Anterior implants and immediate aesthetic restoration: a challenge for clinicians

The placement of implants in the anterior region is one of the most extensively studied topics in the scientific literature and yet the procedure is still very demanding for clinicians. One of the key factors for success is optimal three-dimensional placement of the implant with maximal preservation of surrounding tissue.

The use of surgical aligners during the intervention greatly facilitates this process. Today we can obtain this type of aligner using CAD-CAM technology. We can perform surgery on a virtual model to previously place the computer-designed permanent tooth, or simply use a vacuum-type tooth aligner obtained by making an accurate wax mold of the patient’s mouth. Naturally, we cannot overlook the importance of correct radiological study.

In the anterior zone, if the primary stability of the implant allows it, immediate placement of a temporary crown, known as immediate aesthetic restoration, is indicated. This involves making a temporary crown immediately after the surgical procedure and then freeing the temporary crown from loading and function. This procedure increases patients’ comfort by providing a temporary crown from the first moment, while allowing the clinician to mold the soft tissues for the definitive prosthesis.

Below we present a case in which an Avinent Ocean HI was implanted at 21, guided by a vacuum-molded aligner containing the tooth itself for use as a temporary tooth when performing the “immediate aesthetic restoration” procedure.

Initial view of the case

Placement and details of the surgical aligner in the mouth

Implant placed with holder / Provisional Peek abutment screwed to the implant

Details of the temporary crown / Temporary crown placed in the mouth

View of the temporary restoration