%0 Journal Article
%T Optimizing Maxillary Aesthetics of a Severe Compromised Tooth through Orthodontic Movement and Dental Implants
%A Rafael Scaf de Molon
%A Erica Dorigatti de Avila
%A Joni Augusto Cirelli
%A Mauricio de Almeida Cardoso
%A Leopoldino Capelozza-Filho
%A Luiz Antonio Borelli Barros
%J Case Reports in Dentistry
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/103808
%X Treatment of severe compromised tooth in the maxillary anterior area still poses great challenge to the clinicians. Several treatment modalities have been proposed to restore the function and aesthetics in teeth with advanced periodontal disease. The present study aims to report a case of traumatic injury of a left-maxillary central incisor with ridge preservation, orthodontic movement, and implant therapy. A 45-year-old woman underwent the proposed treatment for her left central incisor: basic periodontal therapy, xenogenous bone graft, and guided bone regeneration (GBR). Six months after the graft procedure, orthodontic movement by means of alignment and leveling was made and a coronal displacement of the gingival margin and vertical bone apposition could be observed after 13 months of active movement. Afterwards, a dental implant was placed followed by a connective tissue graft and immediate provisionalization of the crown. In conclusion, orthodontic movement was effective to improve the gingival tissue and alveolar bone prior to implant placement favoring the aesthetic results. Six years postoperatively, the results revealed height and width alveolar bone gain indicating that the treatment proposed was able to restore all the functional and aesthetic parameters. 1. Introduction Single implant therapy is a predictable treatment and has high success rates, at least when adequate bone volume is present. However, severe compromised tooth in the maxillary aesthetic region poses a great challenge to implant therapy. A correct diagnosis, absence of systemic conditions such as diabetes mellitus [1], an adequate treatment plan, improvement of surgical techniques, and multidisciplinary team planning play an important role in the success of complex cases [2]. According to Savi et al. [3] to achieve an adequate aesthetic result in anterior upper regions with dental implants, favorable periodontal tissue and bone conditions should be present. There are several treatment options to restore the aesthetic and function of a compromised anterior tooth. Different treatment modalities to hard and soft tissue formation at the site of tooth extraction are used, including forced orthodontic eruption [4, 5], ridge augmentation by means of bone and connective tissue graft [2], guided bone regeneration (GBR), immediate or delayed implant placement, and a combination of those [6]. Implant therapy can be complex due to numerous local anatomic or traumatic factors resulting in aesthetic commitment in the maxilla. These factors involve thin gingival biotype, thin buccal bone
%U http://www.hindawi.com/journals/crid/2014/103808/