Missing maxillary central incisor: thoughts?

My patient is missing the maxillary central incisor.  The incisive canal is very large and is situated to the lingual.   There is only 3.19mm between incisive canal and lateral incisor. Buccolingually,  there is only 4.76mm bone labial to the incisive canal area.  Placing a single implant in the maxillary central site may not be a good option.  Another plan would be to extract the lateral incisor and cantilever the central incisor.  A bridge from the lateral incisor to the other central is not an option since it is already and implant and the patient does not want to remove the crown.  Any other options to restore this case?

6 thoughts on “Missing maxillary central incisor: thoughts?

  1. Gary Greenstein says:

    I suggest you read this article.
    Cavallaro J, Tsuji S, Chiu TS, Greenstein G. Management of the Nasopalatine
    Canal and Foramen Associated With Dental Implant Therapy. Compend Contin Educ
    Dent. 2016 Jun;38(6):367-372; quiz 374. PubMed PMID: 28570082.

  2. Re O'Neill says:

    You have posted some detailed measurements for your case that you are having issues with planning but please share the CT imaging data so we can all help. Just under 5mm of available bone width sounds just fine but we would all like to see imaging.

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