OTA Implant Prosthetic Rehabilitation in the presence of vestibular bone dehiscence.

In implantology, research aims to reduce or eliminate bone resorption and prevent the development of excessively long transmucosal paths[1]. Evidence in the literature supports the benefits of platform switching[2], the one-time abutment (OTA)[3], and conical connections (4,5). This case report seeks to demonstrate the efficacy of a novel prosthetic device (GFA – Gingival Former Abutment) used on a subcrestal OTA implant to remodel peri-implant hard and soft tissues one year post-loading, in a patient with vestibular dehiscence. The GFA allows for both horizontal and vertical platform switching, transitioning the implant from subcrestal to transmucosal. This approach helps preserve marginal bone levels and ensures soft tissue stability, encouraging proper adherence[3].

Materials and Methods

The patient’s single-tooth edentulism in site 35 was addressed using a 3.6 x 9 mm Advan® GTB T-Zero implant. The implant was positioned 2 mm subcrestally relative to the most apical bone crest (vestibular margin), and a 5.5 mm Advan® GFA was affixed directly during the surgical procedure.Three months post-surgery, a screw-retained full-contour zirconia Katana® 550 crown was placed.

Clinical and radiographic follow-ups were conducted at 6 and 12 months after prosthetic loading.At both 6 and 12 months, minimal bone remodelling was observed around the GFA, with no interproximal bone loss, no pathological probing or recession, and no structural or aesthetic issues with the prosthesis.

This case report highlights the GFA® as an effective solution for managing bone dehiscences in cases where regenerative bone surgery (GBR) is not an option. It supports aesthetic, biological, and functional outcomes, likely due to the GFA® promoting probe impermeability and soft tissue remodelling through the OTA concept.