# Socket preservation in the aesthetic zone – Clinical case

URL: https://dloralsurgery.com/blog/socket-preservation-absence-of-buccal-bone-plate-in-aesthetic-front/

July 2, 2014

**2014** year

**11** photographs

**3** sections

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![Socket preservation in the aesthetic zone – Clinical case](https://dloralsurgery.com/fotos/2014/07/Socket8.jpg)

[![Aspecto a los 10 días](https://dloralsurgery.com/fotos/2014/07/Socket8-150x150.jpg) Appearance after 10 days](https://dloralsurgery.com/fotos/2014/07/Socket8.jpg)

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:

1. Immediate implant placement with grafting
2. Delayed grafting followed by later implant placement
3. 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.

![socket preservation in the aesthetic zone](https://dloralsurgery.com/fotos/2014/07/Socket4.jpg)

Previous situation

![socket preservation in the aesthetic zone](https://dloralsurgery.com/fotos/2014/07/Socket5.jpg)

Fractured tooth

![socket preservation in the aesthetic zone](https://dloralsurgery.com/fotos/2014/07/Socket6.jpg)

Extraction of tooth

![socket preservation in the aesthetic zone](https://dloralsurgery.com/fotos/2014/07/Socket7.jpg)

Bone and epithelial graft

![socket preservation in the aesthetic zone](https://dloralsurgery.com/fotos/2014/07/Socket8.jpg)

Appearance after 10 days

![socket preservation in the aesthetic zone](https://dloralsurgery.com/fotos/2014/07/Socket0.jpg)

After 4 months

![socket preservation in the aesthetic zone](https://dloralsurgery.com/fotos/2014/07/Socket1.jpg)

Drilled bone

![socket preservation in the aesthetic zone](https://dloralsurgery.com/fotos/2014/07/Socket2.jpg)

Bone and implant appearance

![socket preservation in the aesthetic zone](https://dloralsurgery.com/fotos/2014/07/Socket9.jpg)

X-ray

[← Previous case **1st Iberian Euroteknika Conference – Surgical contribution…**](https://dloralsurgery.com/blog/1st-iberian-euroteknika-conference-finished/) [Next case →**Horizontal defect in upper molar – Bone block and implant**](https://dloralsurgery.com/blog/horizontal-defect-in-upper-molar/)

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