## 2 Case Report  
A 48-year-old female patient presented to the clinic with the chief complaint, \"I need some dental work, and I do not like to wear my removable denture.\" After clinical evaluation, the patient was diagnosed with missing teeth (numbering using the universal tooth numbering system) #1, 4, 5, 9, 12, 14, 15, 16, 17, 19, 20, 30, and 32; spaces between teeth #6 to 7, and #23 and 22; a fixed dental prosthesis (FDP) from #7 to 10 with the pontic on #8; an ill-fitting maxillary cobalt-chromium removable partial denture; generalized incisal and occlusal wear for all present dentition; and torus palatinus. The patient had some loss of vertical dimension of occlusion (VDO). The patient was offered an FMR, including some implants in the edentulous areas; however, the patient rejected any surgical treatment and elected the FMR option with tooth-supported prostheses. An initial digital scan (iTero Element 5D, Align Technology, Inc, San Jose, CA, USA) was captured. The centric relation (CR) was registered with an increased VDO of 3 mm using vinyl polysiloxane (VPS) material (Regisil Rigid Bite Registration Material, Dentsply Sirona, Charlotte, NC, USA) after manual manipulation to the centric relation position (Figure 1). A facial scanner was used to create a virtual patient (Figure 2). Finally, intraoral photos were obtained (Figure 3). Figure 1: Initial intraoral scan. A digital diagnostic wax-up was created, and models were printed out (i.e., additively manufactured) of resin (Dental Model, ASIGA, Alexandria, Australia) with the proposed shape (Figure 4). The intraoral diagnostic mock-up was performed based on the digital wax-up (Figure 5). The patient approved the appearance of the proposed restorations in the mock-up and accepted proceeding with the crown-lengthening procedure. The crown-lengthening procedure was digitally planned and guided by a printed surgical stent (Figure 6). Figure 4: Printed diagnostic wax-up. Figure 3: Initial intraoral photos. (**A**) Smile. (**B**) Frontal view in occlusion. (**C**) Occlusal view of the mandible. (**D**) Occlusal view of the maxilla. Figure 2: Initial face scan. (**A**) extra-oral smiling. (**B**) Close-up of the smile. The provisional restorations were milled out (i.e., subtractive manufacturing) of polymethyl methacrylate (PMMA). After four months of healing time, tooth preparations were refined, final digital impressions (iTero Element 5D, Align Technology, Inc, San Jose, CA, USA) were taken, and the final restorations were designed (DentalCAD 3.1, Exocad GmbH, Darmstadt, Germany) (Figure 7). Figure 5: Intraoral mock-up. (**A**) External smile view. (**B**) Internal view. Figure 6: Crown lengthening phase. (**A**) Design of the guide. (**B**) Printed surgical guide. (**C**) Before surgery. (**D**) After surgery. Tooth preparations were performed followed by the cementation of milled provisional restorations with temporary cement (Temp-Bond, Kerr Dental) (Figures 8 and 9). Figure 8: Full mouth preparations. **(A)** Frontal view. **(B)** Maximillary occlusal view. **(C)** Mandibular occlusal view. Figure 7: Milled provisional restorations on printed models. **(A)** Frontal view in occlusion. **(B)** Maximillary occlusal view. **(C)** Mandibular occlusal view. After four months of healing time, tooth preparations were refined, final digital impressions (iFero Element 5D, Align Technology, Inc, San Jose, CA, USA) were taken, and the final restorations were designed (DentalCAD 3.1, Exocad GmbH, Darmstadt, Germany) (Figure 10). The 3D facial scanner was evaluated with the proposed final restorations (Figure 11). Figure 10: Final imaging. (**A**) Final digital impression. (**B**) Design of final restorations. Figure 9: Full mouth provisional restorations. (**A**) Smile. (**B**) Maximum intercuspation position. Final restorations consisted of milled zirconia partial restorations, single crowns (SCs), and fixed dental prostheses (FDPs) (IPS e.max ZirCAD, Ivoclar Vivadent, Schaan, Liechtenstein) cemented with resin cement (Multilink Automix, Ivoclar Vivadent) (Figure 12).