This case demonstrates the placement of two immediately stabilized maxillary bicuspid implants as well as the fabrication of their transitional stabilization prosthesis, implant level transfer impression, and the insertion of two Integrated Abutment Crowns™.
SURGICAL: Immediate Stabilization and Function
RESTORATIVE: Integrated Abutment Crowns™
TOPICS: Crestal Relieving Incision Impression
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View of failed three unit fixed bridge.
Radiograph of failed root canal treated tooth and failed three unit prosthesis.
Labial view of edentulous ridge.
Occlusal view of ridge after placement of pilot marking holes using a palatal template.
2.0mm pilot drill preparing osteotomy in same trajectory as indicated by paralleling pin in first bicuspid osteotomy.
paralleling pins indicating trajectory of initial osteotomies.
Reamer preparing osteotomy.
Harvested bone being removed from osteotomy.
Reamer enlarging diameter of osteotomy at 50RPM without water irrigation.
Reamer preparing first bicuspid osteotomy.
Harvested bone being collected in dappen dish.
Occlusal view of osteotomy prior to insertion of the implant.
Implant being seated in osteotomy with the implant inserter / retriever instrument.
A 4.5 x 8.0mm HA coated implant being inserted into the second bicuspid osteotomy.
Knurled knob is being held as the straight handle driver is turned displacing the implant from the implant inserter / retriever instrument.
Two guide pins seated in the well of an implant indicating their trajectory.
Shoulder depth gauge seated in the well of the implant facilitating the selection of an abutment with an appropriate shoulder height.
A 5.0mm x 6.0mm shouldered abutment being inserted into first bicuspid implant.
Labial view of two 5.0mm wide shouldered abutments.
A tall one-piece acrylic sleeve seated on second bicuspid abutment.
Suturing of mucosa around one-piece acrylic sleeve.
Suturing of mucosa around one-piece acrylic sleeve.
Sutured mucosa.
Two reduced tall one-piece acrylic sleeves seated on abutments.
Light curing of bonding agent on sleeves.
Transitional composite material, Integrity by Dentsply being injected onto acrylic one-piece sleeves forming a strut.
Hardened composite strut.
Reduction of composite strut to accommodate vacuum formed template.
Occlusal portion only of vacuum formed template being filed with transitional composite material, Integrity by Dentsply.
Vacuum formed template in place forming transitional stabilization prosthesis.
Polished transitional stabilization prosthesis bonded in place.
Radiograph of a 5.0 x 6.0mm and a 5.0 x 2.0mm shouldered abutment seated with only finger pressure in the well of their implant.
Labial view after the removal of transitional stabilization prosthesis.
White 3.0mm impression post being inserted into second bicuspid implant.
Impression post being inserted into first bicuspid implant.
Impression post receiving mandatory tap to achieve definitive seating.
Impression material being injected around impression posts for the making of an implant level transfer impression.
Two bicuspid Integrated Abutment Crowns™ on stone model.
Clear acrylic orientation jig on model.
Mirror view of two Integrated Abutment Crowns™.
Transitional prosthesis prior to its removal.
Shouldered abutments after removal of transitional prosthesis.
Implant wells and soft tissue sulci after removal of finger pressure seated shouldered abutments.
First bicuspid Integrated Abutment Crown™ being inserted into implant well.
Oblique crestal relieving incision being made to facilitate the seating of Integrated Abutment Crown™.
Papilla being elevated to facilitate the seating of Integrated Abutment Crown™.
Integrated Abutment Crown™ being inserted into implant well.
Orientation jig facilitating the seating of the Integrated Abutment Crown™.
Seated first bicuspid Integrated Abutment Crown™.
Initial seating tap being made with orientation jig.
Oblique crestal relieving incision being made to facilitate the seating the second bicuspid Integrated Abutment Crown™.
Insertion of the second bicuspid Integrated Abutment Crown™.
Orientation jig facilitating the seating of the Integrated Abutment Crown™
Occlusal view of the two Integrated Abutment Crowns™.
Definitive seating of first bicuspid Integrated Abutment Crown™ is achieved with a white temporary abutment in a straight driver.
Definitive seating of second bicuspid Integrated Abutment Crown™.
Radiograph of seated Integrated Abutment Crowns™.
Buccal view of two seated Integrated Abutment Crowns™.
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