{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:55:32Z","timestamp":1790571332954,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Adv Periodontics"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Severe alveolar ridge defects in the mandibular anterior region, often associated with congenital tooth absence and subsequent loss of retained primary teeth, present significant challenges for implant rehabilitation. Limited space, horizontal ridge deficiency, and complex site anatomy often require a multidisciplinary approach to achieve stable hard\u2010 and soft\u2010tissue outcomes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A 30\u2010year\u2010old woman presented with absence of teeth #23 and #25, distal rotation of tooth #24, and insufficient mesiodistal space for implant placement. After 15 months of orthodontic space creation, severe horizontal ridge deficiency was confirmed clinically and by cone\u2010beam computed tomography (CBCT). A single\u2010stage surgical protocol was performed consisting of implant placement with guided bone regeneration (GBR) at sites #23 and #25 and guided tissue regeneration (GTR) at adjacent teeth #24 and #26. Deproteinized bovine bone mineral and an absorbable collagen membrane were used for defect regeneration, followed by tension\u2010free primary closure.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Healing was uneventful. At the 5\u2010year follow\u2010up, clinical and radiographic evaluation demonstrated stable buccolingual ridge dimensions, adequate keratinized mucosa, and healthy peri\u2010implant soft\u2010tissue contours. CBCT confirmed maintenance of regenerated bone at the implant sites and adjacent natural teeth, with no evidence of mucosal or gingival recession and preserved bone volume.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This case illustrates that a coordinated approach involving orthodontic space creation followed by implant placement with simultaneous GBR and GTR may support long\u2010term rehabilitation of mandibular anterior defects. Stable hard\u2010 and soft\u2010tissue conditions and favorable functional and esthetic outcomes were maintained over a 5\u2010year follow\u2010up. The simultaneous use of GBR and GTR at adjacent implant and natural\u2010tooth sites, documented over 5 years, distinguishes this case from conventional staged approaches.<\/jats:p>\n <\/jats:sec>\n \n Key points<\/jats:title>\n \n \n \n Orthodontic space creation is often essential for prosthetically driven implant placement in mandibular anterior mesiodistal defects.<\/jats:p>\n <\/jats:list-item>\n \n Simultaneous guided bone regeneration and guided tissue regeneration can allow reconstruction of combined implant\u2010 and tooth\u2010related defects.<\/jats:p>\n <\/jats:list-item>\n \n Performing regenerative procedures and implant placement during a single surgical intervention reduces the number of surgeries for the patient.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Plain language summary<\/jats:title>\n Missing teeth in the front lower jaw can be challenging to replace when there is not enough bone to support implants and when nearby natural teeth have developed supporting tissue problems related to orthodontic treatment. This case report describes the treatment of a patient with missing teeth who first received orthodontic treatment to create enough space for implants. The patient then received dental implants along with procedures to rebuild bone around the implants and regenerate the supporting tissues around nearby natural teeth. Both procedures were performed during the same surgery, and the patient was followed for 5 years. The results showed that the bone and gum tissues around both the implants and natural teeth remained stable, with good function and appearance. This combined treatment approach may be a possible option for carefully selected patients with complex conditions. However, because this report describes only one patient, further studies involving more patients are needed to confirm these findings.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/cap.70117","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:10:48Z","timestamp":1790568648000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Orthodontic, regenerative, and implant management of a mandibular anterior defect: 5\u2010year outcome"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3621-2176","authenticated-orcid":false,"given":"Jia","family":"Yuan","sequence":"first","affiliation":[{"name":"Department of Stomatology The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou 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