Two-Stage Surgical Technique: Placement in the Mandibular Left Second Pre-Molar

This case demonstrates the two stage surgical technique for placement of a five by six millimeter Integra CP implant in the area of a mandibular left second premolar. After clinical and radiographic examination of the site, a crestal incision is made. The flap is reflected to allow for visibility during the procedure. The osteotomy is initiated with a two millimeter pilot drill rotating at eleven hundred RPM with external irrigation. The drill is used with a pumping action to a depth of eight millimeters. A gold colored paralleling pin is placed into the osteotomy to confirm the appropriateness of the osteotomy’s position and trajectory. Beginning with the two point five millimeter latch reamer attached to a four zero one handpiece, the osteotomy is widened in half millimeter increments using subsequently wider latch reamers rotating at fifty RPM without irrigation. The final latch reamer is the gold five millimeter latch reamer which matches the diameter of the intended implant. Prior to placing the implant a curette is used to ensure that there are four walls, a floor and no remnant material that could prevent the implant from being seated to the full depth of the osteotomy. A five by six millimeter Integra CP implant is removed from its sterile packaging and transported to the osteotomy using the black healing plug. The black healing plug is then removed and the implant is fully seated using a three millimeter seating tip attached to a threaded offset handle. The black healing plug is placed back into the implants well and the same seating tip is used to seat the black healing plug prior to its being cut. Harvested autogenous bone collected during latch reaming is placed over the shoulder of the implant. The site is sutured and a radiograph is taken. This completes the demonstration for the two stage surgical placement of a Bicon short implant in the area of the mandibular left second premolar. Thank you for having watched.