Infraposition of anterior maxillary implant‐supported single‐tooth restorations in adolescent and adult patients—A prospective follow‐up study up to 6 years

Digital workflow for prosthetic management of malpositioned implant in an adolescent patient: A 20-year follow-up

OBJECTIVE

Dental implants placed in adolescent patients pose a challenge to restore and maintain an esthetic outcome over longer period of follow-up. Maxillomandibular changes throughout adulthood may lead to complications such as implant infraocclusion and interproximal contact loss. This case report describes an alternate prosthetic treatment strategy for maxillary single implant placed in an adolescent patient in the esthetic zone with inappropriate implant axis and screw hole placement.

CLINICAL CONSIDERATIONS

With temporary restorations, the gingiva and soft tissues were shaped to imitate the emerging profile of the contralateral side. A zirconia screw-retained abutment was customized as a copy-mirror from the contralateral prepared tooth to mimic the exact shape and to avoid labiolingual over contour by computer-aided design/computer-assisted manufacture (CAD/CAM). The porcelain laminate veneer was bonded to the zirconia abutment. Porcelain adhesive approach was used instead of traditional principles of retention and resistance form of the abutment.

CONCLUSIONS

A functional and esthetic outcome was achieved and maintained, while a minimally invasive procedure was implemented to use the malplaced implant instead of explanting it.

CLINICAL SIGNIFICANCE

The present report illustrates the prosthetic management of a malpositioned dental implant placed 20 years ago, utilizing a minimally invasive digital protocol.

Application of CAD-CAM technology in the reconstruction of anterior teeth with implant restorations affected by growth changes in young adults: A clinical report

Anterior implant-supported restorations can be challenging, but for a patient undergoing growth and development changes, clinical resolution becomes complex and demanding. To achieve successful outcomes, multidisciplinary dental therapy is required to manage esthetic consequences while maintaining a minimally invasive approach. This clinical report describes a comprehensive treatment protocol to address and treat growth and development complications for an implant-supported prosthesis. By combining computer-aided design and computer-aided manufacture technology and facially driven procedures, a predictable and favorable outcome was achieved.

3-D tooth movement adjacent to single anterior implants and esthetic outcome. A 14- to 20-year follow-up study

OBJECTIVES

To report three-dimensional (3-D) movement of teeth adjacent to single-implant crowns (SICs) in the anterior maxilla and to relate the findings to patient characteristics and esthetic outcome.

MATERIALS AND METHODS

3-D movements of teeth adjacent to anterior maxillary SICs were measured in 30 patients with original SICs in function after 14-20 years. The movements were related to facial type, lower anterior facial height (LAFH), age at crown delivery, sex, the position of the implant, implant occlusion, cause of tooth loss, follow-up period, orthodontic treatment prior to implant placement, and marginal bone-level changes. The esthetic outcome and quality were assessed using Visual Analog scale (VAS) and California Dental Association (CDA) index.

RESULTS

3-D movement of adjacent teeth between 0 and 2.5 mm was observed at follow-up with incisal and palatal movement being most pronounced. Incisal tooth movement of >1 mm was observed in 30% of the patients and was significantly associated with LAFH ≥70 mm. VAS rating associated poorly between patients and clinicians with scores of >80% in 63% and 20%, respectively. The CDA rating was assessed as satisfactory in 87% of the patients.

CONCLUSIONS

Significantly more extensive infraposition was observed in patients with SICs without occlusion, other causes of tooth loss than trauma, implant in lateral incisor and canine position, and a LAFH of ≥70 mm. Although infraposition occurs, patients are highly satisfied with the esthetics of their implants and the esthetic results are valued as higher by patients than dentists.