case_images: PMC10352529_01
case_images: Initial clinical situation showing the main patient complaint: inaesthetic diastemata.
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case_images: fig1
case_images: Indeed, the patient presented several diastemas as well as a mesioposition of canines before orthodontic treatment (Figure 1).
case_images: Initial panoramic radiography.
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case_images: fig2
case_images: In addition, the patient had asymmetry in her wisdom teeth with agenesis of tooth number 16, therefore, excluding the possibility of mesialising molars (Figure 2).
case_images: Initial profile teleradiography.
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case_images: fig3
case_images: Finally, the cephalometric analysis showed a skeletal Class III (angle ANB = 1 ) as well as a normodivergence with a tendency to hypodivergence (angle FMA = 23 ) (Figure 3).
case_images: Average smile line during extraoral examination and after orthodontic treatment.
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case_images: fig4
case_images: Post-orthodontic maxillary occlusal and frontal views showing maintained restorative spaces with palatal fixed retainer.
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case_images: fig5
case_images: Restorative spaces were about 7.5 mm and were maintained with fixed retainers and maxillary removable resin injected retainer in canine area (Figure 5).
case_images: Panoramic radiography at the end of the orthodontic treatment.
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case_images: fig6
case_images: But root axes were parallel to bicuspid ones, making the implant placement easier (Figure 6).
case_images: Sagittal views from the computed tomography (a) on the region of tooth number 6 with the implant prefiguration (blue) and (b) on the region of tooth number 11.
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case_images: fig7
case_images: On both sides, alveolar crest was narrow (7 mm) and presented a buccal undercut (Figure 7).
case_images: Immediate interim restoration of teeth numbers 6 and 11 using composite injected resin tray.
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case_images: fig8
case_images: Chemicals Groups, Hanau, Germany) were practiced, and the diagnostic setup for the final restoration was made in order to prepare a composite injected resin tray as interim restoration (Figure 8). Careful attention was taken to maintain space between gingiva and tray, in order to avoid healing interactions.
case_images: Pre- and post-operative illustrations: implant placement on the region of tooth number 11, implant platform at bone level with peripheric one, primary closure with resorbable sutures.
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case_images: fig9
case_images: Surgical healing screw (CCNSP, Zimmer Biomet, Palm Beach Gardens, FL, USA) was placed on each implant, and operative sites were primarily closed using resorbable sutures 4.0 (Vicryl , Ethicon) (Figure 9).
case_images: Pre-operative clinical situation showing a lack of keratinized tissue around implant in the region of teeth number 6 with a pigmented gingiva.
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case_images: fig10
case_images: Connective tissue graft during second stage implant surgery at D0 and D + 15.
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case_images: fig11
case_images: The two surgeries were practiced at the same time, and control visits were realized at 2 weeks and 3 weeks (Figures 11, 12, and 13).
case_images: Frontal view of second stage implant surgery: D0 and D + 15.
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case_images: fig12
case_images: The two surgeries were practiced at the same time, and control visits were realized at 2 weeks and 3 weeks (Figures 11, 12, and 13).
case_images: Occlusal maxillary view of second stage implant surgery: D0 and D + 21.
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case_images: fig13
case_images: The two surgeries were practiced at the same time, and control visits were realized at 2 weeks and 3 weeks (Figures 11, 12, and 13).
case_images: Frontal and occlusal views of the integration of temporary implant-supported crowns.
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case_images: fig14
case_images: Temporary implant directly fixed crows were tried, and occlusion was adjusted in order to obtain canine guidance in lateral movement but no interdental contact in static occlusion (Figure 14).
case_images: Management of peri-implant profiles in positions 6 and 11.
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case_images: fig15
case_images: With these temporary crowns, patient had function and aesthetic rehabilitation, and profile emergence was modeled with resin adjunction for the future definitive crowns (Figure 15).