Dental implants in aesthetic zone – cases report

Abstract

Placement of dental implants in the aesthetic zone needs to be planned to consider both atraumatic tooth extraction and the preservation of the socket. The authors presented two clinical cases of patients with indication of dental extraction of the upper central incisor which was planned to use a two-armed lever as atraumatic alveolar preservation technique and managed in two different ways. Case one referred to a traditional approach that included dental extraction, guided bone regeneration, and provisionalization, with a period of healing of 6 months to enable the bone regeneration. Subsequently, it was placed a dental implant TSV 3.7*13 mm (Zimmer Dental). Five months after of clinical and radiographic controls, the second phase was started with the rehabilitation. The second case was about a patient who required dental extractions of maxillary left central incisor due to a fracture of the crown with a poor prognosis, in which the dental extraction was planned to use a two-armed lever. After reclassifying the fresh socket, a dental implant TSV of 3.7 x 13 mm (Zimmer Dental) was placed with modified drilling technique, implant placement resulted in primary fixation with insertion torque level lower than 30 Ncm so the immediate load was not performed. Both patients received a ceramic crown with functional and esthetic results after 16 months of continuous checks and controls. It was concluded that the alveolar preservation in the aesthetic zone is a strategy that starts from the extraction technique. The authors recommend the two-armed lever as atraumatic alveolar preservation technique and different ways to place dental implants.