Abstract
A 49-year-old patient reported for immediate replacement of missing maxillary anterior teeth with implant-retained prosthesis. Elevation of flap alters the mucosal level, causes discomfort, and delays the restorative procedure. To maintain the esthetics, flapless surgery was planned. Since placement of an implant is pre-planned in a predetermined site, fabrication of the prostheses before commencement of the surgery, especially when replacing the teeth in the anterior region, could be a viable option. This case report explains the method of fabrication of the provisional restoration for flapless surgery in the presurgical phase. The technique would avoid any micromotion and implant instability caused due to abutment preparation and impression procedure postsurgically.
Highlights
Full thickness mucoperiosteal flap elevation was practiced during the early period of implant surgical treatment to visualize the bone quality and quantity [1]
Since placement of an implant is pre-planned in a predetermined site, fabrication of the prostheses before commencement of the surgery, especially when replacing the teeth in the anterior region, could be a viable option
With the introduction of cone beam computed tomography (CBCT), threedimensional assessment of probable implant sites facilitate the use of flapless surgery for an implant placement [5]
Summary
Full thickness mucoperiosteal flap elevation was practiced during the early period of implant surgical treatment to visualize the bone quality and quantity [1]. To overcome the disadvantage of mucoperiosteal flap elevation, a flapless approach was introduced, which enabled the placement of an implant without surgical exposure of the underlying bone, while preserving circulation and esthetics of soft tissue contours [3]. This was a drastic revolution from the concept of flap exposure and isolating implants placed into fresh extraction sockets with a barrier membrane and a primary flap closure [4]. Since the angulation of the implant was predetermined, the fitting of the provisional prosthesis did not require any adjustment
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