Rehabilitation of a Maxillary Defect and Missing Teeth in the Esthetic Zone With a Long-Span Fixed Dental Prosthesis:...

Rehabilitation of the esthetic zone is one of the greatest challenges in contemporary prosthodontics. In addition to tooth loss, defects of the alveolar ridge and surrounding soft tissues often compromise functional and esthetic outcomes. When implant therapy is contraindicated or not feasible, treatment should be tailored to the patient's individual needs. The aim of this case report was to present the prosthetic rehabilitation of a complex maxillary defect and missing teeth in the esthetic zone using a long-span fixed dental prosthesis (FDP).

A 51-year-old female patient was referred to the Department of Prosthodontics, School of Dental Medicine, University of Belgrade, for prosthetic rehabilitation following surgical enucleation of a large cystic lesion in the anterior maxilla. The procedure required extraction of the maxillary incisors and canines, resulting in extensive hard and soft tissue loss in the esthetic zone. The maxillary premolars and first molars were prepared as abutments, and a provisional polymethyl methacrylate (PMMA) bridge was fabricated. Three weeks later, a definitive porcelain-fused-to-metal FDP was manufactured. The metal framework and ceramic try-ins were used to evaluate fit, oral hygiene accessibility, occlusion, esthetics, and shade before fabrication of the definitive restoration. After glazing, the long-span FDP was cemented. At the 1-year follow-up, the final restoration demonstrated satisfactory function, esthetics, and stability.

Long-span porcelain-fused-to-metal FDPs can provide a predictable treatment option for selected patients with a maxillary defect and missing teeth in the esthetic zone when implant therapy is not indicated. Careful treatment planning and individualized prosthetic rehabilitation are essential for achieving favorable functional and esthetic outcomes. Further clinical studies with larger samples and longer follow-up are needed to evaluate the long-term success of this treatment approach.