Preservation of Esthetics with Implant Dentistry: a Clinical Report

BACKGROUND: The replacement of single teeth with implants in the anterior maxilla poses a significant challenge to the clinician because of its esthetic implications. PURPOSE: 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. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.