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Simultaneous Hard Tissue and Soft Tissue Graft with Dental Implant Placement and Provisionalization: A Case Report

  • Hyunjae Kim (Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital) ;
  • Young-Dan Cho (Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital) ;
  • Sungtae Kim (Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital)
  • Received : 2024.04.19
  • Accepted : 2024.06.03
  • Published : 2024.06.30

Abstract

Achieving both esthetic and functional implant rehabilitation is crucial for the successful treatment of the anterior maxilla. Adequate peri-implant alveolar bone and soft tissue are essential for optimal rehabilitation of the esthetic area, and there is a direct association between the implant position and prosthetic outcomes. Immediate provisionalization may also be advantageous when combined with augmentation. This case report described the implant placement in a 25-year-old female patient who had lost her right maxillary lateral incisor (#12) due to trauma-induced avulsion. The treatment involved simultaneous grafting and collagenated, deproteinized bovine bone mineral, along with subepithelial connective tissue taken from the right maxillary tuberosity. A polyetheretherketone abutment and non-functional immediate provisionalization were performed by removing both the proximal and occlusal contacts on the composite resin crown. Clinical and radiographic evaluations revealed maintenance of stable ridge contour aspects for six months following surgical treatment. In summary, implant rehabilitation in the esthetic zone can be successful using simultaneous soft and hard tissue grafts. Moreover, soft tissue stabilization post-subepithelial connective tissue grafting can be achieved through early or immediate visualization, along with immediate implant placement.

Keywords

References

  1. Kan JY, Rungcharassaeng K. Site development for anterior single implant esthetics: the dentulous site. Compend Contin Educ Dent. 2001;22:221-6, 8, 30.
  2. Phillips K, Kois JC. Aesthetic peri-implant site development. The restorative connection. Dent Clin North Am. 1998;42:57-70.
  3. Tarnow DP, Chu SJ, Salama MA, Stappert CF, Salama H, Garber DA, Sarnachiaro GO, Sarnachiaro E, Gotta SL, Saito H. Flapless postextraction socket implant placement in the esthetic zone: part 1. The effect of bone grafting and/or provisional restoration on facial-palatal ridge dimensional change-a retrospective cohort study. Int J Periodontics Restorative Dent. 2014;34:323-31.
  4. Kan JY, Roe P, Rungcharassaeng K, Patel RD, Waki T, Lozada JL, Zimmerman G. Classification of sagittal root position in relation to the anterior maxillary osseous housing for immediate implant placement: a cone beam computed tomography study. Int J Oral Maxillofac Implants. 2011;26:873-6.
  5. Cornelini R, Barone A, Covani U. Connective tissue grafts in postextraction implants with immediate restoration: a prospective controlled clinical study. Pract Proced Aesthet Dent. 2008;20:337-43.
  6. Kan JY, Rungcharassaeng K, Morimoto T, Lozada J. Facial gingival tissue stability after connective tissue graft with single immediate tooth replacement in the esthetic zone: consecutive case report. J Oral Maxillofac Surg. 2009;67(11 Suppl):40-8.
  7. Lee EA. Subperiosteal minimally invasive aesthetic ridge augmentation technique (SMART): a new standard for bone reconstruction of the jaws. Int J Periodontics Restorative Dent. 2017;37:165-73.
  8. Lee CT, Tao CY, Stoupel J. The effect of subepithelial connective tissue graft placement on esthetic outcomes after immediate implant placement: systematic review. J Periodontol. 2016;87:156-67.
  9. Gallucci GO, Benic GI, Eckert SE, Papaspyridakos P, Schimmel M, Schrott A, Weber HP. Consensus statements and clinical recommendations for implant loading protocols. Int J Oral Maxillofac Implants. 2014;29(Suppl):287-90.
  10. Barndt P, Zhang H, Liu F. Immediate loading: from biology to biomechanics. Report of the Committee on Research in fixed Prosthodontics of the American Academy of fixed Prosthodontics. J Prosthet Dent. 2015;113:96-107.
  11. den Hartog L, Raghoebar GM, Stellingsma K, Vissink A, Meijer HJ. Immediate Loading of Anterior Single-Tooth Implants Placed in Healed Sites: Five-Year Results of a Randomized Clinical Trial. Int J Prosthodont. 2016;29:584-91.
  12. Esposito M, Bressan E, Grusovin MG, D'Avenia F, Neumann K, Sbricoli L, Luongo G. Do repeated changes of abutments have any influence on the stability of peri-implant tissues? One-year post-loading results from a multicentre randomised controlled trial. Eur J Oral Implantol. 2017;10:57-72.
  13. Gallucci GO, Hamilton A, Zhou W, Buser D, Chen S. Implant placement and loading protocols in partially edentulous patients: A systematic review. Clin Oral Implants Res. 2018;29(Suppl 16):106-34.
  14. Huynh-Ba G, Oates TW, Williams MAH. Immediate loading vs. early/conventional loading of immediately placed implants in partially edentulous patients from the patients' perspective: A systematic review. Clin Oral Implants Res. 2018;29(Suppl 16):255-69.
  15. Cooper LF, Reside GJ, Raes F, Garriga JS, Tarrida LG, Wiltfang J, Kern M, De Bruyn H. Immediate provisionalization of dental implants placed in healed alveolar ridges and extraction sockets: a 5-year prospective evaluation. Int J Oral Maxillofac Implants. 2014;29:709-17.
  16. Couso-Queiruga E, Stuhr S, Tattan M, Chambrone L, Avila-Ortiz G. Post-extraction dimensional changes: A systematic review and meta-analysis. J Clin Periodontol. 2021;48:126-44.
  17. Son MK, Jang HS. Gingival recontouring by provisional implant restoration for optimal emergence profile: report of two cases. J Periodontal Implant Sci. 2011;41:302-8.
  18. Thoma DS, Cosyn J, Fickl S, Jensen SS, Jung RE, Raghoebar GM, Rocchietta I, Roccuzzo M, Sanz M, Sanz-Sanchez I, Scarlat P, Schou S, Stefanini M, Strasding M, Bertl K; working group 2 of the 6th EAO Consensus Conference 2021. Soft tissue management at implants: Summary and consensus statements of group 2. The 6th EAO Consensus Conference 2021. Clini Oral Implants Res. 2021;32(Suppl 21):174-80.
  19. Fagan MC, Owens H, Smaha J, Kao RT. Simultaneous hard and soft tissue augmentation for implants in the esthetic zone: report of 37 consecutive cases. J Periodontol. 2008;79:1782-8.