Immediate Implant Placement With Peri-Implant Contour Augmentation in the Maxillary Central Incisor: A Three-Year Clinical and Cone-Beam Computed Tomography Follow-Up

Although immediate implant placement in the anterior maxilla can shorten the treatment timeline, it presents challenges in preserving peri-implant hard-and soft-tissue contours.We report the three-year clinical and radiographic outcome of immediate implant placement combined with peri-implant contour augmentation in the region of the maxillary right central incisor.A 20-year-old man presented two months after trauma with a non-restorable cervical fracture of the maxillary right central incisor.Clinical and conebeam computed tomography (CBCT) evaluation demonstrated facial bone deficiency with sufficient apical and palatal bone for immediate implant placement.Following atraumatic extraction, a 4 × 14 mm implant was placed in a prosthetically driven three-dimensional position with primary stability of 35 Ncm.The periimplant gap and facial contour were augmented using deproteinized bovine bone mineral (Bio-Oss®, Geistlich Pharma AG, Wolhusen, Switzerland) and a resorbable collagen membrane.Following uneventful healing, second-stage surgery was performed at three months, followed by definitive ceramic crown placement.At the three-year follow-up, the implant remained clinically stable, with healthy peri-implant soft tissues and preserved facial contour, without signs of inflammation, infection, or mobility.CBCT demonstrated maintained bone in the crestal and mid-buccal regions, with satisfactory osseointegration and preservation of peri-implant hard-tissue support.Careful case selection, atraumatic extraction, prosthetically driven implant positioning, primary stability, and appropriate management of facial bone deficiencies are important considerations for achieving predictable outcomes.