UNIVERSIDAD NACIONAL AUTÓNOMA DE MÉXICO Facultad de Odontología División de Estudios de Posgrado e Investigación

REHABILITATION OF MALPOSITIONED IMPLANTS WITH SOFT TISSUE MANAGMENT IN THE AESTHETIC ZONE  Jaime G.G. DDS., López Gazcón Z.K. DDS., Martínez H.R. DDS., Ríos S.E. MScD.

Objective: To describe how an optimal tissue management and implant-supported provisional restoration can improve predictability for the rehabilitation of malpositioned implants in aesthetic zone. Clinical case: Accurate soft tissue management around implants in the aesthetic zone represents a crucial point for restoration success and gingival health. Elements such as maintenance or reestablishment of harmoniously scalloped soft tissue lines and natural contours of the provisional will guide us to a final restoration that will fulfill biological and aesthetics expectations.

Fig.5 Temporary abutments prepared facially, incisally and apically to give gingival support.

Fig.7 The emergence profile has been gradually modified in every appointment to maintain soft tissue volume. Fig.1 Preexisting provisional restoration.

Fig.2 Improper tissue support with provisional restoration.

Fig.9 Polished final provisional fixed partial denture.

Fig.3 Oclussal view showing position of the implants.

Fig.4 Impression to shape the working model.

Fig.6 Abutment design achieving aesthetic outcome.

Fig.8 Intraorally seated impression copings.

Fig.10 Smile appearance with the provisional restoration.

Conclusion: Soft tissue stability around implant restorations and adjacent teeth is of great importance within the aesthetic zone and impacts on tissue preservation and maintenance of longtermed aesthetics. References