[Replacement of extracted tooth by means of implant-supported direct abutment. A case report]

Abutment manipulation, namely repeated screwing and unscrewing may have an affect on the final marginal bone level, consequently, soft tissue position around endosseous implants. In order to maintain the crestal bone level constant and avoid the apical recession of gingiva final abutment (Direct Abutment, Astra Tech) has been connected to submerged OsseoSpeed 4.5 dental implant (Astra Tech) in position of tooth 14, immediately after second surgical exposure. Following a healing period of three weeks, impression was taken using closed tray system and plastic impression pic-up for laboratory manufacturing of zirconium crown restoration. The functional and aesthetic result of the reconstruction was highly met patient is the satisfaction. The maintenance of marginal bone level and the excellent health of the peri-implant tissues, as registered at 6-month recall, may support the benefit of the idea of final abutment insertion immediately after one-, or two-stage surgery.