Navigating Esthetic Challenges: Immediate Implant Placement and Comprehensive Restorative Solutions-A Clinical Case With 2-Year Follow-Up Study.

Introduction

The esthetics of immediate implant dentistry can be challenging. Clinical considerations for immediate implant placement have demonstrated long-term success rates comparable to traditional delayed implant protocols. However, it is a sensitive technique that requires proper treatment planning as well as meticulous execution to be predictable and successful in the long term.

Methods

This clinical situation demands extensive knowledge of soft and hard tissue management for atraumatic tooth extraction followed by implant therapy, along with an understanding of the available materials to meet esthetic needs. This case report features a female patient with the chief complaint of needing to replace an anterior crown due to loss of retention. After a comprehensive oral assessment and cone beam computed tomography (CBCT) radiographic examination, it was determined that the crown on Tooth #9 was fractured at the subgingival level. Furthermore, gingival zenith positions displayed differences at the keratinized mucosa level in Teeth #7, #8, and #9, and the metal marginal areas of the porcelain-fused-to-metal (PFM) crowns in the anterior area of Teeth #5, #7, #8, #9, and #10 were apparent. The procedure involved atraumatic extraction of Tooth #9, followed by immediate implant placement. Crowns on Teeth #5, #7, #8, and #10 were replaced, and veneers on Teeth #6 and #11 were fabricated using press lithium disilicate-reinforced ceramic. Connective tissue graft (CTG) was contoured before final implant restorations.

Results

The final implant crown was restored using a prefabricated abutment with a titanium base and lithium disilicate ceramic dental material. A well-planned combined treatment, including atraumatic tooth extractions for immediate implants and ideal contouring of soft tissues, can significantly impact the outcome of esthetic restorations.

Conclusions

Single immediate implant-supported crowns in the esthetic zone were able to fulfill the patient's esthetic expectations.