Multidisciplinary treatment of an impacted maxillary canine with immediate implant installation

Maxillary permanent canines are the second most frequent cases of impacted teeth; their resolution demands a multidisciplinary evaluation to delineate a viable treatment plan based on the individual esthetic and functional outcomes required. An impacted maxillary permanent canine which was ankylosed in a horizontal position was extracted followed by a regeneration technique, filling the bone defect with biomaterial. An implant was immediately installed in the alveolus of the extracted deciduous canine, and a connective tissue graft was buccally positioned. After the osseointegration period, a modified Palacci and Nowzari surgical technique was performed to gain papilla, and the implant was loaded with an interim restoration with a proper profile to manipulate the soft-tissue contour. Finally, the definitive restauration was cemented achieving the desired outcomes. The achieved clinical outcomes remain stable during a 2-year follow-up. A successful management of this challenge esthetic case lies in the details at surgical and prosthetic phases based in biological response of the peri-implant tissues.