The importance of prosthetic planning for implant-supported dentures in esthetic zones – A case report

INTRODUCTION: Implant-supported dentures in esthetic zones pose a great challenge to dental surgeons, since important factors are involved in treatment success, such as positioning of the implants, morphology of soft tissues, dental esthetics, and biomechanics of the prosthetic structure. PRESENTATION OF CASE: This clinical report describes the case of a patient previously subjected to dental surgery for implant placement on tooth #11 and subsequent prosthetic crown placement. The patient reported poor esthetics due to gingival retraction and changes on the surface of the ceramic material. After proper multidisciplinary planning, the prosthesis was remanufactured, with the selection of new components and periodontal surgery using a modified technique for the handling of soft tissues. After nine postoperative months, the patient had a better gingival alignment and reported esthetic and functional satisfaction. DISCUSSION: After assessing the positioning of implants, it is important to select prosthetic components that are suitable to each clinical case, as they will guarantee clinical success for long time periods. In order to obtain a better gingival contour and avoid an extensive surgical procedure, two techniques were used: the pinhole surgical technique, in which the gingiva is repositioned without the use of grafts; and Tarnow’s technique, in which a semilunar incision is made in soft tissues. CONCLUSION: The multidisciplinary approach, combining prosthetic and periodontal procedures, proved to be efficient, improving esthetic outcomes.