The Management of a Hopeless Maxillary Anterior Tooth Part II: Implant Placement and Restoration

This case video is a continuation of the Hopeless Maxillary Anterior Tooth. Part 1 of Hopeless Maxillary Anterior Tooth discussed post-extraction socket healing and site development for implant placement. In Part II of the series, we describe the implant placement, provisionalization and final restoration. Despite successful regeneration of the original defect, the contour was obviously deficient and was addressed by employing the "Sandwich Technique". This entailed the use of an autogenous bone layer (see Autogenous Bone Collector or Disposable Bone Scraper ) followed by Xenograft Particulate that is layered over the autogenous bone. Following integration, a provisional was fabricated to shape and contour the peri-implant tissue and a final restoration was fabricated. One interesting topic that is brought up during the restoration phase is the issue of residual xenograft material in peri-implant soft tissue. How to handle the residual graft is still somewhat debatable with some clinicians claiming it should be cleaned out with other suggesting it's good for stability of the soft tissue.