This treatment demonstrates the placement of two 4.0 x 6.0mm SHORT® Implants for the replacement of congenitally missing maxillary lateral incisors using harvested autogenous bone, SynthoGraft™ (a pure phase beta-tricalcium phosphate), collagen membranes, and leukocyte platelet-rich fibrin (LPRF) membranes.
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Pre-operative radiograph of a congenitally missing right maxillary lateral incisor.
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Pre-operative radiograph of a congenitally missing left maxillary lateral incisor.
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View of congenitally missing maxillary lateral incisors.
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Full thickness sulcular flap with vertical releases is being reflected at the area of the missing right maxillary lateral incisor.
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Full thickness sulcular flap with vertical releases is being reflected at the area of the missing left maxillary lateral incisor.
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Initial osteotomy for the right maxillary lateral incisor implant is being prepared with a 2.0mm pilot drill rotating at 1100RPM.
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Initial osteotomy for the left maxillary lateral incisor implant is being prepared with a 2.0mm pilot drill rotating at 1100RPM.
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Two gold paralleling pins are seated in the pilot osteotomies to indicate their trajectories. Note the black retraction sutures.
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Osteotomy is being widened with a gray 2.5mm latch reamer rotating at 50RPM.
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Harvested bone in the flute of a violet 4.0mm latch reamer.
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4.0 x 6.0mm SHORT® Implant with a 2.5mm well on an inserter/retriever instrument is being inserted into the right osteotomy.
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Implant is being definitively tapped with a blue 2.5mm seating tip on a straight driver.
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Blue 2.5mm guide pin seated in the implant to confirm its appropriate trajectory.
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Autogenous bone is being collected from the osteotomy with a spoon excavator.
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View of seated 4.0 x 6.0mm SHORT® Implant with a 2.5mm well in the left osteotomy.
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Implant is being definitively tapped with a blue 2.5mm seating tip on a straight driver.
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Blue 2.5mm guide pin seated in the implant to confirm its appropriate trajectory.
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Two blue 2.5mm guide pins seated in the implants to confirm their appropriate trajectories.
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Black polyethylene healing plug is being inserted into its implant with a periodontal probe.
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Black polyethylene healing plug is being inserted into its implant with a periodontal probe.
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Harvested bone, kept separate from SynthoGraft™ material in the Dappen dish, is being collected.
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Harvested bone is being placed over the implant to facilitate healing.
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SynthoGraft™ material is placed over the harvested bone.
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A collagen membrane is being placed over the SynthoGraft™ material.
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4-0 chromic gut sutures were used to retain collagen membrane and SynthoGraft™ material.
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Harvested bone is being pressed over the implant with a cotton tip applicator.
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SynthoGraft™ material is being pressed over the harvested bone with a cotton tip applicator.
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A collagen membrane is being placed over the SynthoGraft™ material.
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View of 4-0 chromic gut sutures retaining the collagen membranes, SynthoGraft™ material, and harvested bone.
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Leukocyte Platelet-Rich Fibrin (LPRF) membrane is being placed over the collagen membrane to facilitate healing.
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Leukocyte Platelet-Rich Fibrin (LPRF) membrane is being placed over the collagen membrane to facilitate healing.
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View of sutured sites.
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Post-operative radiograph immediately after placement of a 4.0 x 6.0mm SHORT® Implant in the area of the missing right maxillary lateral incisor.
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Post-operative radiograph immediately after placement of a 4.0 x 6.0mm SHORT® Implant in the area of the missing left maxillary lateral incisor.
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Five-month post-placement view of titanium temporary abutments after the uncovering of the implants and the making of a full arch implant-level transfer impression.
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View of healed tissue and titanium temporary abutments prior to insertion of two Integrated Abutment Crowns™ (IACs).
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View of sulci.
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Custom thermoplastic seating jig on a straight driver is being used to definitively seat the right maxillary lateral incisor IAC.
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Custom thermoplastic seating jig on a straight driver is being used to definitively seat the left maxillary lateral incisor IAC.
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Complete seating of the right maxillary lateral incisor IAC is confirmed with a post-insertion radiograph. (For implants with a 2.5mm well, the gray bar of negative space should be no larger than one fin of the implant.)
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Complete seating of the left maxillary lateral incisor IAC is confirmed with a post-insertion radiograph. (For implants with a 2.5mm well, the gray bar of negative space should be no larger than one fin of the implant.)
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Profile view of the right maxillary lateral incisor IAC.
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Profile view of the left maxillary lateral incisor IAC.
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Patient's smile.
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Two-month post-insertion view of two maxillary lateral incisor IACs.
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Five-month post-insertion view of two maxillary lateral incisor IACs.
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