Long-term bone retention and gingival aesthetics

This case demonstrates excellent bone retention and soft tissue aesthetics seven years after implant placement.� A 19 year old female was referred by her general practitioner in Glasgow in 2003 following trauma to her upper right lateral incisor. The tooth had developed a chronic sinus and mobility of the crown. Clinical and radiographic investigations revealed a subcrestal fracture, leaving the tooth with a hopeless prognosis. The radiograph also showed mesial bone loss, due to the chronic infection.

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Dr Allan Pirie explains, �The referring dentist had already discussed the treatment options with the patient.� She had decided that she did not want a bridge, as this would involve damage to the adjacent teeth.� She had a temporary partial denture but was not keen on this as a permanent solution.� She therefore elected to have an implant.�

The tooth was removed as conservatively as possible and the area was curetted thoroughly. An Ankylos A14 implant was placed into the extraction socket, about 2 mm subcrestally. �The gap around the implant neck and the deficient mesial area were grafted with a synthetic composite biomaterial.� The gingival cuff was sutured tightly around the healing abutment to maintain the height and contour of the soft tissues.

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Following 12 weeks of healing, the implant was checked for successful integration before the patient was returned to the care of her GDP. The referring dentist then restored the tooth with a ceramic abutment and crown, due to the high aesthetic demands of this case.

The patient was very pleased with the end result and returns to Dr Pirie for biennial reviews.� The 2010 examination showed excellent bone retention on the radiograph and good pink aesthetics, especially at the mesial papilla.