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I case report pletely.20, 6 In this way, we were ensured augmentation of the entire ridge and not only the crestal portion. For GBR, we used autologous bone extracted with a bone scraper (to preserve living osteoblasts) and non-resorbable hydroxyapatite (cerabone, botiss) for 3-D stability. The implant was placed sub-cre- stallyat1.5mminordertopreventunder-coveredge owingtoboneresorption,whichisinevitablefollow- ing tooth extraction.21 Although the implant-neck design guarantees soft-tissue adaptation, we se- lected this kind of implant placement, since we feared unpredictable bone behaviour after so many years of continuous endodontic and inflammatory problems in this region. Another advantage of this implant system is the all-in-one abutment, which supports positioning control and reverse planning for the prosthodontic treatmentasaninsertionaid.Theimplantwasplaced according to the best surgical position and the pros- thetic position. A second all-in-one abutment was shortened to a length of 2 mm and used as a cover screw in order to achieve optimal soft-tissue support (Figs. 5 & 6). In this manner, we conditioned the soft tissue to form the final desired emergence profile. Owingtothemildbutunpredictableinflammation in region 21, we decided against a flap and primary closure of the operating area. The soft tissue was raised buccally in order to place a pericardium mem- brane (Jason, botiss). The membrane covered the whole ridge up to the palatal wall, where it was se- cured between the gingiva and crestal ridge using a 4-0Supramidhorizontalmattresssuture(S.Jackson). We placed a collagen fleece over the membrane to prevent proteolytic resorption of the exposed mem- brane. The fleece was secured with a 5-0 PROLENE criss-cross suture (ETHICON, Fig. 7). Temporarycrown Temporary treatment of the gap was crucial. Free granulation of the extraction wound resulted in a high risk of soft-tissue dehiscence. In order to fill the gap, to support and form soft tissue, and to rehabili- tate the patient aesthetically, we trimmed the ex- tracted tooth to form a pontic and attached it with flowablecomposite(TetricEvoFlow,IvoclarVivadent) to the adjacent teeth. After soft-tissue coverage of the ridge, we attached a Maryland bridge to optimise aesthetics. The papilla support was perfect and the outcome until implant exposure was stabilised. The sutures were removed four weeks post-operatively andtwoweeksaftertheMarylandbridgehadbeenat- tached, without having to remove it (Figs. 5, 6, 8 & 9). Healingphase During the healing phase, we followed a frequent recall pattern of one, two, three, four, eight, twelve and16weeks.Inadditiontohygieneinstructions,the patient was informed about the importance of the control appointments. During the healing phase, there were no complications, inflammation or com- plaints from the patient. Exposure Theimplantwasuncoveredafter14weeks.Owing to sufficient soft-tissue thickness on the labial side, wedecidedtouncoverwithatissuepunch.Thetissue punch was 1 mm thick. The operation resulted in a soft-tissueheightof3mmcrestallyuptotheimplant neck. The papillae were maintained, and labially the 26 I implants3_2012 Fig. 6a Fig. 6b Fig. 6c Fig. 7a Fig. 7b Fig. 8a Fig. 8b Fig. 9 Fig. 10