Labial Wing-retained Modified Maryland Bridge with Monolithic Zirconia Veneers for Deep Bite Rehabilitation: A Case Report

Abstract

Rehabilitation of missing anterior teeth in young patients presents a clinical challenge due to high aesthetic demands, ongoing craniofacial growth and the need to preserve sound tooth structure. The present case report describes a 17-year-old male with peg-shaped lateral incisors, spacing, severe vertical overlap and a missing maxillary left central incisor. A conservative treatment approach was planned using a modified Maryland bridge in conjunction with ceramic veneers, considering the patient’s age, occlusal characteristics and minimally invasive requirements. Unlike the conventional design, the prosthesis incorporated labial retentive wings combined with veneer preparations on the abutment teeth. Monolithic zirconia was selected to enhance fracture resistance in the presence of a deep bite. Additional ceramic veneers were cemented on adjacent teeth to close diastemas (between the maxillary right central incisor and lateral incisor and between the right lateral incisor and canine) and improve tooth morphology. At two-year follow-up, no biological or mechanical complications were observed and satisfactory functional, phonetic and aesthetic outcomes were maintained. The present case highlights the value of individualised prosthetic design and adhesive principles in achieving predictable, minimally invasive anterior rehabilitation in young patients with excessive vertical overlap