Multi-disciplinary rehabilitation of an agenesic upper lateral incisor

Lead:

Sebastian Horvath

A 30-year-old female patient presented in the dental practice with an agenesic, upper lateral incisor #22 FDI (#10 US). The patient had undergone space closure by means of a Maryland bridge fixed to the adjacent teeth. The edentulous space presented horizontal and vertical bone resorbtion. In addition, tooth #21 FDI (#9 US) had migrated mesially, bucally and apically due to occlusal force exerted on the Maryland bridge wing cemented on its palatal aspect and in contact with the antagonist teeth.

The overal medical condition of the patient was good and there existed no concommittant oral pathologies.

Orthodontic treatment to correct the occlusal and aesthetic discrepancies present in the anterior region and to create space for a dental implant in position #22 FDI (#10 US) was planned. This was followed by the placement of an implant simultaneous to a soft tissue augmentation by the means of a subepithelial connectice tissue graft. A cement-retained implant crown on a zirconia abutment was planned. In addition, to harmonize the esthetic region, lithium disilicate veneers were planned in all four upper central incisors.