Immediate Implant With Provisionalization and Soft Tissue Grafting After 4-Year Follow-Up.

INTRODUCTION: This paper presents a case report of immediate implant placement (IIP) with a provisionalization technique to restore function and esthetics with follow-up after 4 years. CASE PRESENTATION: Minimally traumatic extraction was performed with IIP, soft-tissue grafting, and immediate provisional crown. Six months after optimal healing, the patient was submitted to an esthetic restorative work through veneers in lithium disilicate. Fourteen-month and 4-year follow-up visits revealed stability of the peri-implant soft-tissues with peri-implant health status, with the evaluation of the pink and white esthetic score, yielding to mean scores, respectively, in 14 months of 11.62 ± 2.07 (pink esthetic score [PES]) and 18.25 ± 1.46 (PES/white esthetic score [WES]) and in 4 years of 11.0 ± 1.32 (PES) and 17.62 ± 0.65 (PES/WES). Intraoral digital radiographs showed minimal crestal bone level changes throughout the follow-up period. Thus, IIP is a sensitive technique procedure, and a 3D implant position is crucial for success. CONCLUSION: Immediate implant with grafting to fill the gap and soft tissue augmentation led to less horizontal changes and stable mucosal margin, and immediate provisionalization helped to maintain soft tissue architecture, and proper case selection is key for clinical success.

Using Digital Technique to Obtain the Ideal Soft Tissue Contour in Immediate Implants With Provisionalization.

This paper presents a newly developed digital technique to make a provisional crown that mimics the natural tooth during immediate implant placement. Basically, a digital technique results in a precise transfer tooth emergence profile for provisional restoration in immediate implant placement so that an ideal periimplant soft tissue contour can be maintained. The architecture of extraction socket is obtained digitally before the surgery that allows for implant planning by position of the implant as well as the emergence profile of provisional restoration. The introduction of this approach provides a versatile, precise, and predictable procedure leading to better esthetic outcomes.