CLINICAL CASE: Immediate dentoalveolar restoration - Dr. Igor da Silva Brum

The replacement of an anterior tooth with an implant has become frequent in the daily routine of an implantologist. 
This procedure is an enormous challenge because of its esthetic potential and possibility of implant failure.

In this article, we report a case of immediate dentoalveolar restoration, based on the 1-stage protocol proposed by José Carlos Martins da Rosa. 

A 57-year-old female patient presented with pain and a fractured root with mobility of the crown. After analysis of the cone beam computed tomography scan, fracture of the maxillary left central incisor was confirmed and periapical inflammatory lesions affecting both central incisors could be seen.

A cross-sectional image revealed substantial loss of the buccal bone wall and confirmed the 7 mm probing depth. The treatment entailed atraumatic extraction of both central incisors, curettage and preparation of the sockets. 

Two provisional crowns were fabricated previously using composite, simulating the implants’ position on the cast. The implants and abutments were placed. 

The crowns were adjusted. A cortical triangular bone graft was removed from the maxillary tuberosity and inserted into the socket of the left central incisor. After that, the provisional restorations were reinserted to seal the gingival margin. 

After 1 week, the patient showed no postoperative pain or swelling. No mobility of the crowns or implants was observed. Periodic follow-ups were necessary to assess bone formation in the grafted area and to check whether the gingival profile had been maintained. 

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