IM0210

implants2_2010 _The success of dental restorations can be measured in terms of biological stability over time. With regards to dental implantology, the challenge is no longer one of integration, more long term aesthetic stability of the final restora- tion. Nowhere is this biological and aesthetic stability more important than in the aesthetic zone. Teeth and their roots have a supportive role to the alveolar bone in which they are retained. This bone in turn gives support to the gingival tissue overlyingit,andthelevelofthisbonedirectlyaf- fectsthepositionofthisgingivaltissue.1 Follow- ing tooth loss, this support is lost, and both the hard and soft tissue begin a process of remodel- ling. This process invariably results in the loss of bone, and an alteration in the gingival position. While it is possible to replace this support with the use of bone grafting or collagen plug tech- niques, this can involve a number of surgical procedures in order to achieve the final result. Original protocols in implantology required that implants be placed into healed edentulous ridges. Implants can, however, be placed at the time of tooth extraction.2 Such techniques can be used with simultaneous augmentation to preserve ridge width, decreasing total treatment time. This paper, and its case presentation, out- line a technique which allows, in the right con- ditions, the replacement of the support of a lost root, and consequently prevents major bone re- modelling and subsequent alteration of soft tis- sue position. The following case is one of many completed, ranging from the single tooth to multiple units, all of which have a minimum of twelve months follow-up, and the results of which will be collectively published in the near future.Theillustratedcaseinvolvesa63yearold, retired female patient who was referred to the clinic timeously by her general dental practi- tioner following root fracture affecting the up- per left lateral incisor. Her chief complaint was one of poor aesthetics affecting this tooth (Fig. 1). The condition of this tooth had declined gradually, following placement of a composite crown three years previously. The composite crown had been placed, retained by a temporary post, following failed root canal therapy during which an endodontic instrument was fractured in the tooth (Fig. 2). The patient was in good health, a regular dental attendee with an ade- quate oral hygiene regime. A full dental assess- ment was undertaken to include assessment of Immediate implant place- ment and temporisation in the aesthetic zone Author_ Dr Philip J. Friel, Great Britain Fig. 1 Fig. 2 Fig. 3 Fig. 4