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The challenge of the surgical approach in the rehabilitation of a unitary implant in a case of high aesthetic requirements of the anterior sector. Case report

Publicated to:Científica Dental: Revista Científica De Formación Continuada. 18 (2): 27 - 38 - 2021-01-01 18(2), DOI:

Authors: Juan Francisco Peña Cardelles; Ramón Asensio Acevedo; Daniel Ortega Concepción; Jesus Moreno Perez; Daniel Robles Cantero; Iván García Guerrero; Rafael Gómez de Diego

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Abstract

Objective: To describe in detail the clinical approach based on current scientific evidence for a post-extraction implant with immediate loading and provisionalisation. Clinical case: We present the case of a 32-year-old female patient who presented with a possible root fracture of the upper left central incisor (ULCI), accompanied by the appearance of a periodontal abscess in the region of the bottom of the vestibule of said tooth. After carrying out the clinical and radiological examination, it is established that the ULCI prognosis is unfavourable for carrying out conservative treatment of the tooth. After assessing the clinical characteristics of the present case, the chosen treatment plan was to extract the ULCI with the simultaneous placement of a post-extraction osseointegrated implant (OII) and immediate loading of a provisional prosthesis on the implant. Conclusions: Rehabilitation on implants in situations of tooth loss in the aesthetic anterior sector, especially in young patients, requires a multidisciplinary treatment plan in relation to tooth extraction and placement of the OII in the correct three-dimensional position. There are various aspects to be taken into account, particularly the residual remaining bone, the position of the gingival margin, as well as the preservation and conditioning of the peri-implant hard and soft tissues by means of grafts and proper handling of a provisional prosthesis until an ideal emergence profile and gingival contour is achieved before the final crown.

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