Implants in contact with tissues other than bone. Is there room for a potential paradigm shift

RATIONALE: Modern dental implantology is now 30 year old. During this period of time, concepts have evolved and triggered several paradigm shifts. The aim of the present paper is to present a case treated with an innovative unconventional protocol. The latter is aimed to avoid invasive surgery when edentulism is caused by an impacted tooth. OBJECTIVES: The implant has been placed through the impacted canine and led, in addition to the classical implant-bone interface, to several other types of implant-tissue interface. RESULTS: Healing was uneventful; at the 1-year control, the implant was clinically integrated, the soft tissues around the final crown were satisfactory and the radiographic examination did not call any specific observation. CONCLUSIONS: Before endorsing this protocol in routine application, inclusion/exclusion criteria must be asserted and additional clinical cases with longer follow-up are warranted. Nonetheless, this unconventional protocol opens intriguing possibilities; it also suggests that there is still room to further revisit some of the leading concepts in dental implantology.