Ridge Preservation Technique and Rehabilitation with Implant - Case Report

Description of the case: Female, 18 yo, patient, non smoker and with no systemic pathologies, presented an apical lesion in tooth 21, previously subjected to non-surgical, and surgical, endodontic treatment retrograde obturation with MTA. Due to the persistence of the lesion with recurring fistulization, the extraction, followed by ridge preservation techniques (xenograft and collagen membrane) were performed, in order to rebuild the bone architecture. After a healing period of nine months, a Straumann Bone Level (4.1x12mm) implant was placed, in the ideal 3D position; second surgical phase took place after 2 months with ISQ values of 77-81. The provisional crown, was modified three times in order to model the emergence profile of the final crown (4 months). At two years, hard and soft tissue stability is observed. Discussion: Tooth extractions lead to horizontal and vertical bone changes that may restrict the placement of an implant in ideal 3D position, jeopardizing future aesthetics. Six months after a tooth extraction, bone volume decreases 29-63%, horizontally, and 11-22%, vertically [1]. In order to maintain or increase the profile of the existing crest, ridge preservation techniques were developed [2]. The emergence profile must be modeled using a temporary crown, proving the stability of the tissues prior to execution of the final crown [3]. Conclusion: The ridge preservation technique previous to the implant surgery allowed the placement on the ideal 3D position. After 2 years hard and soft tissue stability is observed hard and soft tissues. Bibliografia 1. Tan, W.L., et al., A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. Clin Oral Implants Res, 2012. 23 Suppl 5: p. 1-21. 2. Hammerle, C.H., et al., Evidence-based knowledge on the biology and treatment of extraction sockets. Clin Oral Implants Res, 2012. 23 Suppl 5: p. 80-2. 3. Shor, A., R. Schuler, and Y. Goto, Indirect implant-supported fixed provisional restoration in the esthetic zone: fabrication technique and treatment workflow. J Esthet Restor Dent, 2008. 20(2): p. 82-95; discussion 96-7. Keywords: single-tooth dental implant, dental implant, aesthetics; dental, bone regeneration, Dental Restoration; Temporary, case reports