Screw-retained restoration of a facially-shifted post-extraction implant in the esthetic zone with immediate provisionalization

Aim The aim of this article is to describe an alternative  rehabilitation of a facially shifted postextraction  implant with immediate provisionalization of a screw-retained restoration.

Case report Immediate postextraction implant placement may pose significant challenges. A case is described where, despite proper risk assessment and planning, an implant shifted from the position of the prosthetic driven restoration. This resulted in different positions of immediate postextraction implants in the sites of the upper central incisors. The provisional was constructed with different access holes. The use of an angulated screw channel compensated the access holes from the original implant axis, thus making a screw-retained restoration on the palatal side feasible.

Result The use of angulated screw-retained crowns might benefit periimplant condition in the long-term by eliminating the use of cements. Although the mechanical complications are underreported, this approach is likely to yield good results and allow shifted implant in the anterior region.

Conclusions Angulated screw crowns could correct facially shifted implants in the esthetic zone. The system compensates the natural angulation of maxillary teeth, allows easy application of screw retained crowns, eliminates the risk of cement-related periimplantitis and preserves esthetics.