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Video: Small Teeth Smile Lift

Small Teeth Smile Lift - Patient Story

This patient was initially referred by her father, an existing patient, and presented for improving the aesthetic appearance of the upper ach: colour, small teeth for the size of the arch creating spaces/gaps between the teeth.

Treatment: Smile rejuvenation with improvement in level of tooth display with construction of maxilla (upper arch) using porcelain veneers to improve: tooth shape and close spaces, colour, display, arch formand shape to compliment facial aesthetics of this lovely patient.

patient with small teeth

Patient with small teeth

This study will show:

Initial Presentation

Smile rejuvenation with improvement in level of tooth display with construction of maxilla (upper arch) using porcelain veneers to improve: tooth shape and close spaces, colour, display, arch form and shape

small teeth initial presentation

Initial presentation

Now we have a unique opportunity to improve symmetry and harmony. Therefore the direct diagnostic composite mock is critical in formulating how we design these restorations for an optimal aesthetic outcome.

Chief concerns:

  1. Improve the aesthetic apperance of her smile.
  2. Improve the smile, close the spaces, upper arch shape and smile line as well as tooth colour.
  3. This lovely socilite patient wants to smile understanding the complexity and the precison of the work required.

Diagnosis: Unacceptable tooth an gum display, assymetry and narrow upper arch: creating an aesthetic disturbance

Diagnosis & Patient centred treatment planning

Once we have determined their needs and expectations and when the patient is ready, we begin to restore their teeth to optimal function and aesthetics.

Diagnostic Mock-up

Diagnostic: mock-up and assessment. Finalise degree of gum and tooth showing during smile and speech dynamics, maxillary arch form and smile width. The spaces are closed with natural tooth formation.

We tested the diagnostic mock up for patient acceptance that guided the final desired aesthetic outcome.

diagnostic mock-up patient assessment

Patient assessing diagnostic mock-up

Our Aim: to improve the aesthetics of upper arch: Gum level, tooth shape, display, tooth colour, length, symmetry and smile line in general along the upper arch involving 12 maxillary teeth porcelain veneers.

This was accomplished with minimal discomfort to the patient and using no tooth intervention. No provisional veneers were required since the existing tooth positions were ideal and required no tooth intervention. Therefore, the tooth enamel is left intact.

diagnostic mock-up patient assessment

Porcelain veneers

Treatment

Following with discussion of all risks and treatment modalities with our patient that included:

  1. No treatment: this is not an option since the patient is most concerned about spaces: affecting aesthetics
  2. Composite additions: this could work but this is a temporary measure and not accepted by the patient
  3. Orthodontic closing of the spaces: this could make the upper arch narrower, further complicating aesthetics: not accepted by the patient
  4. Porcelain veneers: best long-term solution: accepted by the patient

Procedure & Results

  1. Diagnostic: mock-up and assessment. Finalise degree of gum and tooth showing during smile and speech dynamics, maxillary arch form and smile width
  2. Impressions for porcelain veneers
  3. Issue the porcelain veneers

The ultrathin porcelain veneers are tried in the mouth: note the change in colour, length and shape of the teeth.

The work was completed in two visits. In general it takes about 3-4 weeks from diagnosis to final outcomes.

patient with porcelain veneers to correct small teeth

Porcelain veneers: creating balance and complementing facial aesthetics: Note how all compositional elements of teeth gums lips and face are in concert together.

Final treatment outcome: we have restored aesthetics. However most importantly we have complemented our lovely patient’s facial aesthetics.

The aesthetic effect should establish harmony and balance between dentition and surrounding soft tissues

Hence I use the term: dentofacial rejuvenation.

Thank you for taking the time to explore this patient's story. I hope this gives you an idea of what I can do for you if you are having difficulty and need help, because there is always hope.

Dr. Sarkis Nalbandian
Visiting Professor YSMU
Specialist Prosthodontist & Implant Surgeon
B.D.S. (Hons), Dip. Clin. Dent. (Oral Implants) Uni Syd, M. Clin. Dent (Prosth) King’s College, Uni London
D. Clin. Dent (Prosth) Uni Syd, FRACDS, MRACD (Prosth) FIADE, FPFA

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