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Case of the Month with Dr. Johnson Zhang

20 Jul 2021

Esthetic Challenges of Immediate Implant Placement and Provisionalistation of Maxillary Anterior Single Implants



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Immediate implant placement and provisionalisation is a viable option for replace failing maxillary anterior teeth. 
Chairside provisionalization can provide aesthetic solution and maintain the gingival contour around the previous crown.
Customized chairside impression copings preserve soft tissue and transmit contours to the lab.

Initial Situation Description:

The patient presented with marginal gingival inflammation around the #21 crown.

Clinical and radiographic examination revealed increased pocket depth, deep subgingival fracture, and secondary caries on #21 crown. 

After presenting possible treatment options, the patient chose the treatment plan as follows:
1. Extraction of #21
2. Immediate implantation as possible
3. Simultaneous hard and soft tissue augmentation as needed (soft tissue graft was not placed during implant placement since the gingival tissue was still inflamed. The need for soft tissue graft can be reassessed later)
4. Chairside immediate provisional crown with bis-acrylic material and temporary abutment

  


Surgical procedure:

Atraumatic extraction and implant placement with Xenografts fill the gap to socket wall.