Prosthetic restoration of missing upper canine, In the case of buccaly tilted implant

Abstract

Introduction and aim: The missing tooth in the upper anterior zone is both aesthetically and functionally demanding. Patients extremely seek a satisfactory aesthetic and functional treatment. The solution can easily be complicated by a number of factors such as space closure or vestibular bone resorption.The aim of this paper is to briefly outline and show the issue of prosthetic tooth replacement by implant in the anterior zone. Particular attention is paid to the pitfalls and possibilities of treatment by implant-retained prosthesis. In this broad issue, there is a debate on indications of cementation of these prosthesis, and also a solution to the poor placement of the implant in the anterior zone. Methods, material: This case report focuses on the possibility of replacing a missing upper canine and describes in detail the individual clinical steps of the procedure in the fabrication of screw-retained crown on angled abutment. The protocol for impression making for a provisional crown, an individual impression for the definitive crown and the crown delivery is described. The discussion is focused on planning of the prosthesis, possible risks and their prevention and important points in decision making during planning, where the greatest emphasis is placed on the decision between the cemented and screw-retained prosthesis. Various alternatives for avoiding cemented restoration on dental implants are mentioned. Conclusion: The reason for our decision is to maximize the health of periimplant tissues, which differ from the biological width of the natural tooth both in height, histology, and in vascularity. In the vicinity of the dental implant there are multiple collagen fibers parallel to the implant axis with low adherence to the implant neck. The soft tissue around the implant is thus similar to a scar. Its stability is essential and is determined by multiple factors: tissue phenotype, width of the labial wall of the alveolar ridge, the height of the alveolar ridge and the margins of the prosthesis.

Keywords

• implant
• missing canine
• screw-retained crown
• cemented crown