Prophylactic Root Resection and Alveolar Ridge Reconstruction for Future Implant Placement in the Esthetic Zone: A 2-Year Follow-Up Case Report

Abstract: Management of a failing maxillary anterior tooth with extensive periapical pathology and loss of the buccal alveolar plate carries a significant esthetic and biological challenge, particularly in esthetically demanding patients. This report describes the interdisciplinary management of a compromised maxillary central incisor. Sequenced treatment plan included prophylactic root end resection, site reconstruction for future implant placement while preserving the tooth temporarily throughout the treatment period. After eight months of healing, digital implant planning was utilized to facilitate prosthetically driven immediate implant placement and immediate provisionalization. The provisional restoration was maintained for approximately 1 year before delivery of the definitive restoration. Clinical and radiographic findings at the two-year follow-up demonstrated stable peri-implant hard and soft tissues. Keywords: immediate implant placement, esthetic zone, alveolar ridge reconstruction, guided bone regeneration, digital implant planning