Therapeutic alternatives for addressing pink esthetic complications in single-tooth implants: A proposal for a clinical decision tree.

OBJECTIVE: Esthetic complications in implant therapy today represent a clinical challenge, when the aim is to overcome the sequelae and obtain a pleasing result. The current scientific literature about this topic is scarce and often based on case reports and the personal opinions of clinicians.

CLINICAL CONSIDERATIONS: The aim of this article is to introduce a decision tree for diagnosis and treatment of complications, focusing on the pink esthetic of single-tooth implants and based on three diagnostic pillars (3D implant position, peri-implant hard-tissue anatomy, and peri-implant soft-tissue anatomy). Different shortcomings have been identified for each of the three diagnostic areas.

CONCLUSIONS: Following this tree, the article proposes treatment alternatives including soft- and hard-tissue reconstruction, implant submergence, orthodontic extrusion, and implant extraction in order to help clinicians establish a logical therapeutic sequence.

CLINICAL SIGNIFICANCE: Guidelines for adequate diagnosis and management of single implant-supported restorations with compromised esthetics is mandatory when attempt to overcome shortcoming in the pink esthetic result.