Reclaiming the smile: Digital prosthetic management of a malpositioned anterior maxillary implant

Rehabilitation of missing maxillary anterior teeth with malpositioned implants presents significant esthetic and functional challenges.This case describes a 29-year-old male who lost both maxillary central incisors due to trauma, with implant placement in region 11 positioned buccally outside the ideal prosthetic envelope.Clinical and radiographic evaluation revealed adequate bone volume, allowing prosthetic correction without additional surgery.Management involved a custom cobalt-chromium abutment for implant 11, a prefabricated angled titanium abutment for implant 21, and digital design of a two-unit porcelain-fused-to-metal bridge using Exocad software.The framework was fabricated via Direct Metal Laser Sintering (DMLS) and veneered with natural and pink porcelain to optimize emergence profile, interdental spacing, and gingival esthetics.The final prosthesis achieved excellent functional stability and esthetic integration, successfully correcting implant malposition.This case demonstrates that combining digital workflows, customized abutments, and additive manufacturing can effectively address complex anterior implant restorations, emphasizing the importance of precise diagnosis, interdisciplinary planning, and tailored prosthetic strategies for predictable long-term success.