A Caucasian female patient in her 20s was just about to get married and wanted to look the best. She was missing laterals with vampire-like fangs that bothered her. Because of the timeframe, orthodontic treatment was not an option.

 

Since the teeth are all vital, we need to be conservative in prep generally, but the aggressive prep is necessary where required. Boding strength is another element we must consider. Thus, we decided to go with lithium disilicate (e.max) restorations – veneers on the central incisors and first-premolars, with joint crowns to replace the laterals and canines off one abutment for each quadrant.

 

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Fig 1 shows the pre-op condition. When working a case like this, the communication between the clinician and technician is crucial. The way the clinician preps will influence the outcome and can limit the technical capacity. The positions of the canines are right in the middle between the central incisors and first premolars. Thus, we commenced the case with diagnostic wax-up with careful planning to determine the required amount of preparation.

 

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Figs 2-5 show the virtual try-in of the diagnostic wax-up on the Aesthetic Articulator (more information will be published in the upcoming blog-post).

Based on the idealised smile design, we can determine exactly where the tooth position will be, and to eliminate any guesswork or possible error that might occur down the track.

 

The treating clinician produced the temps in the mouth, followed by the diagnostic wax-up, accurately transferred from the putty key (click here for more information).

 

Note the pink stain between the laterals and canines, which indicates where to apply pink ceramics. The patient was already thrilled with the appearance of her smile at this point.

 

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Fig 7 shows the master model mounted on the Aesthetic Articulator, which shows the prep followed by the initial design’s blueprint.

 

Fig 8 shows the completed restorations on the Aesthetic Articulator, visualising the outcome before sending out the case to the practice.

 

Fig 9 shows the completed restorations in situ – a 2-week follow-up. The patient was ecstatics of the outcome and ready to start a happy family with confidence!

 

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Acknowledgement:

 

I’d like to thank Dr Michael Cai from Pitt St Dental Centre in Sydney CBD NSW, Australia, for his clinical excellence. https://www.pittstdentalcentre.com.au/

 

This case was issued in November 2015 with no remakes.

 

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