Über den Autor
Dr. Mischa Krebs, Prof. Dr. Georg-Hubertus Nentwig
Aesthetic reconstruction with soft and hard tissue management in the anterior upper jaw
A patient introduced herself requesting for a solution due to a vertical fracture in region 21. She desired a treatment with dental implants and high-end aesthetics. A treatment in five steps was planned. The tooth was extracted and socket preservation was performed. After 4.5 months the alveolar crest defect was augmented with an autologous bone graft of the lower jaw and covered by a pediculated tissue graft. To avoid recessions of the teeth an enamel matrix protein was applied. After another 4.5 months of healing the implant was inserted and a second palatinal pediculated connective tissue graft was performed and a key to determine the implant position was taken. Therefore it was possible to provide the patient with a provisional crown at the day of second stage surgery three months later. The final restoration of an all-ceramic crown on an individual circonia abutment was delivered six weeks after dynamic healing.
The literature describes several successful therapy methods for the implant reconstruction of the anterior region after tooth loss. Nevertheless the gold standard is still the autologous bone block, which is quiet invasive for the patient.
The presented therapy approach is a very safe method for an aesthetic reconstitution in the anterior jaw region as the final result shows us after a two-year follow up with a harmonious keratinised gingival margin.