Rationale for esthetic tissue preservation of a fresh extraction socket by an implant treatment concept simulating a tooth replantation

Abstract

In cases of an immediate insertion and loading of implants after a traumatic loss of the patient's own dentition or due to an inevitable extraction of an anterior tooth, it is essential to provide the patient with an adequate provisional crown. A soft-tissue recession must be avoided, whether it is due to a compression of the peri-implant soft-tissue caused by an over-dimensioned restoration in the cervical collar of the provisional crown or to a too small dimensioned sulcus former. A simulation of the exact dimension of the lost tooth - especially on the cervical part of the new provisional restoration - is expected to preserve all relevant information and allows the design of a naturally looking emergence profile. Based on theoretical considerations and a case report, the authors intend to demonstrate that a near-naturally dimensioned sealing of the dento-gingival soft-tissue collar may initiate a tissue-maintaining healing process, similar to a tooth replantation. The natural dental crown, connected to an implant instead of the root, is applied for a tight sealing of the wound. If due to traumatic impact the tooth is no longer available, a naturally dimensioned crown restoration will serve as an alternative wound sealant.

Peri‐implant tissue management after immediate implant placement using a customized healing abutment

“…Cellular adhesion to customized healing abutments may support the peri‐implant mucosa and maintain its architecture . Moreover, based on the prosthetic socket seal concept, this device acts protecting and containing any bone substitute that fills the gap beneath it, avoiding a more invasive procedure to obtain primary wound closure . In addition, it has been suggested that a stabilization of the graft material either by placing a contoured healing abutment or a provisional restoration would limit contour changes of the ridge .…”

The prevalence of peri-implant disease following immediate implant placement and loading: a cross-sectional analysis after 2 to 10 years

“…Occlusion was adjusted to avoid any functional loading. Definitive ceramic restorations were placed 3-4 months after the surgery [19]. Patients were enrolled in a yearly control program.…”

A Combination of Buccal Plate Preservation and Dual Zone Therapeutic Technique in Immediate Implants: A One-Year Follow-Up

“…One year follow up showed stable soft tissue architecture with optimal esthetics (figure 13,14). (27) In conclusion, utilizing all the aforementioned techniques was shown to maintain the bone and soft tissue contour in the case presented. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 When clinicians face a situation regarding whether to extract a tooth or not, the decision is not easy to make.…”