Before and After 2012: Smile Makeover – Achieving Significant Change in Proportion with porcelain veneers
A Caucasian male patient in his 30s was deeply concerned about the aesthetics of his smile. There are several issues we had to address: most notably, changing the proportion and tooth size within the aesthetic zone, crown-lengthening/gum-contouring, and a replacement of a missing tooth on 14 (right first-premolar).
We selected a Zirconia bridge on 15-13, and lithium disilicate (e.max) veneers for the rest – 12-26 (missing 25), from the right second-premolar to the left first-molar, a total of 10 units.
I must admit that this case was one of the most challenging smile makeovers I had encountered at that time, but the result spoke for itself. The patient was “over the moon” with the outcome.
The key to achieving such a result was the following elements:
- Good communication between the dental professionals and the patient
- Performing crown-lengthening/gum-contouring designed at the diagnostic wax-up stage
- Precise and accurate preparation by the treating clinician followed by the diagnostic wax-up
- Reproduction of the smile design in the provisionals/temps
- Reproduction of the idealised shade in the final restorations
- Applying suitable contour on the ceramic restorations to help gain (in Q2) and push (in Q1) the soft-tissue/gum for better balance/proportion
- Creating illusion in morphology to make the central incisors look as narrow as possible.
- Empirical skills to colour match in different materials
For this blog post, I present step by step photos below without detailed explanations. A picture is worth a thousand words, and I wanted to keep it simple within the realm of complexity.
For more information about smile design, read ‘Reproducing Nature Part 4: Smile Design’ in the Publication section – click here to read.
I’d like to thank Dr Mark Gadeley (now retired) from Pitt St Dental Centre in Sydney CBD NSW, Australia, for his clinical excellence to achieve such a fantastic result.
This case was issued in October 2012 with no remakes.