Implants can replace a single tooth or an area where several teeth are missing. The majority of implants are positioned where only one tooth is missing. That one failed tooth does not have to cause all the stress it used to. Patients can now have an intact dentition again without having to wear a denture, or have teeth prepped for a bridge. Trauma to that front tooth does not have to commit someone to a lifetime of disfiguration. With root shaped implants, the bone profile can be maintained which will maintain the gum profile. The crown of the tooth can then be positioned to give an excellent final result.
The difficulty arises when the trauma or pathology causes loss of bone as well as the loss of teeth. In this case, the gum profile is also lost, and the final result will look questionable. Here we will need to rebuild the bone prior to restoration of the tooth to give a good result.
The importance of the gum profile cannot be over-exaggerated. There is a technique to judge the “Pink Aesthetics” with regard to the height of the gum between teeth, and at the facial contour. The thickness, colour and texture of the gum or mucosa is also important. The crown could look beautiful, but if the gum does not look good, it may have more of a profound affect on the final aesthetics. The balance between the Pink and White aesthetics can make or break the case.
I recently had to diagnose a case to replace a single front tooth. The case looked easy at the first appearance, but on closer examination, there was a little bit of bone missing, and a little bit of gum contour missing. When we thoroughly worked out the treatment required, this easy case became quite a challenge. We had to replace the bone and gum prior to implant placement to make this case acceptable. The work we do needs to mimic nature so thoroughly that one cannot tell the difference between the natural tooth and the bought one.