Biological Preservation Surgery

FP1 Surgery & Tissue Preservation

The most refined approach to single-tooth implant replacement: socket shield, root membrane, partial extraction therapy, pontic shield, and root banking — surgical techniques that preserve your natural tissue architecture so the final result looks indistinguishable from a real tooth.

Maximum Tissue Preservation

Indistinguishable Aesthetics

X-Nav Guided

Same-Day Provisional

Book Free Consultation What is FP1?

At a Glance

FP1 Treatment

Visible Metal/Acrylic None
Tissue Preservation Maximum
Surgical Planning Blue Sky Plan
Surgical Guidance X-Nav Dynamic
Provisional Delivery Same Day
Final Restoration 3–4 months

FP1 anterior implant restoration — natural appearance

Understanding FP1

What is FP1 surgery?

The "FP1" classification — short for Fixed Prosthesis Type 1 — describes a dental implant restoration that replaces only the crown of the missing tooth, with the gum line and surrounding tissue preserved exactly as nature created them. The result is an implant that looks indistinguishable from a real tooth, even when smiling fully.

The challenge is that FP1 only works when the bone and soft tissue around the extraction site are preserved. The moment a tooth is removed, the body begins reabsorbing the bone and gum that supported it — and within months, what remains is often inadequate for a true FP1 result. This is why most implant cases default to FP3, where pink prosthetic gum material is added to compensate for lost tissue.

The difference between FP1 and FP3 is the difference between a tooth that looks real and a tooth that looks like an implant.

FP1 surgery uses biological preservation techniques at the time of extraction to keep the tissue architecture intact — so when the final crown is placed, the result is a natural smile, not a prosthetic one.

Biological Preservation Techniques

Five techniques. One philosophy.

Each of these techniques preserves a different aspect of the natural tissue architecture. The right choice depends on your specific anatomy, the condition of the tooth being replaced, and the aesthetic demands of the case.

01 / Most Established

Socket Shield

A thin slice of the natural tooth root is intentionally retained on the buccal (cheek-side) of the socket during extraction. This shield maintains the periodontal ligament's blood supply and prevents the buccal bone from collapsing — preserving the gum line precisely.

02 / Refined Variation

Root Membrane Technique

A modification of socket shield that retains a thinner, shaped root remnant — providing the same biological benefit while reducing the technical complexity. Particularly effective in narrow-ridge anterior cases.

03 / Comprehensive Approach

Partial Extraction Therapy

An umbrella protocol that combines selective root retention with immediate implant placement. Indicated when the tooth's root structure can serve as a natural scaffold for both the implant and the surrounding tissue.

04 / Bridge Application

Pontic Shield

For cases where a bridge spans an extraction site, a portion of the natural root is preserved beneath the pontic (replacement tooth). This maintains the ridge contour and prevents the typical sunken appearance under bridge pontics.

05 / Future Planning

Root Banking

Strategic preservation of root structure during extraction for patients who may need an implant later. Allows future implant placement without the bone loss that typically follows months or years of an empty socket.

Custom Combinations

Most real cases use these techniques in combination, tailored to your anatomy. Pre-surgical planning with Blue Sky Plan determines which approach fits your specific situation — and what the predicted aesthetic outcome will be.

Pre-Surgical Planning

Blue Sky Plan: where every FP1 case begins.

FP1 surgery cannot be planned freehand. The margin for error in tissue preservation is too small. Every FP1 case at the Institute begins with Blue Sky Plan — implant planning software that uses your CBCT scan to map the exact position, depth, and angulation of the implant in three dimensions, calibrated against the planned final crown.

The Blue Sky Plan output drives the entire surgical workflow: from where the socket shield will be cut, to where the implant will be placed, to how the same-day provisional will fit. The plan is then executed using X-Nav dynamic navigation — meaning what was planned digitally is what happens surgically, accurate to within fractions of a millimeter.

Treatment Workflow

From planning to final delivery.

FP1 is a single-visit surgical procedure with a 3-4 month healing window before the final crown. Here's exactly what to expect at each stage.

Step One · Planning Visit

CBCT & Blue Sky Plan Workup

3D imaging captures your bone, tooth root, and surrounding anatomy. Blue Sky Plan software is used to design the implant position, the socket shield geometry, and the planned final restoration. You preview the predicted aesthetic result before any surgery happens.

Step Two · Surgery Day

Partial Extraction & Implant Placement

Under local anesthesia (or IV sedation if preferred), the buccal portion of the natural root is retained as a shield while the rest of the tooth is removed. The implant is placed using X-Nav dynamic navigation following the Blue Sky Plan exactly. A custom abutment is connected.

Step Three · Same Day

Provisional Crown Delivery

A provisional crown is delivered the same visit so you leave with a complete smile. The provisional is shaped to support the gum tissue and guide its healing into the precise contour planned digitally.

III

Step Four · 3–4 Months

Healing & Tissue Maturation

During this period, the implant osseointegrates with the bone while the soft tissue heals around the provisional crown. Most patients have no functional limitations during this phase. Routine check-ins ensure tissue health.

Step Five · Final Visit

Final Crown Placement

A digital scan captures the exact tissue architecture, and a custom zirconia or e.max crown is fabricated and placed. The result: a tooth that looks indistinguishable from your natural dentition, with no visible metal, no pink acrylic, and a gum line that matches the surrounding teeth precisely.

Candidacy

Is FP1 right for you?

FP1 surgery is most beneficial when aesthetics matter — typically anterior teeth, or any visible-zone tooth where the result must look indistinguishable from natural dentition. It's also beneficial whenever maximum tissue preservation is desired, regardless of position.

I

A failing front tooth

FP1 is the ideal solution when a front tooth needs to be replaced. The visible gum line is preserved, eliminating the risk of an aesthetic compromise.
II

High smile line

Patients whose smiles show significant gum tissue benefit most from FP1. With FP3 restorations, the transition between natural and prosthetic gum often becomes visible.
III

Thin biotype anatomy

Patients with naturally thin gum tissue are most vulnerable to bone collapse after extraction. Biological preservation prevents this from the start.
IV

Long-term aesthetic priority

For patients who want the best possible aesthetic outcome over the next 20+ years — not just the year after surgery — FP1 preserves the foundation that makes long-term aesthetic stability possible.

Common Questions

FP1 surgery answered.

How is FP1 different from a standard implant?+

A standard implant replaces a missing tooth, but typically results in some bone and tissue loss in the months after extraction. The final crown often requires pink porcelain or acrylic to compensate for that lost tissue (called FP3 restoration). FP1 surgery uses biological preservation techniques to prevent that tissue loss in the first place — meaning the final crown sits in natural gum, looking identical to a real tooth.
Is FP1 surgery more expensive?+

FP1 typically carries a modest premium over standard implant placement due to the additional surgical complexity and the use of Blue Sky Plan and X-Nav technology. The exact difference depends on the case. Most patients find the aesthetic outcome justifies the difference, particularly for anterior teeth — but we'll review pricing transparently at your consultation.
What if I'm not a candidate for socket shield?+

Several conditions can rule out a true socket shield — significant root fracture, internal resorption, periapical pathology, or anatomy that doesn't allow safe root retention. In these cases, alternative biological preservation techniques (root membrane, custom grafting protocols, or carefully managed conventional placement with immediate provisional) may achieve similar aesthetic outcomes. The CBCT and Blue Sky Plan workup tells us what's possible.
Can FP1 surgery fail?+

Like any surgical procedure, FP1 has risks — primarily the possibility that the retained root fragment doesn't heal as planned (rare with proper case selection) or that the implant fails to integrate. Modern protocols with X-Nav guidance and Blue Sky Plan have made these complications uncommon, but no procedure is risk-free. Failure rates published in peer-reviewed literature are similar to or better than conventional immediate implants.
How long does the surgery take?+

A single FP1 surgery typically takes 60–90 minutes, including the partial extraction, implant placement, and provisional crown delivery. Most patients are surprised by how quickly the procedure is completed, especially given the precision involved.
Will the retained root cause problems later?+

When properly executed, the retained root fragment integrates with the surrounding tissue and remains stable for the long term. Long-term clinical studies on socket shield procedures (now extending past 10 years in published literature) show that properly retained shields remain healthy and continue to perform their biological function indefinitely. Case selection and surgical execution are critical — which is why Blue Sky Plan workup matters.

FP1 Surgery & Tissue Preservation

What is FP1 surgery?

Five techniques. One philosophy.

Socket Shield

Root Membrane Technique

Partial Extraction Therapy

Pontic Shield

Root Banking

Custom Combinations

Blue Sky Plan: where every FP1 case begins.

From planning to final delivery.

CBCT & Blue Sky Plan Workup

Partial Extraction & Implant Placement

Provisional Crown Delivery

Healing & Tissue Maturation

Final Crown Placement

Is FP1 right for you?

A failing front tooth

High smile line

Thin biotype anatomy

Long-term aesthetic priority

FP1 surgery answered.

Related procedures.

Anterior Immediate Implants

X-Nav Dynamic Surgery

Single Tooth Implants

See if FP1 is right for your case.