Asian Journal of Dental Sciences

Aims: To describe the staged interdisciplinary management of a young patient presenting with a localised Seibert Class III alveolar ridge defect at the site of a missing maxillary central incisor together with dental fluorosis, and to show how regenerative site development combined with a digitally planned monolithic zirconia rehabilitation addressed both the edentulous defect and the intrinsic enamel discolouration in a single aesthetic outcome.

Presentation of Case: A 19-year-old female from a fluorosis-endemic region reported a missing upper front tooth (11), lost to trauma and extraction seven years earlier, and unaesthetic discoloured teeth. Examination revealed an edentulous 11 site with a combined width-and-height (Seibert Class III) ridge deficiency, confirmed on cone-beam computed tomography (CBCT), and pitting-type dental fluorosis of the maxillary anteriors. Guided bone regeneration (GBR) was performed at the 11 site using a particulate xenograft and a resorbable collagen membrane with papilla preservation. After healing, a diagnostic wax-up and digital smile design guided a four-unit monolithic zirconia fixed partial denture (13–12–11–21, with 11 as an ovate pontic) and monolithic zirconia veneers on 22 and 23, luted with resin cement. Zirconia was selected for its ability to mask the fluorosed substrate.

Discussion: Ridge deficiency precludes a natural pontic emergence and papillary form, so regenerative site development preceded prosthetic reconstruction. Monolithic zirconia was preferred over translucent glass-ceramics because its opacity masks intrinsic fluorosis staining while providing high strength.

Conclusion: A sequenced perio-prosthetic protocol simultaneously corrected a Class III ridge defect and dental fluorosis, restoring function and aesthetics in the maxillary anterior region.