Anterior implant esthetics: Restoration of congenitally missing lateral incisors
Aim: to present the rationale and treatment considerations to ensure esthetic results for patients receiving implant rehabilitation for missing maxillary lateral incisors and veneers for enhancing the adjacent teeth alignment.
Material & Methods: A 23-year-old female patient presented for treatment of her congenitally missing #7,10. After the comprehensive exam, and the diagnostic work–up, the placement of two implants on the areas #7,10 was decided. GBR and simultaneous placement of implants were performed. Provisional implant crowns were fabricated to create the proper soft tissue contour. Soft tissue conditioning in esthetic areas may take time; hence maturation period of several weeks was needed and it was done by modifying the temporary implant crown to gain more papilla. Veneer preparations were done for teeth #6,8,9,11 followed by final impression. The final impression was taken with customized impression copings, used to ensure the accurate transfer of the emergence profile, created during provisionalization, to the master cast. The final rehabilitation consisted of implant level screw-retained crowns on #7,10 and porcelain veneers on teeth #6,8,9,11.
Results: This prosthetic treatment option solved esthetic and restorative problems arising from congenitally lateral incisor (#7,10) and misaligned teeth in the esthetic zone. Proper provisionalization will ensure the biological, functional and esthetic outcome of the final implant crowns. The resulting prosthesis achieved the esthetic expectations of this patient.
Conclusion: Combination treatment with implants and porcelain veneers in the esthetic zone can give excellent functional and esthetic results. The patient was satisfied with the treatment outcome and was enrolled on a 6-month recall program.
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