BACKGROUND: The aim of the present clinical case is to show buccal bone repair around a dental implant placed by flapless technique and immediately loaded in fresh socket with acute buccal dehiscence-type defect. METHODS: A 58-year-old female presented with a fistula on the buccal side and a root fracture at the left lateral incisive. The dental extraction was performed without mucogingival flap elevation; the absence of buccal bone plate was recorded. A screw-shaped implant was placed. Immediately after the surgical procedure, the patient received temporary prosthetic restoration, and 3 months later definitive metal-ceramic restoration was positioned. RESULTS: Four years later, a fracture of the crown and gingival inflammatory process were observed. The crown was removed and a fracture of the zirconia abutment was reported. Surgical reentry was performed, gingival flap was raised, and buccal bone repair was observed. CONCLUSION: Biologically, it is very difficult to explain the bone repair process around implants in the acute dehiscence-type defect, and only biologic speculations explain the outcome of this clinical result.
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