Implant placement in the aesthetic zone: Long-term results.

SUMMARY: Implant placement is considered to be a routine procedure for oral rehabilitation, in cases of tooth agenesia or tooth loss (due to factors such as periodontitis, trauma,caries). Dental implants’ position does not change over time due to the process of “osseointegration”. On the contrary, teeth follow craniofacial growth (in particular, orofacial and dentoalveolar growth) and move. The stomatognathic system undergoes changes in its vertical and horizontal dimensions after adulthood. Implant placement on the anterior maxilla is challenging for clinicians, because of continuous eruption of adjacent teeth, as well as, due to occurrence of occlusal changes. Long-term aesthetic complications, such as differences in incisal edges’ length, position of gingival margins and open contact points between implant restorations and adjacent teeth, should be taken into consideration. The aim of this study is to review literature concerning long-term complications after implant placement in the anterior maxilla. Furthermore, 2 case reports concerning aesthetic problems of implant restorations in the esthetic zone will be presented, together with their treatment procedure. Consequently, with time, implant restorations in the anterior maxilla present aesthetic complications of various degrees, which are in need of personalized treatment plan. In order to avoid such complications, implant placement is recommended to be performed after completion of skeletal growth and maturation.