Natural Crown as Immediate Implant Provisional Prosthesis: A Case Report
Antonio Ednardo de Souza Filho *
GO UP Training, Sobral - CE, Brazil.
Jamilly Vitória Souza Frota
Federal University of Ceará (UFC) - Sobral Campus, CE, Brazil.
Francisco Taylan Santos de Lima
Federal University of Ceará (UFC) - Sobral Campus, CE, Brazil.
João Marcos de Sales Brandão
Federal University of Ceará (UFC) - Sobral Campus, CE, Brazil.
Ana Luize Andrade Oliveira
Federal University of Ceará (UFC) - Sobral Campus, CE, Brazil.
João Isaac Santos de Souza
Inta University Center - Sobral Campus, CE, Brazil.
Guilherme Salles Ottoboni
GO UP Training, Sobral - CE, Brazil.
Calebe Lamonier de Oliveira Costa Paiva
GO UP Training, Sobral - CE, Brazil.
Marcelo Sousa Roberto
GO UP Training, Sobral - CE, Brazil.
Poliana Bastos Ottoboni
Federal University of Ceará (UFC) - Sobral Campus, CE, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Background: Dental agenesis in the anterior maxilla represents a significant esthetic and functional challenge, requiring rehabilitative approaches that preserve both hard and soft tissue architecture while providing immediate esthetic outcomes.
Aims: To report the clinical management and interdisciplinary protocol for the rehabilitation of maxillary canine agenesis via implant and immediate loading, using the deciduous crown itself as a temporary prosthesis to maintain gingival architecture.
Presentation of Case: A 34-year-old healthy female patient presented with an aesthetic complaint in the anterior maxilla associated with the persistence of the deciduous tooth 63 and agenesis of element 23. Given the unfavorable prognosis due to severe root resorption, atraumatic extraction followed by immediate placement of a Morse taper implant (3.5 x 15 mm, 60 N torque) was chosen. Grafting was performed with xenogeneic biomaterial and a resorbable membrane. High primary stability allowed for immediate loading, in which the extracted deciduous tooth crown was sectioned and adapted as a provisional crown on a titanium abutment. Subsequently, a virtual model was obtained via intraoral scanning (CAD/CAM) for the fabrication and cementation of the definitive lithium disilicate crown.
Discussion: The association between extraction, immediate implant placement, and immediate loading promoted a reduction in clinical time, as well as the preservation of marginal bone crests and soft tissue architecture. The use of digital workflow and CAD/CAM technology provided high precision, better marginal adaptation, and superior aesthetic results.
Conclusion: The technique proved to be a highly effective clinical strategy, providing a less traumatic rehabilitation workflow, immediate aesthetics, restoration of function, and a significant improvement in the patient's quality of life.
Keywords: Dental implants, immediate dental implant loading, mouth rehabilitation.