Background: Congenital missing laterals are considered a quite common dental abnormality. The limited arch length makes implant procedure sometimes very challenging to be considered as a restorative option.
Aim: This case report aimed to demonstrate the benefit of utilizing three-dimensional (3D) printed models in managing challenging implant cases in limited arch length for congenitally missing maxillary lateral incisors.
Case report: A 39-year-old female Afro-American patient presented at the Ashman Department of Periodontology and Implant Dentistry, New York University College of Dentistry, to replace her congenitally missing maxillary laterals. Adequate mesiodistal arch length was present for edentulous areas of #12 and 22 clinically. Cone beam computed tomography (CBCT) showed adequate buccolingual bone width. Three-dimensional printed models were used to evaluate the labial angulation of the alveolar ridge, facial concavities and to demonstrate the surgical implant placement prior to the day of surgery. Bonelevel tapered implant with 3.3 mm diameter and 12 mm length (StraumannRoxolid®SLActive® implant) was placed in palatal position. Immediate cement retained nonfunctional provisional crown, fabricated, cemented on a prefabricated abutment to provide soft tissue contouring and immediate esthetic restoration. One week later, the same surgical protocol was followed in the area of missing #12.
Conclusion: Placement of dental implant in limited mesiodistal edentulous space in an esthetic zone is a challenging procedure that requires thorough assessment and adequate surgical and restorative expertise to achieve optimum outcome. The 3D printing has proved its valuable benefit in treatment planning and executing difficult implant treatment by visualizing the supporting tissues in spatial dimensions and providing accurate measurements and in demonstrating hands on before the surgery time.
Clinical significance: The 3D visualization (using CBCT) allows for rapid site analysis and predictable treatment planning in various difficult cases of implant placement, especially in cases of congenitally missing maxillary lateral incisors with less arch length.
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