Background
A 24-year-old female patient, a non-smoker with no significant medical history or medications, presented with a congenital absence of tooth #4, adjacent tooth recession, and thin tissue. The assessment revealed sufficient crest width but thinning bone in the apical two-thirds, along with adequate keratinized gingiva. A space maintainer for tooth #4 caused inflammation due to gingival impingement, and tooth #5 exhibited noticeable recession.
Case Description
Radiography revealed suitable bone for implant placement, though there were concerns about buccal thinning and potential perforation in the apical two-thirds of tooth #4. The treatment plan included
the removal of the space maintainer, debridement, ND Yag laser treatment, guided implant placement at tooth #4, facial contour grafting, and primary closure for the recession of tooth #5. OSSIX Agile™ (15×20)
was used for bone regeneration, along with a particulate allograft (0.5cc) for bone support. A DS Prime Taper Implant (3.6×11) with a cover screw and healing abutment was placed. The approach resulted in successful implant placement, with significant bone gain observed in the CBCT scan four months post-op.