All of the following cases were completed by Dr. Fioritto.
Fractured tooth #9, replaced immediately with an implant, graft and custom healing abutment. Following 4 months healing, the papilla and gingival margins are well maintained making the final impression as simple as a conventional crown and bridge impression.
Four months later:
Hopeless tooth #13 due to extensive decay, replaced immediately with an implant and custom healing abutment. Maintaining the papilla for posterior teeth not only helps with esthetics but it improves the emergence profile and prevents food traps in the gingival embrasures.
After 4 months healing, the preserved papilla are transferred to the lab using a customized impression post.
Tooth #19 required extraction due to fracture. Extraction, immediate placement and custom healing abutment were again used to maintain the gingival architecture.
After 3 months healing:
Teeth #9-11 are hopeless to restore due to decay and fracture. Extraction, immediate implant placement and provisionalization were completed to maintain the tissue architecture while providing the patient with an esthetic interim fixed bridge.
After four months:
Tooth #9 had broken to the gumline and was temporarily repaired with pins. Due to a hopeless prognosis for #9, extraction and immediate implant placement with provisionalization was completed. By maintaining the thin papilla with the provisional, we were able to obtain an excellent esthetic outcome in a thin gingival biotype and scalloped tooth form.
Five months post-operative: