Displacement of the incisive foramen in conjunction with implant placementin the anterior maxilla without jeopardizing vitality of nasopalatine nerve and vessels: a novel surgical approach

Accurate implant placement in the anterior maxilla is essential in achievin g optimal prosthetic rehabilitation with proper function and acceptable est hetic and phonetic demands. One of the preferable prosthetic solutions to r estore a missing maxillary incisor in young adults is by an implant-support ed crown. Bone resorption together with an enlarged incisive foramen, chall enge proper implant placement. A simultaneous procedure where the implant o steotomy site penetrated the incisive canal is presented. A configurated co rtico-cancellous block graft core was adjusted to fit the foramen while its soft tissue content was pushed back posteriorly but not removed. This proc edure was followed by an immediate implant placement. Re-entry at 9 months revealed solid bone support embracing the implant body. Although the size o f the incisive foramen diminished significantly, the nasopalatine branches were still evident. No complications and/or loss of sensation were observed .