Customized Treatment Option for Malpositioned Dental Implant Placed in Aesthetic Zone

Replacement of single missing tooth in the aesthetic region presents a challenge for a dentist.1 Various treatment considerations have to be dealt before decision making. Treatment options for such cases are removable partial denture, conventional or resin - bonded fixed partial denture (FPD), and implant-supported fixed prosthesis. Each modality is a possible treatment option and has its advantages and disadvantages.2,3 The treatment option selected would depend on patients’ age, desires, compliance, also the treatment cost, adjacent teeth conditions, bone availability and aesthetics being of prime concern. However, it is found that implant-supported crown is the most preferred option in case of single missing tooth in the aesthetic zone.2,4,5 Implants besides being advantageous over resin-bonded or traditional fixed partial dentures, they also prevent the unnecessary restoration on the adjacent sound teeth as required in an FPD. Hence, implants help in saving the integrity of the existing tooth in situations where the adjacent tooth is vital and have no restorations.2 Also, many authors have suggested implant as a predictable treatment option in case of single tooth replacement.6,7The success of implant is not only defined by the Osseo integration achieved but also its proper placement and with harmonious and naturally blending prosthesis.8 Yet sometimes, there may be situations wherein misaligned placement of implant and reduced interarch space for future prosthesis may pose a challenge for the Prosthodontist, especially in aesthetic zone. Methods like angulated abutments, castable abutments or in severe cases even removable prosthesis have been suggested to surmount such complications.4 The following article presents with two such case scenarios dental implants were restored with castable abutment.Restoration of missing teeth in aesthetic zone is of concern for any individual. Treatment options like removable partial denture, fixed partial denture or implant retained prosthesis can be opted. The treatment option selected would depend on patients’ age, desires, compliance, also the treatment cost, adjacent teeth conditions, bone availability and aesthetics being of prime concern.Keeping in mind the patients’ age bone and periodontal conditions, implant-supported crown is the most preferred option in case of single missing tooth in the aesthetic zone. The success of implant is not only defined by osseointegration achieved, but also its proper placement and with harmonious and naturally blending prosthesis. Yet sometimes, there may be situations wherein misaligned placement of implant and reduced interarch space for future prosthesis may pose a challenge for the prosthodontist, especially in the aesthetic zone. In such complex cases, restoration with a customized treatment plan has to be carried out in order to fulfil patients’ aesthetic requirement as well as restore the implant with a fixed prosthesis. The following article presents with two such case scenarios where the misaligned dental implant placed and the other with reduced interarch space were restored with castable abutment.