A anterior implant case with aesthetic complications

0 Rating(s).

Posted on By Ming Ye In Implants

Briefly, A 18 years old student with a thin biotype came to my office for an accidental fracture of his upper right central incisor in 2014, after meticulous examination and evaluation. The tooth was hopeless, and then I communicated with his mother and suggested doing immediate implant placement and immediate restoration. I installed the implant and provisional prosthesis without occlusal contact on an exact day. One week later, I came up for the revisit, and the healing was uneventful. Unfortunately, three weeks later, the patient complained about the mobility of the temporary. After my examination, the failure of the implant was diagnosed, and I removed the failing implant, and socket preservation was done simultaneously. After waiting for the following three months, the patient was revisited for the reentry. Unfortunately, I sound the vertical bone loss and facial gingival recession, especially on the distal interproximal aspect.

I inserted the fixture simultaneously combined with vertical bone augmentation using a Non-resorbable PTFE membrane. Unfortunately, two weeks later, the patient was revisited for suture removal. I discovered the disastrous exposure of the membrane. From the psychological point of view, there was no reason for the patient and me to fail again. At that time, simplification means more minor complications. I took out the membrane and waited for four weeks for the tissue to heal naturally. Then the patient comes up with soft tissue augmentation. Though healing was fair, three months later, the implant was not perfectly osseointegrated, we decided to move on to molding the soft tissue. After two years of temporary reshaping, the result is acceptable, and the final restoration was delivered. I thought the story was over.

Three days ago, the patient showed up to improve the aesthetic result for social needs. After my clinical evaluation, I can appreciate the black triangle around the distal side of the implant neck and gingival recession of the upper right later incisor on the facial aspect.

What am I supposed to do to improve the result?
Should I remove the crown and let it heal 4-to six weeks before reentry for another vertical bone augmentation de novo?
Or Should we try the lateral incisor orthodontic forced eruption?
Or Could I simply do the soft tissue augmentation?

Add to Favorites
Add a comment to the discussion on A anterior implant case with aesthetic complications

Upload photos
1.  Photo Title:

2.  Photo Title:

Would you like to follow this post?
Case has been added to your favorites.
Case has been removed from your favorites.
Thank you for your input. Your comment has been posted.
You are now following this member. You will get notified on any new topics posted by this member.
You are no longer following this member. You will not get notified on any new topics posted by this member.
Edit Comment
1.  Photo Title:
Current Image:   Delete Image
2.  Photo Title:
Current Image:   Delete Image
Comment has been updated.


Latest follow-up
Asymmetry and interproximal tissue(including bone and soft tissue) loss


Before molding and molding procedure


Thank you so much for sharing this case.


Thank you for sharing the case. This is very relevant information I can add to my knowledge about dentistry.

Hawaii Family Dental