Samir Absy
Mestre em Periodontia e doutorando em Implantodontia – Unip.
ORCID: 0009-0006-3479-0807.

Carla Aparecida Seno Plaza Casati
Especialista e mestre em Prótese Dentária – Fousp.
ORCID: 0009-0009-1062-6983.

Márcio Zaffalon Casati
Professor doutor em Periodontia – FOP-Unicamp.
ORCID: 0000-0001-9234-0536.

Suzana Peres Pimentel
Professora doutora em Periodontia – FOP-Unicamp.
ORCID: 0000-0002-3577-8600.

Mônica Grazieli Corrêa
Professora doutora em Periodontia – FOP-Unicamp.
ORCID: 0000-0003-1895-3283.

Raissa Micaella Marcello-Machado
Professora doutora em Prótese – FOP-Unicamp.
ORCID: 0000-0001-7661-703X.

Fabiano Ribeiro Cirano
Professor doutor em Periodontia – Fousp.
ORCID: 0000-0002-7331-4612.

DOI: https://doi.org/10.71440/2675-5610.10.5.25.660-665.art

RESUMO

Este caso clínico ilustra uma abordagem de tratamento de um insucesso estético na região anterior de maxila. Paciente do sexo feminino com 46 anos de idade, saudável e não fumante, procurou a clínica por problemas no sorriso. No exame clínico, observou-se a desarmonia da margem gengival com recessões de mucosa peri-implantar e gengival no implante dentário (22) e canino superior (23), respectivamente. Além disso, a coloração da mucosa peri-implantar apresentou-se alterada pelo posicionamento incorreto do implante. O plano de tratamento consistiu na remoção do implante, preenchimento do leito ósseo com enxerto ósseo do tipo bovino com colágeno (Extra Graft), enxerto subepitelial de tecido conjuntivo (ESTC) removido da região de palato nos dois elementos como manejo tecidual, além de uma prótese provisória adesiva na área do 22. A nova terapia cirúrgica com implante foi realizada após seis meses, e todo o processo de reabilitação definitiva deste elemento realizado após três meses. A terapia periodontal/peri-implantar de suporte vem sendo realizada regularmente, com um acompanhamento de quatro anos, o que é primordial para o sucesso a médio prazo.

Palavras-chave: Recessão gengival; Tecido mole; Área estética; Remoção do implante dentário.

Aesthetic management of a malpositioned implant in the maxillary lateral incisor region – clinical case report with four-year follow-up

ABSTRACT

The objective of this clinical case report is to illustrate a treatment approach for a case of aesthetic failure in implant-supported rehabilitation in the anterior region of the maxilla. A 46-years-old, female, healthy, non-smoker patient, sought the clinic with aesthetic complaints when smiling. The clinical examination demonstrated disharmony of the gingival margin with peri-implant mucosa and gingival recessions in implant (22) and tooth (23), respectively. In addition, the color of the peri-implant mucosa was altered due to the incorrect positioning of the implant. Therefore, the implant was removed, the bone bed was filled with a bovine bone graft with collagen (Extra Graft), ESTC was removed from the palate region in both elements as tissue management, in addition to the provisional adhesive prosthesis in 22. The new surgical therapy with implant was performed after 6 months, and the entire definitive rehabilitation process of this element, after 3 months. It is worth highlighting that the establishment of supportive periodontal/peri-implant therapy is performed regularly, with a 4-year follow-up, which is essential for medium-term success.

Keywords: Gingival recessions; Soft tissue; Esthetic zone; Dental implant removal.

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