Clinical Indication: The Anterior Aesthetic Zone
Clinical Treatment By Dr. Roberto Cocchetto (ITALY)
INITIAL PATIENT PRESENTATION
A 28-year-old male patient presented with nonrestorable maxillary central incisors that had previously been treated endodontically before being fractured by trauma. The patient desired a fixed restoration.
DIAGNOSIS
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Nonrestorable, fractured, maxillary central incisors
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Healthy, stable, soft-tissue
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Adequate bone to support placement of dental implants
TREATMENT
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Atraumatic removal of fractured, maxillary central incisors and debridement of extraction sockets
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Immediate placement of two 5mm x 13mm Certain® PREVAIL® (internally interfaced) Implants and EP® Healing Abutments in a single-stage protocol
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Three days post implant placement, placement of two GingiHue® Posts and two immediate non-occlusal loaded acrylic resin provisional crowns
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Osseointegration
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Two months post implant surgery, placement of definitive metal-ceramic crowns
SURGICAL TREATMENT
The fractured, non-restorable maxillary central incisors (Figures 1 and 2) were carefully extracted and two 5mm platform diameter x 13mm length Certain Prevail Implants were placed in a single-stage protocol with the aid of a surgical guide. To facilitate the implant osteotomies, the surgical procedure was accomplished without an incision. This flapless approach was done in order to minimize trauma to the buccal cortical plate and interproximal height of bone, and to preserve the interdental papillae in this highly visible aesthetic zone. The specific implant diameters and lengths were selected based on the size and shape of the extraction sockets. A polyether impression was made and sent to the laboratory for the development of a master cast.
EP® (Emergence Profile System) Healing Abutments with 5mm emergence profiles and 4.1mm restorative platforms were placed onto the implants in lieu of cover screws (Figures 3 and 4). The patient was then discharged with antibiotic and anti-inflammatory medications.
