Case study: replacing a failed front tooth with an implant

The concern

An upper front tooth, root-treated years earlier after a sporting injury, had fractured below the gum and could not be saved. The patient's concern was less the tooth than the gap, and whether a replacement would look obvious.

Why the front is different

A back tooth implant has to function. A front tooth implant has to function and be invisible, which means the gum must sit at exactly the right height and the crown must match a neighbour that everyone sees. Bone and gum volume are lost when a tooth is removed, so preserving them is planned before the extraction, not after.

The sequence

• A CBCT scan to assess bone volume and the position of the nasal floor
• Careful extraction preserving the surrounding bone, with grafting at the same visit
• A temporary tooth so the patient was never without one
• Implant placement after healing, then a further healing period before the final crown
• A custom-shaded crown made to match the adjacent natural tooth

The outcome

Roughly nine months from extraction to final crown, most of it waiting for biology rather than chair time. The patient had a fixed temporary throughout.

Details anonymised. Implant treatment depends on bone, gum health and general health; suitability is assessed individually.