PMC5962252_01
Pretreatment photographs: intraoral view of the Class II dental relationship; intraoral view of the anterior temporary prostheses; occlusal view of the upper and lower arches. Pretreatment panoramic radiograph confirming the absence of the maxillary incisors, left canine and mandibular right first molar, and the extent of anterior alveolar bone loss. Note the short gingival exposure while smiling and slight asymmetry of the lower lip due to a scar.
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Initial panoramic radiograph confirmed the absence of teeth and the extent of alveolar bone loss (Fig 1).
Intraoral photographs following placement of the alveolar bone graft. Panoramic radiograph showing the positioning of the alveolar bone graft.
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One year after this treatment, she was not satisfied with the treatment outcomes and sought a second treatment option (Fig 2). 
Intraoral photographs showing the replaced mandibular right first molar and the Class I canine relationship. Frontal and lateral views of the five dental implants placed in the anterior area. Final panoramic radiograph showing the dental implants.
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I canine relationship (Fig 3). Improvement in mandibular incisor positioning was necessary to establish the correct position of the maxillary implants in the anterior area.
Final photographs, radiographies and superimposition: the prosthesis were placed, and aesthetic and functional rehabilitation was achieved.
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Finally, the prosthesis was created with a more convex shape in the cervical region of the maxillary incisors, to support the subnasal region, and aesthetic and functional rehabilitation was completed (Fig 4). The prostheses were placed to complete the aesthetic and functional rehabilitation (Fig 4).
Two-year follow-up photographs demonstrating the maintenance of occlusal stability. CBCT with the implant position.
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The long-term maintenance of these results after 2 years of follow-up (Table 1), with a pleasing smile and adequate overbite and overjet, and adequate positioning of the implants are shown in Figure 5.