Esthetic rehabilitation of maxillary incisors in conjunction with flapless surgical techniques, an implant zirconia crown, and porcelain veneers.

ABSTRACT Esthetic replacement of a maxillary central incisor using a dental implant can be a challenging task. The hard and soft tissues must be managed in a way that minimizes the risk of tissue loss, while preserving and/or regenerating full interdental papillae. In order to achieve this, flapless surgical techniques have been developed. Advances in dental materials have led to the introduction of zirconia abutments and crowns that can be synergistically combined with other ceramic materials. This article describes a case in which a hopeless maxillary central incisor is replaced with an implant using flapless techniques, and restored with a customized zirconia abutment and crown. In addition, the remaining maxillary incisors were restored with feldspathic porcelain veneers to yield a highly esthetic result. CLINICAL SIGNIFICANCE This case demonstrates how a conservative multidisciplinary approach facilitates excellent results in an esthetically demanding area. Atraumatic surgical techniques can maintain the natural soft tissue architecture, while a detailed approach to provisional and final restorations allows for a highly esthetic smile. (J Esthet Restor Dent 21:294-303, 2009).