Implants in Deficient Anterior Maxilla: A Modified Prosthetic Approach

Anterior maxilla represents the esthetic zone and implant placement in a deficient anterior maxilla is a unique challenge. This case report highlights a modified prosthetic approach using zirconia copings for achieving a satisfactory restoration in a deficient maxilla where implants have been placed following ridge augmentation. The patient presented with loss of upper incisors except upper left central incisor and a deficient residual alveolar ridge, following trauma due to road traffic accident. Implant site preparation involved- atraumatic extraction of the upper left central incisor and a combination of bone expansion with osteotomes and grafting with allograft supplemented with Platelet rich fibrin for wound healing and stabilization. Four root form implants were placed and submerged for six months with a successful osseointegration. An esthetic challenge during the prosthetic phase was overcome by placement of customized zirconia copings following which the Zirconia crowns with gingival ceramic were prepared and cemented.