Brief History
- 55 years old female patient complaining on mobile and displaced upper left central incisor
- Patient is healthy without any medical problem or any know allergies
- Patient wishes to replace the compromised tooth #21 with an Implant
- Patient does not want any autogenous bone or soft tissue harvested
Treatment Plan
- Extraction with socket preservation to preserve hard tissue
- Delayed Implant placement with any tissue graft in necessary
- Long term provisional crown to remodel and re-establish gingiva zenith, interdental papilla and soft tissue contour
- Final prosthesis with customized abutment copying the profile of the established soft tissue support
Pre-operative
Atraumatic extraction and socket curratage
Collagen membrane placement
Pre-preparation
GBR with mixture of allograft and PRF
Closure of socket with pre membrane
Composite bonded bridges as provisional for 4 months
Healing after 4 months, good soft tissue
Pre-operative OPG : bone density poor
CBCT assessment : Bone graft poorly integrated
Incision and flap opening
Bone is soft with much granulation tissue
Implant placed slightly for higher primary stability
Insertion torque
GBR with xenograft
Tension free primary closure
Post-operative OPG
1 Month healing
4 Months healing
Changing Healing abutment
Provisional crown for 4 months
Final Impression
Final customized abutment with Titanium base for soft tissue adherence
Crown in place
Final OPG
Final smile
Before & After