Soft Tissue Reconstruction of a Class III Ridge Deformity: Case Report with a 9-Year Follow-up.

A healthy, 45-year-old woman requested that her general dentist whiten her two front teeth. Internal bleaching was performed on the teeth at sites 11 and 12 (FDI tooth-numbering system). An internal barrier was not placed, and tooth 11 developed external root resorption. The patient was referred to an oral surgeon to extract the tooth and place an implant. Tooth 12 was salvageable, but the surgeon recommended extraction of both teeth. Implants were immediately placed in the sockets. The implant at site 12 failed and was removed, resulting in a severe ridge defect. Multiple hard and soft tissue surgeries were unsuccessful and the defect worsened, resulting in a Class III ridge defect. The patient was referred to a prosthodontist for consultation, and he recommended referral to a periodontist to reconstruct the badly damaged ridge prior to prosthetic restoration. The periodontist successfully reconstructed the damaged ridge, and a restoration was placed on the implant at site 11 with a cantilevered pontic for site 12. This case elucidates the difficulty in reconstructing a damaged ridge and returning it to its preextraction contour when two adjacent teeth are extracted.

Titanium tattooing associated with zirconia implant abutments: a clinical report of two cases.

Worn particulate titanium abraded from a titanium dental implant that discolors the adjacent soft tissues has not previously been reported. Two cases of this gingival tissue "tattooing" are reported here. While the use of zirconia abutments in areas of high esthetic concern is widespread, the effects of particulate titanium being worn from the implant by the much harder abutment material and then taken up in the adjacent soft tissues should be considered as a potential complication and a consideration when selecting the type of abutment to be used.