Dental Implants in the Aesthetic Zone

Michael Tischler, DDS


We would like to focus on the various > CBCT-generated implant guides that are available > and look at their advantages and disadvantages. > A CBCT-based implant guide is a state-of-the-art > concept that represents the highest aspects of implant technological advancements.

This month’s Implants Today section focuses on one of the most demanding areas of implant dentistry: implants placed in the aesthetic zone. Every aspect of dental implant treatment is an immense responsibility since, as the late Dr. Carl Misch used to say, “We are replacing millions of years of evolution with this procedure.” This objective to replace missing teeth in the most predictable manner by replacing human dental evolution requires excellent treatment planning and often multidisciplinary knowledge and technical skills. With that as a perspective, the level of responsibility needed to achieve predictable and consistent success in the aesthetic zone with dental implant treatment is high.

When the aesthetic zone is discussed, we are talking about many sub areas of implant dentistry, including soft-tissue grafting, hard-tissue grafting, growth factor addition, and, of course, the surgical placement and prosthetic aspects. It’s focus time! The real start to successful implant treatment in the aesthetic zone begins with treatment planning. Unless a clinician has a good overall knowledge of a patient’s present and future overall condition, creating nice papilla on an anterior tooth may be the wrong thing to focus on. Sometimes a patient may be better served with a full-arch implant solution that addresses an overall situation in a more sensible, economic, and long-term manner.

A full-arch implant treatment plan is often a consideration when we are talking about the baby boomer population, as previous dental restorations age along with the patient. In my opinion, this is treatment planning with a big picture perspective that involves looking at all the options. Full-arch implant treatment is dentistry in the aesthetic zone with a big-picture perspective. It is a legitimate aesthetic zone option, especially for baby boomers who have to make decisions with optimal longevity in mind.

Single-tooth implants in the aesthetic zone offer the challenges of aesthetically matching the adjacent teeth. This creates different challenges and skill sets than full-arch tooth replacement with dental implants.

We have some great articles in our Implants Today section this month. Implants Today Advisory Board member Dr. Timothy Kosinski presents an article on creating a proper emergence profile for implant-supported restorations that brings in many of the principles I have mentioned and demonstrates why treatment planning is especially important in single-tooth replacement situations. Drs. Delia Tuttle and Gregori Kurtzman discuss the full-arch perspective of the aesthetic zone in their article. Our third contribution this month, by Dr. Steven Rasner, focuses on the paramount importance of doing atraumatic extractions in the aesthetic zone.

If you have any questions or comments about this topic, or any other subject presented in Implants Today, feel free to contact Dr. Tischler at