Provisional Crown Research Articles

Aesthetics outcome of immediately restored single implants placed in extraction sockets in the anterior maxilla: A case series study.

Background. Immediate single implant placement and restoration (IIR) is recognized as a novel method and is the main request of many patients. This study was designed to evaluate the aesthetic outcomes of immediately restored single implants placed in extraction sockets in theanterior maxilla. Methods. In this case series study, 18 patients were selected from two private clinics after placing a single-tooth implant in the anterior maxilla. Immediate provisional crowns were delivered on the following day or at most 48 hours later, and guidelines were provided. The Pink Esthetic Score (PES) questionnaire was used at 6- and 12-month follow-ups to assess aesthetic outcomes. Data were analyzed with single t-test and dependent t-test. Results. In general, the results showed that the status of the mesial papilla, distal papilla, curve of the facial soft tissue line, level of the facial peri-implant mucosa and root convexity soft tissue in IIR method were optimal (P<0.05), with total PES means of 9.44±0.783 and 8.58±1.003 after 6 and 12 months, respectively. Also, the results showed a significant difference in PES between the 6-month and 12-month intervals (P<0.05). Conclusion. IIR is a viable method that resulted in optimal aesthetic outcomes based on PES in the short term. Considering its confirmation in this study and previous studies, it is recommended that dentists apply this method.

Remodeling of gingival contour in the rehabilitation with fixed partial dentures – case report

One of the most challenging aspects in rehabilitations is the correct manipulation of gingival tissues, aiming to achieve a natural contour, with interdental papillae and emergence profile, compatible with a natural tooth. The rehabilitation is impaired when there is loss of the interproximal papilla. To solve this problem, it is possible to use the gingival conditioning technique, which comprises relining the provisional crown with acrylic resin, applying gradual pressure, leading to formation of a gingival papilla. This paper presents a case of esthetic and functional recovery in a fixed partial denture by remodeling of the gingival contour by the gradual pressure technique, by gradual relining of the provisional crown. It is concluded that this gingival conditioning technique is simple, easy to accomplish and very effective for esthetic-functional reestablishment in rehabilitations with fixed partial dentures, provided the patient maintains correct hygiene and plaque control.

Comparison of Marginal Accuracy of Interim Restoration Fabricated from Self-cure Composite and Autopolymerizing Acrylic Resin: An In Vitro Study.

ABSTRACTBackground and Objectives:One of the important steps toward achieving a successful fixed partial denture treatment is the fabrication of interim restorations with good marginal adaptation. Poor marginal adaptation of the interim restorations will allow ingress of fluids and microorganisms between the restorations and may lead to caries and pulpitis. The objective of this study was to evaluate and compare the marginal accuracy of interim restorations made from two polymethyl methacrylate (PMMA) and two bis-acryl materials.Materials and Methods:An in vitro method was used to replicate a clinical procedure in which the interim crown was made using a direct technique. A maxillary first molar typodont tooth was prepared to receive a full cast crown restoration having 1 mm chamfer and a taper of 5°, and then the prepared artificial tooth was cast into a cobalt chromium metal die. Wax patterns were prepared on the metal die using type 2 inlay wax for full metal crowns. The impression of the die along with the wax pattern was made with a putty-type polyvinyl siloxane, and this impression was used as a mold for making interim restorations. Two PMMA and two bis-acryl provisional crown materials were distributed as follows: Group A: Unifast Trad (GC Dental), Group B: DPI self-cure tooth molding material, Group C: Structur 2 QM (VOCO), and Group D: Cool Temp Natural (Coltene/Whaledent). A total of 60 interim restorations from all the four materials were fabricated (15 interim restorations from each material). The marginal discrepancy of the interim restoration was determined by measuring the space between the margin of the interim restoration and the finish line of the metal die at four vertical reference lines previously marked at the midpoint of the metal die finish line at the buccal, palatal, mesial, and distal surfaces of the die. The marginal gaps were visualized at ×45 magnification using a stereomicroscope and interpreted using ProgRes image capture software.Results:The mean marginal discrepancy calculated in PMMA materials was 269 µm for DPI and 205 µm for Unifast Trad, and the mean marginal gap for the bis-acryl material was 171 µm for Cool Temp and 140 µm for Structur 2 QM.Interpretation and Conclusion:Comparison of marginal accuracy showed that bis-acryl provisional crown material showed better marginal accuracy than PMMA provisional crown material. Among the materials tested, Structur 2 QM showed the best marginal accuracy, and the least marginal accuracy was shown by DPI.

Customized healing abutment: An alternative technique for maintain peri-implant soft tissue and create implant crown emergence profile

The immediate load procedures in immediate implants have become routine in dental offices because of high esthetics demand by clients. Nevertheless, in some cases, it is not possible to perform immediate load procedures. The purpose of this article was describing the technique for creating a customized healing abutment to preserve the contours of peri-implant soft tissues and maximize peri-implant esthetics in immediate implants when it is not possible to place provisional crowns directly onto the implant. This technique is simple and easily performed and is an interesting alternative treatment for maintaining the stability of the peri-implant tissues while the osseointegration time.

Aesthetic restoration of anterior teeth with monolithic self-glazed zirconia crowns via a completely digital workflow: a clinical case report

ABSTRACT This case represents aesthetic restoration by full-contour monolithic zirconia crowns without porcelain veneer via a completely digital workflow. Virtual prostheses were designed following intraoral scanning and digital smile design (DSD) process. Polymethyl methacrylate (PMMA)-based provisional restorations were used and adjusted as guide for aesthetic and occlusal evaluation. Definite self-glazed zirconia crowns were delivered by superimposing the abutment teeth and modified temporary crowns in situ. Such novel zirconia crowns were formed by net-shape manufacturing process following biogeneric copying of the provisional crowns. The restorations represented functionally tailored hierarchical structures exhibiting superior smoothness on the surface without conventional manual work of grinding, polishing and veneering. The application of full-contour monolithic zirconia restorations in the anterior region via a completely digital workflow indicates a reliable treatment option.

Real-time pulp temperature change at different tooth sites during fabrication of temporary resin crowns

AimTo record the pulp temperature at different tooth sites during fabrication of two different temporary crown systems. MethodologyTwo temporary crown systems were investigated; a conventional direct fabricated and a preformed thermoplastic resin system. Extracted caries-free human teeth (incisor, premolar and molar) were prepared for full coverage ceramic restoration with roots sectioned below the cemento-enamel junction. Thermocouple wires were secured at the surface of crown material, the cut dentine and inside the pulp cavity. Provisional crowns (n = 10/group) from each system were formed prior to placement in a water bath of 37 °C to simulate pulpal temperature. Temperatures were recorded using a K-type thermocouple data logger to collect the mean and peak temperature during crown fabrication. Statistical analysis was carried out on all tested groups and heat flow was calculated. ResultsFor direct fabricated crowns, the mean rise in pulpal temperature recorded was 0.1 °C with the mean temperature range of 37.3 °C–37.8 °C. For the preformed thermoplastic crowns, the mean rise in pulpal temperature recorded was 37.3 °C–45.1 °C. The increase in temperature was significantly higher (6.5 °C for the incisor group, 7.5 °C for the premolar group, and 6.7 °C for the molar group). For both crown systems, the temperature difference between the three different sites; pulp, crown and tooth surface showed a statistical difference (P < 0.01). ConclusionsThe direct fabrication system showed minimal temperature changes within the teeth, while the preformed thermoplastic fabrication system showed larger temperature change in the teeth.

Rehabilitation of anterior maxilla with a novel hyperbolic profile transmucosal implant in elderly patients.

This study aims to evaluate soft and hard tissues response of a two-piece implant placed nonsubmerged in elderly patients' anterior maxilla. Marginal bone level and Pink Esthetic Score (PES) were evaluated up to 24 months. Twelve healthy consecutive patients (mean age 65.8±5 years; 65.5 median) were included in the study. Implants were inserted with flapless technique after 3 months or immediately after extraction. The smooth machined neck of the implant was characterized by a hyperbolic neck which follows biologically oriented preparation technique (BOPT) principles. A customized abutment and a provisional resin crown was positioned with care to avoid excessive soft tissue compression after 3 months, according with BOPT technique. A definitive ceramic crown was positioned after approx. 4 months. After 24 months all implants were stable and osseointegrated. PES improved at 6 and 12 months recalls, remaining stable at 24 months, indicating a healthy soft and hard tissue response. No complications were observed. Impression procedures and provisional/definitive crown cementation resulted simple and free from complications. The hyperbolic profile allowed the preparation of prosthetic crown free from any gingival tissue pressure to create the adequate soft tissue contour. The use of hyperbolic profile implant associated with the transmucosal (not-submerged) technique is a safe procedure that allow the preservation of soft and hard tissue also in elderly patients.

Digital protocol for creating a virtual gingiva adjacent to teeth with subgingival dental preparations

PurposeThis article describes a digital technique used to record gingival emergence profiles modeled for the prosthetic restoration of teeth prepared using biologically oriented preparation technique (BOPT). Materials and methodsThe description of the technique of intraoral recording, manipulation of digital files, and chairside protocol of prosthetic restorations is developed in the present manuscript on two anterior teeth treated with vertical and subgingival dental preparations for restoration with ceramic crowns. The manipulation of the digital files registered with an intraoral scanner with software that allows its alignment (best-fit) and the performance boolean of operation manages to create a virtual gingival emergency like the one it presents when it is adapted on the cervical part of the interim prosthesis. ConclusionsThe technique allows the dentist and laboratory technician to obtain a digital reproduction of the subgingival soft tissues around the prosthetic crown, unaffected by the collapse of the gingival sulcus when the provisional crown is removed, as well as an exact copy of the provisional restoration, making it possible to fabricate a definitive prosthesis that ensures precise anatomy, and so good compatibility with periodontal tissues.

Marginal adaptation of provisional crowns made of acrylic and bisacrylic resins using different impression materials

Aim: To evaluate the marginal adaptation of provisional crowns made of acrylic and bisacrylic resins using different impression materials. Methods: a metal die and a matrix applied through a direct technique were used to fabricate the specimens. The impression materials used as a matrix were divided into four groups: Irreversible hydrocolloid (IH), laboratory silicone (LS), condensation silicone (CS), and addition silicone (AS). After the impression procedures, each matrix was loaded with the provisional prosthetic materials, Alike, Duralay, Protemp 4, and Structur 3 (n = 12). Marginal discrepancy was evaluated using a stereomicroscope at ×45 magnification. The images obtained were transferred to the Corel Draw X7 program, and the distances from the cervical margins of the specimen to the reference lines at the metal die were measured vertically. The data were analyzed by using 2-way ANOVA followed by the Tukey test (α=.05). Results: the acrylic resins had higher values ​​of marginal discrepancy compared to the bisacrylic resins. A statistically significant difference was found between all impression materials, and the irreversible hydrocolloid presented higher values of discrepancy (303.28–613.31 μm), whereas addition silicone had the lowest (48.61–190.06 μm). Conclusions: the bisacrylic resins had a better marginal adaptation compared to the acrylic resins. The addition silicone promoted a better marginal adaptation of the provisional prosthetic materials tested, followed by condensation silicone, laboratory silicone, and irreversible hydrocolloid.

Customized vs Conventional Implant-Supported Immediate Provisional Crowns for Fresh-Socket Implant: A Medium-Term Cone Beam Computed Tomography Study.

To measure the volume effect on maintaining a sealing around immediately rehabilitated dental implants in a comparison between customized and conventional provisional crowns at a 3-year follow-up. A single crown supported by a dental implant was used as a rehabilitation strategy for a failing tooth. The primary predictor was the type of immediate restoration with custom or conventional provisional crowns; a secondary predictor was tooth position: incisor, canine, or premolar. In order to accurately measure the width between buccal and palatal plates at the alveolar margin in a comparison between preoperative (before tooth extraction) and postoperative (at the 3-year follow-up) radiographs, two cone beam computed tomography (CBCT) scans were three-dimensionally analyzed and superimposed. Seventy-six patients, rehabilitated with single implants, were selected (31 implants belonging to the custom group and 45 to the conventional group). In patients treated with conventional restorations, a significant shrinkage (-0.6 ± 1.2 mm with P = .002) was registered. On the other hand, the bone change registered for the custom restoration group appeared negligible, with a nonsignificant and slight increase in width (+0.2 ± 0.7 mm). When the subgroups regarding the implant sites were investigated, the decrease in width was very limited for the canine tooth in the custom group (-0.3 ± 0.2 mm), whereas the shrinkage at the canine in the standard group appeared to be significantly higher (-1.5 ± 0.7 mm with P = .0001). An anatomically contoured provisional restoration may provide a strategy to stimulate peri-implant soft tissue healing, minimize loss of buccal bone plate at the marginal level, and maintain pristine volume in the alveolar bone better than noncustomized restorations.

Influence of a Retentive Shoulder Design to Prevent Early Failure of Three Core Build-Ups.

This study evaluated the influence of a retentive shoulder design to prevent early failure of three resin composite build-ups on molars. Ninety-six intact extracted human maxillary third molars were assigned to two groups (n=48) based on occlusal, buccal cusps only and all cusps reduction. The groups were divided into two subgroups: pin retained and non-pin retained build-ups resulting in four groups (n=24), according the cusps reduction: pin retained/partial, pin retained/complete, non-pin retained/partial, non-pin retained/complete. Occlusal reduction was 3 mm with a semi-lunar retentive shoulder of 3 mm and an axial wall height of 1.5 mm. Groups were restored using a microhybrid, flowable or titanium reinforced resin composite. Modified self-curing acrylic resin provisional crowns were fabricated, cemented with non-eugenol temporary cement and thermal cycled. An instron machine applied tension to the provisional crowns parallel to the long axis of the tooth until dislodgement. A three-way analysis of variance was conducted on the influence of the variables on the retention of the core build-up. Ninety-three build-ups were retained under tensile load, while three core build-ups without pins were dislodged. Three-way analysis of variance showed no statistically significant difference between core build-ups using a retentive shoulder and pin retained core build-ups when tested under tensile load. With the advent of adhesive systems, increased surface area and retentive shoulder design can provide a retentive core foundation to prevent early failures of core build-ups during indirect restoration fabrication which will contribute to the longevity of final restorations.

Small trial suggests that patients receiving a single implant-supported crown in the anterior maxilla who receive provisional crowns have better soft-tissue esthetic outcomes than do those who do not

Furze D, Byrne A, Alam S, Brägger U, Wismeijer D, Wittneben JG. Influence of the fixed implant-supported provisional phase on the esthetic final outcome of implant-supported crowns: 3-year results of a randomized controlled clinical trial [published online ahead of print June 7, 2019]. Clin Implant Dent Relat Res. https://doi.org/10.1111/cid.12796.

Preservation of Peri-implant Hard Tissues Following Immediate Postextraction Implant Placement. Part I: Radiologic Evaluation.

Immediate implant placement may represent a possible treatment plan for single tooth restoration. This study evaluated the insertion of osseointegrated implants in intact fresh extraction sockets in the anterior maxilla. The bone-to-implant gap was accurately grafted with a bovine bone mineral prior to implant engagement, and an immediate screw-retained restoration was delivered. After 3 months, the provisional crown was replaced with the definitive ceramic crown. Marginal bone levels remained stable after 1 year. The horizontal ridge dimension was also evaluated at three levels using CBCT scans after 1 year. The horizontal width of the postextraction crest was well preserved independently from the thickness of the buccal bone plate at baseline.

IN VITRO STUDY ON MARGINAL MICROLEAKAGE OF FOUR TEMPORARY CEMENTS IN PROVISIONAL CROWNS

Background: Prolonged retention of provisional restoration is depends upon the long term affinity between restoration and teeth structures which depend upon the use of good mechanical characteristics, low solubility, and superior adhesion quality of luting cement which also resist bacterial and molecular penetration. Hence, assessment of marginal leakage of provisional restorative materials sealed with provisional cements using the standardized procedures is essential.&#x0D; Aim: This study aimed at in vitro study of microleakage of 4 provisional cements, a cavity base compound and a zinc-phosphate luting cement in provisional acrylic resin crowns fixed on extracted human teeth.&#x0D; Material &amp; Methods: The teeth with acrylic restorations were randomly divided into 6 groups of 6 specimens each. Each group received different types of temporary cement. Acrylic resin crowns were made and fitted on intact human premolars with the 4 cements. All restorations were applied in a standardized manner. Specimen were submerged in a 2% methylene blue solution, then sectioned and observed under a stereomicroscope for the detection of marginal microleakage. Obtained data were subjected to ANNOVA and Chi –square test to know statistical significant difference between different groups. P value less than 0.05 was considered significant.&#x0D; Results and observation: Mean frequency of microleakage was statistically significant among all the groups under study with Pvalue&lt;0.017.&#x0D; Conclusion: Among all the temporary cement, Zinc-phosphate cements has the best property with reduced microleakage. Even it is used as cavity base but can be used as good temporary cement as far as microleakage is concerned.&#x0D; Key words, Microleakage, provisional cement, restorations, crowns, in vitro

Impact of 0.5 mm vs 1.5 mm subcrestal implant placement on marginal bone loss and aesthetics ‐ 3‐year results of a multicenter RCT

Background Among the legends circulating in implant dentistry there is the belief that aesthetics can be improved by placing implants in a subcrestal position.In literature, there are only a few RCT evaluating the differences between crestal and subcrestal placement and their main outcome is limited to short term bone loss.The influence of implant depth in subcrestal placement on the mid-long term esthetic and biological outcomes remains poorly investigated, especially in conical connection implant. Aim/Hypothesis To evaluate if the placement of single dental implants either 0.5 or 1.5 mm subcrestally in healed bone crests has an impact on long term esthetic and biological outcomes. Material and Methods Sixty partially edentulous patients requiring two single implant-supported crowns were recruited from six centres. According to a split-mouth design , the two sites were randomly allocated either to 0.5 mm or 1.5 mm subcrestal implant placement. During the healing period of 3 months, surgical sites in aesthetic areas were closed while a one-stage approach with transgingival healing screw was followed in non-aesthetic areas . Provisional acrylic crowns were delivered and were replaced after 2 months by definitive metal-ceramic crowns. Patients were followed to 3 years after loading. Outcome measures were- crown and implant failures, complications, aesthetics assessed using the pink esthetic score (PES), peri-implant marginal bone level changes, and patient preference, recorded by blinded assessors. Results At delivery of definitive crowns, 2 months after loading, the mean pink aesthetic score was 11.2 ± 1.9 and 11.1 ± 1.5 for the 0.5 and 1.5 mm group, respectively. At 3 years after loading, the mean pink aesthetic score was 12 ± 1.9 and 12.2 ± 1.8 for the 0.5 and 1.5 mm group, respectively. There were no statistically significant differences between the two groups at 2 months (P = 0.626), at 1 year (P = 0.920) or at 3 years (P = 0.296). Three years after loading, patients of the 0.5 mm group lost on average 0.34 ± 0.87 mm and those of the 1.5 mm group 0.19 ± 0.54 mm, the difference being statistically significant (difference = 0.15 mm; 95% CI 0.00 to 0.30; P = 0.046). The implant placement was not reflected in patient preference. There were no differences in outcomes among centres. Conclusion and clinical implications Both surgical protocols resulted in very high esthetic outcome (PES > 12) and minimal bone resorption (<0.5 mm) after 3 years. A slightly lower bone resorption was measured with 1.5 mm subcrestal placement compared to 0.5 mm, with no impact on the esthetic score. This tends to show that deeper implant placement might be beneficial only regarding bone stability, which will be confirmed after 5 years of follow-up.

Using Digital Technique to Obtain the Ideal Soft Tissue Contour in Immediate Implants With Provisionalization.

This paper presents a newly developed digital technique to make a provisional crown that mimics the natural tooth during immediate implant placement. Basically, a digital technique results in a precise transfer tooth emergence profile for provisional restoration in immediate implant placement so that an ideal periimplant soft tissue contour can be maintained. The architecture of extraction socket is obtained digitally before the surgery that allows for implant planning by position of the implant as well as the emergence profile of provisional restoration. The introduction of this approach provides a versatile, precise, and predictable procedure leading to better esthetic outcomes.

Influence of the fixed implant-supported provisional phase on the esthetic final outcome of implant-supported crowns: 3-year results of a randomized controlled clinical trial.

The aim of this investigation was to evaluate whether the use of a provisional implant-supported crown improves the final esthetic outcome of implant crowns that are placed within esthetic sites. Twenty endosseous implants were inserted in sites 13 to 23 (FDI) in 20 patients. Following the reopening procedure, a randomization process assigned them to either cohort group 1: a provisional phase with soft tissue conditioning using the "dynamic compression technique" or cohort group 2: without a provisional phase. Screw-retained all ceramic crowns were inserted. Clinical follow-up appointments were completed at 36 months evaluating clinical, radiographic outcomes, and implant success and survival. After 3 years, all implants survived; one implant-supported crown was excluded from the study due to adjacent tooth failure replaced with a further implant supported crown. Modified pink esthetic score (ModPES) scores were significantly different between groups 1 and 2 (P = .018); white esthetic scores (WES) were not statistically different between both groups (P = .194). Mean values of combined modPES and WES were 15.6 for group 1, with a SD of 3.20. Group 2 had a mean combined modPES and WES of 12.2, with a SD of 3.86. Mean bone loss after 3 year was -0.05 and -0.04 mm for groups 1 and 2 respectively, without being statistically significant. Fixed implant-supported provisionals improve the final esthetic outcome of the peri-implant mucosa.

Evaluation of the marginal accuracy of provisional restorations made of acrylic resins

Aim: To evaluate the marginal accuracy of provisional crowns made with acrylics resins and to identify the surface(s) with the highest marginal discrepancy. Methods: A direct technique was used to fabricate 96 provisional restorations with 8 materials: Dencrilay, Dencôrlay, Dencôr, Vipicor, Duralay, Resinlay Speed, Refine Bright and Alike (n=12). The provisional crowns were made on a prepared molar-shaped metal die with a vinyl polysiloxane impression as a matrix. Marginal discrepancy of provisional restorations was analyzed at buccal, lingual, mesial and distal surfaces of metal die finish line in a stereomicroscope lupe at 100X. The images obtained were transferred to the Corel Draw X7 program and the distances from the cervical margins of the specimen to the reference lines were measured vertically. Comparisons were made with 1-way analysis of variance and the Tukey test (p &lt;0.05). Results: The Alike resin exhibited the lowest marginal discrepancy (0.018 mm) and was significantly different from the Dencôrlay (0.037 mm), Filter Bright (0.034 mm), Duralay (0.033 mm) and Vipicor (0.032) resins. The buccal surface showed the highest marginal discrepancy (0.040 mm) compared to those of other surfaces (distal 0.029mm, lingual 0.028mm and mesial 0.024mm). Conclusion: The marginal adaptation of all materials and surfaces tested in this study were within a clinical acceptable limit. The Alike resin showed the best performance compared to Dencôrlay, Refine Bright, Duralay, and Vipicor resins. The buccal surface showed the highest marginal discrepancy than those of the other tested surfaces.

ADHESION OF PERIODONTAL PATHOGENS TO MATERIALS USED FOR LONG-TERM TEMPORARY CROWNS

Provisional crowns are widely used in prosthodontic treatment in dentistry, and new materials for temporary crowns, including polyetheretherketone, have emerged, which have high-quality requirements for use in long-term temporary prosthetics. Of particular importance in prosthetics are the features of adhesion of pathogenic oral microflora to orthodontic structures. This study evaluated the adhesion of cariogenic and pathogenic periodontal bacterial flora and Candida species to unpolished and polished Dentokeep polyetheretherketone (PEEK), polished polymethyl methacrylate (PMMA) material (Re-Fine Acrylic), and hotcuring acrylic plastic ─ a powder-liquid type, where the powder is a suspension graft fluorine-containing copolymer, and the liquid is a mixture of acrylic monomers, and oligomers─(Sinma-M) recommended for manufacturing long-term temporary crowns. The effect of polishing or un-polishing the study material on the adhesion of various microorganisms was studied. Polishing of Dentokeep PEEK significantly influenced primary adhesion. Microbial adhesion to sample materials was studied using ultrasonic cavitation. Adhesion of microorganisms to each material was categorized as low (0–0.27), moderate (0.28–0.69), or high (0.70–1). Streptococcus sanguinis, Prevotella intermedia, and Candida albicans adhered moderately to unpolished Dentokeep PEEK, whereas Porphyromonas gingivalis and Candida krusei were highly adherent. Candida species and P. intermedia pathogenic periodontal strain moderately adhered to polished Dentokeep PEEK, whereas S. sanguinis and P. gingivalis were highly adherent. Temporary crowns require additional hygienic measures to eradicate cariogenic (acidogenic), pathogenic periodontal, and fungal microbiota and maintain the normal qualitative and quantitative composition of oral microbiocenosis during prosthodontic treatment. In conclusion, PEEK is a promising material for the manufacture of long-term temporary crowns.

Strategy of Esthetic Implant Restoration in Maxillary Anterior Teeth with Severely Resorbed Labial Bone Plate: A Case Report

As implant procedures become more common, many patients require more aesthetic restoration and shorter treatment periods. Maxillary anterior dentition is very challenging site for esthetic final restoration. It becomes more difficult at the site of labial bone resorption. A strategy for esthetics is necessary before extraction. Nineteen years old girl had maxillary anterior teeth with external root resorption and severe resorbed labial plate due to inflammation. Before extraction, antibiotics and anti-inflammatory drugs were administered to relieve the infection and inflammation. Eight weeks after extraction, implant was placed using computer guided surgery. Guided bone regeneration with transmucosal healing was performed and then, fixed provisional restoration was delivered immediately. Soft tissue molding was performed with modification of provisional crown for 6 months. We achieved esthetic final implant restoration in compromised maxillary anterior teeth.