Int J Periodontics Restorative Dent 27 (2007), No. 1 1. Feb. 2007
Impaction of a maxillary canine is common. Orthodontic realignment is not always the therapy of choice. Instead, the impacted tooth can be extracted and replaced by an implant. The replacement of a single tooth with an implant in the anterior maxilla is a topic of interest for clinicians because of its esthetic implications, mostly when immediate loading has been planned. This article describes a clinical case in which an impacted maxillary canine was replaced by an immediately restored osseointegrated implant. A 21-year-old woman with a palatally impacted maxillary canine and the corresponding primary tooth still remaining in the arch was treated. Both the primary and permanent teeth were surgically extracted. A conical-shaped blasted implant was immediately placed into the socket of the primary canine. A self-contained osseous defect remained on the palatal aspect and was filled with bovine bone mineral. The implant achieved excellent primary stability, so it was immediately restored with a provisional acrylic resin crown in light centric occlusion. After 6 months, the definitive metal-ceramic crown was placed. The therapy provided an excellent esthetic result, maintaining ideal soft tissue contours and papillary height. No signs of radiolucency were visible at the 1-year evaluation. The case presented supports the use of single implants for the replacement of extracted primary teeth, especially in areas where esthetics is a high priority. Furthermore, because the prosthetic restoration was done immediately, the overall time needed to restore the patient was considerably reduced in comparison with the time required for the conventional approach.