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Contusive trauma or malocclusionrelated periodontal disease can severely compromise the upper anterior teeth, leading to labial bone resorption and ultimately loss of function and unsightly root exposure. To resolve these issues, we propose the replacement of compromised teeth using one-piece, immediateload, post-extraction implants. These can be implanted and fitted with customised temporary crowns in a single surgical procedure, restoring function and aesthetics and allowing recovery of the bone deficit with reduced healing times and limited patient discomfort. This study aims to assess the one-piece, immediateload, post-extraction implants in labial bone-deficient upper jaws. Materials and methods One-piece, wide diameter, titanium screw implants with thread measurements of 3.5 mm and 4.5 mm, with an abutment of 2.5 mm, were positioned and splinted by intraoral welding. Results These implants yielded satisfactory functional and aesthetic outcomes in bone-deficient upper anterior sectors, without invasive regenerative procedures. Conclusion The low invasiveness of the approach used in this research study consents rapid healing, reduced biological burden and greater patient benefit. Introduction Root fracture and, more often, occlusal trauma-related periodontal disease1–3 can severely compromise the teeth in the upper anterior sector, leading to labial bone deficit, root exposure, loss of function and poor aesthetics. The front teeth, i.e. the central and lateral incisors and the canines, are particularly susceptible to these problems. This is due to their natural inclination, which causes them to develop transversal forces upon contact, unlike the vertical forces that develop in molars and premolars, where the occlusal forces are dispersed along the long axis of the root and are therefore well tolerated. Hence, in physiological static occlusion, the anterior teeth should barely touch their antagonists if these damaging forces are to be avoided4. At the occurrence of centric pre-contacts in these teeth, stable static mandibular support is compromised, disturbing both swallowing and chewing mechanisms and the harmony of the neuromuscular system. In order to counteract this occlusal instability, the lower jaw, which is unable to rotate, moves forwards and/or to the side (prochoresis) in the search for replacing static contacts and achieving new equilibrium. Although this compensatory position consents mastication and swallowing, it is in fact pathological because it is based on traumatic non-centric contacts. During swallowing, the dysfunctional occlusal loads and transversal forces are mainly dispersed into the portion of the bone that is labial to the front teeth, leading to ischaemia and gradual atrophy of the alveolar ridge5–12. If this condition is left untreated, it can severely compromise the integrity of the entire periodontium and the stability of the teeth, ultimately leading to their loss and the consequent functional and aesthetic damage. In order to restore both function and aesthetics in such cases of bone deficit, multiple surgical procedures are scheduled. In addition to being burdensome and uncomfortable for the patient, these procedures neither consent the immediate loading of implants nor the healing times before temporary prosthetics and definitive fixed prosthetics can be fitted. Hence, we propose a minimally invasive alternative using one-piece, immediate-load, screw implants which consent rapid resolution of functional and aesthetic issues by means of a single surgical procedure13–18. Materials and methods This study conforms to the values laid down in the Declaration of Helsinki (1964). The protocol of this study has been approved by the relevant ethics committee associated to our institution in which it was performed. All subjects gave their informed consent to participate in this study. One-piece, titanium, single-structure fixtures featuring an abutment of 2.5 mm and thread diameters of 3.5 mm and 4.5 mm, were implanted. * Corresponding author Email: francorossi020@gmail.com 1 Private practice in Busto Arsizio (Varese) Italy 2 Private practice in Milano, Italy 3 Department of D.M.C.C.C., Section of Maxillofacial and Plastic Surgery, University of Ferrara, Ferrara, Italy 4 Private practice in Cuneo, Italy 5 Medical Director and Head of Radiology EOSMED UO, Rome, Italy 6 Private practice in Rome, Italy 7 Department of Oral Science, Nano and Biotechnology, University ‘G. D’Annunzio’, Chieti, Italy Im pl an to lo gy

�One-piece� immediate-load post-extraction implants in labial bone-deficient upper jaws