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

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Maurice Salama, Alessandro Agnini, David Garber, henry salama, Andrea Agnini

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Implant, Soft Tissue, Crowns and Bridges,
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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.