The presentation describes comprehensive esthetic and implant rehabilitation of the maxillary anterior region in a patient with significant medical and surgical history. The patient had previously been diagnosed with stage IV lung, lymph, and liver cancer in 2011 and underwent extensive chemotherapy treatment, including Carboplatin and Cisplatin therapy, before transitioning to Alectinib (ALECENSA), with remission achieved by 2019.
Clinical complications included persistent oro-antral communications documented in December 2018, with radiographic evidence of sinus involvement and implant-related complications. Surgical repair of a large sinus perforation was performed using a stem cell UC membrane.
By December 2021, pretreatment clinical views demonstrated compromised maxillary anterior dentition requiring rehabilitation. Preoperative radiographs revealed multiple failing anterior restorations and deficient supporting structures.
Treatment involved minimally invasive placement of multiple zirconia implants (4.3 × 11.5 mm and 4.3 × 13 mm implants) combined with minimally invasive bone replacement procedures. Digital workflows were used throughout treatment, including:
- Digital implant planning
- Digitally designed and printed immediate provisionals
- Fully digital design and milling of final zirconia restorations
Immediate postoperative photographs and 14-day postoperative clinical views demonstrated rapid healing and preservation of soft tissue contours. Final photographs and radiographs documented successful integration of the zirconia implants with highly esthetic definitive restorations and favorable peri-implant bone stability.