Don't miss an issue! Renew/subscribe for FREE today.
×
Special Issues
July/August 2024
Volume 45, Issue 1
Peer-Reviewed

Managing Anterior Implant Esthetics: Technique for Immediate Placement

A 37-year-old male patient presented with a fractured crown on tooth No. 9, which had been previously treated and restored with a zirconia crown. Clinical examination revealed that the crown had broken at the gingival level, and a ferrule effect could not be achieved without compromising esthetics. Radiographic evaluations confirmed sufficient bone levels for implant placement. The tooth was atraumatically extracted, preserving the buccal bone wall. A 4.2 mm x 12 mm tapered implant with a 3.5 mm platform was placed with an initial torque of 40 Ncm. To facilitate implant success and preserve esthetics, a temporary cylinder was used to maintain the emergence profile, and Duo-Link Universal (BISCO, bisco.com) adhesive resin cement was applied to secure the cylinder. The cylinder was relined with composite, and a temporary crown was fabricated. For stabilization, a ribbon was bonded from teeth Nos. 7 and 8 to tooth No. 10 using 37% phosphoric acid, All-Bond Universal® (BISCO), Z-Prime Plus (BISCO), and A2 composite. After 4 months, the implant integrated successfully, with the papillae and emergence profile preserved. Digital impressions were taken with an intraoral scanner (Trios®, 3Shape), and a zirconia crown (Katana Zirconia, Kuraray) was fabricated and cemented with Thera­Cem® (BISCO). The final restoration achieved excellent esthetics and a functional outcome.

KEY TAKEAWAYS

In anterior implant cases, understanding proper implant placement and
effective management of surrounding tissues is essential to achieving optimal esthetic outcomes.

Use of a temporary cylinder along
with well-polished composite in the extraction site aids in maintaining the emergence profile and preserving the papillae, which are essential for achieving ideal esthetic results.

Employing high-quality materials and ensuring proper bonding techniques are critical to guarantee success throughout the treatment phases, from temporization to the final outcome.

Luis Abrahante, DMD
Private Practice, Alabaster, Alabama; Member, International Congress of Oral Implantologists

© 2024 Conexiant | Privacy Policy