engleski

Soft tissue management after tooth extraction in the esthetic zone - a case report

Tooth extraction results in alveolar ridge resorption that is more pronounced on vestibular bone wall. The reduction of hard and soft tissues usually causes functional and esthetic difficulties when planning future restorative procedures. Patient with chronic periodontitis wanted to improve esthetic appearance of his incisors: gingival recession, protrusion, tooth mobility of the tooth 21. After initial periodontal therapy, the plan was to extract the tooth 21 and to preserve the alveolar socket Bioabsorbable barrier (collagene membrane) was used to replace the resorbed vestibular bone wall and to cover the entrance of the alveolus, which was filled with bone substitute material, while free gingival graft from the palate was sutured to seal the entrance of the alveolus. After four months, ridge defect was obvious (Class I according to Siebert) so it was decided to perform soft tissue augmentation (pouch graft procedure with free connective tissue graft harvested from the palate using the “trap-door” technique). Restorative procedure followed after three weeks including temporary bridge with ovate pontic, and root canal therapy on the tooth 22. After the healing period of three months, impressions for definitive bridge were taken, and zirconium oxide framework was milled from IPS e.max ZirCAD block using Sirona InLab CAD CAM system. Definitive bridge was made from IPS e.max ceramics using layering technique and cemented with composite cement. In order to achieve optimal results in the esthetic zone, augmentation, adaptation and reshaping of the soft tissue should be performed before restorative procedure

tooth loss; esthetics; mucogingival surgery

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