Overview
This case focuses on anterior fracture management in a high-aesthetic-risk patient, where extraction alone would likely cause major contour loss without simultaneous ridge and soft-tissue support.
Clinical Background
Root fracture is a known indication for extraction in many restored teeth. In anterior zones, however, extraction often removes additional buccal plate support and compromises the soft-tissue profile.
In patients with a high smile line, this risk must be addressed proactively.
Case Snapshot
- Main complaint: mobility in anterior crowns (11-21)
- History: prior zirconia bridge/post complex
- Examination: mobile buccal fracture component and compromised local hard tissue
- Imaging: CBCT confirmed buccal plate-related fracture complexity
Treatment Objective
Preserve ridge contour and gingival architecture at the time of extraction to support both biologic healing and future prosthetic aesthetics.
Staged Protocol
Prosthetic planning stage
- Pick-up impression of existing restoration
- Indirect post-related impression planning
- Antagonist and bite registration
Surgical stage
- Atraumatic extraction with controlled instrumentation
- Subepithelial connective tissue graft (SCTG) harvesting and buccal stabilization
- Collagen scaffold adaptation
- Allograft placement for socket preservation
- Sutured closure for graft and tissue stability
Immediate provisional restoration was adjusted to protect the surgical zone and minimize pressure on healing tissue.
Why SCTG Was Important Here
In this scenario, connective tissue support was essential to maintain soft-tissue volume after extraction and reduce visible contour collapse risk during healing.
Clinical Video
Key Clinical Point
In anterior extraction cases with buccal compromise, combining socket preservation with soft-tissue augmentation can be decisive for long-term aesthetic and functional success.