PMC9030309_01
(a) Missing maxillary right lateral incisor region. (b) Cone-beam computed tomography scan. (c) Evaluation with paralleling depth pins. (d) Final insertion
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F1
The implant site preparation was completed at a depth of 10.5 mm [Figure 1c]. Final insertion was done using a torque ratchet with an insertion torque of 30 Ncm [Figure 1d].
PMC9030309_02
(a) Missing maxillary right lateral incisor region. (b) Cone-beam computed tomography scan. (c) Evaluation with paralleling depth pins. (d) Final insertion
CCD-13-95-g001.jpg
PMC9030309_02_CCD-13-95-g001.jpg
F1
The implant site preparation was completed at a depth of 10.5 mm [Figure 1c]. Final insertion was done using a torque ratchet with an insertion torque of 30 Ncm [Figure 1d].
(a) Midline vertical incision. (b) Particulate bone graft. (c) Compaction on the defect site. (d) Partial thickness horizontal incision
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F2
In the attached gingiva, a midline vertical release incision [Figure 2a] was performed to get access to the donor site extending from distal sides of both the canines. Particulate bone graft material was taken from mandibular symphysis region [Figure 2b] and compacted on the defect site [Figure 2c]. A partial-thickness horizontal incision [Figure 2d] was made on the palatal aspect of the ridge from central incisor to canine.
(a) Oblique incision from mesial line angle extending from right canine to second premolar. (b and c) Placement of horizontal mattress sutures. (d) Essex appliance
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F3
From the horizontal incision line, an oblique incision was placed from mesial line angle of right canine to second premolar [Figure 3a]. Horizontal mattress sutures were placed on the donor and defect site [Figure 3b and c]. A prefabricated Essex appliance made of vacuum-formed sheet and artificial lateral incisor [Figure 3d] was inserted in the patient's mouth.
(a) Postoperative evaluation after six months of healing. (b) Periapical radiograph 12 region. (c) Placement of healing abutment. (d) Provisional crown
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F4
Three-month postoperative evaluation showed a considerable amount of ridge thickness with soft tissue emergence profile [Figure 4a], with no postoperative complications which have been assessed with a periapical radiograph [Figure 4b]. A second-stage surgery was performed after 6 months for exposure of the permucosal element and placement of a healing abutment to recontour the emergence profile [Figure 4c]. After 10 days, a provisional crown [Figure 4d] was given.
(a) Milling of titanium abutment and preparation of adjacent central incisor. (b) Final impression. (c) Metal coping trial. (d) Final prostheses
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F5
The adjacent root canal-treated central incisor was prepared for porcelain fused to metal crown, and simultaneously, the titanium abutment was milled and adjusted for the lateral incisor [Figure 5a]. Impression was obtained from an open tray method [Figure 5b]. After metal coping trial [Figure 5c], final prosthesis was delivered with desirable esthetics and accurate fit [Figure 5d].