Socket preservation in the aesthetic zone – Clinical case
We present a case of socket preservation in the aesthetic zone involving a 40-year-old, non-smoking patient with no relevant medical conditions. The patient was referred to us due to pain and mobility in the upper left central incisor. Clinical signs and over 10 mm of probing depth suggested a vertical root fracture.
Diagnosis and extraction
After extraction, we confirmed a vertical fracture reaching the apex. Additionally, the buccal bone plate was entirely absent, a common complication in anterior maxillary teeth with long-standing endodontic treatment.
At this point, we considered three treatment options:
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Immediate implant placement with grafting
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Delayed grafting followed by later implant placement
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Grafting immediately and delaying implant placement to preserve the socket
We chose the third approach to prioritize socket preservation in the aesthetic zone.
Grafting and soft tissue closure
To fill the defect, we harvested autologous bone from the mandibular ramus using a bone scraper. We packed the socket with this material to promote stable bone regeneration.
To close the site, we took an epithelial free graft from the palate. This technique allowed for better soft tissue sealing and supported the underlying graft during healing.
📎 Learn more about epithelial graft techniques in our clinical archive
Implant placement and final outcome
After 4 months, we re-entered the site. The graft had integrated well, and we were able to place the implant completely surrounded by bone.
We waited another 4 months for osseointegration before performing the gingiva former surgery. The results were predictable, both functionally and esthetically.
Clinical photographs below show the healing sequence and final result. We hope you find this case helpful for managing similar anterior socket defects.
