Immediate implant placement in the esthetic area with signif
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A newer surgical approach in the immediate implant placement using connective tissue graft that provides good esthetics and patient satisfaction even when the buccal bone wall of the extraction socket has been extensively compromised, allowing treatment time and cost reduction.

Recent clinical recommendations contraindicate immediate implant placement when the socket buccal bone plate is significantly damaged. The connective tissue graft (CTG) is increasingly being used in implant therapy and can replace periodontal defects. Therefore, CTG could be used to allow immediate implant placement and loading even when the buccal socket wall is damaged, facilitating graft material stability.

In the first case, deep bone dehiscence was caused by a vertical root fracture. In the second case, a big bone fenestration was caused by a chronic endodontic periapical lesion. Both cases were treated with immediate implant placement and loading. A buccal CTG was used to compensate for the lack of bone and allow stabilization of the particulate xenograft in the gap between the implant and the damaged buccal socket wall.

In both cases, a provisional screw retained crown was immediately delivered, and the definitive layered zirconia crown was delivered after 3 months. Esthetic results and patient satisfaction monitored for 1 year after loading proved to be encouraging.

Conclusively, further investigations with longer follow up are required, the approach is likely to yield good results after 1 year of loading. The report provides a surgical approach that allows for good esthetic results and patient satisfaction even when the buccal bone wall of the extraction socket has been more than 50% compromised, allowing treatment time and cost reduction.

Journal of Esthetic and Restorative dentistry
Source: https://doi.org/10.1111/jerd.12707
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