Dental Implant Replacement of a Molar with Bone and Gingiva Loss

Case report

This patient had a missing lower molar with thin bone and gingiva. While a dental implant placement was possible in the existing bone, it would have been off axis and proper position and it would have resulted in undercut area with food impaction problems and aesthetic issues. Hence a bone and soft tissue augmentation was first done to restore the proper foundation. Then, following a complete digital workflow, a single dental implant was placed using surgical guide and restored with customized abutment and restoration.


  1. Site bone graft to augment foundation tissue
  2. 3-D computer-assisted planning
  3. Surgical guide fabricated from 3-D work up using 3-D printing
  4. Proper placement of a dental implant with ideal axis and position
  5. Manipulation of the soft tissue (gingiva) to create thicker quality
  6. Following 3 months of healing, a custom abutment and crown were fabricated and placed.

Success factors

  1. Bone and soft tissue augmentation
  2. The diagnostic work up began with the end in mind.
  3. 3-D digital work flow for diagnostics and planning
  4. A proper surgical guide allowed accurate placement of the implant.
  5. Site development with soft tissue development allowing proper tissue topography and emergence.
  6. Well-designed and fabricated implant restoration
  7. A close collaboration between surgeon and restorative dentist, each doing what they do best.