The Class III defect environment entails a vertical and horizontal deficiency in the edentulous ridge. Often, bone and soft tissue surgical procedures fall short of achieving a natural esthetic result. Alternative surgical and restorative protocols for these types of prosthetic gingival restorations are presented in this three-part series, which highlights the diagnostic and treatment aspects as well as the lab and maintenance challenges. A complete philosophical approach involves both a biologic understanding of the limitations of the hard and soft tissue healing process as well as that of multiple adjacent implants in the esthetic zone. These limitations may often necessitate the use of gingiva-colored "pink" restorative materials and essential preemptive planning via three-dimensional computer-aided design/computer-assisted manufacture to achieve the desired esthetic outcome. The present report outlines a rationale for consideration of artificial gingiva when planning dental prostheses. Prosthetic gingiva can overcome the limitations of grafting and should be a consideration in the initial treatment plan. (Int J Periodontics Restorative Dent 2009;29:471-477.).