Development of gingival esthetics in the edentulous patient prior to dental implant placement using a flangeless removable prosthesis: a case report.

Development of gingival contours found in healthy natural dentitions enhances the esthetic results achieved with implant-supported fixed prostheses. However, this endeavor is frequently difficult to achieve, especially in the completely edentulous patient. Edentulous patients with optimal hard and soft tissue can be treated with a specially designed removable prosthesis that will develop gingival contours prior to implant placement. By means of a transitional complete removable prosthesis with ovate pontics and no labial flange, a natural-looking soft tissue profile can be developed prior to dental implant placement. A minimally invasive tissue punch surgical technique is used to place the implants, which are immediately restored with a 1-piece, cross-arch, provisional fixed prosthesis. This article presents the prosthodontic and surgical protocols utilized to improve the appearance of the definitive implant rehabilitation.