A Combination of Buccal Plate Preservation and Dual Zone Therapeutic Technique in Immediate Implants: A One-Year Follow-Up

Figure 1. Initial clinical situation of maxillary left second premolar. Figure 2. Initial clinical situation occlusal view. Figure 3. Periapical radiograph showing good proximal bone levels, substandard endodontic treatment. Figure 4. Use of periotome for cutting of the periodontal ligament fibers. Figure 5. Atraumatic extraction to preserve the buccal bone. Figure 6. Immediate implant placement in proper prosthetically guided position, leaving 3 mm of space to the buccal bone, 3 mm apical to the free gingival margin.

Figure 7. Pouch preparation on the facial aspect of the buccal bone extending to the mucogingival junction. Figure 8. Xenograft material packed in the pouch and in the buccal and tissue zones all the way to the free gingival margin. Figure 9. Screw-retained provisional crown delivered to contain the bone graft and preserve the soft tissue architecture. Figure 10. Periapical radiograph showing proper implant position and abutment adaptation. Figure 11. Vinyl polysiloxane impression material adapted to the final crown. Figure 12: The copy abutment of the final crown.

Figure 13. One-year follow-up showing proper soft tissue thickness. Figure 14. One-year follow-up showing excellent esthetics, stable soft tissue architecture. Figure 15. One-year follow-up periapical radiograph showing stable bone levels.