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. 2025 Aug 27.
doi: 10.1111/jerd.70025. Online ahead of print.

Optimizing Hard and Soft-Tissue Esthetics With Anterior Cantilever Zirconia Ceramic Resin-Bonded Fixed Dental Prostheses

Markus B Blatz  1 , Tony Rotondo  2 , Szabi Hant  3 , Lea S Prott  1   4
Affiliations

Optimizing Hard and Soft-Tissue Esthetics With Anterior Cantilever Zirconia Ceramic Resin-Bonded Fixed Dental Prostheses

Markus B Blatz et al. J Esthet Restor Dent. .

Abstract

Objective: The replacement of missing maxillary lateral incisors poses both functional and esthetic challenges, not only from a restorative but also from a periodontal aspect. This case report presents a step-by-step protocol for ideal hard and soft-tissue esthetics with cantilever zirconia ceramic resin-bonded fixed dental prostheses (RBFDPs).

Clinical considerations: A 20-year-old female patient presented with congenitally missing maxillary lateral incisors, seeking treatment to enhance the esthetics of her smile. Due to the age and ongoing skeletal development, implant placement was deferred. Treatment involved the extraction of a retained deciduous tooth, soft tissue augmentation with a subepithelial connective tissue graft, and the placement of zirconia ceramic single-retainer RBFDPs. The pontic design and tissue contouring were carefully managed with a removable partial denture to achieve a natural emergence profile and long-term stability.

Conclusion: The combination of RBFDPs and soft tissue augmentation offers a highly esthetic and minimally invasive treatment alternative for replacing missing anterior teeth. Proper case selection, bonding technique, and soft tissue management are critical for long-term success.

Clinical significance: This report highlights the clinical efficacy of zirconia RBFDPs as a conservative alternative to implants in young patients and demonstrates the importance of soft tissue management for optimal esthetic integration.

Keywords: ceramic bonding; congenitally missing teeth; ovate pontic design; resin‐bonded fixed dental prosthesis; ridge augmentation; zirconia cantilever fixed dental prosthesis.

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