Dental Implant Provisionals & Esthetics
A common dental implant concern among clinicians is how to improve the outcome in the esthetic zone. The health and stability of the tissue around the dental implant and quality of the crown determines whether the treatment is a success. A growing trend is to immediately temporize a dental implant at the time of placement. This can be attributed to demanding patients looking for quick results, among other factors. However, is this the best treatment for the esthetic outcome?
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Every patient presents with different circumstances, and not every dental implant can be temporized at the time of placement. Unfavorable factors include infected sites, inadequate bone, or lack of initial stability of the dental implant (35N-cm). A recent systematic review analyzed multiple studies dealing with this topic. It compared changes in the soft tissue and bone levels surrounding a temporized and non-temporized (delayed) single dental implant placed in the esthetic zone. It concluded that the overall success rate was comparable at 97% and changes in soft tissue and bone levels were improved for temporized dental implants compared to delayed. The difference in the level changes were not immense, approximately <.50 mm versus >.50 mm. However, when dealing the esthetics of a smile, any improvement cannot really be quantified.
The current patient presented with a hopeless anterior tooth with severe mobility and nerve necrosis due to secondary occlusal trauma. Therefore, I treated the patient by extracting the tooth and replacing it with a immediate dental implant and bone graft. The extracted tooth was sectioned and bonded to the adjacent teeth as a temporary solution. After initial healing was complete, the patient’s General Dentist removed the bonded tooth and replaced it with a dental implant supported temporary.