Cesar Luchetti
Department of Implant Dentistry. National University of La Plata. Argentina
One of the most challenged situations we must face regarding esthetics results is when we must do a crown over a natural tooth adjacent to a crown over a dental implant.
The differences between natural tooth and implant anatomy make difficult to harmonize the two emergency profiles.
Over the last years, slopped implants have proposed to be the solution to this problem. Although this could be true regarding the anatomy, there were some difficulties of some clinicians for the correctly implementation of its use.
We are presenting a case where we must restore a natural upper lateral incisor adjacent to an implant in upper central incisor area.
 |
| Pre-operative situation. An acrylic restoration was present over the lateral with an extension to the central incisor. |
 |
| Pre-operative situation after the bridge was retired. A depression is noticed in the buccal area together with a loss in papilla height in the mesial aspect of the lateral. |
 |
| Implant placement. Incision was made to the palatal and implant was placed in one stage approach to maximize the soft tissue in the buccal aspect and to avoid future soft tissue manipulation. |
 |
| Once the implant was integrated, a combined transfer – natural tooth impression was made. Note that the implant is slightly placed to the palatal to achieve better force distribution and also to allow a bigger amount of soft tissue in the buccal area. |
 |
| Metal substructures try in. |
 |
| Definitive crowns in place. |
 |
| Pre and post-operative comparison. |
...
