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Implant Placement & Restoration (a typical
example) |
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The best way to describe how a typical dental
implant is placed and restored for a singly
tooth scenario is through illustration of a
simple case scenario.
The following
page goes through a complete case. There are
some mildly graphic surgical images ahead,
however the emphasis is more on the
reconstruction.
The patient in this case is a
teenager with two congenitally missing lateral
incisors, as you can see in the pictures below: |
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His restorative options were a
Removable Partial Denture, a fixed
Bridge or two
dental implants. The patient chose the implant option.
Below you can see the patient during
surgery. Two Root Form Implants (screw-type) are placed
in the edentulous sites. The two x-rays show before
(left) and after (right) images. |
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After the implants were placed,
the tissues were sutured back together again.
The sutures were removed approximately ten days
after the surgery. Four weeks after the surgery
the patient presented for a post-operative
check-up. Below, you can see images of the
surgical sites four weeks after surgery. |
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The implants were left
undisturbed for approximately six months, after
which they were uncovered. The
Uncovery
procedure involves a small exposure of the head
of the implant and placement of either a
Healing Abutment or a
Temporary Crown. Both are designed to
“train” your gum tissues to grow around the
future prosthesis in a collar-like fashion. The
temporary crowns are usually the better choice
in an esthetic area, such as in this case, since
they are able to shape the gum tissues into the
nice, scalloped appearance, which makes the
entire restoration look more natural. The
healing abutments are designed to stick out of
our gums after they are placed, which would make
them esthetically not so pleasing in this case.
In this
case temporary crowns were chosen for the patient an the
images below show the temporaries in place right after
uncovery of the implants (left image) and approximately
4 weeks after uncovery of the implants (right image). |
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Once the tissues are in
satisfactory condition, a final impression is
taken with the help of specialized
transfer impression pins,
as you can see below to the left (the
transfer pins
connect to
implant analogs,
which will record the position of the implants
in the stone cast. The impression is then
poured into stone with the appropriate
implant analogs in
place (below to the right). The analogs
(arrows) are metal components duplicating the
exact position and “neck morphology” of the
implant fixture as it is in the patient’s mouth. |
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The laboratory technician will
then make custom abutments (red arrow in the
left image below), which are attached to the
implant fixtures in the mouth via screws (green
arrow in the left image below). The crowns
(blue arrow in the same picture) are then
cemented over the custom abutments. Below to
the right you can see the custom abutments
inserted. At this point, the screws, connecting
them to the implants will be torqued to a
pre-determined torque value, in order to achieve
the correct
pre-load value of
the screw. This step is very important, because
it will prevent future loosening of the screws. |
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Once the abutments are torqued
in, the screw access is sealed off and the
porcelain crowns are cemented onto the
abutments, much like crowns are cemented onto
natural teeth. Below you can see two views of
the restored lateral incisors. |
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Again, please keep in mind that
this is only one example of how a condition like
the one above can be restored. There are always
several solutions to a given problem in implant
related reconstruction. |
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