Preservation of esthetics with implant dentistry: a clinical report

The replacement of single teeth with implants in the anterior maxilla poses a significant challenge to the clinician because of its esthetic implications.

The purpose of this article is to report a protocol in which single teeth are replaced by implants and temporarily restored without load, immediately after extraction.

Between June 2001 and July 2002, 16 cases were followed up in which this protocol was used. Briefly, the teeth are extracted with a Periotome (Friadent, Mannheim, Germany), using a flapless technique, the sockets are evaluated and débrided, an osteotomy is performed following the direction of the socket, and a tapered implant is placed using the alveolar crest as the landmark. A temporary abutment is immediately custom made, and a temporary crown is placed without loading. The 16 cases are summarized, and 4 of them are presented to illustrate this approach.

All four cases have provided excellent esthetic results maintaining an ideal implant-to-supporting-tissue relationship. Furthermore, the overall time needed to restore the cases was considerably reduced when compared with time needed for the conventional approach.

The four cases presented support the use of the described protocol in the placement of single implants in areas of the maxillary anterior region where esthetics is a high priority.