Early Implant Placement Following Single Tooth Extraction in the Esthetic Zone with Contour Augmentation - Selection Criteria, Surgical Procesures and Long-Term Results

Buser, Daniel Albin; Chappuis, Vivianne; Janner, Simone; Belser, Urs (2019). Early Implant Placement Following Single Tooth Extraction in the Esthetic Zone with Contour Augmentation - Selection Criteria, Surgical Procesures and Long-Term Results. Forum implantologicum, pp. 6-21. Quintessence Publishing Group

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Implant placement post single tooth extraction in the esthetic zone is an important and frequent indication for implant therapy. Today, the clinician can choose from four different treatment approcaches for the timing of implant placement. The decision for the most appropriate treatment plan should be based on a thorough clinical and radiographic examination and well-defined selection criteria. Early implant placement after soft tissue healing is one of the treatment options available. This approach is applied by our team in the case of a thin bone wall phenotype (<1mm) or a missing facial bone wall at the extraction site, and sufficient bone volume available in the palato-apical area to allow good primary stability of the implant. The surgical procedures include a flapless thooth extraction, a 4-to-8 week soft tissue healing period, implant placement in the in the correct 3-dimensional position, a simultaneaous contour agmentation on the facial aspect with the GBR technique using a 2-layer composite graft with locally harvested aoutologous bone chips and a low-substitution bone filler, application of a double-layer collagen membran, and a tension-free primary wound closure. Following 8 weeks of healing, the implant site is reopened with a punch technique, and the implant can be resored with a screw-retained single crown. The rationale for this surgical approach is presented including inclusion criteria, surgical procedures, case reports and long-term documentation.

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