Management of an extensive soft tissue deficiency prior to immediate implant in the aesthetic zone: a 4-year follow-up

BMJ Case Rep. 2024 Jun 25;17(6):e259271. doi: 10.1136/bcr-2023-259271.

Abstract

Soft tissue deficiency in a tooth extraction site in the aesthetic area is a common and challenging clinical situation. This case report demonstrates the successful treatment of extensive gingival recession and buccal bone dehiscence associated with a hopeless tooth. Initially, a connective tissue graft was used to cover the root and thicken the soft tissue. After 2 months, the tooth was extracted, an implant was immediately placed, and a temporary restoration was installed. After 3 months, the soft tissue exhibited a natural and harmonious architecture. A custom zirconia abutment and crown were then fabricated and placed. At the 4-year follow-up, the peri-implant tissue displayed satisfactory aesthetics, with a well-structured buccal bone plate and healthy peri-implant indicators. This two-stage approach, addressing gingival recession first and proceeding with immediate implant placement after soft tissue healing, proved to be a safe and effective method with stable long-term results.

Keywords: Dentistry and oral medicine; Mouth.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Connective Tissue / transplantation
  • Crowns
  • Dental Implants, Single-Tooth
  • Esthetics, Dental*
  • Female
  • Follow-Up Studies
  • Gingival Recession* / etiology
  • Gingival Recession* / surgery
  • Humans
  • Immediate Dental Implant Loading / methods
  • Male
  • Middle Aged
  • Tooth Extraction
  • Treatment Outcome