PMC4258702_01
Patient prior to treatment.
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F1
After initial examination, the left canine tooth along with an associated endodontic-periodontal lesion was extracted (Fig. 1).
FGG application of the anterior maxillary area, including the augmentation area.
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F2
To increase pre-implant KM width (KMW), we used the free gingival graft (FGG) technique (Fig. 2).
Six months post-implant surgery and bone augmentation.
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F3
Block bone augmentation was performed under local anesthesia three months after the FGG application (Fig. 3).
Implant surgery and the papilla regeneration technique (second surgery). A full-thickness flap was elevated, and simultaneously, an
immediate implantation was performed in the right central tooth area. Semilunar bevel incisions were made, recreating a scalloped shape
similar to that of tissues around natural teeth (The rotation of the pedicles made it possible to close the space between the abutments).
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F4
This technique was done not only around implants placed four months previously, but also immediately after for the additional implants placed that day (Fig. 4, 5).
Suturing of the flap.
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F5
This technique was done not only around implants placed four months previously, but also immediately after for the additional implants placed that day (Fig. 4, 5).
Provisional restorations with over contouring in the central tooth area.
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F6
To prevent infection, the pontic was polished carefully, and restoration was temporarily luted (Fig. 6).
Papilla formation in edentulous area.
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F7
Follow-up visits were continued until we were satisfied with the appearance of the papilla and alveolar ridge at the end of the fourth month (Fig. 7).
Clinical appearance after prosthetic rehabilitation was completed.
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F8
At the 24-month follow-up, the patient had no functional, psychological, aesthetic, or phonetic problems (Fig. 8).