The Importance of Interdisciplinary Treatment in an Esthetically Challenging Case

A single missing tooth is a common occurrence among young patients and impacts esthetics and long-term oral health in terms of compromised bone, gum tissue, and, if warranted, an implant and final prosthesis. In this case report, after years of poorly executed orthodontic therapy, the patient's dental growth complicated the development of an esthetically pleasing smile. An interdisciplinary approach was utilized comprising periodontal surgery, a second course of orthodontics, and prosthodontics to provide comprehensive patient care that included evaluation of occlusion and esthetics. Orthodontic treatment was performed to position the teeth in the most esthetic, functionally optimal position. An implant crown in the maxillary left central incisor position and direct bonding on the maxillary right central incisor were indicated to treat a large edentulous area. Final orthodontic treatment achieved a substantial reduction of incisor protrusion and proper mesial-distal distance between the future implant and adjacent teeth. An ideal emergence profile, appealing esthetics, and a provisional restoration were created before the final crown. Optimal alignment of teeth relative to the arch was achieved, and adequate tissue dimensions were created by combining surgical augmentations with provisional restorative therapy.