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Delayed Implant placement on periodontally compromised single anterior tooth

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



Atraumatic extraction and socket curratage

Collagen membrane placement


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

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