This case demonstrates the two-stage placement, uncovering, implant-level transfer impression, and restoration of a congenitally missing right lateral incisor with a Bicon Integrated Abutment Crown™ and a veneer on the maxillary right canine to achieve an aesthetic result.
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Osteotomy being prepared with 2.0mm pilot bur rotating at 1100RPM with external irrigation.
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Osteotomy being enlarged with an olive green 2.5mm latch reamer. Reamers are used at 50RPM without water irrigation.
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Osteotomy being enlarged with a teal 3.0mm latch reamer. Reamers are used at 50RPM without water irrigation.
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Harvested bone in the flute of a blue 3.5mm latch reamer. Reamers are used at 50RPM without water irrigation.
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Harvested bone in the flute of a red 4.0mm hand reamer. Reamers are used at 50RPM without water irrigation.
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Harvested bone in the flute of silver 4.5mm hand reamer. Reamers are used at 50RPM without water irrigation.
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Curette harvesting residual bone while confirming the integrity of the five bony walls of the osteotomy.
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A 4.5 x 6.0mm HA coated implant being inserted into the osteotomy with an implant inserter/retriever.
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Implant seating tip attached to a straight handle which will be tapped to definitively seat implant into the osteotomy.
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View of seated implant with polyethylene healing plug.
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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 seated implant.
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Sutured site.
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Post-operative radiograph.
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Second Visit: Four months after previous visit View of existing bonded Maryland bridge.
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View after removal of Maryland bridge.
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Healing plug being removed with healing plug removal instrument.
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Green 3.0mm impression reamer being rotated on a 3.0mm standard guide pin to remove any tissue which might inhibit the complete seating of an impression post.
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Green 3.0mm plastic impression post being inserted into the 3.0mm well of an integrated implant for the making of an implant-level transfer impression.
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Impression post being gently tapped into place to assure its proper seating.
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Impression material being injected around the impression post for the making of a full arch implant-level transfer impression.
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Third Visit: Three weeks after previous visit View of Integrated Abutment Crown™ and veneer on a stone model.
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View of Integrated Abutment Crown™. Note the fact the the hemisphical base of the abutment is not covered by composite material.
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Removal of transitional prosthesis.
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Veneer try-in.
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Well of implant being cleaned with alcohol on a cotton-tipped applicator.
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Integrated Abutment Crown™ being inserted.
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Integrated Abutment Crown™ after initial insertion.
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Roughening of surfaces prior to veneer bonding.
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Etchant being applied in preparation for the bonding of the veneer.
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Bonding material being applied.
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Light curing of bonding material.
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Bonding material being applied to the veneer prior to its bonding.
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Veneer being cemented.
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Light curing of bonding material.
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Removal of excess bonding material.
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Cervical aspect of the Integrated Abutment Crown™ being modified with 7408 carbide finishing bur.
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Cervical surface of the Integrated Abutment Crown™ being polished with a gray acrylic polishing wheel.
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Diamond finishing strip being used to lighten the interproximal contact area eliminating the possibility that the tight contact may prevent the engagement of the locking taper connection.
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Well of implant being cleaned with alcohol on a cotton-tipped applicator.
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Yellow thermoplastic custom seating jig (formed with a crown alignment device) in a crown seating tip attached to a straight handle facilitates directing the tapping forces in the long axis of the abutment post and implant well.
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Integrated Abutment Crown™ being modified with 7408 carbide finishing bur after verification of appropriate incisal contacts.
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Facial view immediately after the definitive seating of the Integrated Abutment Crown™.
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Post-insertion radiograph.
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View of Integrated Abutment Crown™ one month post-insertion.
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Facial view of Integrated Abutment Crown™ one month post-insertion.
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Right profile view of Integrated Abutment Crown™ one month post-insertion.
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Left profile view of Integrated Abutment Crown™ one month post-insertion.
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Patient’s smile one month post-insertion.
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Integrated Abutment Crown™ one year post-insertion.
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Right profile view of Integrated Abutment Crown™ one year post-insertion.
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Right profile view of Integrated Abutment Crown™ in occlusion one year post-insertion.
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