Stephen Chu, DMD, MSD, CDT
Immediate tooth replacement therapy [ITRT} has become a mainstream treatment modality for single tooth implants in the esthetic zone. However there exists rewards and risks associated with ITRT. Risks involve the loss of the labial bone plate with time due to avascular necrosis if the labial bone plate is too thin post-treatment. The threshold amount of bone to achieve a vascular network for esthetic sustainability will be discussed and supported through evidence-based studies.
The second risk involves the loss of the interdental papilla due to horizontal formation of biologic with as well as the potential for crestal bone resorption. In addition, solutions for screw-retained restorations versus cement-retained will be elucidated with the use of subcrestal angle correction implants. Lastly, the future solutions in macro implant design, the diameter or ‘body-shift concept in regards to implant diameter and shape, will be demonstrated and supported with pre-clinical and clinical research to enhance esthetic outcomes.
Upon completion of this presentation, participants should be able to: 1) describe the value of peri-implant tissue thickness with platform switched implant designs; 2) explain how angle correction implants can enhance peri-implant soft tissue thickness as well as increase the incidence of screw-retained definitive restorations; and 3) discuss the biologic and esthetic outcomes associated with the ‘body-shift’ implant design concept in shape and diameter.