CONELOG Special Issue

CONCLUSIONS The example demonstrates the successful immediate implantation in the anterior maxilla on a female patient with thin biotype and high smile line. In addition, the buccal bone lamella was missing so that bone and soft tissue had to be augmented as part of immediate implantation – without preparing a flap. This demanding task can only succeed when the surgeon, and, if applicable, the prosthodontist and the dental technician, work together as an optimal team and use suitable methods and materials. In the presented case, surgery and prosthetics were performed by the same dentist who has been working together intensively for many years with the dental technician in the same location. At the beginning of the treatment, the patient presented in the laboratory for an esthetic analysis to give the dental technician a detailed picture. In order to obtain an adequate tissue volume in the implantation area, the surgeon employed proven bone and soft-tissue surgical procedures. These included using a bone mixture for augmentation and a tunnel technique for thickening the buccal soft tissue. The literature shows that stable tissue volume and a constant marginal soft-tissue border can be achieved in this way even in case of an impaired implantation site with missing bone lamella. This procedure is not (yet) recommended in the current consensus state- ments by the professional associations due to difficult predictability of individual results. As all components of the implant-supported restoration were bonded in the laboratory, the dentist was able to screw them in place together as a single piece and in a single session. This meant fewer treatment sessions for the patient, who did not have to return to the practice after impression-taking until final insertion. The esthetic try-in before final bonding of the indi- vidual parts was performed in the laboratory. The described procedure is only possible in close cooperation and with full confidence between the team partners. Final restoration Fig. 45: The patient’s relaxed smile confirms that the effort and attention to detail have been appreciated. Fig. 43: The close-up shows the healthy periimplant soft tissue and the natural surface of the restorations. Fig. 44: The side profile also shows the natural contours of the restoration and the successful interplay between red and white. Initial situation Fig. 46: Initial situation with tooth 11 (not worth preserving). Fig. 47: X-ray of final restoration shows successful osseointegration. Case Report 16 | 2013