Multidisciplinary treatment approach for enhancement of implant esthetics

A "team approach" that includes different specialties from the initial stages of implant treatment is important to achieve predictable and esthetically pleasing outcomes in compromised dental replacement cases. This report describes a severely compromised case that was properly managed by the combined efforts of a team of specialists. Briefly, prior to tooth extraction, orthodontic forced eruption was applied to coronally displace the attachment apparatus (i.e., hard and soft tissues). Then, atraumatic tooth extraction together with immediate implant placement was performed. The "sandwich bone augmentation" technique was used to augment the deficient buccal alveolar ridge. A second stage surgery was performed 6 months after healing, revealing 100% of bone fill/augmentation. This technique allowed fabrication of a final restoration that respected the proportions of the natural dentition in a case that would otherwise result in a poor esthetic outcome.