All-ceramic prosthetic rehabilitation of the upper incisors after removal of a periapical lesion from the lateral incisors: palatal approach

The indication of Osseointegrated implants to restore edentulous gaps or replace hopeless teeth could be assumed as a routine dental treatment; instead, if possible natural teeth should be preferred for the support of fixed prostheses. A continuous pervasive pain was referred by a 49 year-old female patient at the palatal aspect of the anterior maxillary area. Soft tissue swelling at the palatal aspect was present during the clinical intraoral examination. An extensive radiolucent area apically to the area from teeth 21 to 23 was showed by means of the X-ray examination. That teeth supported single crown fixed prostheses. A surgical entry was performed for the lesion treatment. The fixed dental prostheses were removed and root canal therapies were performed on teeth 13 and 23. After that, muco-gingival surgery was performed in order to expose the tooth root. A provisional fixed restoration on the four upper incisors was made. After the lesion resolution an all-ceramic definitive fixed prosthesis was delivered. No adverse events or prosthetic complications were detected during the two years of follow-up after prostheses cementation.