Seeking the Optimal Aesthetic Result in the Maxillary Anterior
Single or multiple tooth extractions, due to periodontal disease, periapical infection, root fracture or dental trauma, may lead to insufficient bone volume for the insertion of endo-osseous implants. Literature evidence suggests the possibility to compensate for post-extraction marginal ridge contraction using socket preservation techniques, using bone substitutes and collagen membranes via an open-healing concept. On the contrary, augmentation procedures are needed when the pre-existing bone height doesn’t allow for a correct space-related implant insertion, when a proper primary stability cannot be reached or when the prosthetic rehabilitation will provide an unfavorable crown/root ratio. Severe horizontal and vertical bone resorptions require lateral and supra crestal regeneration, a challenge for clinicians since the external soft tissue pressure is considered to be a major reason for failure of the surgical procedure in non-space-making bone defects. Guided bone regeneration using non-resorbable membranes, customized titanium mesh as well as compressed collagen membranes have been proposed for horizontal and vertical bone augmentation.