Dentistry has evolved over the past decade to involve several different treatment modalities for the replacement of singular and multiple missing anterior teeth in adult patients. With the advent of new technologies, techniques and materials the ability to replace missing teeth with the form, function and beauty of the natural dentition is now possible. Resin bonded bridges, porcelain fused to metal and all ceramic restorations as well as implants can be offered as solutions to patients suffering from the loss of teeth in the “Esthetic Zones.”

With any and all of these procedures, in order to attain a successful outcome, the focus must be the framing of the restoration within the confines of the lip and gingivae to provide for ideal proportion and beauty in the final restoration.

Therefore, any restorative endeavor in this region must entail the foundation of a beautiful soft tissue frame and the construction of harmony of the gingival scallop between the restorations, the adjacent dentition and the border of the lip perimeter.

This presentation will focus on the interdisciplinary relationship of the restorative dentist, periodontist and orthodontist to reconstruct the soft tissue foundation for all of these restorative options in anterior tooth replacement. The diagnosis of deficiencies as well as the varied treatment options will be discussed in detail. This includes periodontal crown lengthening, esthetic periodontal plastic soft tissue grafting procedures as well as prescription adjunctive orthodontic tooth movement to manipulate the soft tissue foundation prior to or subsequent with the restorative options of implants, bridges, or pontic replacement.