Immediate implant placement and provisional crown fabrication after a minimally invasive extraction of a peg-shaped maxillary lateral incisor: a clinical report

Ilser Turkyilmaz, Jose Carlos Suarez, Andrea M Company
Journal of Contemporary Dental Practice 2009 September 1, 10 (5): E073-80

AIM: The aim of this case report is to describe the replacement of a maxillary peg-shaped lateral incisor with the placement of an immediate implant and a provisional restoration following a minimally invasive extraction to preserve anterior esthetics.

BACKGROUND: Extraction sites in the anterior maxilla can present restorative challenges with regard to esthetics. Resistance to wearing a temporary removable partial denture during healing makes immediate implant therapy an appealing alternative to patients. Implant placement into fresh extraction sockets using no flap elevation has recently become more popular due to some advantages including less bleeding, swelling, and the preservation of existing soft tissue contours.

CASE REPORT: A 20-year-old woman with a peg-shaped maxillary left lateral incisor was treated using an implant placed into the fresh extraction socket using a flapless approach and immediate provisional crown fabrication. Flapless implant placement helps to preserve site morphology by protecting and supporting existing hard and soft tissues while minimizing surgical trauma to the adjacent tissues. Using a previously fabricated acrylic index, a provisional acrylic crown was fabricated on the adjusted temporary abutment and delivered to the patient the same day during the extraction visit.

SUMMARY: This report describes the diagnosis and treatment of an over-prepared peg-shaped maxillary left lateral incisor associated with multiple crown decementations. The tooth was extracted without flap elevation and an implant was inserted immediately using flapless surgery and placement of an immediate provisional single crown.

CLINICAL SIGNIFICANCE: Flapless implant insertion into fresh extraction sockets and placement of immediate provisional crowns in cases involving the maxillary anterior region represent a viable treatment option in appropriate clinical situations where esthetics are a high priority. The strategy preserves optimum gingival contours and papillary height may be a viable option compared to fixed partial dentures.

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