JIACD
The Journal of Implant & Advanced Clinical Dentistry
Anterior Esthetic Zone Implant Placement: What are the guidelines you use when placing the implant to get best outcome?
Sun, 02/28/2010 - 10:08 — jrhodesdmd
Placing implants in the anterior zone can be tough. There aren't many textbooks out there that explain where to place the implant and why to get the best esthetic outcome
When placing an implant in lets say the #8 position for example what are the consideration? How much bone do you need? How deep do you place the implant for proper emergence profile? What is the proper mesial/distal/Buccal/lingual positioning of the implant during placement. Size selection etc??
thanks in advance


Comments
Anterior implants simple? WRONG!
Anterior implants seem simple right? Just plop an implant into the hole and you are done. Not so my friend! The anterior implant is one of the most technically demanding implants out there! That is, if you want it to look good...
Here are some of my considerations. First, you must have a good base. By this, I mean thick bone and thick gingiva. If you don't have it...make it! Graft people! Second. The implant should be approx 3mm apical to your anticipated gingival margin. Be sure to check the adjacent teeth before you place the implant. You know how many cases I have seen where people place the implant in what they think is the correct spot, only to later realize that they needed to crown lengthen the adjacent teeth prior to placing the implant? Guess what? You are too late buddy! The patient now has to live the rest of their life with a tiny Chicklet tooth all because you did not realize you should have crown lengthened first. Nice job. Buccal-lingual placement depends on whether you are doing cement retained or screw retained. There are many factors to consider here. These are just a few to think about.
Anterior Implants
I agree with mental foramen. I place and restore alot of anterior implants. Your comments are on the mark. Sometimes it is better to place it greater than 3mm. apical to the adjacent gingival margin.
Anterior Esthetic Zone Implant Placement
I have nothing to add after mental foramen's soap box comments. Good job.
implants in the esthetic zone ..question..
if a patient comes in with dx of root fracture on #9 and the gingival margin of #8 is 3 mm Apical to that of 9 and pt has a high smile line...
what would u do????
implants in the esthetic zone ..question.. answer
Immediate Implant on #9 and CTG on #8 to gain gingival symmetry.