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KMID : 0362820100290020040
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Journal of the Korean Academy of Implant Dentistry
2010 Volume.29 No. 2 p.40 ~ p.46
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A staged approach for rehabilitation of multiple missing teeth in the esthetic zone: Case report
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Sohn Joo-Yeon
Han Hyun-Jin
Park Jung-Chul
Kim Jee-Hwan
Yun Jeong-Ho
Kim Sung-Tae
Park Young-Bum
Jung Ui-Won
Kim Chang-Sung
Shim June-Sung
Moon Hong-Seok
Choi Seong-Ho
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Abstract
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Replacement of missing teeth in the esthetic zone is often a challenge for the clinician. Especially, in the area with soft tissue and hard tissue deficiencies, a step by step approach accompanying bone augmentation procedure and soft tissue graft is necessary. In the present case, severe gingival recession and horizontal bone deficiency were noted in maxillary anterior region. Prior to the implant placement, vascularized interpositional periosteal connective tissue (VIP-CT) graft was performed at the time of extraction of anterior teeth to increase keratinized tissue and soft tissue dimension. After 2 months, implants were installed and guided bone regeneration (GBR) was performed on the horizontal alveolar defect. Additional soft tissue graft was done for improvement of horizontal contour at the time of the healing abutment connection. To obtain the proper gingival contour and papilla, temporary restoration was used for 3 months prior to the delivery of final restoration. Relatively enough bone and soft tissue were acquired using staged soft tissue and hard tissue augmentation procedures with implant installation, and the patient was satisfied with the restoration and gingival architcture. Implantation restorations to replace multiple missing teeth in esthetic zone with the soft tissue and hard tissue deficiencies require
presurgical planning, proper implant positioning, skillful practitioner and teamwork of the entire implant team.
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KEYWORD
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dental implant, bone grafting, soft tissue, esthetics
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