Using an Ovate Pontic During Immediate Implant Placement
Perserving the Peri-Implant Architecture
Joseph Y.K. Kan, DDS, MS
hearing this podcast, the listener should:
the process of constructing a removable ovate pontic for the preservation of
gingival architecture in the aesthetic zone.
how to transition from an ovate pontic place holder to a definitive restoration
while preserving gingival architecture.
Y.K. Kan, DDS, MS
The impending loss of a single tooth in the anterior
aesthetic zone can be a traumatic experience. Although single-tooth restoration
with osseointegrated implants has been well-documented, successful placement of
an anterior single implant may be complicated based on its position and
surrounding tissue support. Numerous authors have demonstrated the significance
of the underlying osseous structures to the ultimate location of the gingival
tissue. Dentogingival dimensions of 3 mm facially of the failing tooth and 4.5
mm interproximally of the adjacent teeth must be established and the osseous
architecture must be preserved for predictable implant aesthetics.
Nevertheless, tissue stability of the anticipated implant restoration is
dependent upon the periodontal form of the prospective implant site. Since
gingival and interproximal papillary recession is difficult to regain, osseous
structures must be preserved to ensure maintenance of the gingival
architecture. If the failing tooth possesses a gingival architecture with
proper underlying bony support that harmonizes with the surrounding dentition,
these structures must be maintained using the appropriate surgical and
prosthodontic techniques at the time of tooth extraction.
Professor, Department of Restorative Dentistry, Loma Linda University School of
Dentistry, Loma Linda, California.
1. Andersson B, Odman P, Lindvall AM,
Lithner B. Single-tooth restorations supported by osseointegrated implants:
Results and experiences from a prospective study after 2 to 3 years. Int J Oral
Maxillofac Impl 1995;10(6):702-711.
2. Avivi-Arber L, Zarb GA. Clinical
effectiveness of implant-supported single-tooth replacement: The Toronto study.
Int J Oral Maxillofac Impl 1996;11(3):311-321.
3. Priest GF. Failure rates of
restorations for single-tooth replacements. Int J Prosthodont 1996;9(1):38-45.
4. Kois JC. Predictable single tooth
peri-implant esthetics: Five diagnostic keys. Compend Contin Educ Dent
5. Saadoun A, LeGall M, Touati B.
Selection and ideal tridimensional implant position for soft tissue aesthetics.
Pract Periodont Aesthet Dent 1999;11(9):1063-1072.
6. Salama H, Salama M, Garber D, Adar P.
Developing optimal peri-implant papillae within the esthetic zone: Guided soft
tissue augmentation. J Esthet Dent 1995;7(3):125-129.
7. Phillips K, Kois JC. Aesthetic
peri-implant site development. The restorative connection. Dent Clin North Am
8. Kan JYK, Rungcharassaeng K. Site
development for anterior implant esthetics: The edentulous site. Compend Contin
Educ Dent 2001;22:221-232.
9. Kois J. Altering gingival levels: The
restorative connection. Part I: Biologic variables. J Esthet Dent 1994;6:3-9.
10. Kan JYK, Rungcharassaeng K. Immediate
placement and provisionalization of maxillary anterior single implants: A
surgical and prosthodontic rationale. Pract Periodont Aesthet Dent