Implant in the Esthetic Zone

Question 1

Contrary to missing a posterior tooth, most patients have an __ regarding a maxillary anterior missing tooth

Answer 1

emotional response

Question 2

__ implant is one of the simplest procedures in implant surgery and prosthetics

Answer 2

Posterior single-tooth

Question 3

__ is often the most difficult procedure in all of implant dentistry

Answer 3

Maxillary anterior single-tooth replacement

Question 4

Why esthetics matter

Answer 4

Impact on patient satisfaction and quality of life
Role in social and professional interactions
Higher expectations for natural-looking restorations

Question 5

Critical anatomy of implants in the esthetic zone

Answer 5

Alveolar bone dimensions/quality (PIC)
Nasopalatine canal
Gingival biotype

Question 6

Attempting to place implants in cases with large nasopalatine canal leads to

Answer 6

penetration into the canal and a soft tissue interface

Question 7

What are the 2 types of gingival biotypes

Answer 7

Thick and thin
(Pics of both)

Question 8

This type of gingival biotype has more resistance to shrinkage/recession of periodontal pocket after bone loss

Answer 8

Thick biotype

Question 9

This type of gingival biotype is more prone to shrinkage after extraction and more difficult to augment after extraction.

Answer 9

Thin biotype

Question 10

Treatment planning and diagnosis : Comprehensive assessment includes

Answer 10

Clinical examination
Radiographic analysis
Digital planning

Question 11

What do we evaluate at the clinical examination

Answer 11

Smile line and lip dynamics
Important to evaluate when observing the cervical region

Question 12

Clinical results such as these things are much LESS demanding

Answer 12

Emergence contours
Interdental papilla presence
Shade and contour of the crown

Question 13

Radiographic analysis includes

Answer 13

CBCT scans for bone assessment

Question 14

Digital planning includes

Answer 14

CAD/CAM integration

Question 15

What are the smile design principles

Answer 15

Proportion and symmetry
Tooth form, size, shade
Patients facial features

Question 16

When looking at tooth form, size, and shade matching, we are looking at the influence on __ and __

Answer 16

interproximal contact area and gingival embrasure

Question 17

With a square shaped tooth, it is most favorable when the contact is further __

Answer 17

apical

Question 18

With a triangular shaped tooth, it is less __ and the contact is more __

Answer 18

predictable
Incisal

Question 19

The distance between the underlying interproximal alveolar crest height on the adjacent natural teeth and the final prosthetic contact point dictates the presence or absence of __

Answer 19

Interdental papilla

Question 20

Interdental papilla:
If this distance is more than __, the complete papilla formation will be compromised, this is called a __

Answer 20

5 mm
Black triangle

Question 21

Know the tooth size dimensions

Answer 21

Look at the pic

Question 22

What are some anatomic challenges

Answer 22

Natural tooth size vs. Implant diameter
Compromised bone height
Compromised mesiodistal space
Compromised faciopalatal width

Question 23

Natural tooth size vs. implant diameter:
Challenges in restoring __ with round-diameter implants

Answer 23

cervical esthetics

Question 24

Compromised bone height:
Importance of evaluating bone available for implant size and position.
Influences the __

Answer 24

soft tissue drape, implant size, implant position, and the final esthetic outcome
(Look at pics)

Question 25

Compromised bone height: Bone height and the impact on soft tissue height. Midcrestal = Interproximal =

Answer 25

Midcrestal = 2-3 mm below CEJ Interproximal = scalloped 3 mm more incisal than midcrestal

Question 26

Compromised mesiodistal space: __ for esthetic outcomes

Answer 26

Minimum space requirements (Look at pics for compromised mesiodistal space)

Question 27

Compromised faciopalatal width: Bone width loss primarily from the __

Answer 27

facial region

Question 28

Compromised faciopalatal width: Necessity of bone grafts to __

Answer 28

restore ridge anatomy

Question 29

Compromised faciopalatal width: Available bone should be at least __

Answer 29

3mm greater than the implant diameter

Question 30

Ideal implant positioning: __ below the free gingival margin __ from adjacent teeth __ of buccal bone

Answer 30

3 mm 1.5 mm 2 mm

Question 31

Ideal implant position: Faciopalatal - if it is too buccal =

Answer 31

dehiscence and gingival recession (Look at pic)

Question 32

Ideal implant position: Faciopalatal - if it is too palatal =

Answer 32

Improper restoration, not hygienic, not esthetic

Question 33

Ideal implant position: Facial angulation - risks of facial angulation leading to __ and __

Answer 33

esthetic and functional complications (look at pics)

Question 34

Ideal implant position: Cingulum angulation - Challenges with __ and __

Answer 34

screw-retained crowns and facial ridge lap (plaque control in almost impossible)

Question 35

Ideal implant position: Ideal angulation - The implant must be positioned in such a way that the __ aspect of the implant __ just touches an imaginary line that touches the __ of the adjacent teeth

Answer 35

Buccal platform incisal edges

Question 36

Common esthetic complications

Answer 36

Soft tissue recession / loss of papilla Malposition affecting smile line Peri-implantitis