Implants in the esthetic area are challenging for many reasons, all the more so when the hard and soft tissue are deficient at the beginning of the procedure. Numerous grafting techniques are available for the clinician, each one with its own strengths and weaknesses. It is important to understand these differences and to carry out a thorough diagnosis and case selection in order to make the right choice for each patient. The present article describes the treatment of a deficient maxillary central incisor site after extracting an ankylosed tooth. A palatal bone plate was utilized to reconstruct the missing buccal wall in the first place. Three months later, an implant was inserted and at the same time the soft tissue was augmented with a connective tissue graft. The case was successfully restored and finalized with a satisfactory esthetic outcome. The morbidity related to autogenous bone and soft tissue harvesting is discussed, but the shorter healing periods and optimal tissue quality obtained are highlighted.
