Immediate Provisional for Bicon Implant

Bicon implant does not have threads.  It cannot achieve primary stability.  It cannot be used for immediate provisional unless it is splinted to an osteo-integrated implant or a neighboring tooth.

A 62-year-old man has had a Bicon abutment supported crown at #30 for nearly 2 years (Fig.1, 2 (when Tatum implant was failing)).  Probably due to the fact that the implant is placed distally, there is food impaction mesially.  Prior to #31 implant placement, the crown/abutment will be removed with the universal forceps and reseated.  Pick up impression will be taken and sent to lab for mesial gap closure with porcelain.  Take photos to show the gap preop.

Before crown removal, use the 3.5 mm (vs. normally 5 mm) implant spacer and #15 to mark an entrance point for #31 implant (make a cross over the crestal gingiva).  After crown removal, insert a 3 mm Guide Pin into #30 implant well as a parallel pin.  Use 2 mm pilot drill to start osteotomy through the cross and then make incision.  While drilling and reaming, pay attention to the submandibular fossa (Fig.3 SF) and the Inferior Alveolar Canal (orange).  When a 4.5x8 mm implant is placed, place abutments and make splinted provisional.

Bicon implant usually requires 2 surgeries.  Immediate provisional avoids the 2nd surgery.  Another way to avoid the 2nd surgery is to place a healing abutment.  Our next goal is to place an immediate Bicon implant and immediate splinted provisional.

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Xin Wei, DDS, PhD, MS 1st edition 10/10/2015, last revision 10/23/2015