Asha Rathod, Gaurang Mistry, Rajeev Singh, Mansi Shukla, Foram Dama, Sanpreet S Sachdev
Esthetic replacement of missing teeth in the anterior maxilla requires coordinated management of gingival contours, pontic emergence profiles, restorative materials, and occlusal function. This case report describes the interdisciplinary rehabilitation of a 21-year-old female patient whose maxillary lateral incisors had been extracted following failed endodontic treatment. Clinical examination revealed a high smile line with approximately 4 mm of gingival display and bilateral Siebert Class I ridge defects at the healed extraction sites. Treatment comprised diode laser-assisted esthetic gingival recontouring, intentional endodontic treatment of the selected abutments, and progressive development of the ovate pontic sites using a provisional restoration over 6-8 weeks. A six-unit monolithic zirconia fixed dental prosthesis extending from 13 to 23 was subsequently fabricated and cemented. Occlusal adjustment maintained central-incisor guidance during protrusion and canine guidance during lateral excursions, while the ovate pontics remained free of centric and excursive contacts. At the one- and three-month follow-up visits, the peri-pontic tissues demonstrated stable contours, minimal plaque accumulation, and no bleeding, ulceration, debonding, or fracture. The patient reported satisfactory esthetics, phonetics, mastication, and comfort. Longer follow-up is required to confirm the stability of the soft tissues and prosthesis.