Early Loading, Soft Tissue Manipulation, and Digital Intraoral Scanning to Achieve Optimal Results When Restoring Multiple Adjacent Implants in the Esthetic Zone: A Clinical Case Report

Abstract

Introduction: This clinical case outlines the surgical and restorative steps involved when a young female with a high smile line and thin gingival biotype underwent extraction and immediate implant placement for three adjacent maxillary anterior teeth.Case Presentation: A 30‐year‐old female with failing maxillary central incisors and left lateral incisor underwent implant therapy to restore function and esthetics. The patient requested single individual implant crowns and not a fixed partial denture. The surgical phase of treatment included atraumatic extractions, immediate implant placement, placement of a bone substitute, and connective tissue graft. The restorative phase involved early loading, dynamic compression of the soft tissues to idealize the marginal and papillary levels, and use of digital intraoral scanning to capture the soft tissue profile accurately.Conclusions: Replacement of a single anterior tooth with a dental implant is a predictable esthetic outcome of implant therapy. However, a predictable protocol for multiple adjacent teeth is not supported by strong evidence in the literature. The treatment protocol described here may be used to predictably replace multiple adjacent anterior teeth. Clinicians placing implants in the esthetic zone require a clear understanding of the biology of the attachment apparatus around teeth and implants. They must precisely understand how the three‐dimensional placement of the implant affects bone, soft tissue, and the final esthetic outcome.