Patient M.B. 63 years old, with previous periodontal disease and grade 2 mobility on the two central incisors. The treatment plan involved the extraction of the compromised elements and the delayed insertion of two Shelta implants, with cemented metal-ceramic crowns. During the surgical phase, the low implant insertion torque and the considerably compromised situation of the alveolus in position 2.1, vertically 2 mm more reabsorbed compared to the alveolus 1.1 and with greater alveolar space, made us fear for the favorable outcome of the healing of 2.1. It was decided to maintain the implant in place and to wait for the healing period, keeping the progression of the implant in position 2.1 carefully monitored. Despite our attention, as feared, during the impression taking phase the implant in position 2.1 wasn’t stable. We opted for its removal and waited further 2 months to insert a new implant. Given the considerable difference between the bone level in position 1.1 and 2.1, we opted for the insertion of a Prama that, thanks to its neck, allowed a prosthetic compensation.
