An Alternative Method for Flapless Implant Placement and an Immediate Provisional Crown: A Case Report

Abstract

The aim of this case report is to present a description of bone mapping as an alternative method to determine the dimensions of bone prior to placement of a flapless implant and an immediate provisional crown. The use of a temporary removable partial denture (RPD) or "flipper" during healing following an extraction is not acceptable for some highly demanding patients. As a result, flapless implant placement is gaining popularity because it offers some advantages such as less bleeding, less swelling, and the protection of soft tissue contours. A 65-year-old woman missing a maxillary left lateral incisor was treated using flapless implant placement and an immediate provisional acrylic crown. Under local anesthesia, the bone anatomy was mapped by inserting a standard periodontal probe in the gingiva. By using the recorded measurements, the thickness of soft tissue was removed from the cast. A surgical guide based on this adjusted model was fabricated prior to surgery. The guide was seated on the teeth when actual surgery was performed to facilitate bone drilling and then the implant was placed. Utilizing the previously fabricated acrylic tooth index, the temporary acrylic crown was fabricated on the adjusted temporary metal abutment and delivered to the patient the same day. In this case report the missing maxillary left lateral tooth was restored using flapless implant placement and an immediate provisional single crown. The dimension of the bone at the implant recipient area was determined by an alternative bone mapping method. This case report suggests the use of flapless implant placement using the bone mapping method and immediate provisional crowns for single crowns when esthetics are a high priority and preserving ideal soft tissue contours and papillary heights are critical.