Soft Tissue Surgical Procedures for Optimizing Anterior Implant Esthetics

Figure 3

((a), (b), and (c)) Patient presented for implant rehabilitation of number 7 lateral incisor. Not the high interdental smile line that poses an esthetic challenge. Following ridge resorption, a concavity consistent with a Seibert Class I defect is seen in the edentulous site. ((d), (e), and (f)) A block autograft was screwed in place to achieve horizontal ridge augmentation prior to implant placement. Particulated allograft was utilized to graft the area between the block and the recipient bed. Note the significant enhancement of the tissue profile postsurgically. ((g), (h), and (i)) At four months after grafting the site was reentered and an implant was placed in the ideal 3-dimensional position. A SCTG was utilized to replicate the root eminence and provide a natural emergence profile. ((j), (k), (l), and (m)) Postoperative healing view shows excellent tissue contours at the site. A customized healing abutment was selected to mold the tissues after 2nd stage surgery. Note the excellent positioning of the mucosal zenith at the time of provisionalization. ((n), (o)) Intraoral view of the final restorations in place. Crown lengthening was performed on the adjacent teeth to address the patient’s overall esthetic demands. Note the excellent replication of gingival characteristics on the peri-implant mucosa and the natural appearance of the restoration as it emerges from the augmented hard on soft tissues at the site.

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