2018 Volume 31 Issue 1 Pages 49-55
The indications and methodology of implant treatment for young patients are dependent on individual growth and development, and so the planning of endosseous implant treatment in younger individuals should be based on both careful diagnosis and established growth predictors. Here, we report a case of a 16-year-old female treated with an implant in the maxillary esthetic zone, with long-term observational follow-up for over 20 years. The patient has reported both functional and esthetic satisfaction.
In over 20 years of function, a step of approximately 2.1 mm at the incisal edge between the single tooth implant restorative superstructure and the adjacent central incisor tooth has developed. This change in spatial position may have been influenced by various factors, specifically: growth of the pre-maxilla and mandible, eruption of the third molars, and sequential development and eruption of the permanent dentition. Indeed, it seems better to wait for growth to be completed prior to initiating implant treatment. However, early implant intervention may be required for a variety of reasons in younger patients. Reasons include medical conditions such as partial or total edentulism or specific cases of trauma. In such cases, we have to consider the growth curve of each patient, the bone age, the influence of eruption forces of the third molar teeth, and orthodontic analysis facilitated with a lateral cephalogram. Additionally, it is important to confirm the position of the adjacent tooth CEJ and incisal edge positions, followed by careful implant insertion with palatal placement to limit the depth and preserve the buccal plate.
