Article:
Surgical Veneer Grafting - Compensation for Natural Labial Plate Remodeling After Immediate Implant Placement

Summary:
Contemporary implant therapy aims to provide highly
esthetic and predictable treatment outcomes while decreasing
treatment duration and complexity. The clinician
must therefore be cognizant of circumstances with a predisposition
toward esthetic outcomes and treatment plan
accordingly. Preservation of the surrounding hard and
soft tissues associated with an immediate postextraction
socket implant to replace a nonrestorable tooth in the
esthetic zone is one of the greatest challenges facing the
dental team. Several studies have documented the biologic
and esthetic benefits of bone graft containment with
either a custom healing abutment or provisional restoration.
Because esthetic complications increase in patients
with a thin periodontal phenotype, additional surgical
intervention may be necessary to enhance the surrounding
soft tissue architecture before, during, or after implant
placement. A combination of bone graft and connective
tissue graft can help in overbuilding the socket site and
achieve a sustainable and predictable esthetic outcome,
especially in patients with a thin gingival phenotype. A
case report of a hopeless maxillary left central incisor in a
patient with a thin periodontal phenotype illustrates this
new surgical and prosthetic approach. Clinical, radiological,
and esthetic parameters were recorded to evaluate primary
treatment outcomes.