Early Implant Placement with Simultaneous Bone Augmentation and Digital Planning in the Aesthetic Zone: A Clinical Case Report
DOI:
https://doi.org/10.24191/cos.v13i1.9744Keywords:
aesthetics, dental implant, digital dentistry, CADCAM, guided bone regeneration, emergence profileAbstract
Anterior implant rehabilitation presents challenges in terms of soft and hard tissue preservation, aesthetics, and long-term function. Early implant placement with guided bone regeneration (GBR) and digital planning is a predictable approach to manage compromised anterior sites. This case report aims to highlight a multidisciplinary approach involving prosthetically driven planning, bone augmentation, and soft tissue management in a compromised central incisor case. A 33-year-old male patient presented with persistent pain in a previously root canal treated maxillary left central incisor. Clinical and radiographic evaluation revealed reinfection, periapical pathology, and insufficient ferrule, rendering the tooth unrestorable. Cone beam CT showed a narrow alveolar ridge measuring approximately 5.63. mm. Tooth 21 was atraumatic extracted, and a fixed provisional restoration was delivered for aesthetic maintenance. After 12 weeks, early implant placement (AnyRidge® Megagen Ø 4.0 x 10 mm) was performed using a 3D-printed surgical guide, along with simultaneous GBR using autogenous bone from the mandibular ramus and xenograft (Bio-Oss®), covered with a collagen membrane (Biomend®). Six months later, an apically positioned flap was used to enhance buccal keratinized tissue, and a provisional crown was placed to contour the emergence profile. Final prosthetic rehabilitation was completed with a monolithic zirconia crown supported by a prefabricated titanium abutment. This case demonstrates the benefit of combining digital planning with early implant placement and GBR in the aesthetic zone. This approach enhances aesthetic outcomes and implant stability. It reinforces the significance of prosthetically guided implant placement and supports future research comparing timing strategies in anterior implant therapy.
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