This case demonstrates a maxillary ridge split, two stage placement, uncovering, implant level transfer impression, and restoration with Bicon Integrated Abutment Crowns™ of two implants replacing congenitally missing lateral incisors.
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Preoperative radiograph of the congenitally missing right lateral incisor.
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Preoperative radiograph of the congenitally missing left lateral incisor.
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View of right preoperative site.
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View of left preoperative site.
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Preoperative smile.
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View of preoperative sites after the removal of orthodontic braces.
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View of maxillary preoperative sites.
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Initial incision.
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Osteotomy being prepared for the right lateral incisor implant with 2.0mm pilot bur rotating at 1100RPM with external irrigation.
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Osteotomy being prepared for the left lateral incisor implant with 2.0mm pilot bur rotating at 1100RPM with external irrigation.
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Parallel pins seated in pilot osteotomies indicating their trajectories.
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Osteotomy being enlarged with an olive green 2.5mm hand reamer.
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Harvested bone within the flute of an olive green 2.5mm hand reamer.
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Ridge being split by the use of blue 3.0mm Expanding Chisel.
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Ridge being split by the use of blue 3.0mm Expanding Chisel.
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Ridge being split by the use of sliver 4.5mm Expanding Chisel.
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Osteotomy being enlarged with a blue 3.5mm hand reamer.
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Osteotomy being enlarged with a red 4.0mm hand reamer.
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Osteotomy being enlarged with a red 4.0mm hand reamer.
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Curette harvesting residual bone while confirming the integrity of the five bony walls of the osteotomy.
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Curette harvesting residual bone while confirming the integrity of the five bony walls of the osteotomy.
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Osteotomy being prepared with a silver 4.5mm bone expander.
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A 4.5mm x 8.0mm HA coated implant being inserted into the osteotomy with an implant inserter/retriever.
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A 4.5mm x 8.0mm HA coated implant being inserted into the osteotomy with an implant inserter/retriever.
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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 shoulder of the implant.
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Post operative radiograph.
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Post operative radiograph.
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Second clinical visit. View of operative site prior to the two stage uncovering four months after the implant placement.
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View of the trimmed black polyethylene plug seated in the well of the implant.
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Healing plug being removed with a healing plug removal instrument.
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Green 3.0mm impression reamer being rotated on 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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Green 3.0mm plastic impression post receiving its mandatory seating tap.
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Healing plug being removed with a healing plug removal instrument.
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Green 3.0mm impression reamer being rotated on guide pin to remove any tissue which might inhibit the complete seating of an impression post.
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View of green 3.0mm plastic impression posts seated in the well of the implants.
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Impression material being injected around impression posts for the making of a full arch implant level transfer impression.
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Third clinical visit. Integrated Abutment Crowns™ on stone model with acrylic orientation jig.
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Facial view of Integrated Abutment Crowns™ on stone model.
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View of Integrated Abutment Crowns™.
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View of transitional prostheses prior to their removal for the insertion of Integrated Abutment Crowns™
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View of green 3.0mm plastic impression posts which were used as temporary abutments after the removal of transitional prostheses.
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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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View immediately after the insertion of right maxillary lateral Integrated Abutment Crown™.
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Right maxillary lateral Integrated Abutment Crown™ being adjusted.
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Yellow thermoplastic custom seating jig, which was 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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Green 3.0mm plastic impression post which was used as a temporary abutment is being removed.
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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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Floss being used to confirm the fact that the interproximal contacts are passive and will not interfere with the engagement of the locking taper.
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Diamond finishing strip being used to lighten the interproximal contact area eliminating the possibility that the contact may prevent the engagement of the locking taper connection
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Yellow thermoplastic custom seating jig, which was 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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Yellow thermoplastic custom seating jig, which was 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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Facial view immediately after the insertion of two Integrated Abutment Crowns™.
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Post operative radiograph after the insertion of the right maxillary lateral Integrated Abutment Crown™.
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Post operative radiograph after the insertion of the left maxillary lateral Integrated Abutment Crown™.
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View of Integrated Abutment Crown™ two weeks after being inserted.
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View of Integrated Abutment Crown™ two weeks after being inserted.
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View of Integrated Abutment Crowns™ two weeks after being inserted.
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Left profile two weeks post insertion of Integrated Abutment Crowns™.
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Right profile two weeks post insertion of Integrated Abutment Crowns™.
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Patient’s smile two weeks post insertion of Integrated Abutment Crowns™.
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