Surgical Grafting with Veneers. Part 2

Concept of Dual-Zone


In 2012 researchers investigated the change of a buccolingual contour at implant positioning. They introduced their dual-zone concept after that. The concept is reckoned to be a real success in aesthetics achievements. It also shows the significance of taking buccal photographs at the early stages as well as provides occlusal views for evaluation of the further steps for restoration. The protocol, which is widely called “dual-zone”, presupposes the residual gap existence while placing the implant. This helps to stop buccal contour changes and make the periimplant soft tissues thicker. Finally, the restoration looks aesthetically nice.

The conclusion was made by the scholars and authors of the research that positioning the bone graft into the gap relating to the anterior implant can limit the changing of buccal contours. The authors reported that for achievement of aesthetic look it is necessary to keep to the following essential points:

  • the molar should be extracted nontraumatically, no flap lift must take place;
  • positioning of a dual-zone bone graft (bone and tissue zones are meant here), the bone graft is placed in the gap immediately after the extraction;
  • the restoration should be screw-retained, serving as a socket seal tool.



When aesthetics is the thing which is very important, immediate placement of an implant should take place. It must be performed accurately, especially when it is a possibility to injure the facial bone wall or if the tissues are too thin. This protocol is recommended as guidance to the procedure, which is highly technique sensitive. All the cases must be revised beforehand carefully. Utilization of a connective tissue graft as well as socket bony graft at the implant positioning is the best way of replace a missing molar and achieve an appropriate aesthetic look. At the meantime, in order to utilize this practice every day, it is needed to receive the results of the long-term investigations.