Esthetic Implant Complication Management

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Posted on By Maurice Salama In Soft Tissue Enhancement

A 3o yr old woman presents 7 years after implant replacement with concerns over tissue recession, bone loss and esthetic issues. Management involved removal of fixture with simultaneous bone and soft tissue augmentation in preparation for implant replacement. Thoughts and comments. Dr. Salama

Preop Smile
Frontal view

Without crown
Salvin Implant Removal

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3 months healing.....

Post op Smile
Frontal at 3 months


Before & After 3 months

Before Smile
After Smile


Really interesting case Maurice, Thanks for sharing.
I would like to ask to all of you something; This is a 30 year-old lady, rigth? And the implant was place 7 years ago when she was 23.
I don't know If it was placed in a wrong way or just biology an time have have done their work.
But, would you consider a Maryland Bridge as a good alternative for replacing lateral incisors in young patients? What problem can a maryland bridge give (If occlusion is Ok)? Decementation once every 2-3 years? Some soft tissue atrophy?
It is just a thought, we are receiving quite a lot of young patients in our office with this same situation. (Implants placed 7-9 years ago somewhere else and asking for a second opinion)
But in the other hand, very few complications with maryland bridges. Some complains about soft tissue, easely soved with a connective tissue graft through a tunnel approach...
Please tell us ypour thoughts!


Young patients....I would agree to postpone implants especially in high lipline vertical growers....maryland bridges are an excellent alternative. regards Maurice


Excelente caso Dr. Salama !! En la regeneración uso solo fibrina o alguna membrana ? Cuanto espera en estos casos para colocar nuevamente el implante ? Gracias y saludos Eduardo.


We have a choice here....delay implant placement until after growth, attempt to repair with existing implant or replace implant. Dr. S


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