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I case report _ central incisor restoration 28 I cosmeticdentistry 4_2012 emergence profile for the crown (Figs. 17 & 18). The use of ceramic abutments prevents discoloration in the gingival area even when the soft issue is thin. Twoporcelaincrownswerefabricatedtothedesired shape and colour (Figs. 19 & 20). The final result fulfilled the patient’s aesthetic demands and her initial insecurity dissolved after the insertion of the implant and the provisional restoration. The hard- and soft-tissue condition around the implant was stable at the one-year recall (Fig. 21). _Discussion and conclusion Implant placement subsequent to tooth extrac- tion in conjunction with the use of provisionals in theanteriormaxillaryregioniscertainlychallenging for the dental practitioner. However, this treatment modality offers several advantages, including re- duced clinical time, a single local anaesthetic injec- tion,aflaplessprocedureandimmediateplacement of the implants. From the patient’s point of view, the immediate incorporation of a fixed implant- supportedprovisionalrestorationisveryacceptable andevenrequested.Withtheclinicalprocedurede- scribed here, both dentist and patient can evaluate the aesthetics of the restoration. Soft-tissue sup- port is enhanced and achievement of the desired result is facilitated. With initial implant stability, proper tissue management and correct use of the available implant components, a predictable aes- thetic result can be produced. On the other hand, occlusal control, oral hygiene and a regular recall programme should be considered prerequisites for maintaining a long-lasting restoration. Single-toothimplantshaveshownhighsuccess rates in both the anterior and the posterior regions ofthemaxillaandthemandible.1–4 Immediatepost- extraction implant placement has been done since the early years of the clinical application of im- plantswithverygoodclinicaloutcomes.5–8 Decisive factors for immediate implant placement are lack ofinfectionintheperiodontaltissuesandanintact toothsocket.Immediateincorporationofatempo- rary restoration has been presented in the litera- ture with most encouraging results.7–14 Although clinical experiences have advocated this clinical technique for many years, more extended long- term clinical studies are necessary to prove the ef- ficacy of the method and establish a stable clinical protocol._ Editorial note: A complete list of references is available fromthepublisher. Fig. 16_Impression for the prepared natural tooth and the XiVE S plus implant. Fig. 17_All-ceramic crown and corresponding implant abutment (CERCON). Fig. 18_Try-in of the modified ceramic CERCON abutment. Fig. 19_Final clinical result: buccal view of the implant restoration. Fig. 20_Buccal view of the restored natural tooth. Fig. 21_Radiographic control at one year post-implant placement. Fig. 16 Fig. 17 Fig. 18 Fig. 19 Fig. 20 Fig. 21 Dr Stefanos Kourtis Dept.of Prosthodontics,University ofAthens Plaza Chrys.Smyrnis 14 17121Athens Greece Tel.:+30 21 0 935 7306 stefkour@dent.uoa.gr _contact cosmeticdentistry Direct link to the reference list. Just scan QR-Code with your smart phone.