Predictable 3D Bone Reconstruction and Implant Restoration with Full Digital Workflow in Aesthetic Zone

Implant restoration in anterior maxilla often present a challenging dilemma to both surgeons as well as restorative dentists. Several factors influence the outcome of the case such as available residual bone, soft tissue type, restorative space, smile line, and implant position. Careful implant planning and placement play a critical role for successful implant therapy. The presence of good bone support is often scarce in the anterior maxilla Bone resorption due to peri-apical or periodontal infections and in case of delayed implantation, there is often the need for bone augmentation procedures especially in the aesthetic zone. Bone augmentation procedures advocated in literature demonstrate a variable success rate in achieving predictable bone volume. This case report of a 30-year-old male presents an endodontically failing central incisor, with inadequate surrounding bone (Seibert class 3) demonstrating both horizontal and vertical bone defect. Rehabilitation was carried-out by bone augmentation using autogenous cortical bone harvested from the ramus in combination with Xeno bone particles. On maturation this is followed by guided implant insertion and immediate Cad-cam restoration, following a full digital workflow. Final Restoration was given after 6 weeks. Conclusion: Bone augmentation using a thin autogenous bone plate stimulates revascularization and accelerates graft regeneration. The Xeno particles help in maintaining the volume during the remodelling stage. Complete digital workflow with guided implant placement and immediate prefabricated restoration provides accuracy for an aesthetic outcome besides reducing overall treatment time and patient acceptance. The customized BioHpp one-time abutment provides softer loading of the implant and maintains 3-dimensional bone volume and provides good soft tissue stability. The author advocates the described treatment workflow for such complex cases as it demonstrates reliable and predictable treatment outcome.