Two-Stage Surgical Technique: Placement in the Mandibular Right First Molar

This case will demonstrate the two stage surgical technique for placement of a four point five by six millimeter Integra CP implant in the area of a mandibular right first molar. After clinical and radiographic examination of the site, a crestal incision is made. A retraction suture is placed to keep the flap open while preparing the osteotomy. 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 as measured from the interproximal crestal bone. A gold colored paralleling pin is then placed into the pilot osteotomy to confirm the appropriateness of the osteotomy’s position and its trajectory. The osteotomy is widened with the use of a latch reamer attached to a 400:1 handpiece. Beginning at two point five millimeters, 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 grey four point five millimeters latch reamer which matches the diameter of the intended implant. Prior to placing the implant, the depth gauge is used to confirm the depth of the osteotomy. A four point 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 removed and the implant is fully seated using a three millimeter seating tip attached to a threaded straight handle. The black healing plug is then placed back into the implant’s well and the same seating tip is used to seat the black healing plug prior to its being cut. The harvested autogenous bone collected during latch reaming is placed over the shoulder of the implant. The site is sutured and the radiograph is taken. This completes the surgical technique for the placement of a Bicon short implant in the area of the mandibular right first molar. Thank you for having watched.