OMFS-0136Surgical casesReconstructionintermediateAnterior maxilla

Single tooth implant replacement in the aesthetic zone

29-year-old female

Draft — educational study aid, pending faculty review.

§Chief complaint

Missing upper front tooth after a sports injury 6 months ago

§Medical & dental history

01Healthy non-smoker
02No bisphosphonates or uncontrolled diabetes
0311 avulsed and not replantable; currently wearing a removable partial denture

§Clinical examination

01Healed edentulous 11 site with a mild horizontal ridge defect (Seibert class I)
02High smile line exposing full gingival margins
03Adjacent teeth 12 and 21 vital, unrestored
04Good oral hygiene, no periodontal pockets over 3 mm

§ figuresFigures (3)

Dental Implantology — radiology image: The x-ray controlling from 1976/77 shows an subperiosteal implant (according Cherchéve) in the maxilla. Two implant tripods (according Pruin) in the lower canine region and two stabilized blade Implants (according Heinri — Fig. 1The x-ray controlling from 1976/77 shows an subperiosteal implant (according Cherchéve) in the maxilla. Two implant tripods (according Pruin) in the lower canine region and two stabilized blade Implants (according Heinri
“Panoramic radiograph of historic dental implants” · Dentistxxx · CC BY-SA 3.0 · Wikimedia Commons

Dental Implantology — radiology image: Dental radiograph depicting both platform switching and platform matching dental implants — Fig. 2Dental radiograph depicting both platform switching and platform matching dental implants
“Platform switch” · DRosenbach · CC BY-SA 3.0 · Wikimedia Commons

Dental Implantology — radiology image: Dental radiographs demonstrating different emergence profiles on a lower left implant crown. — Fig. 3Dental radiographs demonstrating different emergence profiles on a lower left implant crown.
“Emergence profile” · w:user:DRosenbach · Public domain · Wikimedia Commons

Verified open-access images only, reproduced for education under their stated licences · no AI-generated or illustrative artwork · Dental Implantology figures pending faculty review.

§Differential diagnosis

Implant-supported single crownAdjacent teeth intact — most conservative fixed option

Resin-bonded bridgeConservative but lower long-term survival

Conventional bridgeRequires preparation of sound adjacent teeth

Removable partial dentureInterim solution only

§Final diagnosis

Single edentulous space at 11 suitable for implant rehabilitation after horizontal ridge augmentation

The adjacent teeth are sound and unrestored, so preparing them for a conventional bridge is unjustifiable. A high smile line raises the aesthetic risk and mandates ridge augmentation and careful three-dimensional implant positioning.

§Investigations

01CBCT — 5.5 mm buccolingual ridge width, 16 mm vertical bone height, nasopalatine canal mapped
02Digital intraoral scan and diagnostic wax-up
03Photographic smile analysis and aesthetic risk assessment

§Treatment plan

01Guided bone regeneration for horizontal augmentation, then delayed implant placement
02Fully guided implant surgery using a surgical stent from the wax-up
03Provisional crown for soft tissue conditioning before the definitive screw-retained crown
04Maintenance programme with 6-monthly peri-implant review

§Surgical procedure

01Stage 1: GBR with particulate xenograft and resorbable membrane
02Stage 2 at 6 months: guided placement of a 3.5 x 12 mm implant, 3 mm below the planned gingival margin, 2 mm palatal to the emergence profile
03Connective tissue graft for buccal contour at second-stage uncovering
04Screw-retained provisional at 3 months, definitive zirconia crown at 6 months

§Follow-up & outcome

01Osseointegration confirmed clinically and radiographically
02Pink aesthetic score 12/14 at 1 year
03Stable marginal bone level at 2 years; peri-implant tissues healthy

§Clinical pearls / learning points

01Implant position is prosthetically driven — plan the crown before placing the implant.
02A high smile line is the single biggest aesthetic risk factor in the anterior maxilla.
03Peri-implantitis prevention starts with adequate keratinised tissue and cleansable prosthetic contours.

§ evidenceReferences & Evidence

Current Classification

WHO Classification of Tumours Online — Head and Neck

IARC / WHO · 2022

Continuously updated online edition of the WHO head and neck tumour classification.

View official source

Evidence summary

Highest level of evidence linked to this page: WHO / Official Classification.

L1 · Classification — 1
L6 · Textbook — 4

1 linked source was published from 2024 onwards. Where guidance is limited or contested, rely on the higher-level sources above rather than this summary. Educational use only — not a substitute for clinical judgement.

Content last reviewed

September 2026

Evidence last reviewed

September 2026

Next scheduled review

September 2027

Review status

EVIDENCE REVIEWED

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Last literature search: 7 September 2026

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Current Classification