Computer-guided implant placement in contact with root remnants in the esthetic area

Area of Science:

• Dental Implantology
• Periodontology
• Oral Surgery

Background:

• Tooth extraction due to root resorption often involves significant alveolar bone loss, complicating esthetic rehabilitation with dental implants in the anterior maxilla.
• Minimally invasive treatment options are preferred by patients seeking alternatives to complex extractive surgeries.
• Computer-guided surgery presents a potential solution for precise implant placement in challenging anatomical sites.

Observation:

• A clinical case describes immediate implant placement in an anterior maxilla site with root resorption, leaving root fragments to avoid invasive extraction.
• A flapless, computer-guided technique was employed for implant placement.
• Long-term follow-up (8 years) demonstrated stable clinical and radiologic outcomes.

Findings:

• The implant-supported crown maintained healthy peri-implant gingival tissues.
• No signs of esthetic compromise (e.g., dark translucency) or periodontal complications (pathologic probing depth, bleeding on probing) were observed.
• Computer-guided surgery facilitated precise osteotomy preparation through root remnants.

Implications:

• This minimally invasive approach, utilizing computer-guided surgery, can successfully manage dental implant placement in sites with root resorption and ankylosis.
• Preserving root fragments and employing flapless techniques can mitigate bone loss and simplify esthetic rehabilitation.
• Computer-guided implantology offers enhanced predictability and safety in complex restorative cases.