Digitally-Guided Implant Restoration In Aesthetic Zone With Embedded Teeth

Implant surgery in the anterior aesthetic zone requires careful planning, especially for fully embedded teeth. Digital positioning guides with Guided Bone Regeneration (GBR) enhance implant precision and bone augmentation, offering a novel repair-oriented approach. The patient presented with a defect in the 11-22 region with severe ridge resorption and an embedded tooth in the apical region of 11. Initial treatment involving the fabrication of a diagnostic wax-up of resin teeth using the original removable denture as a reference. The patient wore the resin teeth for intraoral scanning after confirming satisfaction with morphology and occlusion. A digitally guided implant positioning system was designed with CBCT, using the restoration as a reference. Digitally guided implant placement with GBR was performed at sites 11 and 22. Six months later, second-stage surgery with gingival contouring and temporary restorations was completed, followed by the final restoration three months later. At the 1-year follow-up, the patient exhibited no discomfort. Imaging demonstrated successful osseointegration of the implants. CBCT and intraoral scanning technology acquire high-resolution 3D imaging data of the patient’s oral structures, which is integrated with implant planning software to optimize surgical precision, ensuring that the implant's position, angulation, and depth align with anatomical and functional requirements. For cases with bone-embedded teeth in the anterior aesthetic zone, the combination of digital surgical guides and CBCT can significantly reduce the complexity of the procedure.