Background and details
Left: Absence of central incisor, gain depression in the gums for lack of bone. Centre: Absence of a central incisor, note a collapse of the gums from a lack of bone. RightFinal crown. It became a bone graft prior to the implant's placement: note the excellent state of the gum that surrounds the crown onto the implant and the complete symmetry of both incisors in shape and color.
In the front area, the aesthetics of the smile does not depend only on a porcelain dental crown that mimics in color and shape with its neighbor teeth. It's even more important than what we call "pink esthetic," that's to say, the gums around the implant have dimensions and looks similar to that of their neighbor teeth.
But we have to know that the dimensions of the gum and even its color depend on the underlying bone and that when there isn't enough bone surrounding the labial area of the implant the gum looks grey and antiesthetic as well as the emergency profile of the porcelain crown looks unnatural, that's to say that of a healthy tooth.
That's why to conduct an aesthetic implantology of high quality the surgeon should be an expert in managing bone grafts.
Although trauma inherent in surgery is often used as an excuse to justify the non-performance of a bone graft, the benefits are so clear that it's worth a bone graft procedure, especially if we are to be assured in the long term the health, function and even aesthetics of our implants, as an implant that isn't completely surrounded by bone is more susceptible to infectious and mechanical complications.
Another common excuse was the possibility of "rejection" and the patient should know that bone grafts were very sensitive to the surgeon's hand. That's why in inexperienced hands, the risk of failure is far greater, but the specialist who's accustomed to performing bone graft in a customary way usually has a very high percentage of success.
It's important to note that using the microscope helps to make more precise and atraumatic incisions and sutures with what success is greater.
Virtually all patients undergoing bone graft claim that they felt nothing during surgery and with proper after-operative medication, they have been able to do all sorts of physical activity and sports after the first few days. Over time as these patients see the result of mid- and long-term treatment, they feel even lucky that they have been treated most sensitily from a medical point of view because they know their implants are completely healthy. It's important at this point to emphasize that the main requirement for an implant to have a success in terms of health, function and aesthetics is that it's completely surrounded by bone.
At Orthodoxy Clinic we are specialist in bone grafts and conduct regular courses and publications about this delicate matter.
Can you get to them? publications from Dr. David González and to explore the excellent aesthetics obtained by performing bone grafts for implant placement.
Cases as illustrated by this post are routine in our consultation, as you can see the result is excellent from an aesthetic point of view not only because the porcelain crown mimics the adjacent tooth but also because we have intermittent bone leading to a magnificent "pink esthetic."
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