A Paradigm Change in Macro Implant Concept: Inverted Body-Shift Design for Extraction Sockets in the Esthetic Zone.

An innovative macro hybrid implant design is aimed at enhancing labial plate dimension and tooth-implant distance while achieving consistent esthetic outcomes. This unique "body-shift" concept in diameter and shape combines a tapered apical portion with a cylindrical coronal portion in a singular implant body design. The overall configuration of the implant is inverted and "convergent" in form toward the implant-abutment interface where bone is thinnest. Conversely, the tapered apical portion is wider where the bone is greatest in volume and vascularity. By reducing the coronal portion of the implant with the inverted body-shift design, a coronal circumferential chamber is created, thereby allowing larger amounts of graft material to be placed labially and interdentally to create a net increased bone dimension. Use of the implant is demonstrated in a case report.

A multidisciplinary esthetic approach to single-tooth replacement and diastema closure.

Anterior tooth replacement has always posed an esthetic challenge for dentists. A multidisciplinary approach makes it possible to provide patients with esthetics and function. Treatment planning should involve other specialists when clinicians are faced with the additional esthetic concerns of the patient (such as anterior spatial anomalies and esthetically unpleasant existing restorations). Metal-ceramic fixed partial dentures have been used to allow the replacement of missing teeth for many years, providing both strength and esthetics. Several other options also are available, including implant placement. Dental implants in the esthetic zone are well-documented in the literature; numerous controlled clinical trials have shown overall implant survival and success rates. This article illustrates a step-by-step analysis and treatment option for a single-tooth replacement and maxillary anterior spatial dilemma using Captek crowns.