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.
RESTORATIVE: Integrated Abutment Crowns™
TOPICS: Congenitally Missing Laterals SynthoGraft™
TAGS: Bicon Resorbable Collagen Membrane
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Pre-operative radiograph of a congenitally missing right maxillary lateral incisor.
Pre-operative radiograph of a congenitally missing left maxillary lateral incisor.
View of congenitally missing maxillary lateral incisors.
Full thickness sulcular flap with vertical releases is being reflected at the area of the missing right maxillary lateral incisor.
Full thickness sulcular flap with vertical releases is being reflected at the area of the missing left maxillary lateral incisor.
Initial osteotomy for the right maxillary lateral incisor implant is being prepared with a 2.0mm pilot drill rotating at 1100RPM.
Initial osteotomy for the left maxillary lateral incisor implant is being prepared with a 2.0mm pilot drill rotating at 1100RPM.
Two gold paralleling pins are seated in the pilot osteotomies to indicate their trajectories. Note the black retraction sutures.
Osteotomy is being widened with a gray 2.5mm latch reamer rotating at 50RPM.
Harvested bone in the flute of a violet 4.0mm latch reamer.
4.0 x 6.0mm SHORT® Implant with a 2.5mm well on an inserter/retriever instrument is being inserted into the right osteotomy.
Implant is being definitively tapped with a blue 2.5mm seating tip on a straight driver.
Blue 2.5mm guide pin seated in the implant to confirm its appropriate trajectory.
Autogenous bone is being collected from the osteotomy with a spoon excavator.
View of seated 4.0 x 6.0mm SHORT® Implant with a 2.5mm well in the left osteotomy.
Implant is being definitively tapped with a blue 2.5mm seating tip on a straight driver.
Blue 2.5mm guide pin seated in the implant to confirm its appropriate trajectory.
Two blue 2.5mm guide pins seated in the implants to confirm their appropriate trajectories.
Black polyethylene healing plug is being inserted into its implant with a periodontal probe.
Black polyethylene healing plug is being inserted into its implant with a periodontal probe.
Harvested bone, kept separate from SynthoGraft™ material in the Dappen dish, is being collected.
Harvested bone is being placed over the implant to facilitate healing.
SynthoGraft™ material is placed over the harvested bone.
A collagen membrane is being placed over the SynthoGraft™ material.
4-0 chromic gut sutures were used to retain collagen membrane and SynthoGraft™ material.
Harvested bone is being pressed over the implant with a cotton tip applicator.
SynthoGraft™ material is being pressed over the harvested bone with a cotton tip applicator.
A collagen membrane is being placed over the SynthoGraft™ material.
View of 4-0 chromic gut sutures retaining the collagen membranes, SynthoGraft™ material, and harvested bone.
Leukocyte Platelet-Rich Fibrin (LPRF) membrane is being placed over the collagen membrane to facilitate healing.
Leukocyte Platelet-Rich Fibrin (LPRF) membrane is being placed over the collagen membrane to facilitate healing.
View of sutured sites.
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.
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.
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.
View of healed tissue and titanium temporary abutments prior to insertion of two Integrated Abutment Crowns™ (IACs).
View of sulci.
Custom thermoplastic seating jig on a straight driver is being used to definitively seat the right maxillary lateral incisor IAC.
Custom thermoplastic seating jig on a straight driver is being used to definitively seat the left maxillary lateral incisor IAC.
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.)
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.)
Profile view of the right maxillary lateral incisor IAC.
Profile view of the left maxillary lateral incisor IAC.
Patient's smile.
Two-month post-insertion view of two maxillary lateral incisor IACs.
Five-month post-insertion view of two maxillary lateral incisor IACs.
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