cosmetic dentistry_ beauty & science International

crown completed the attractive final cosmetic result. In the case of completely or partially toothless arches, implant-aided and -supported rehabilita- tion is a successful method of treatment in which single-tooth implants are largely used to restore function and aesthetics. Anatomically correct positioning of the implant can, however, only be realised, if the necessary bone level and soft tis- sue profile are considered in the planning and treatment. Tooth shape and colour are equally important for providing an aesthetically harmo- niousappearance.Theanteriorregionofthemax- illa is not referred to as the aesthetic zone with- out reason. After all, it is the most striking region of the stomatognathic system and affects facial appearance. This is why special rules apply to implant- supported single-tooth restoration in this region with regard to the choice of abutment: titanium abutments may show through translucent ce- ramics, lead to dark colour effects or have a neg- ative impact on the optical effect of the papillae. In the course of time, the edge of the abutment may even become visible owing to changes in gingival profile. A number of established surgical procedures can be employed to improve condi- tions for a natural appearance of the restoration, butthehealingofthesofttissueplaysamajorrole in ensuring long-term success of these measures. Ideally, primary wound healing remains the ob- jective. Any loss of bone after tooth loss is to be compensated for with suitable augmentation techniques. _Case report A 50-year-old female patient with a non-con- tributory medical history presented to our dental practice with complaints about tooth 21, which had been fractured in a traffic accident (Fig. 1). The X-ray showed no apical lucency in the area of the destroyed tooth (Fig. 2). Clinical examination showed a sufficient volume of attached gingiva and that the frenulum was in a physiological position. However, the vestibular soft tissue was ruptured in the area of the fractured tooth. It seemed as if the bone underneath the rupture had also been involved. Although most of the mesial and distal papil- lae were in their correct position and still con- nected to the root cement of the neighbouring teeth, the distal papillae had receded by approxi- Fig. 5_Determining the ideal position for the implant with an Iglhaut locator and surgical suture materials. Fig. 6_After insertion of the XiVE S plus implant, a 1 to 2 mm wide gap remains. Fig. 7_An absorbable membrane and a connective tissue graft are placed over the implant and the filled defect. Fig. 8_The flap is repositioned and sutured. I 21 industry report _ single-tooth implants I cosmeticdentistry 3_2011 Fig. 8Fig. 7 Fig. 6Fig. 5