Journal of Oral Implantology October 2013 - (Page 621)

CASE REPORT Implant Esthetic Restoration in Ridge Deficiencies in Cases of Trauma: A Case Report Puneet Sharma, MDS1 G. N. Anandakrishna, MDS2 Palwinder Kaur, MDS1* Varun Dahiya, MDS3 The long-term success of implant therapy does not depend solely on osseointegration, but the gingival architecture surrounding the implant system. It becomes very important to restore the gingival tissues in the areas that enhance one’s esthetics. The esthetic zone can be defined as any dentoalveolar area of esthetic concern to the patient. The anterior maxillary teeth in the esthetic zone usually extend from first premolar to first premolar, but in some individuals can extend as far distally as the first molar. The patients requiring esthetic reconstruction at the site of trauma pose a great problem in implant placement and prosthetic restoration as scar tissue interferes with the same. To be successful, an implant-supported restoration should meet biological, mechanical, and esthetic goals. The most challenging situation is when esthetics is of prime concern in deficient ridge cases. This clinical report presents problems faced during implant placement and the sequential procedure to rehabilitate with an implant that was esthetically harmonized at the site of trauma. Key Words: trauma, scar tissue, electrocautry, dentascan INTRODUCTION D espite the availability of various implant and abutment types in the market, it often becomes quite challenging to achieve the biological and esthetic goals in a patient who has ridge deficiencies because of trauma.1 Oral implantology is often complicated by the limitation faced at the site of trauma that is covered by dense scar tissue. Sometimes this scar tissue covers the alveolar ridge that hinders the implant placement as well as prosthetic rehabilitation.2 Challenges do occur in selecting implants because the amount of bone in such regions is much reduced, and in performing the restorative portion during the second-stage surgical procedure, scar tissue causes problems in (1) exposing the submerged implant, (2) controlling 1 Swami Devi Dyal Dental College, Panchkula, India. M.S. Ramaiah Dental College Hospital, Bengaluru, India. DJ College of Dental Sciences, Modinagar, India. * Corresponding author, e-mail: DOI: 10.1563/AAID-JOI-D-11-00181 2 3 the thickness of the soft tissues surrounding the implants, (3) creating attached gingiva around the implants, and (4) ensuring proper abutment seating.3 Sometimes advanced surgical procedures are designed to overcome these difficulties. It is important to carefully weigh the benefits versus the risks of these procedures. Prosthetic rehabilitation with a minor periodontal surgical procedure is sometimes very beneficial in restoring this type of case. Reports have demonstrated that nonsurgical management of soft-tissue deficiencies is equally beneficial and can fulfill the goals of successful implant therapy.4,5 Sometimes edentulism is associated with extensive or limited soft-tissue deficiencies due to trauma. This loss requires tissue reconstruction therapy to restore the ideal emergence profile, which is indispensable for a good esthetic result.6–8 This case report discusses the concerns, difficulties, and prosthetic challenges that must be addressed when restoring a patient with residual ridge resorption to acceptable function and esthetics. Journal of Oral Implantology 621

Table of Contents for the Digital Edition of Journal of Oral Implantology October 2013

Food and Drug Administration: Reclassification of Blade Form Dental Implants
Optimizing Platelet-Rich Plasma Gel Formation by Varying Time and Gravitational Forces During Centrifugation
Effect of Surface Roughness and Low-Level Laser Therapy on Removal Torque of Implants Placed in Rat Femurs
Impression Techniques for Multiple Implants: A Photoelastic Analysis. Part I: Comparison of Three Direct Methods
Impression Techniques for Multiple Implants: A Photoelastic Analysis. Part II: Comparison of Four Acrylic Resins
A Pig Model for the Histomorphometric Evaluation of Hard Tissue Around Dental Implants
In Situ Tooth Replica Custom Implant: A 3-Dimensional Finite Element Stress and Strain Analysis
Influence of Different Soft Liners on Stress Distribution in Peri-Implant Bone Tissue During Healing Period. A 3D Finite Element Analysis
Influence of Surface Nano-Roughness on Osseointegration of Zirconia Implants in Rabbit Femur Heads Using Selective Infiltration Etching Technique
Modified Titanium Surfaces Alter Osteogenic Differentiation: A Comparative Microarray- Based Analysis of Human Mesenchymal Cell Response to Commercial Titanium Surfaces
Hemorrhage Secondary to Interforaminal Implant Surgery: Anatomical Considerations and Report of a Case
Rehabilitation of a Patient With Mandibular Resection Using Osteointegrated Implants: A Case Report
Two-Stage Bone Expansion Technique Using Spear-Shaped Implants Associated With Overlapped Flap: A Case Report
Implant Esthetic Restoration in Ridge Deficiencies in Cases of Trauma: A Case Report
Rehabilitation of the Atrophic Maxilla With Tilted Implants: Review of the Literature

Journal of Oral Implantology October 2013