Rehabilitation of anterior upper incisor area with combined therapy Maryland Bridge and Prama Implant: two case reports three

Background: New implant system with an innovative trasmucosal surface profile morphology (BOPT) have been recently developed. The transmucosal neck surface is characterized by a controlled passivation treatment and a conical morphology to allow a biological corrected prosthetic form of ceramic crown. Aim/Hypothesis: The aim of this clinical cases study was to evaluate the marginal crestal bone loss (MBL) and gingival/periodontal status of transmucosal implant placed in anterior upper area. Material and methods: Three healthy subjects with acute active periapical lesion of seriously compromised upper incisor requiring tooth extraction were consecutively included in the study. After tooth extraction, all patients were rehabilitated with the positioning of a Maryland bridge to preserve the aesthetic line. Approximately 3 months later a transmucosal zirconium blasted acidetched titanium (ZirTi) implant (PRAMA, Sweden & Martina, ITALY) was positioned with flapless technique. All implants had insertion torque of 50–65 N/cm. Each implant was finally loaded after 3 months with a provisional resin crown and a di-silicate ceramic crown as definitive restoration. Clinical and radiographic follow-up (mucosal profile, periodontal indices and MBL) was performed 1, 2, 3 months after implant placement and 3 and 6 months after loading. Results: No gingivitis and other complications were observed. No marginal bone loss was observed around the implants before and after loading. Adequate and corrected aesthetic crown profile was obtained with a reduced compression of mucosal marginal tissues. Conclusions and clinical implications: The combined prosthetic and surgery technique and the use of ZirTi implant system with BOPT profile showed valid aesthetic and biological profile and allow the placement of the ceramic crown with a corrected emergency profile that may prevent MBL.