İmmediat İmplant Yerleştirme, Yükleme ve Greftleme ile Maksiller Ön Bölgenin Estetik Rehabilitasyonu: Bir Vaka Raporu

Abstract

Modern diş hekimliğinde, özellikle estetik bölgede, immediat implant yerleştirme ve yükleme protokolleri öngörülebilir tedavi stratejileri olarak ortaya çıkmıştır. Bu yaklaşımlar, tedavi süresinin kısaltılması, implant çevresi yumuşak doku mimarisinin korunması ve hasta memnuniyetinin artırılması gibi avantajlar sunmaktadır. Ancak, uzun vadeli başarıyı garantilemek için yeterli kemik ve yumuşak doku desteği ile primer stabilitenin sağlanması da dahil olmak üzere biyolojik ve protetik ön koşulların karşılanması gerekmektedir. Bu olgu sunumunda, yüksek estetik talepleri olan ve maksiller anterior bölgede hemen implant yerleştirme, greftleme ve geçici restorasyon uygulanan 18 yaşında bir kadın hastanın yönetimi sunulmaktadır. Atravmatik çekim ve yeterli stabiliteye sahip implant yerleştirilmesinin ardından greftleme yapılmış ve 24 saat içinde vida tutuculu geçici protez uygulanmıştır. Üç aylık iyileşme sürecinin ardından zirkonyum definitif restorasyonlar üretilmiş ve simante edilmiştir. On aylık takip süresince herhangi bir komplikasyon gözlenmemiş ve tatmin edici estetik ve fonksiyonel sonuçlar elde edilmiştir. Sonuçlar, uygun vaka seçimi, yeterli primer stabilite ve dikkatli protetik planlama ile acil implant yüklemesinin güvenilir ve öngörülebilir sonuçlar sağlayabileceğini göstermektedir.

Keywords

• anterior maksilla
• estetik rehabilitasyon
• immediat implant yerleştirme
• immediat yükleme
• tek diş restorasyonu

Esthetic Rehabilitation of the Maxillary Anterior Region with Immediate Implant Placement, Loading, and Grafting: A Case Report

Abstract

Immediate implant placement (IIP) and loading protocols have emerged as predictable treatment strategies in contemporary dentistry, particularly in the esthetic zone. These approaches offer advantages such as reduced treatment time, preservation of peri-implant soft tissue architecture, and improved patient satisfaction. However, biological and prosthetic prerequisites, including adequate bone and soft tissue support and primary stability, must be fulfilled to ensure long-term success. This case report presents the management of an 18-year-old female patient with high esthetic demands who underwent IIP, grafting, and provisionalization in the maxillary anterior region. Following atraumatic extraction and implant placement with sufficient stability, grafting was performed and a screw-retained provisional restoration was delivered within 24 h. After a 3-month healing period, definitive zirconia implant-supported restorations were fabricated and cemented. Over a 10-month follow-up, no complications were observed, and satisfactory esthetic and functional outcomes were achieved. The results indicate that, with proper case selection, sufficient primary stability, and careful prosthetic planning, immediate implant loading can provide reliable and predictable outcomes.

Keywords

• Anterior maxilla
• esthetic rehabilitation
• immediate implant placement
• immediate loading
• single tooth restoration

References

1. Khoury G, Chamieh F, Fromentin O. One-by-one immediate dental implants: a papillae preservation concept for adjacent implants in a compromised periodontal case. Clin Case Rep. 2020; 8: 2664-72.
2. Wittneben JG, Molinero-Mourelle P, Hamilton A, et al. Clinical performance of immediately placed and immediately loaded single implants in the esthetic zone: a systematic review and meta-analysis. Clin Oral Implants Res. 2023; 34: 266-303. doi:10.1111/clr.14172
3. Dinçkal Yanıkoğlu N, Oktay F. Role of Immediate Loading in the Success of Implants and Implant-Supported Dentures. Arch Basic Clin Res. 2023; 5: 296-305. doi:10.5152/ABCR.2023.22044
4. Kan JYK, Rungcharassaeng K, Deflorian M, et al. Immediate implant placement and provisionalization of maxillary anterior single implants. Periodontol 2000. 2018; 77: 197-212.
5. Guzman G, Rojas-Rueda S, Floriani F, et al. Aesthetic clinical case for immediate implant therapy for maxillary central incisor. Case Rep Dent. 2024; 2024: 4199406. doi:10.1155/crid/4199406
6. Trimpou G, Schwarz F, Begić A, et al. Clinical performance of immediately placed and restored progressive-type implants in the esthetic zone: a prospective observational study. Int J Implant Dent. 2022; 8: 57. doi:10.1186/s40729-022-00462-y
7. Tettamanti L, Millan-Figuera A, Santos A, et al. Immediate loading implants: review of the critical aspects. J Osseointegr. 2017; 9: 61-8.
8. Brown SDK, Payne AGT. Immediately restored single implants in the aesthetic zone of the maxilla using a novel design: 1-year report. Clin Oral Implants Res. 2011; 22: 445-54. doi:10.1111/j.1600-0501.2010.02125.x

9. Belser UC, Grütter L, Vailati F, et al. Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: a cross-sectional, retrospective study in 45 patients with a 2- to 4-year follow-up. J Periodontol. 2009; 80: 140-51.
10. Carini F, Longoni S, Pisapia V, et al. Immediate loading of implants in the aesthetic zone: comparison between two placement timings. Ann Stomatol (Roma). 2014; 5: 15-26.
11. Stanley M, Braga FC, Jordao BM. Immediate loading of single implants in the anterior maxilla: a 1-year prospective clinical study on 34 patients. Int J Dent. 2017; 2017: 8313680. doi:10.1155/2017/8313680
12. Afrashtehfar KI, Annamma LM, Alshayeb MA, et al. Selection criteria for immediate implant placement and immediate loading for single tooth replacement in the maxillary esthetic zone: a systematic review and meta-analysis. Clin Oral Implants Res. 2023; 34: 304-48.
13. Chatzopoulos GS, Wolff LF. Survival rates and factors affecting the outcome following immediate and delayed implant placement: a retrospective study. J Clin Med. 2022; 11: 4598. doi:10.3390/jcm11154598
14. Pour DG, Rompen E, Lambert F. Soft-tissue esthetic outcome of single implants. Clin Implant Dent Relat Res. 2018; 20: 346-54.
15. Wittneben JG, Buser D, Belser UC, et al. Clinical performance of immediately placed and immediately restored progressive-type implants in the esthetic zone: a prospective observational study. Clin Oral Implants Res. 2022; 33: 1232-43. doi:10.1111/clr.13994
16. Çelik E, Polat S, Alp H. Immediate loading of a single implant in the anterior maxilla: a case report. Atatürk Üniv Diş Hek Fak Derg. 2013; 40: 81-5.
17. Köroğlu AE, Gönüldaş F, Oztas DD. Immediate implant placement and loading protocols. Turkish J Clin Lab. 2024; 15: 297-303. doi:10.18663/tjcl.1428688
18. Papaspyridakos P, Chen CJ, Gallucci GO, et al. Accuracy of implant impressions for partially and completely edentulous patients: a systematic review. Int J Oral Maxillofac Implants. 2014; 29: 836-45.
19. Bi C, Wang X, Tian F, et al. Accuracy of complete-arch digital implant impressions: a systematic review and meta-analysis. Clin Oral Implants Res. 2022; 33: 123-35.
20. Papaspyridakos P, Vazouras K, Chen YW, et al. Digital vs conventional implant impressions: a systematic review and meta-analysis. J Prosthodont. 2020; 29: 660-78. doi:10.1111/jopr.13211
21. Najeeb S, Zafar MS, Khurshid Z, et al. Applications of polyetheretherketone (PEEK) in oral implantology and prosthodontics. J Prosthodont Res. 2016; 60: 12-9.
22. Akay C, Ersöz MB. PEEK in dentistry: properties and application areas. Int Dent Res. 2020; 10: 60-5.
23. Gamborena I, Sasaki Y, Blatz MB. Predictable immediate implant placement and restoration in the esthetic zone. J Esthet Restor Dent. 2021; 33: 158-72.
24. Wittneben JG, Millen C, Brägger U. Clinical performance of screw- versus cement-retained fixed implant-supported reconstructions: a systematic review. Int J Oral Maxillofac Implants. 2014; 29: 84-98.
25. Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants. 2004; 19: 43-61.