심미적 영역에서 단계적 접근을 통한 다수 치아 임플란트 수복: 증례보고

Abstract

Replacement of missing teeth in the esthetic zone is often a challenge for the clinician. Especially, in the area with soft tissue and hard tissue deficiencies, a step by step approach accompanying bone augmentation procedure and soft tissue graft is necessary. In the present case, severe gingival recession and horizontal bone deficiency were noted in maxillary anterior region. Prior to the implant placement, vascularized interpositional periosteal connective tissue (VIP-CT) graft was performed at the time of extraction of anterior teeth to increase keratinized tissue and soft tissue dimension. After 2 months, implants were installed and guided bone regeneration (GBR) was performed on the horizontal alveolar defect. Additional soft tissue graft was done for improvement of horizontal contour at the time of the healing abutment connection. To obtain the proper gingival contour and papilla, temporary restoration was used for 3 months prior to the delivery of final restoration. Relatively enough bone and soft tissue were acquired using staged soft tissue and hard tissue augmentation procedures with implant installation, and the patient was satisfied with the restoration and gingival architcture. Implantation restorations to replace multiple missing teeth in esthetic zone with the soft tissue and hard tissue deficiencies require presurgical planning, proper implant positioning, skillful practitioner and teamwork of the entire implant team