Seeking the Optimal Aesthetic Result in the Maxillary Anterior
Learning Objectives:
Abstract:
Single or multiple tooth extractions, due to periodontal disease, periapical infection, root fracture or dental trauma, may lead to insufficient bone volume for the insertion of endo-osseous implants. Literature evidence suggests the possibility to compensate for post-extraction marginal ridge contraction using socket preservation techniques, using bone substitutes and collagen membranes via an open-healing concept. On the contrary, augmentation procedures are needed when the pre-existing bone height doesn’t allow for a correct space-related implant insertion, when a proper primary stability cannot be reached or when the prosthetic rehabilitation will provide an unfavorable crown/root ratio. Severe horizontal and vertical bone resorptions require lateral and supra crestal regeneration, a challenge for clinicians since the external soft tissue pressure is considered to be a major reason for failure of the surgical procedure in non-space-making bone defects. Guided bone regeneration using non-resorbable membranes, customized titanium mesh as well as compressed collagen membranes have been proposed for horizontal and vertical bone augmentation.

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