. View of the blue Impression Sleeve captured within a full-arch implant-level transfer impression.
29. Occlusal registration material being injected around an Impression Post and Sleeve for the recording of the occlusal registration.
30. 4.0 x 6.5mm Temporary Abutment being inserted into the well of the implant.
31. Facial view of the seated 4.0 x 6.5mm Temporary Abutment.
32. Post-operative radiograph of the 4.0 x 8.0mm Bicon SHORT® Implant with its 4.0 x 6.5mm Temporary Abutment.
33. LABORATORY PHASE: Blue 2.5mm Implant Analog seated in its blue Impression Sleeve captured within the full-arch implant-level transfer impression.
34. 5 Series Extra-Tall Universal Abutment seated in a soft tissue stone model.
35. Modified 5 Series Extra-Tall Universal Abutment seated in a soft tissue stone model.
36. Opaqued 5 Series Extra-Tall Universal Abutment seated in a stone model.
37. Layers of Ceramage composite material built up over the 5 Series Extra-Tall Universal Abutment.
38. Oxygen barrier being applied to the Ceramage composite material prior to being light-cured.
39. Pencil markings indicating anatomical lines to be applied.
40. Blue markings indicating surface texture.
41. Fine-grit, silicone acrylic polisher being used to polish the crown.
42. Silicone bristle brush being used to polish the Integrated Abutment Crown™ (IAC).
43. Soft goat hair brush being used to polish the crown.
44. Crown Alignment Device being used to fabricate a custom Hydroplastic Resin seating jig.
45. Custom Hydroplastic Resin orientation jig seated on the IAC in a soft tissue model.
46. THIRD VISIT: Facial view of the 4.0 x 6.5mm Temporary Abutment prior to its removal.
47. 4.0 x 6.5mm Temporary Abutment being removed from the well of the implant with a rongeur.
48. Magenta 4 Series Sulcus Former being rotated on a blue 2.5mm Guide Pin to remove excess tissue and shape the implant's sulcus.
49. IAC being inserted into the well of the implant with rubber-tipped pliers.
50. Custom Hydroplastic Resin orientation jig seated on the IAC and adjacent teeth to facilitate its appropriate positioning.
51. Dental floss being used to confirm passive mesial contact.
52. Dental floss being used to confirm passive distal contact.
53. Custom Hydroplastic Resin seating jig in a Crown Seating Tip being used to definitively tap the IAC in the direction of the long axis of the implant.
54. Diamond bur being used to roughen the surface of the IAC prior to the intraoral modification of its shade.
55. Bonding agent being applied to the IAC.
56. Ceramage composite material being added to the IAC.
57. Ceramage composite material being shaped with a spatula.
58. Oxygen barrier being applied to the IAC.
59. Modified IAC being light-cured.
60. Dental floss being used to reassess the mesial contact.
61. Dental floss being used to reassess the distal contact.
62. Medium-grit, pointed universal polisher being used to polish the modified IAC.
63. Fine-grit, pointed universal polisher being used to polish the modified IAC.
64. Silicone bristle brush being used to polish the modified IAC.
65. Soft goat hair brush being used to polish the modified IAC.
66. Post-insertion view of the polished IAC.
67. Post-insertion view of the polished IAC with a black Shade Enhancer prior to a labial frenectomy.
68. Patient's post-insertion smile.
69. Post-insertion radiograph of the IAC with its 4.0 x 8.0mm Bicon SHORT® Implant.
70. FOURTH VISIT: Incision being made for a labial frenectomy one day after the insertion of the IAC.
71. Incision being widened with scissors.
72. Incision being widened with carbide tips.
73. Muscle attachment being removed.
74. Incision being made where the frenum meets the soft tissue.
75. Scissors being used to free more of the muscle attachment.
76. Scissors being used to snip more of the muscle attachment.
77. View of the finished frenectomy.
78. Surgical site being sutured with controlled retraction of the lip.
79. View of the sutured site.
80. Laser being used to coagulate the site.
81. Post-operative view.
82. FIFTH VISIT: One-day post-operative view.
83. SIXTH VISIT: Three-week post-operative view of the healed frenum.
84. Three-week post-insertion view of the IAC.
85. SEVENTH VISIT: Three-month post-operative view of the healed frenum.
86. Three-month post-insertion view of the IAC.
87. Three-month post-insertion view of the IAC with its 4.0 x 8.0mm Bicon SHORT® Implant.
