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ePaper created 2015-05-29, 13:18:43 | version 1.38.0
I case report _ CBCT in diagnosis _Thelimitedbonevolumeoftenpresentinanterior zones means that the use of standard-diameter im- plants is not always possible. In order to avoid bone grafts,weusenarrowimplantswithsatisfactoryresults. Byreviewingfourclinicalcases,theauthordemon- strates how the replacement of maxillary lateral inci- sors and mandibular incisors can be considerably simplifiedthroughtheuseofsmall-diameterimplants, while providing results that are entirely satisfactory to the patient both aesthetically and functionally. _Case 1: Small vestibulo-palatal bone volume A 42-year-old patient presented with bilateral agenesis of the maxillary lateral incisors (Fig. 1). The smile line analysis indicated a low smile line associ- ated with toned lips. The oral examination showed small mesiodistal spaces in regions #12 and 22, as well as a rather thick gingival biotype. The patient’s reason for consultation was aes- thetic. After discussing alternative solutions with the patient—orthodontic space closure, replace- ment with fixed prostheses (bridge or crowns)—the patient ultimately chose implant-supported pros- theses.Weworkedinclosecollaborationwithanor- thodontist colleague, Dr Frédéric Chalas, who took responsibility for adapting the mesiodistal spaces, which were required for the placement of the en- dosteal implants in regions #12 and 22. We saw the patientagainafter14monthsoforthodontictreat- ment (Figs. 2a & b), which consisted of wearing a multi-bracket appliance to open up the spaces at Fig. 1_Baseline panoramic radiograph. Figs. 2a & b_The clinical situation at the end of orthodontic treatment. Figs. 3a–d_CT scan cross-sections showing the small exploitable volume on the vestibulo-palatal plane. Small-diameter implants for single anterior restorations Author_ Dr Richard Marcelat, France 20 I cone beam2_2015 Fig. 1 Fig. 2a Fig. 2b Fig. 3a Fig. 3b Fig. 3c Fig. 3d