This young 23 years old patient reported the loss of the element 1.1 at the age of 13 due to a trauma, followed by repeated dental interventions in the following years, unfortunately obtaining poor aesthetic results. The repeated failures, moreover, aroused in her a strong fear and a sense of distrust such as to prevent her from smiling freely in public. The request and the aim were to improve the appearance of the smile by reducing the number of surgical sessions and the invasiveness of the intervention to a minimum. To comply with the patient’s requests, it was decided to complete in a single surgical session both the missing element restoration and the vestibular volumes increment. Once examined, the CBCT confirmed the severe bone atrophy in area 1.1, we proceeded with the planning of the insertion of a Prama RF implant with guided surgery, exploiting the convergent intramucosal neck to manage the irregular crestal morphology and at the same time to support the soft tissues. To increase the vestibular volumes an Ossix™ Volumax membrane was inserted and the gingival morphology was conditioned by a screw-retained provisional crown.
For aesthetic reasons the element 2.2 was prepared according to the B.O.P.T. technique and the element 1.2 was restored.