Ridge expansion and immediate implant placement in the esthetic zone

Implant placement and tooth restoration in the maxillary esthetic zone is challenging. In the case reported here, the treatment site was tooth # 8, which had been extracted one year previously. Available bone in three dimensions was evaluated by computerized tomography. The bucco-lingual bone width at the crest was 3 mm to 4 mm wide, an inadequate width for implant placement. Ridge expansion was accomplished with hand osteotomes, followed by tapered drills. A 4.3 x 13 mm Nobel Biocare implant was placed. Following osseointegration, a PFM crown, supported by an esthetic abutment, was placed. A very pleasing esthetic result was achieved.