Eric van Dooren: Key surgical considerations for soft-tissue integrity and associated optimal esthetic outcomes

The presentation explains the treatment approach and treatment steps in a complex unilateral case with two fractured upper central and lateral teeth. Dr van Dooren reviews the diagnostic tools and highlights the additional insights patient videos can provide e.g. regarding the evaluation of smile line and lip line. The lecture discusses the treatment options and guides through the treatment steps for the chosen therapy with implants and full ceramic Zirconia crown restorations, covering model based planning and provisionalization concepts, atraumatic removal of the fractured teeth and roots, connective tissue grafting, implant placement, immediate provisionalization, final restoration try-in and cementation procedures. Dr van Dooren explains the interaction between abutment / crown design and soft tissue development, and highlights that after the healing phase the challenge is to prosthetically catch up with the soft tissue. Long-term the eruption of adjacent natural teeth can lead to vertical discrepancies. Dr van Dooren concludes that it is difficult to mimic nature completely and recommends to look at and evaluate a restored case rather from distance than focus too much on details.