Dental implant in the aesthetic zone: Bone graft + Soft tissue + Immediate loading

Dear colleague, today we present a clinical case involving a dental implant in the aesthetic zone, specifically a central incisor with significant aesthetic demand. The tooth shows bone loss and grade III mobility, requiring a comprehensive and efficient approach.

Can it all be solved in a single surgery?

The patient came to us with an old endodontic treatment and reported pain and discomfort. His dentist referred him due to the case’s complexity and aesthetic expectations.

In the anterior maxillary region, precise management of both soft and hard tissues is critical. These cases require specialists dedicated to bone and soft tissue grafting to ensure predictable outcomes.

By managing these tissues properly, we can avoid graft failure and achieve optimal functional and aesthetic results.

Step-by-step clinical approach

We extracted the tooth atraumatically and thoroughly curetted the socket. As expected, the bone volume was insufficient for implant placement.

We performed a bone graft, mixing 50% autogenous bone from the patient with 50% biomaterial, and placed the implant simultaneously. This approach reduces future complications like discomfort, pain, or implant failure.

To ensure proper soft tissue volume, we added a connective tissue graft during the same procedure.

👉 Watch this video for tips on Immediate Implant placement

Immediate loading and long-term success

The management of the connective tissue graft is crucial in modern implantology to achieve stable and esthetic results. Immediate loading is then performed: a provisional crown is placed at the same time, avoiding removable devices.

This procedure was completed by Dr. Sarmini.
In the images, you can observe the full clinical sequence: bone deficiency, implant placement, soft tissue grafting, and 4-year follow-up showing a stable result with complete bone preservation.