Single implant to replace a lost upper central incisor
35-year-old male
§Chief complaint
Missing front tooth after trauma; wants a fixed replacement
§Medical & dental history
- 01Non-smoker, healthy
- 0211 extracted 4 months ago after a root fracture
- 03Good oral hygiene
§Clinical examination
- 01Healed ridge at 11 with mild buccal contour loss
- 02Medium lip line; thick gingival biotype
- 03Adjacent teeth healthy; no active gum disease
§ figuresFigures (3)
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
Fig. 2Dental radiograph depicting both platform switching and platform matching dental implants
“Platform switch” · DRosenbach · CC BY-SA 3.0 · Wikimedia Commons
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
§Final diagnosis
Single-tooth gap at 11 suitable for implant with simultaneous contour bone grafting
CBCT showed adequate height but a thin buccal wall, so the implant was placed with a small bone graft to restore the contour.
§Investigations
- 01CBCT with a radiographic guide
- 02Digital smile design for crown planning
§Radiology
- 01CBCT — ridge 6.5 mm wide, 18 mm high, buccal concavity
- 02Post-operative IOPA — implant well positioned, graft in place
§Treatment plan
- 01Guided implant placement (3.5 x 13 mm) with buccal contour bone graft and membrane
- 02Temporary crown after 3 months to shape the gum
- 03Final screw-retained crown at 5 months
§Surgical procedure
- 01Flap with papilla preservation, guided drilling, implant placed 3 mm below the planned gum margin
- 02Particulate graft and resorbable membrane placed buccally; tension-free closure
§Follow-up & outcome
- 01Month 3 — implant stable; provisional crown fitted
- 02Month 5 — final crown
- 03Year 2 — stable bone levels
Outcome: Natural-looking, stable implant crown with healthy gum at 2 years.
§Discussion
- 01The aesthetic outcome depends on implant depth, buccal bone thickness and soft tissue shaping with the provisional crown.
§Clinical pearls / learning points
- 01Keep at least 1.5 mm from neighbouring roots and 2 mm of buccal bone.
§Viva questions
What distance is needed between an implant and a tooth?
At least 1.5 mm.
§MCQs
Q1Ideal implant depth in the aesthetic zone is about:
§ 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.
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
Search latest PubMed evidence
Last literature search: 7 September 2026
Current Classification
IARC / WHO. IARC · 2022
Continuously updated online edition of the WHO head and neck tumour classification.
Histopathology References
Barnes L. CRC Press · 2008
Detailed histopathological reference for head and neck diagnostic criteria.
Textbook References
Neville BW, Damm DD, Allen CM et al.. Elsevier · 2024
Standard reference textbook of oral and maxillofacial pathology used throughout this atlas.
Rajendran R, Sivapathasundharam B. Elsevier · 2020
Undergraduate and postgraduate oral pathology textbook widely used in BDS and FCPS curricula.
Hupp JR, Ellis E, Tucker MR. Elsevier · 2019
Core surgical textbook covering exodontia, infection, trauma and preprosthetic surgery.
Additional sources cited on this page
- Buser D et al. Optimizing esthetics for implant restorations in the anterior maxilla. Int J Periodontics Restorative Dent.
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