Restoration of a Maxillary Left Central Incisor with an e.max® CAD/CAM Crown

This case demonstrates the two-stage placement of a 4.5 x 8.0mm SHORT® Implant, its uncovering, implant-level transfer impression, and restoration for a maxillary left central incisor with an abutment with a titanium base and extra-orally cemented Zirconia coping abutment which was restored with a lithium disilicate crown.

SURGICAL: Two Stage Uncovering
TOPICS: CAD/CAM Impression
TAGS: Bicon Resorbable Collagen Membrane Extra-Oral Cementation

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1.

First Visit: Implant Placement. Pre-operative radiograph.

2.

Pre-operative site.

3.

Luxating previously endontically treated tooth.

4.

Extracting the root from the socket.

5.

Extracted tooth.

6.

Extraction site.

7.

Pilot osteotomy being drilled with a 2.0mm pilot drill.

8.

Osteotomy being enlarged with an olive green 2.5mm hand reamer attached to a threaded straight handle.

9.

Osteotomy being enlarged with a teal 3.0mm hand reamer attached to a threaded straight handle.

10.

Harvested bone in the flute of a blue 3.5mm hand reamer.

11.

Harvested bone in the flute of a magenta 4.0mm hand reamer.

12.

Harvested bone in the flute of a silver 4.5mm hand reamer.

13.

View of 4.5mm osteotomy.

14.

A 4.5 x 8.0mm Bicon SHORT® Implant being inserted into the osteotomy. For this case, we have selected the Bicon Integra-CP™ surface treatment.

15.

A blue 2.5mm seating tip on a threaded straight handle being used to definitely seat the implant into its osteotomy.

16.

Seated implant in its osteotomy.

17.

Trimmed polyethylene healing plug being inserted into the well of the seated implant with a #110 endodontic file.

18.

Patient’s harvested bone in dappen dish prior to being placed over the shoulder of the implant.

19.

Patient’s harvested bone being placed over the shoulder of the implant.

20.

View of bone over the shoulder of the implant.

21.

Cut Bicon Resorbable Collagen Plug being inserted.

22.

Sutured surgical site.

23.

Surgical site prior to fabricating a temporary pontic.

24.

View of temporary bonded pontic.

25.

Post-operative radiograph.

26.

Second Visit: Three months after the placement of 4.5 x 8.0mm Bicon SHORT® Implant. Radiograph prior to the uncovering of the 4.5 x 8.0mm Bicon SHORT® Implant.

27.

Temporary pontic being removed.

28.

Crestal incision being made.

29.

Healing plug being removed with a #110 endodontic file.

30.

Blue 2.5mm seated guide pin assessing the implant's trajectory and integration.

31.

Blue titanium impression post and acrylic sleeve in place prior to the making of a full arch implant level transfer impression.

32.

Impression material being injected around the blue impression sleeve for the making of a full arch implant level transfer impression.

33.

Blue 2.5mm impression sleeve within the full arch implant level transfer impression.

34.

A 4.0 x 6.5mm non-shouldered abutment being inserted in the well of the implant.

35.

Non-shouldered abutment after being gently tapped into the well of the implant.

36.

Third Visit: Extra-oral cementation of zirconia sleeve and Insertion of zirconia coping and e.max® crown one month after the uncovering of the 4.0 x 8.0mm Bicon SHORT® Implant. Applying Metal Coupler to the titanium abutment.