Rationale for esthetic tissue preservation of a fresh extraction socket by an implant treatment concept simulating a tooth replantation.

In cases of an immediate insertion and loading of implants after a traumatic loss of the patient's own dentition or due to an inevitable extraction of an anterior tooth, it is essential to provide the patient with an adequate provisional crown. A soft-tissue recession must be avoided, whether it is due to a compression of the peri-implant soft-tissue caused by an over-dimensioned restoration in the cervical collar of the provisional crown or to a too small dimensioned sulcus former. A simulation of the exact dimension of the lost tooth - especially on the cervical part of the new provisional restoration - is expected to preserve all relevant information and allows the design of a naturally looking emergence profile. Based on theoretical considerations and a case report, the authors intend to demonstrate that a near-naturally dimensioned sealing of the dento-gingival soft-tissue collar may initiate a tissue-maintaining healing process, similar to a tooth replantation. The natural dental crown, connected to an implant instead of the root, is applied for a tight sealing of the wound. If due to traumatic impact the tooth is no longer available, a naturally dimensioned crown restoration will serve as an alternative wound sealant.