The insertion of a dental implant to replace an anterior tooth, thus calling one of the 6 upper teeth of the front of the mouth, implies a great challenge in current dentistry. Today it is possible to replace natural teeth with artificial teeth in porcelain which look and work in a highly similar way. However, to achieve this result, the level of detail and accuracy of the procedures are maximum. In the front of the mouth a millimeter is the difference between a successful result and a poor result. An artificial anterior frontal tooth must be completely mimicked both between neighboring teeth and in the surrounding gingiva, fusing throughout the oral cavity environment. Therefore, the implementation of a multidisciplinary team between an orthodontist, a periodontist and a prosthodontist is imperative.

Orthodontics allows us to move the teeth by mechanical means, not only to align but also to generate a space, a bone formation and an adequate position of the gum before extracting a tooth, which guarantees quantity and quality of gum in the area of the future implant. After having increased the amount of gum before extracting the tooth, the periodontist must extract the root, a procedure that must be atraumatic. It is important to bear in mind that a millimeter is a kilometer when we work in the front of the mouth. After extraction of the root of the tooth, the periodontist in conjunction with the prosthodontist can surgically insert the implant where the root was. This surgery must be exact and thorough since the three-dimensional location of a dental implant from the anterior area of the mouth is one of the most important requirements to achieve the aesthetic success of the final restoration. Usually, after the insertion of a post-exodontic implant, an immediate provisional crown is placed, which is preferably screwed directly onto the implant and is manufactured by the prosthetist using special attachments.

After having inserted the dental implant and a minimum healing of 3 months with a temporary screwed crown, the final crown in porcelain is manufactured by the prosthodontist and his dental laboratory. This procedure is now carried out with CAD CAM computer technology and ideally it must be manufactured entirely in porcelain (Zirconia). The zirconia avoids the metallic gray color in the gum, it is strong enough to withstand the forces of chewing.

If all these processes are fulfilled, the final result of an implant-supported crown will be satisfactory both from an aesthetic and biological point of view. In conclusion, it requires great specificity and meticulousness in each of the stages of reconstruction, the difference between the success or failure of a crown are small details in the process.

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