{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:40:11Z","timestamp":1756312811855,"version":"3.44.0"},"reference-count":21,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,6,15]]},"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>Soft tissue deficiency in a tooth extraction site in the aesthetic area is a common and challenging clinical situation. This case report demonstrates the successful treatment of extensive gingival recession and buccal bone dehiscence associated with a hopeless tooth. Initially, a connective tissue graft was used to cover the root and thicken the soft tissue. After 2\u2009months, the tooth was extracted, an implant was immediately placed, and a temporary restoration was installed. After 3\u2009months, the soft tissue exhibited a natural and harmonious architecture. A custom zirconia abutment and crown were then fabricated and placed. At the 4-year follow-up, the peri-implant tissue displayed satisfactory aesthetics, with a well-structured buccal bone plate and healthy peri-implant indicators. This two-stage approach, addressing gingival recession first and proceeding with immediate implant placement after soft tissue healing, proved to be a safe and effective method with stable long-term results.<\/jats:p>","DOI":"10.1136\/bcr-2023-259271","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T02:25:21Z","timestamp":1719368721000},"page":"e259271","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Management of an extensive soft tissue deficiency prior to immediate implant in the aesthetic zone: a 4-year follow-up"],"prefix":"10.1136","volume":"17","author":[{"given":"Oswaldo","family":"Villa-Campos","sequence":"first","affiliation":[{"name":"Department of Stomatology, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9249-4540","authenticated-orcid":false,"given":"Isabella Neme 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