The patient presented a temporary Maryland Bridge to hide a left upper canine in evident palatine position. After repeated attempts to get an orthodontic therapy accepted to bring the malpositioned canine back into the arch, she decided to extract it and proceed with the implant-regenerative therapy.
Maryland Bridge in position 2.3
The canine in palatine position
3 months after the canine extraction and the delivery of a new provisional Maryland bridge
It is evident a bone dehiscence buccally to the implant
Some bone chips harvested with ACM Drill from the mandibular angle have been positioned over the implant surface
then some bone substitute (Calcitos, Biotech, ITA) has been placed over the autologous bone to increase the volume, to reduce the harvest reabsorption and to create a root bone prominence with a natural shape
The Cytoplast non reabsorbable membrane fixed with the cover screw and two pins in apical position
at 6 months later as just having removed the membrane it is evident the amount of the regenerated bone
a connective tissue graft is positioned to increase the volume and the soft tissue quality
after 6 months of tissue maturation with the provisional screw-retained crown, the tissues are ready for the definitive restoration
Final definitive Zirconia-ceramic screw-retained crown at two years from the surgery in a frontal view
the definitive crown in a lateral view. It is evident the quality of both the ceramic crown and of the shape, volume, and texture of the surrounding soft tissue
the smile now is pleasant
the final X-ray