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Categories ; Posterior, flapless, immediate load, CBCT, Implant

Direct

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Sagittal cut of stone cast.

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Denture tooth wax - up

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CBCT with VPS impression worn during scan. VPS is radio opaque so the soft

tissues are imaged also

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Bone availability based on CBCT data transfer

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BLP ( Bucco Lingual Positioner) locks in BL axis and top of the implant, for screw

retained crown.

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Narrow Diameter Buccal wing. Limited MD space between teeth. Reversible

connection via hot glue.

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Wings are permanently connected to vacuform carrier, crossbar is removed

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RIR’s overlap, X-ray is diagnostic. No need for correction, so green 0 degree

rotation-block

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Model surgery in preparation for fabrication of provisional

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Small hole enlarged for analog placement

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Provisional composite used to cement analog into cast

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Guided implant carrier and implant analog placed back into surgical guide

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Analog is cemented with composite

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Analog now in place of planned implant allowing pre-fabrication of provisional

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Teflon tape used to separate during fabrication of provisional

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Screw retained premade provisional

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Under contoured emergence profile

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Guide in place without rotation-block

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Mark on rotation-block to indicate position of tri lobe for pre-made provisional

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Implant is 4.3 mm , diameter of rotation-block is 4.1 mm, so stack

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Tissue punch

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Guided start-drill

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Drill sequence

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Intra operative radiograph

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Guided screw tap from Nobel Biocare although Implant direct implant

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Stack assembly

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Once implant is a few turns in the osteotomy , snap in rotation-block, for guided

implant placement

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Matching tri-lobe to mark on rotation-block to allow provisional placement in

predetermined position

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Reactive 4.3 x 10, Implant Direct

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Implant seated

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Delivery of provisional

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Provisional in place, no occlusal or interproximal contacts.