Replacement of two adjacent teeth in an anterior maxilla with deficient hard and soft tissues appears to be the utmost challenge in implant dentistry in the esthetic zone. In this case report, baseline conditions for implant placement were improved by alveolar distraction to enhance hard and soft tissues around the maxillary central incisors. Three months after the active phase of distraction, the roots of the central incisors were extracted and two screw-type dental implants were immediately placed into the extraction sockets.
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