The patient returns 6 days postop asymptomatic.  The provisional is loose.  After extending access labially, the temporary abutment screw is retightened.  The access is repaired with composite (Fig.8 arrowheads).  The fistula has disappeared, as compared to Fig.1,6,7.

Note the gingiva adapts the provisional nicely with good papilla morphology.  When the implant osteointegrates and the temporary abutment is removed, the socket will look good.  A 15° angled or straight abutment is tried in with possible lingual reduction, leaving labial gold coating intact.  Cosmetics should be promising.

Tough Case

Xin Wei, DDS, PhD, MS 1st edition 03/04/2015, last revision 01/19/2018