Immediate Implant Placement with Soft & Hard Tissue Management

Case Study 6

CASE DESCRIPTION:

The patient presented with a failed and visibly discoloured Upper Left Canine (UL3) located in the aesthetic zone, creating both functional concerns and a noticeable impact on the patient’s smile. The situation was further nuanced by the presence of an existing implant at the Upper Left Lateral Incisor (UL2), which had been placed seven years prior using a similar treatment philosophy. Notably, this implant remained stable with well-preserved hard and soft tissues, providing a valuable reference point for long-term success and guiding the approach for the adjacent site.

Following a comprehensive clinical and aesthetic assessment, Dr. Nik proceeded with a minimally invasive extraction of the compromised UL3, carefully preserving the surrounding bone and soft tissue architecture. This atraumatic approach was essential in maintaining the integrity of the site, particularly given the high aesthetic demands of the anterior region. Immediately after extraction, a Conelog Progressive implant was placed using a precisely fabricated pilot guide, ensuring accurate three-dimensional positioning in line with prosthetic requirements.

The implant’s advanced thread design played a crucial role in achieving excellent primary stability, even in areas where bone quality was less than ideal. Furthermore, the implant platform allowed for controlled subcrestal placement, supporting optimal emergence profile development. The combination of platform switching and a deep, secure conical connection contributed to the preservation of crestal bone levels, which is critical for maintaining long-term aesthetic outcomes.

To manage the residual gap and support bone regeneration, Dr. Nik utilised MinerOss allograft from BioHorizons. This biomaterial was carefully placed to encourage predictable bone healing and volume maintenance. In parallel, a connective tissue graft harvested from the palate was performed to enhance buccal tissue thickness and improve soft tissue contours. This step was particularly important in supporting the interdental papillae and achieving a harmonious, natural-looking aesthetic result that blends seamlessly with the adjacent dentition and existing implant.

During the provisional phase, the patient’s natural tooth crown was repurposed and securely attached to a temporary titanium abutment. This innovative approach provided an immediate aesthetic solution while also helping to shape the soft tissues during healing, maintaining gingival architecture and patient confidence throughout the treatment period.

After a healing phase of approximately ten weeks, which progressed smoothly and without complications, Dr. Nik transitioned to the final restorative stage. Using high-precision intraoral scanning technology, a definitive zirconia restoration was designed and fabricated on a custom anatomic abutment by Techniques Dental Lab. This allowed for exceptional accuracy, strength, and aesthetics tailored specifically to the patient’s anatomy.

The final outcome demonstrated excellent integration of both hard and soft tissues, with stable bone levels and well-contoured gingiva. Particularly noteworthy was the continued health and aesthetic stability of the UL2 implant placed seven years earlier, reinforcing the predictability and longevity of Dr. Nik’s treatment protocols in the aesthetic zone.

This case exemplifies Dr. Nik’s advanced expertise in immediate implant placement, meticulous management of both hard and soft tissues, and the delivery of highly aesthetic, long-lasting restorations. His attention to detail, use of innovative techniques, and consistent clinical outcomes position him as a trusted partner for referrals and a valuable mentor for clinicians aiming to master complex aesthetic implant procedures.