Achieving Optimal Esthetics with Immediate Implants and Veneers in the Smile Zone: A Case Study.

Abstract

Background: This case report outlines the clinical workflows for immediate implant placement for both maxillary central incisors and ceramic laminate veneers for the remaining teeth in the smile zone.

Methods: The patient's chief complaint was to improve her smile and address periapical infections with purulent exudate at the apex of her central incisors. Clinical and CBCT evaluations determined that the maxillary central incisors were non-restorable, while the lateral incisors and canines showed signs of incisal wear. Atraumatic extractions were performed for the central incisors, and immediate implants were placed with a 3D-printed surgical guide in conjunction with an autogenous soft tissue grafting procedure. Once the soft tissue between the central incisors was contoured with provisional implant restorations, minimally invasive veneer preparations were performed for porcelain laminate veneers. Final restorations were bonded under dental dam isolation.

Results: Single immediate implants for maxillary central incisors can be successfully paired with ceramic laminate veneers on adjacent teeth in the smile zone to replace non-restorable teeth in the esthetic zone.

Conclusions: Atraumatic tooth extraction, 3D implant planning with grafting procedures, and minimally invasive ceramic veneers can help in meeting patients' esthetic and functional expectations. Total isolation using a dental dam maximizes the bonding performance of ceramic restorations.