Tommaso Ghedini

A 55-year-old female came to my attention for a failed inferior central incisor due to a corono-radicular fracture. The patient wanted to solve the problem in a short period time and without any removable prosthesis. The esthetic concern was evaluated before the surgery and a mucogingival flap was planned to prevent soft tissue shrinkage. In addition, the space for the implant placement was very narrow so we decided to proceed with a guided drilling sequence to avoid any damage to the adjacent roots. We planned to use a 2,9 mm Straumann BLT implant with a temporary ovate shape abutment. The mucogingival flap was raised before the root avulsion so to have better control on the extraction phase. The buccal bone was intact, so we proceeded as planned with the drilling sequence through a stent. Unfortunately for these narrow implants we couldn’t insert the fixture guided but, in this case, we had enough bone to place it properly and we reached a good primary stability. We went on with the immediate loading of a screw-retained prosthesis without any masticatory or guidance function. After 2 months of healing, we made another provisional prosthesis to shape the soft tissues and functionalize the tooth. Then, we were ready for the final impression with the digital copying of the provisional emergence profile. The metal abutment was customized to reach a good support for the zirconia that was bonded on it and then veneered with ceramic so to achieve an acceptable esthetic result. The stability of the hard and soft tissues at 1 year follow-up seems promising for a good long-term result. The combination of a mucogingival approach and a digital workflow helped to minimize the treatment time and to proceed with a one-stage surgery to achieve the functional and esthetic goals needed for the case resolution.

Dr. Tommaso Ghedini graduated in Dentistry at Milan University with full marks and honors. Specialized at the same university with honors in Oral Surgery. Member of the International Team for Implantology (ITI), Active Member of the Italian Academy of Esthetic Dentistry (IAED) and Active Member of the Italian Academy of Osseointegration (IAO). Within IAO he was part of the Young Working Group, now he is a member of the “Communication Commission” for the period 2021-2024. Member of the “Young Dentists Commission” for the Order of Surgeons and Dentists of Milan for the period 2018-2024. Speaker at national and international conferences and author of scientific publications in the field of oral and implant surgery. He works in private practices in Milan and its province. He also collaborates at the Humanitas Dental Center (Humanitas Research Hospital) department where he mainly deals with oral and implant surgery.