PMC10313465_01
Missing upper left.
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A 43-year-old female patient was referred due to a missing upper left canine (Figure 1).
CBCT examination.
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CBCT (Vatech, Gyeonggi-do, Korea) revealed the presence of an impacted left upper canine palatally (Figure 2).
The extracted canine.
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Tusla, OK, USA), it was separated into two pieces by the rounded carbide bur, then it was extracted atraumatically (Figure 3). The apical and ridge crest bone was intact, but the remaining palatal bone after canine extraction was defective.
Implant Direct Legacy 2  after insertion.
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ATG and PRF membranes, the procedure was directed to prepare the implant osteotomy after elevation of a buccal flap in the coronal region of the canine site under the abundant irrigation of saline. An implant (Implant Direct Legacy 2 , Thousand Oaks, California, USA) measuring 4.2 mm in diameter and 10 mm in length was inserted according to the manufacturer's surgical instructions, with an increasing torque up to 32 NCM, with good primary stability (Figure 4).
Palatally bone deficiency.
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A bone deficiency remained palatally, where part of the circumference of the implant was left without bone coverage, except for the apical and coronal areas (Figure 5), so the implant screw threads and the bone defect around the implant were covered by sticky bone ATG and blocks of ATG, followed by PRF membranes (Figures 6 and 7).
Sticky bone ATG and blocks of ATG on implant.
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A bone deficiency remained palatally, where part of the circumference of the implant was left without bone coverage, except for the apical and coronal areas (Figure 5), so the implant screw threads and the bone defect around the implant were covered by sticky bone ATG and blocks of ATG, followed by PRF membranes (Figures 6 and 7).
PRF membranes on grafts.
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A bone deficiency remained palatally, where part of the circumference of the implant was left without bone coverage, except for the apical and coronal areas (Figure 5), so the implant screw threads and the bone defect around the implant were covered by sticky bone ATG and blocks of ATG, followed by PRF membranes (Figures 6 and 7).
Periapical radiograph.
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A periapical radiograph was taken (Figure 8).
Final prosthesis. (a) An abutment on implant. (b) Final prosthesis on the canine after cementation. (c) The final view of zirconia crowns after 12 months.
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The patient required a mouth rehabilitation so she had zirconia crowns on all her teeth (Figure 9).
CBCT after 12 months. (a) Occlusal view. (b) Sagittal views.
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