Immediate flapless implant placement and provisionalization: challenge for optimum esthetics and function: a case report.

This report presents a case of tooth extraction and immediate flapless implant placement followed by fabrication of transitional restoration. The tooth was extracted atraumatically with the use of a periotome followed by careful debridement. An osteotomy was performed up to 5 mm beyond the base of the socket and depth using the alveolar crest as a landmark, following a slightly palatal direction. The implant shoulder was inserted 3 mm below the cementoenamel junction of the adjacent tooth. The interproximal distance from the neighboring teeth was 3 mm. No membranes and/or grafts were used. Initial impressions were taken immediately after implant placement; 6 hours later a well-polished and slightly overcontoured (at the distal-mesial aspect) acrylic crown was fixed onto the implant. There were no contacts in the centric and lateral positions. Five months later, the occlusion was modified allowing slight contacts in the centric position for an additional 2 months. The final prosthetic restoration was placed 2 months later (7 months after surgery), consisting of a full ceramic crown cemented on a customized metal ceramic UCLA abutment. The technique maintained the integrity of hard and soft tissues and created a very favorable esthetic result. It also provided the patient with a transitional fixed restoration and reduced the time required for therapy completion. Because research on this field is limited, further investigation is required to support the results of this report, despite the promising clinical outcome.