Abstract
Replacement of a tooth in the anterior esthetic zone with a lifelike implant restoration can be a significant challenge. In this chapter, a microsurgical procedure for tooth extraction, implant placement, bone grafting, a connective tissue graft, and fabrication of a tissue supporting provisional crown is detailed. The SMILE Technique, developed by Dr. Dennis Shanelec, is an exacting, predictable procedure that has been used in over 1700 cases in multiple practices with a 98.58% overall success rate. The only exclusion criterion, other than ASA type IV patients, was uncontrolled diabetes and uncontrolled periodontal diseases.
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Reduction of proximal contacts to assist in an atraumatic tooth extraction (MP4 84861 kb)
Complete microscopic socket debridement and apical granulation tissue (MP4 29744 kb)
Osteotomy preparation through the palatal wall of the extraction socket and past the apical aspect of the extraction socket, measuring the osteotomy depth, and inserting the implant (MP4 116568 kb)
Bone Graft Placement (MP4 66648 kb)
Harvesting the palatal donor connective tissue graft and suturing of the donor site with primary closure (MP4 95337 kb)
Surgical preparation if a buccal envelope and freeing the papillae for placement of the connective tissue graft, compressing the surface of the bone graft material, advancing the flap occlusally, and fixing the graft in place with 6-0 polypropylene suture, removing the non-sterile Teflon tape, filling the screw hole with Metronidazole gel, and seating the provisional custom provisional crown into the internal hex, insert the fixation screw with a torque of 25 Ncm, place Teflon tape into the access, and close the access with light cured composite (MP4 103104 kb) Keep References 9, 13 and 15. They were accidentally deleted. Remove reference 19
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Tibbetts, L.S., Cross, J.D., Pearson, B.S. (2022). The Shanelec SMILE Technique: Immediate Microsurgical Implant and Provisional Restoration Placement in Anterior Esthetic Sites. In: Chan, HL.(., Velasquez-Plata, D. (eds) Microsurgery in Periodontal and Implant Dentistry. Springer, Cham. https://doi.org/10.1007/978-3-030-96874-8_13
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DOI: https://doi.org/10.1007/978-3-030-96874-8_13
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