Immediate Embrasure Closure I

To reduce the large black triangle between the lateral incisor/canine and central incisor (Fig.1 *), osteotomy is not established mesial enough initially (Fig.2).  Since the bone density is not high, trajectory change is not attempted.  The ridge is wider within the socket.  A relatively large 2-piece implant (3.5x13 mm) is placed (Fig.3), but a 4x5.7(2) mm abutment is incompletely seated (<).  Use of 4.6 and 5.6 mm bone profile drills does not appear to solve the problem.  The implant is backed up to the supra-gingival level so that it seems easier physically to insert the same abutment into the implant.  Then both of them are torqued into the place together (Fig.4).  An immediate provisional is fabricated to close the gingival embrasure as much as possible (Fig.5).  Consider reducing the provisional margin (arrow) as early as possible postop.    In fact the patient agrees to have a new crown made for #8 to further close the embrasure.

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Xin Wei, DDS, PhD, MS 1st edition 02/11/2020, last revision 04/12/2020