Placement of Two 4.5 x 8.0mm Bicon SHORT® Implants and their Restoration with a Two-Unit and a Single Integrated Abutment Crown™ (IAC) for Two Congenitally Missing Maxillary Lateral Incisors and a Right Canine
This treatment demonstrates the extraction of a deciduous maxillary right lateral incisor and its replacement with a 4.5 x 8.0mm Bicon SHORT® Implant adjacent to a congenitally missing canine, as well as bone grafting with SynthoGraft™ in the area of a congenitally missing maxillary left lateral incisor. The placement, six months later, of a 4.5 x 8.0mm Bicon SHORT® Implant in the area of the maxillary right lateral incisor is also shown, as well as the uncovering of the two implants, their full-arch implant-level transfer impression, and their restoration with a two-unit and a single Integrated Abutment Crown™ (IAC).
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Pre-operative radiograph of a congenitally missing maxillary right canine and a deciduous lateral incisor.
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Deciduous tooth being luxated.
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Deciduous tooth being extracted.
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Facial flap being elevated.
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Retraction suture being placed to facilitate visibility of the surgical site.
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2.0mm Pilot Drill being rotated at 1100RPM with irrigation to initiate the osteotomy.
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Gold Paralleling Pin seated in the pilot osteotomy to indicate the trajectory of the intended implant.
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Light yellow 2.5mm Hand Reamer attached to a Threaded Instrument Adapter being rotated at 50RPM to widen the osteotomy.
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Teal 3.0mm Hand Reamer attached to a Threaded Instrument Adapter being rotated at 50RPM to widen the osteotomy.
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Blue 3.5mm Hand Reamer attached to a Threaded Instrument Adapter being rotated at 50RPM to widen the osteotomy.
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Autogenous bone collected in the flute of the blue 3.5mm Hand Reamer, which will be used later for grafting over the implant.
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Autogenous bone collected on a Curette, which will be used later for grafting over the implant.
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Magenta 4.0mm Hand Reamer attached to a Threaded Instrument Adapter being rotated at 50RPM to widen the osteotomy.
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Gray 4.5mm Hand Reamer attached to a Threaded Instrument Adapter being rotated at 50RPM to widen the osteotomy.
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Gray 4.5mm Hand Reamer on a Threaded Straight Handle being manually rotated to gently widen the osteotomy while maintaining the integrity of its floor and walls.
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Blue 2.5mm Implant Inserter/Retriever being used to transport a 4.5 x 8.0mm Bicon SHORT® Implant to its prepared osteotomy.
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Blue 2.5mm Guide Pin being inserted into the well of the implant to confirm its trajectory, and if necessary, adjust it.
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Cut polyethylene Healing Plug being inserted into the well of the implant.
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Harvested bone being placed over the implant.
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Resorbable Collagen Plug being placed over the implant to facilitate healing.
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Post-operative radiograph of the 4.5 x 8.0mm Bicon SHORT® Implant in the area of the congenitally missing maxillary right canine and lateral incisor.
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Pre-operative radiograph of a congenitally missing maxillary left lateral incisor.
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Crestal incision being made.
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Facial flap being elevated.
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Facial bone defect being scraped of soft tissue prior to bone grafting with SynthoGraft™.
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Bur being used to perforate the cortical bone to facilitate bleeding for the healing of the bone graft.
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View of harvested bone and SynthoGraft™ in a Dappen Dish, which will be used with the patient's blood for the bone graft.
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SynthoGraft™ mixed with the patient's blood being placed over the bone defect.
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View of the SynthoGraft™ and harvested bone graft.
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Collagen Membrane being sutured over the SynthoGraft™ and harvested bone graft to stabilize it.
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View of the sutured Collagen Membrane.
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Surgical site being sutured.
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Post-operative radiograph of the SynthoGraft™ and harvested bone graft.
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Post-operative view of the sutured surgical sites.
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Winged TRINIA® temporary prosthesis being seated prior to its cementation.
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Resin cement being applied to cement the winged TRINIA® temporary prosthesis to the adjacent teeth.
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Six-month post-operative facial view of the winged TRINIA® temporary prosthesis.
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Six-month post-operative palatal view of the winged TRINIA® temporary prosthesis.
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Gray 4.5mm Osteotome being used to mark the site of the intended implant.
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View of the marked tissue.
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Incision being made.
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Facial flap being elevated.
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Retraction suture being placed to facilitate visibility of the surgical site.
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2.0mm Pilot Drill being rotated at 1100RPM with irrigation to initiate the osteotomy.
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Gold Paralleling Pin seated in the pilot osteotomy to indicate the trajectory of the intended implant.
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Light yellow 2.5mm Hand Reamer attached to a Threaded Instrument Adapter being rotated at 50RPM to widen the osteotomy.
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Teal 3.0mm Hand Reamer attached to a Threaded Instrument Adapter being rotated at 50RPM to widen the osteotomy.
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Blue 3.5mm Hand Reamer attached to a Threaded Instrument Adapter being rotated at 50RPM to widen the osteotomy.
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Autogenous bone collected on a Curette to be used later for grafting over the implant.
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Magenta 4.0mm Hand Reamer attached to a Threaded Instrument Adapter being rotated at 50RPM to widen the osteotomy.
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Autogenous bone collected in the flute of the magenta 4.0mm Hand Reamer to be used later for grafting over the implant.
52.
Gray 4.5mm Hand Reamer on a Threaded Straight Handle being manually rotated to gently widen the osteotomy while maintaining the integrity of its floor and walls.
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Blue 2.5mm Implant Inserter/Retriever being used to transport a 4.5 x 8.0mm Bicon SHORT® Implant to its prepared osteotomy.
54.
Blue 2.5mm Guide Pin being inserted into the well of the implant to confirm its trajectory, and if necessary, adjust it.
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View of the seated blue 2.5mm Guide Pin confirming the implant’s trajectory.
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Cut polyethylene Healing Plug being inserted into the well of the implant with a periodontal probe.
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SynthoGraft™ mixed with the patient's blood being placed over a bone defect.
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Harvested bone being placed over the bone defect.
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Collagen Membrane being placed over the bone graft to stabilize it.
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View of the sutured Collagen Membrane.
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Releasing incision being made to facilitate closure of the flap over the surgical site.
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View of the surgical site prior to closure of the flap.
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Surgical site being sutured.
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Post-operative view of the sutured surgical site.
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Post-operative radiograph of the 4.5 x 8.0mm Bicon SHORT® Implant in the area of the congenitally missing maxillary left lateral incisor.
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Radiograph of the 4.5 x 8.0mm Bicon SHORT® Implant in the area of the congenitally missing maxillary canine and right lateral incisor prior to its uncovering, seven months after its placement.
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Incision being made to uncover the implant.
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Minimal tissue being removed to uncover the implant.
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Minimal bone being removed with a teal 3.0mm Hand Reamer to uncover the implant.
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Healing Plug Removal Instrument being used to retrieve the polyethylene Healing Plug from the implant.
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Blue 2.5mm Guide Pin being inserted into the well of the implant to confirm its osseointegration and trajectory.
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Magenta 4.0mm Sulcus Former being rotated on the Guide Pin to remove tissue to shape the implant’s sulcus.
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Gold 5.0mm Sulcus Former being rotated on the Guide Pin to remove tissue to shape the implant’s sulcus.
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Tissue collected on the blade of the gold 5.0mm Sulcus Former.
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Blue 2.5mm Impression Post seated in the well of the implant for the making of a full-arch implant-level transfer impression.
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Blue Impression Sleeve seated on its corresponding Impression Post for the making of a full-arch implant-level transfer impression.
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Impression material being injected around the Impression Post and Sleeve.
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Titanium Temporary Abutment being inserted into the well of the implant.
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Radiograph of the 4.5 x 8.0mm Bicon SHORT® Implant in the area of the congenitally missing maxillary left lateral incisor prior to its uncovering, ten months after its placement.
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Blue Impression Sleeve seated on its corresponding Impression Post for the making of a full-arch implant-level transfer impression.
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Impression material being injected around the Impression Post and Sleeve.
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View of the titanium Temporary Abutment prior to its removal for the insertion of a two-unit Integrated Abutment Crown™ (IAC).
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Abutment Removal Forceps being used to remove the titanium Temporary Abutment from its implant.
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Two-unit IAC being inserted into its implant.
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Hydroplastic Resin orientation jig being used to appropriately position the two-unit IAC.
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Custom Hydroplastic Resin seating jig in a Crown Seating Tip being used to definitively tap the two-unit IAC in the long axis of its implant.
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Post-insertion view of the two-unit IAC. Note how the soft tissue will cover the exposed metal in time!
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Temporary crown, fabricated from a Temporization Sleeve and acrylic, being removed from a 4 Series Tall Profile Universal Abutment.
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4 Series Tall Profile Universal Abutment being removed from its implant.
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View of the implant's sulcus.
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Single IAC being inserted into its implant.
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Hydroplastic Resin orientation jig being used to appropriately position the IAC.
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Dental floss being used to verify appropriate mesial contact.
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Dental floss being used to verify appropriate distal contact.
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Custom Hydroplastic Resin seating jig in a Crown Seating Tip being used to definitively tap the IAC in the long axis of its implant.
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Post-insertion view of the single IAC and four-month post-insertion view of the two-unit IAC.
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Post-insertion radiograph of the two-unit IAC with its 4.5 x 8.0mm Bicon SHORT® Implant.
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Post-insertion radiograph of the single IAC with its 4.5 x 8.0mm Bicon SHORT® Implant.
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Six-month post-insertion view of the single IAC and ten-month post-insertion view of the two-unit IAC.
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Six-month post-insertion view of the single IAC and ten-month post-insertion view of the two-unit IAC.
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