Treatment Planning Challenges in the Maxillary Anterior Region Consequent to Severe Loss of Buccal Bone

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The burgeoning popularity of dental implant usage in the maxillary anterior region is well recognized. On the other hand, challenges involved in achieving optimal esthetics through implants have also been discussed extensively. Presence of labial/buccal bone in the maxillary anterior region is necessary for esthetic success of treatment, with or without the use of dental implants. This case report describes the multidisciplinary management of a rare case with severe loss of buccal bone confined to the maxillary central incisor region. A patient with a recent history of orthodontic treatment presented with a large buccal dehiscence of soft tissue that exposed nearly the entire buccal root surface of both maxillary central incisors. The treatment plan included extraction of both central incisors, hard and soft tissue ridge augmentation, and an all-ceramic fixed partial denture. After 2 years in function, the condition of soft tissues and integrity of the restorations remained stable. A discussion of traditional versus contemporary treatment planning using dental implants in such situations is presented.


Although implant therapy has proven to be a highly successful option, traditional treatment without implants may be advantageous in certain clinical situations. Compared to implant therapy, it can provide similar or better esthetic results with reduced treatment procedures, expenses, and time.

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