Prophylactic root resection and periapical grafting for anterior implant aethetics: an integration of tissue-reconstruction and tissue-preservation concepts.

The presence of active infections involving the labial bony plate of a failing maxillary anterior tooth presents a challenging situation for aesthetic implant replacement. Not only would the septic state of an abscess be detrimental for immediate implant placement and bone augmentation, but the accompanying bony destruction would also increase the likelihood and magnitude of gingival recession, making this a bioaesthetic challenge. This article describes a technique that integrates tissue-reconstruction and tissue-preservation concepts to achieve peri-implant tissue aesthetics as well as its clinical rationale.