Objective: The combination of partial edentulism and a worn anterior tooth in the esthetic zone can be a challenge for the dentist. This clinical situation requires extensive knowledge of soft and hard tissue management, surgical planning and execution for implant therapy, and conservative tooth preparation with ideal bonding protocols for the tooth-supported prosthesis. Moreover, an optimal selection of the final restorative materials is imperative to manage occlusal forces and fulfill the patient's esthetic demands.
Materials and methods: The patient presented with partial edentulism on site 11, a worn incisal edge, and facial defects on tooth 21. Minimally invasive implant therapy for site 11 was performed with a papilla-sparing flap design that only included the edentulous site, and the soft tissue contouring was started for an immediate provisional restoration. A suturing technique was executed that aimed at maintaining an interproximal papilla. Conservative veneer preparation was performed on tooth 21 in order to bond the restoration to the enamel structure. Final restorations included a custom abutment with a lithium disilicate fused to zirconia crown for the implant on site 11 and a lithium disilicate veneer on tooth 21.
Conclusions: A well-planned single implant and a ceramic veneer restoration was able to fulfill the patient's esthetic expectations. The selection of materials for the final restoration was crucial to manage the occlusal forces and to mimic the shade and shape of the adjacent teeth.