Multidisciplinary treatment of implant-supported fixed prostheses in the aesthetic region: a case report
Tuğçe Koç1, Assoc. Prof. Işıl Sarıkaya1, Asst. Prof. Gözde Işıker Kara2
1 Department of Prosthodontics, Faculty of Dentistry, Gaziosmanpaşa University, Tokat, Turkey,
2 Department of Periodontology, Faculty of Dentistry, Gaziosmanpaşa University, Tokat, Turkey.
Introduction
In implant-supported restorations to be made in the aesthetic area, ensuring the harmony, function, and aesthetics of the crown with the soft tissue around the implant can create difficulties for the dentist. In this case report, we present the adaptation of implant-supported prostheses with poor fit and aesthetics, periodontal surgery applications, and aesthetic and functional results.
Case Description
A 22-year-old female patient without any systemic disease applied to Tokat Gaziosmanpaşa University Faculty of Dentistry with aesthetic concerns and gingival appearance of her implant-supported fixed prostheses with occlusal screws numbered 12-22, which were implanted three years ago (Medentica Gmbh, Hugelsheim, Germany). Clinical and radiological examination of the patient revealed 1-2 mm marginal bone loss on the labial surface of the implants, thin gingival biotype, a reflection of implant metal colour in the labial gingival region, presence of laceration in the gingiva and contour inconsistencies in the implant-supported fixed prostheses. First, implant-supported fixed prostheses were removed, and closure screws were inserted. Bleeding foci were created, and the gingiva was allowed to heal for two weeks. After the necessary adjustments were made to the contour of the implant-supported fixed prostheses, a subepithelial connective tissue graft operation was applied to the relevant area. Following the healing period, an increase in gingival thickness and gingiva compatible with the arranged implant-supported fixed prosthesis was achieved. Gingivectomy and gingivoplasty were performed on the maxillary incisors to improve the aesthetics, and gingival levels were aligned. After the treatments, the patient's aesthetic expectations and functional needs were successfully met.
Discussion
Aesthetically and functionally appropriate rehabilitation of tooth deficiencies in the anterior region is only possible with interdisciplinary coordination of all diagnostic, planning, and treatment procedures. Implant-supported prostheses can be improved in the proper case of patient selection and appropriate treatment planning.