A 23 year-old female lost her maxillary central and lateral incisors in a water skiing accident at age 13. These teeth were reimplanted on the same day. The patient had continued sensitivity over the following seven years. At age 20, four incisors were extracted.

The patient came to our office realizing the need for prosthodontic treatment and had two dental implants placed. The second stage of surgery was performed seven months later. That same day, the patient received a conversion prosthesis. One month later, a final double casting tissue integrated prosthesis was delivered. Because of the severe defect in the premaxilla, a gingival replacement unit was fabricated. The unit masked the titanium abutment and restored the contour of the soft tissue which had been lost.