Resumo

The tooth removal promotes itself a chain of reaction, leading to bone remodeling and compression of the alveolar ridge. The
technique used to extract can booth increase or decrease the amount of bone loss, even more when in the anterior area of the maxilla.
It is known that incisions and flap elevation associate with the use of traumatic devices, as elevators creates microfractures and loss
of blood supply in the buccal plate, in the other hand, minimal traumatic approaches, using vertical extractors device and flapless
technique can maintain the ridge architecture. If the minimally invasive technique is also associate with bone grafts, filling the gap
between implant and buccal plate with low rate bone substitute and sub epithelial connective tissue graft to improve the amount
of peri-implant soft tissue, the probability to achieve excellent aesthetic result is high.

This case report an atraumatic approach to
remove a fractured tooth in the aesthetic zone, using a new device to anchor and pull, vertically, the root, without compromising the
adjacent tissue. In order to decrease the morbidity of the treatment, immediate implant placement was done. The gap between the
implant and buccal plate was filled with hidroxiapatite, and the soft tissue amount increased with a connective tissue graft removed
from the palate. After 180 days, the prosthetic fase could be realized without complication or need of any surgical complement