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Dental Tribune Middle East & Africa Edition | 4/2017 mCME 11 ◊Page 10 or resin-bonded bridge, the luxury of dental implants with no prepara- tion and/or reduction to the adjacent natural dentition. Proper placement procedures and restorative techniques can lead to very esthetic results, allowing for natural tissue contours and emer- gence profile formation, reminiscent of the natural tooth. Note: Originally published in Inside Dentistry. © 2014 to AEGIS Publica- tions, LLC. All rights reserved. Reprint- ed with permission from the publish- ers. References 1. Branemark P-I, Zarb GA, Albrektson T, eds. Tissue-Integrated Prosthesis: Osseointegration in Clinical Den- tistry. Carol Stream, IL: Quintessence Publishing: 1985:11-81 2. Adell R, Lekholm U, Rockler B, et al. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg. 1981; 10(6):387-416. 3. Babbush CA. Dental Implants: The Art and Science. Philadelphia, PA: WB Saunders Co. 2001:201-216. 4. Kan JY, Rungcharassaeng K. Im- mediate placement and provision- alization of maxillary anterior single implants: A surgical and prosthetic rationale. Pract Periodontics Aesthet Dent. 2000; 12:817-824. 5. Saadoun AP. Immediate implant placement and temporization in ex- traction and healing sites. Compend Contin Educ Dent. 2002; 23:309-323. Editorial note: The full list of refer- ences is available from the publisher. Paul S. Petrungaro, DDS, MS, FICD, FACD, DICOI, USA. He is internationally rec- ognized for his educational and clinical contributions to modern dentistry. He graduated from Loyola University Dental School in 1986, where he completed an independent study of periodontics at the Welsh National Dental School in Wales, U.K. He completed his residency in peri- odontics and has a specialty certificate in addition to a master’s of science degree in periodontics from Northwestern Univer- sity Dental School. He is the former coordinator of implan- tology, Graduate Department of Peri- odontics, Northwestern University Dental School. Petrungaro has been in the private practice of periodontics and implantalogy since 1988 and holds a license in both Il- linois and Minnesota. Fig. 5. Immediate postoperative clinical view. Fig. 6. Immediate postoperative radio- graph Fig. 7. Lab-processed, long-term provisional restoration Fig. 8. 10-year postoperative clinical view Fig. 9. 10-year postoperative CT serial view gle coring of the site with a 1.4 mm spade drill to full depth, within the sculpted tissue emergence profile previously created (Fig. 4). Conversion to an esthetic pro- visional restoration was completed by placing an abut- ment coping with a silicon retention screw (Dentatus USA, New York, N.Y.). An ion shell provisional crown was then hollowed out and retrofitted to the abutment coping with flowable composite. The margins of the provisional were cor- rected and provisional contoured out of the mouth. The restoration was polished and seated with the set screw from the palatal. The immediate postoperative clinical view is seen in Fig. 5. The immediate postoperative peri- apical view is seen in Fig. 6. The patient then went through the three-month healing and observation phase prior to construction of a lab-pro- cessed provisional restoration (Fig. 7). One year later, the patient underwent final restoration fabrication at the left lateral incisor site. A 10-year postoperative clinical image can be seen in Fig. 8 and a 10-year postoperative CT scan of the implant in Fig. 9. Please note the beautiful soft-tissue esthetic result obtained and excellent main- tenance of the crestal and lateral contours. Conclusion The management of compromised intertooth spaces presents a challenge for the contemporary dental im- plant team. These spaces have limits on how they are handled and require implants 3.0 mm wide or less, as was demonstrated in the text of this article. Availabil- ity of smaller-diameter implants allows patients that normally would have to proceed with a fixed bridge,