Replacing Congenitally Missing Central Incisor: A Case Report with a Special Method to Achieve the Optimal Emergence Profile

Mark Antal

doi:10.4172/2161-1076.s11-003

Abstract

Aim: In this case report a male patient is presented with a congenitally missing right upper central incisor. Different treatment methods have been combined, including ridge-split technique and flapless surgery. Methods: The internal tri-lobed impalnt was placed during the bone splitting procedure. Presurgical orthodontic treatment and post-surgical soft-tissue manipulation is described. Results: The high esthetic outcome, achieved with the screw-retained crown, evaluated with the PES and PI are presented. Results are documented right after final restortion and after one year. Conclusion: The use of screw-retained temporary composite crowns for soft-tissue contouring is affirmed. One year after rehabilitation the screw-retained press-ceramic crown is still in function without any esthetic compromise. The surgical method described and used in this case report still needs long-term evidence-based evaluation and verification.

Highlights

Dental patients with congenitally missing front teeth may present with undeveloped alveolar bone, causing challenges in implant reconstruction [1,2]
The first premolar was transformed to mimic the esthetics of a canine, the canine to a lateral incisor and the lateral incisor to a central incisor [14]
Within the limitations of a case report, the use of screw-retained composite crowns for temporary and screw retained press-ceramic crowns as final restorations can be affirmed. In this current case the combination of split ridge bone augmentation with flapless surgery resulted in a sufficient outcome

Summary

Introduction

Dental patients with congenitally missing front teeth may present with undeveloped alveolar bone, causing challenges in implant reconstruction [1,2]. While missing teeth have been successfully replaced by titanium implants in the last decade, dental restoration and surgery still struggles with cases of restoring anterior teeth where the use of implant supported restorations is still a technically sensitive issue [3]. Restoration and management of congenially missing lateral incisors is well documented in literature [4,5,6,7,8,9]. Some cases have been described about prosthetic restoration of missing central incisors with implant supported dental bridgework. Description of the prosthetic replacement of a missing central incisor has been published, where transformation of the anterior teeth were achieved, with laminate veneers, to simulate a complete dentition. The first premolar was transformed to mimic the esthetics of a canine, the canine to a lateral incisor and the lateral incisor to a central incisor [14]

Objectives

Results

Conclusion