case_images: PMC6304909_01
case_images: Preoperative smile view.
case_images: CRID2018-9867402.001.jpg
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case_images: fig1
case_images: A 24-year-old female patient in a good health condition without any chronic diseases reported to the Postgraduate Department of Prosthodontics, SGT University, Gurgaon, with a chief complaint of abnormal-looking upper front teeth since 10 years (Figure 1).
case_images: Preop intraoral frontal view.
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case_images: fig2
case_images: On examination, the retained deciduous maxillary right lateral incisor and canine and deciduous left canine were observed along with the congenitally missing permanent maxillary left lateral incisor (Figure 2).
case_images: Preop OPG.
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case_images: PMC6304909_01_CRID2018-9867402.003.jpg
case_images: fig3
case_images: Preoperative orthopantomograph (Figure 3) and RVGs with respect to 52, 53, and 63 were taken.
case_images: Atraumatic extraction.
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case_images: fig4
case_images: After administration of local anesthesia, the procedure was performed atraumatically with the careful use of luxators (SDI ) and periotomes (Medessa ) to avoid damage of the continuity of the alveolar ridge and with anterior forceps (Figure 4) with minimal tissue damage to preserve the gingiva as well as the socket.
case_images: Root length measurements.
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case_images: fig5
case_images: The extraction sites were examined for the presence of any bony defect, and the root measurements of the extracted teeth were taken to decide the tentative implant sizes (Figure 5).
case_images: Withdrawing venous blood.
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case_images: fig6
case_images: Ten milliliters of venous blood was withdrawn from the antecubital vein of the patient (Figure 6) and immediately centrifuged (PRF Duo ) at 3000 rpm for 13 min to obtain an L-PRF clot (Figure 7).
case_images: PRF machine.
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case_images: PMC6304909_01_CRID2018-9867402.007.jpg
case_images: fig7
case_images: Ten milliliters of venous blood was withdrawn from the antecubital vein of the patient (Figure 6) and immediately centrifuged (PRF Duo ) at 3000 rpm for 13 min to obtain an L-PRF clot (Figure 7).
case_images: Preparation of the L-PRF membrane.
case_images: CRID2018-9867402.008.jpg
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case_images: fig8
case_images: L-PRF membrane (Figure 8).
case_images: Apical and palatal preparation of the osteotomy site.
case_images: CRID2018-9867402.009.jpg
case_images: PMC6304909_01_CRID2018-9867402.009.jpg
case_images: fig9
case_images: The osteotomy sites were prepared on the palatal and apical aspects (Figure 9).
case_images: Palatal orientation of the osteotomy sites.
case_images: CRID2018-9867402.010.jpg
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case_images: fig10
case_images: The palatal orientation of the osteotomy sites was checked using paralleling pins (Figure 10).
case_images: PRF gel-coated implant surface.
case_images: CRID2018-9867402.011.jpg
case_images: PMC6304909_01_CRID2018-9867402.011.jpg
case_images: fig11
case_images: The implant surfaces were coated with PRF gel (Figure 11). The implants were placed in the sockets, and cover screws were placed along with the L-PRF membrane using the poncho technique.
case_images: Poncho technique.
case_images: CRID2018-9867402.012.jpg
case_images: PMC6304909_01_CRID2018-9867402.012.jpg
case_images: fig12
case_images: In this, PRF membranes were wrapped around the healing cap to favor soft tissue attachment and prevent infection and help to maintain the soft tissue profile (Figures 12 and 13).
case_images: Final implant in placement.
case_images: CRID2018-9867402.013.jpg
case_images: PMC6304909_01_CRID2018-9867402.013.jpg
case_images: fig13
case_images: In this, PRF membranes were wrapped around the healing cap to favor soft tissue attachment and prevent infection and help to maintain the soft tissue profile (Figures 12 and 13).
case_images: Temporization irt implants placed in positions of 53, 53, and 63.
case_images: CRID2018-9867402.014.jpg
case_images: PMC6304909_01_CRID2018-9867402.014.jpg
case_images: fig14
case_images: Following completion of the endodontic therapy, temporization was done wrt tooth no. 23 as well (Figure 14).
case_images: Postop OPG.
case_images: CRID2018-9867402.015.jpg
case_images: PMC6304909_01_CRID2018-9867402.015.jpg
case_images: fig15
case_images: Augmentin (625 mg) TID for 5 days and the tablet Enzoflam D TID for 3 days were prescribed. A postoperative OPG was taken, and the patient was recalled after 1 week for follow-up (Figure 15).