Implants · Dana A., 30s
A Single Front Tooth
The hardest implant in dentistry is a single central incisor next to a natural one. There is nowhere for an error to hide.
- Treatment
- Implants
- Duration
- 5 months
- Appointments
- 7 visits
- Clinician
- Dr. Karim Haddad
Patient Goal
What they came in for.
A failed root canal from a childhood trauma had finally fractured the root of her upper right central incisor. She knew it had to come out. Her only requirement, stated at the first appointment, was that she should not be able to tell which one it was.
Initial Condition
What we found.
Vertical root fracture of tooth 11, unrestorable, with a chronic sinus tract on the buccal aspect and 2.1mm of buccal bone loss on CBCT. The adjacent central incisor was intact, unrestored, and — as is usual — a shade that no ceramic block comes in. High smile line: the gum margin was fully visible when she laughed, which removed any margin for error in the soft tissue result.
Final Result
Where it finished.
Papilla height matched within 0.2mm of the contralateral tooth at twelve months. Buccal contour maintained by the connective tissue graft with no visible concavity. Marginal bone level unchanged at the one-year radiograph. Three of her colleagues have since asked her which tooth it was and guessed wrong.
Patient Experience
In their words.
She had expected the surgery to be the difficult part and described it afterwards as the easiest appointment of the whole case. The part she found hard was the waiting — four months between the extraction and the implant, with a temporary she was convinced everyone could see. Nobody could.
The plan, before anything started.
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Phase 01
Atraumatic extraction
The root removed without raising a flap, preserving the buccal plate and the papillae on either side.
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Phase 02
Ridge preservation
The socket grafted at the time of extraction and sealed, with an immediate temporary bridge so she was never without a tooth.
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Phase 03
Guided placement
Implant placed at four months through a printed guide, palatally positioned to leave room for a thick buccal graft.
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Phase 04
Soft tissue
A connective tissue graft placed at the same surgery by Dr. Vogel to thicken the biotype over the implant.
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Phase 05
Emergence shaping
A custom healing abutment shaped the gum for eight weeks before the final crown was even designed.
Treatment process
What actually happened, in order.
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Week 1
Extraction, socket graft, and a temporary bonded bridge using her own crown as the pontic — which meant the tooth she walked out with was literally her own.
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Month 4
CBCT confirmed the graft. Implant placed through the guide, 3mm below the planned gum margin and 2mm palatal, with a simultaneous connective tissue graft.
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Month 6
Integration confirmed by resonance frequency. Custom healing abutment placed and adjusted twice to shape the emergence profile.
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Month 8
Cross-polarised shade photography against the adjacent central, then a layered zirconia crown built by our ceramist over four firings.
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Month 9
Try-in. Rejected once — the incisal translucency was a shade too grey against the natural tooth — and re-characterised before fitting.
The same mouth.
Photographed under identical lighting, 5 months apart
- 0.2mm
- Papilla height variance
- 4 firings
- To match one natural tooth
- 0
- Days without a front tooth
Technology used
What it took.
- CBCT planning
- coDiagnostiX surgical guide
- Custom healing abutment
- Cross-polarised shade photography
- Layered zirconia
Every item here is in the building. See how it is used.
Start your own
Every case here began with one hour.
An examination, your own images on screen, and a written plan with a price. Whether you proceed is a separate decision, made later.
Or call +965 2242 8800 — Sunday to Thursday, 9:00 to 20:00.