Immediate substitution of central incisors with an unusual enamel paraplasia by a newly developed titanium implant: a case report.

The replacement of incisors with an unfavorable hard and soft tissue environment in the maxilla can be a challenging procedure in terms of esthetic outcome. The present report describes the replacement of two hopeless central incisors by newly developed titanium implants (TE Implant, Straumann) for immediate placement. This type of implant was chosen to compensate for the natural esthetics, which became compromised because of periodontitis and an unusual root anatomy. Both incisors presented with an atypical enamel paraplasia characterized by a circumferential enamel projection in apical direction. The consequence was a markedly reduced surface for periodontal attachment. Two weeks after implant placement, two acrylic resin crowns were cemented onto the new temporary titanium abutments. Five months later, the definitive prosthetic restoration was processed by porcelain pressed onto galvanic-cap crowns, which were cemented to standard wide-neck abutments. Control radiographs showed uneventful healing.