Immediate implant in the esthetic area when immediate loading is not an option: a clinical case report

Aims: Tooth extraction in the frontal area is associated with significant bone resorption, especially at sockets presenting with a thin buccal wall, such as most of the maxillary incisors. In the case of favorable residual hard and soft tissue anatomy, immediate implant placement in the esthetic area might be an opportunity to drive the alveolus healing course in the desired direction. Case presentation: In this clinical case, a fractured upper central incisor was replaced by an immediate two-piece implant covered with a healing screw. After 3 months, the implant was restored. The facial and interdental soft tissue was maintained with appreciable success at the 3-year follow-up visit. Conclusion: When immediate loading of the implant is not an option and the fresh extraction socket presents with fair soft tissue quality, the use of an interim healing screw might help sustain and prevent the shrinkage of peri-implant tissues. This simple technique might be a valuable option when there is no indication for adjunctive hard or soft tissue grafting or immediate loading feasibility conditions.