Anterior Maxilla Esthetic Zone
In the esthetic zone of the anterior maxilla, successful integration alone is not adequate. The implant must have proper position, angulation, and depth for esthetic restoration. These parameters are prosthodontically determined and communicated to the surgeon by the surgical stent. TIie stent must show the ideal position; labial thickness of porcelain and metal; and location’ of the CEl of the final prosthesis. If inadequate bone is present to place the. implant with proper position and angulation, grafting is necessary. Esthetic concerns and compromised bone often pr sent in the situation of congenitally missing teeth. Fail- . ure of tooth formation is associated WIth severe hypoplasia of the alveolar bone. Grafting using either guided bone regeneration tee niques or corlicocancellous blocks must be considered (see Fig. 14-61). Implai.t depth is also important to allow proper “me ge .ce profile. Excessive depth will lead to increased pocket depth, and too shallow placement can result in a poorly contoured crown or metal showing at the gingival margin. As a general rule, the top of the Implant should be placed 3 mm below the planned position of the CEl of the final restoration.