Computer-aided planning of soft tissue augmentation with prosthetic guidance for the establishment of a natural mucosal contour in late implant placement

OBJECTIVE: Late implant placement in volume deficient sites has been considered a challenging situation for the establishment of a natural mucosal topography. Dimensional relations of hard and soft tissues together with the prosthetic components have not been clarified in the literature. The aim of this proof-of-concept case report was to establish the tooth-like appearance with virtual planning prior to surgical intervention and to calculate the ideal amount of desired soft tissue. CLINICAL CONSIDERATIONS: Minimum amount of tissue reconstruction was calculated with computer-aided soft tissue augmentation and a temporary restoration mimicking the emergence profile of a molar was fabricated for guiding the peri-implant mucosa in the early wound healing phase. After 4 months of healing, the final restoration was completed with a screw-retained crown-abutment. The 2-year follow-up period demonstrated a stability of the mucosal margin and peri-implant health. CONCLUSIONS: A natural mucosal contour could be established with the help of virtual planning. The calculation of required tissue quantity may help clinicians for the creation of a natural appearance in late implant placement. CLINICAL SIGNIFICANCE: Virtual soft tissue augmentation may determine the required tissue quantity and therefore, could play an important role in the establishment of natural mucosal contour for late implant placement.