Placement of Bicon SHORT® Implant after a Ridge Split and Uncovering of a Bicon SHORT® Implant

Hello and welcome everyone to the latest version of the Bicon Surgical Webcast. Today’s program will consist of the placement of one implant in a mandibular ridge split. We will open the implant so that we will use it for guidance. So the idea is to develop the flap entirely toward the lingual. With the guide pin, we will do two things. First, we will check integration. As you can see, I can move the whole head. It doesn’t move relative to the bone, to the jaw. Okay? And we will keep it in there now. This will serve as a guide. So now to make sure that it’s separated, we’re going to use a curved coronal chisel. Place it in. And give it a few taps. This is about five millimeters so it will go probably a width and a half. Or it might, a shadow that’s making it hard for you to see. There we go. It just separated. That’s the whole idea. And see how I can now spread it. Okay and here it is. On the mesial followed by one on the distal. The idea is to allow for the buccal plate to escape any drilling by directly going in and drilling in the at the bottom. Now I’m at a depth of about six millimeters. Okay? Fine, that’s one millimeter only so it doesn’t really sit in it that securely. So, it appears to be pretty close to the bicuspid but it really is not. Alright? It’s sort of in the middle of that space. So my goal is to go to a depth of roughly eight, which is where we are now. And roughly now about ten. So that gives me about an extra millimeter of leeway if the crestal bone were to atrophy because of lack of blood supply at the very crest, we’ll lose about a millimeter or so. Okay? As soon as you find the base, this will engage. It will go in very smoothly. My goal is to get to about four and a half millimeters. This is a three millimeter latch reamer. Gingerly and very slowly we’re gonna go in. Notice the buccal plate is bouncing off, not being drilled at all, nor is the lingual plate because there’s no resistance offered. Until we get to the basal layer, we have no reaming taking place, just spreading of the already split bone. This is a three and a half. We are now at a depth of about seven millimeters. We are eight to eleven millimeters in depth. Let’s go to the hand reamers mounted on the adapter. You have to be careful when using the hand reamers not to apply too much pressure because they have an offset lip at the tip that can make them deepen your osteotomy even if you don’t want to. So don’t press too hard. We are almost there. Okay. Before we go to the final size, we’ll take a curette. And again, you want to see it smoothly going from undisturbed, unsplit bone to the split bone without a gap in the middle. Okay? And we’re doing the final size. This is a four and a half millimeter reamer and it’s going to be bouncing a little bit until we get into the apical osteotomy which is about now. Alright, here we go. And we’re almost there. We can speed up a little bit more now. Maximum speed is fifty RPM of course. I’m going to take a four and a half by six. Good. Alright. There’s a lot of little things taking place and a lot of little things that have to fit in a very tight space. I will not need to seat it with tapping at all. I will just grab the implant by pushing the plate against it. Then instead of cutting the plug in the mouth, I will twist it a little bit so it comes out. Before I go any further, I will take the shoulder depth gauge to see at what depth did I place it. Because I can see the soft tissues already and this is between two and four millimeters shoulder and that will be perfect for the restoration. If you look closely, you see that below the lips of the cutter there’s a bit of a mark. That’s the top of the implant. Okay? I’m just going to cut just above that. You can put the suction on it. Good, thank you. It still flies sometimes. Alright, we’ll use a regular perio probe and we’ll place this plug in place in position. And the reason why I’m using a new one because I think I beat it up a little bit more than I wanted to when I was removing it. This is all of the bone that we collected from this osteotomy. We will remove the retraction suture. I will use a continuous suture. It will apply a little less pressure across from the posterior to the anterior. Tuck this in to this flap. All it’s going to do is just provide a containment. Here’s one. This bite is important to stay above the bone without pulling it off of the, pulling the soft tissue that is off of the bone. So it has to be above the periosteum somewhat. And take a bite of the tissues. Avoid the bone, avoid bothering the periosteum. And again loop it in and we will end it in the very far mesial area creating more tension. Okay? So we have healthy bone and we are well within the parameters that we could work with. The mesial tipping of the previously placed implant will help us also bridge this gap by not having an overly wide crown from an aesthetic standpoint as well as functional of course placed onto the placed implant that we placed today. Thank you all for your attention. I look forward to talking with you soon.