Uncovering of a Bicon SHORT® Implant

Good afternoon. Coming live to you again from Boston. Good morning and good evening to all of our colleagues around the world. My name is Shadi Daher. This afternoon’s webcast is beginning right now. The mandibular left second bicuspid. It is a five millimeter wide, six millimeter long Bicon implant that was placed as a two stage technique. And today we will uncover it. We will take an implant level impression and we will place a temporary abutment. The presence of keratinized tissue will allow us to split sort of the difference between the buccal and lingual to provide for attached gingival cuff around the neck of the abutment and implant. Using an angled curette as a periosteal elevator, we’re able to start our dissection to see if the incision was complete. And we will just use blunt dissection by sort of introducing the scissors into the incision and opening them thereby spreading the tissues apart. All we will end up having to do is release the anterior gingival cuff. Here is our flap. I will leave the distal gingival papilla attached for now as it is around an implant and that is pretty thick and deep around in there. So I don’t wanna have to excise too far deep. Okay, perfect. Now we start seeing the full extent of the black healing plug. Okay, so you see the full round black top of the black healing plug. Now we will remove it. There is a small hole at the center of the black plug that will help us engage the retriever by twisting it clockwise and it comes out like so. We will use a guide pin to check integration to kind of get an idea of the angulation. And now, as we are making sure that there is no interference, we will use a sulcus reamer that is of the appropriate size, which is five millimeters for a bicuspid. And that will remove any excess bone allowing for the hemispherical undersurface of the Bicon abutment to sit unimpeded and for the locking taper to be coupled and activated fully. And in this case, there’s really maybe just a little bit at the mesial lip here. There wasn’t really much bone that is interfering with it. There is plenty of bone to hold the implant in place and that’s it. This is the two piece impression post for the implant level impression. We’ll introduce it there. I will put it in and then put a suture. That suture will help hold the tissues kind of close to reduce the chance of any parts of the impression material really getting in too deep. All we want it to be is around the top, the plastic part of it. And because we are doing an impression, I will use a buried suture where the knot is within the tissues. So we’ll take a bite from the inside out, then from the outside in. We have to keep both ends on one side otherwise it doesn’t work. And here we are. Okay, let’s see. And here we go. So when we tie this, just a little part of the suture will be visible and the knot and the tails of the knot will be buried inside the tissues hidden away and they won’t get in the way. They won’t bother the patient but they also won’t bother us while taking impression. You can start doing the impression tray. I need a small one please. So the impression is that simple. I don’t restore teeth, but this is something that even I, an oral surgeon, can do for my referring dentist. We will take a shade. We already have an opposing model taken and ready. This doesn’t, I want this to be loose in fact, because the final or the transitional abutment will be a little bit bigger. And so, okay, good. And so I will take that off in a second. So we’ll take this light body and you really it’s not as delicate an operation as taking you know crown and bridge impression because of the two piece abutment or impression post system. Open. Stay open please. Come out, stay open wide. Okay, don’t bite me yet. Okay, here we go. Support the jaw, go ahead. And that’s basically what you want to see. You want to see the green sleeve in the impression. Open please. And you want to see your titanium impression post and obviously how the suture is still in place. First we’ll take the impression post out. We’ll place the healing abutment which is made of plastic. It’s PEEK it is of medical grade. It can be in the soft tissues. We will just seat it firmly, support the chin by tapping it to engage the locking taper. Okay. That’s it. Thanks to everyone who has been patient, attended with us online. Thanks to all of you guys for being here for two days and still have one day to go. And I look forward to seeing you in one of our future webcasts. Please check back frequently at bicon dot com slash webcast. Thank you. Thanks everyone.