Purpose: Transferring precise information to the dental laboratory is one of the key factors to achieving clinical success. The aim of the present study was to describe classical and digital work-flows used to rehabilitate an implant with a convergent collar in the aesthetic zone following the BOPT (biologically oriented preparation technique) approach and to report the three years follow-up outcomes of two patients rehabilitated following such procedures. Materials and methods: Two central incisors of two different patients were rehabilitated with a tissue-level implant with a convergent collar and, after a provisional and healing phase, one implant was “impressed” using a classical workflow and one using a digital one. The primary outcome measured was the mean bone loss. An intraoral radiograph was taken at crown delivery and at the three years follow-up visit. Secondary Esthetic outcomes pre-op and post-op were evaluated using the PES (pink esthetic score). Results: At the three years follow-up visit, radiographic analysis showed no signs of bone resorption. For the analogic procedure, the pre-and post-op PES scores were 8, whereas for the digital procedure the pre-op PES score was 4 and a post-op score of 9 was obtained. Conclusions: classical and digital work flows succeeded in giving precise and complete anatomical information of implant position, including the soft tissue contour. Minimum bone loss and an esthetic success were obtained in both procedures.

Background : The thickness of buccal hard and soft tissue has been claimed to be of great clinical relevance in terms of aesthetics and health around implants. To improve such condition several surgical techniques have been proposed and several biomaterials have been used. Collagen products, cross-linked through the use of sugar according to GLYMATRIX technology, have shown their ability to undergo ossification in both animal and human studies, maintaining space for regeneration for long time. Aim/Hypothesis : To evaluate, through a series of consecutively treated patients, the ability of a GLYMATRIX collagen scaffold to improve buccal tissue thickness when used simultaneously to implant positioning in native bone. Materials and Methods : 16 patients, pre-operatively showing adequate bone for implant placement in a CBCT and flat\concave horizontal profile of the ridge in a clinical evaluation, were included in the study. Preoperative virtual models were developed using an intraoral scanner and a dedicated software. All patients received one or two implants and a cross-linked collagen scaffold (OSSIX Volumax, Datum Dental) was placed on the buccal bone plate at the same time. Flaps were repositioned to cover the matrix and sutured around a healing cap. After a conventional healing protocol (post-operative home care, suture removal, clinical and radiographic follow up visits) implants were loaded at 6 months and a new virtual model was obtained with the procedure of above. Gain in tissue thickness buccally to the implant was measured, by means of a computed superimposition of pre-and 6-month virtual models, as the largest improvement along the first 5 mm vertically measured from the gingival margin. Results : 20 implants with sugar cross-linked collagen matrix on the buccal side were consecutively placed in 16 patients. The mean buccal tissue gain at 6 months was 2.4 mm (SD = 0.7 mm). Conclusions and Clinical Implications : The use of a sugar cross-linked collagen matrix showed very promising results in improving buccal tissue thickness around implants. Such ability could be of high clinical relevance to improve this clinical parameter so important for health and esthetics with no needs for major procedures for augmentation.