Interdisciplinary Treatment of a Front Tooth Trauma by Using a Bone Augmentation, Orthodontic Space Opening with a Provisional Solution and Prosthodontic Crown Work

Introduction: In 2013 the patient's wish was a crown supply for his lost front tooth after more than 12 years of treatment with a denture. His bone was atrophied, and the gap between 21 und 12 was not wide enough for an implant-crown treatment. Therapy: At first, an augmentation-slice with dimensions of 1cm x 0.75 cm was withdrawn from a retromolar during the extraction of tooth 48. This cortico-spongiosa-slice was fixed with osteosynthesis (Ustomed screw, 1.2mm x 11mm) and covered with Bio-Oss and a Bioguide-membrane. After healing, the orthodontic treatment began. The gap was opened, and for temporary aesthetic reasons, a denture tooth was included in the fixed orthodontic appliance for the missing tooth 11. When the gap had enough space for the implant, an Anklylos implant was inserted in this region. Even during the healing of the implant, the interim supply of tooth 11 was solved by using the fixed orthodontic appliance. Than a VMK crown was inserted and the small mesial and distal gaps of 11 were closed by the orthodontist. The retention phase was realised by using a splint. Every six months, the patient is checked. Conclusion: After 12 years without an adequate solution, the orthodontist and the prosthodontist realised an aesthetically appealing provision for the gap in region 11. It healed properly, with a periodontally and aesthetically good interim solution during the therapy. The patient's deep smile line gave him a good impression of his outer appearance. Keywords: implant, bone augmentation, orthodontics, prosthodontics