Rehabilitation of the Esthetic Zone Using Multiple Adjacent Individual Implant-Supported Restorations: Where Are the Limits?

Abstract

Rehabilitation of the partially edentulous anterior maxilla is considered one of the most difficult challenges for the restorative dentist due to the esthetic, functional and psychological implications. Implant-supported restorations provide an appealing treatment alternative that responds to today’s patient expectations. The gold standard for this scenario has been the use of an implant-supported fixed partial denture with pontics that masks the soft tissue deficiencies, with acceptable esthetic results. However, nowadays patients are looking for individual single crowns since they believe that this type of restorations resemble the natural dentition, are easy to clean and floss. From the dentist perspective, they are easy to maintain and in case of prosthetic complications they can be repaired or changed without compromising the adjacent restorations. Three parameters have been identified that could guide the decision-making process when multiple adjacent implant supported restorations (MAISR) are selected as the treatment of choice: 1) Smile line 2) Inter-implant distance and tooth-implant distance 3) Patient's expectations and ability to clean.

Four single implant‐supported crowns replacing the maxillary incisors: A retrospective report of 10 cases with 2–9 years of follow‐up

“…To the best of the authors knowledge, this is the first case series study presenting clinical and radiographic outcomes on the use of four adjacent implant supported single crowns in the maxillary incisor area. Previous publications reporting this approach were either narrative reviews or case reports (Bernal‐Dulcey et al, 2019; Chen et al, 2011; Levine et al, 2021; Vailati & Belser, 2007). According to Vailati and Belser (2007), the major advantages on the use of four adjacent implants are the facilitated marginal adaptation and management of prosthetic complications (porcelain chipping) in single crowns, and the patient being able to use a simple flossing technique for interdental plaque control.…”