Surgical treatment planning for the single-unit implant in aesthetic areas.

The clinical application of multiple implant-supported restorations in edentulous jaws has proven to be a predictable long-term treatment (1, 2). The implant-supported restoration has also been proposed for the replacement of the single tooth (48). The single-tooth implant restoration has changed treatment planning of the missing tooth in the anterior sextant. Clinical situations in which singletooth implants are considered the first option include 1) edentulous areas delimited by non-restored teeth, 2) edentulous areas delimited by intact restorations and 3) dentitions with diastemata (25). The success rate of implant-supported singletooth restorations is comparable to that of implantsupported prostheses in totally edentulous patients (Table 1). However, the goal of modern implant therapy in aesthetic areas is no longer represented just by the successful osteointegration of the implant. The final result has to be an implant-supported restoration surrounded by a soft and hard tissue environment in harmony with the existing dentition (82). Although current dental technology allows creating artificial teeth perfectly matching the natural tooth, the soft and hard tissue surrounding the restoration cannot always be reconstructed. To pursue a predictable aesthetic result with the single-tooth implant, the practitioner needs to consider all the variables that influence the final outcome before the treatment is provided. Furthermore, surgical procedures must be performed precisely. An error in soft tissue management or implant positioning, despite the presence of a sufficient volume of soft tissue and bone, may lead to a major aesthetic failure. This chapter discusses the surgical treatment planning of implant placement for a single-tooth restoration in aesthetic areas. Pre-surgical determinants, surgical procedures and treatment sequenc-