Designer Smiles
Case Study – Reverse ageing smile line with reduced cost to the patient.

The reverse smile line is the least desirable smile preferred by patients.

With the advent of new composite technology and application by Dr Sarkis Nalbandian, we are able to transform reverse smilesto greatsmiles and preserve tooth biologyin just one visit.

Patient initiallypresented with:

  1. General teeth discolouration.
  2. Concerned re: length of upper front teeth, general alignment etc. Due to upper anterior tooth wear, and the negative spaces present due to narrow upper arch.
  3. The presence of lower anterior crowding.
  4. Wishes to improve her
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Examination, study models, photos and x-rays confirm the presence of general discolouration. There was also general canting of the teeth alignment and off the centreline. The anterior wear has created what we refer to as a “reverse smile line”. This tends to create ’dark” spaces during normal speech and smiling, which has affected her dental appearance.

Periodontal (gum) examination shows some bone loss at sites 16 & 46 as well as generalised gum recessions on front teeth areas. However adequate stability exists for proposed dental treatment. Normal Craniomandibular (jaw) function.  Class-I Div 1 normal overbite. Multiple, complex restorations: requiring future treatment.

We discussed using composite or porcelain veneers as well as orthodontic/surgical correction, however due to time and cost factors, orthodontic/surgical treatment was not an option for you.

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Cost factors and preserving biology

Using composite veneers is a conservative treatment, since there is minimal intervention to your teeth and biologically, sound way of treatment. We also discussed no treatment and consideration of porcelain veneers, and for opted for composite veneers on upper teeth: 16, 15, 14, 13, 12, 11,21,22,23, 24 and 25 on upper arch and four veneers. The composite mock application allowed us to assess the effect of tooth alignment, arch broadening and tooth emergence and arrangement across midline as well improving the smile line and general symmetry. The speech was also satisfactory after the diagnostic mock up. Teeth (11, 21, and 43-33) would require slight recontouring to improve centre-line canting and incisal plane levelling, emergence profile and teeth arrangement.

For this lovely patient you would have noticed the following;

  1. Improved tooth colour
  2. Improved smile line
  3. Improved lip support, outline, symmetry, shape and thickness

But most of all her smile is elegantly natural.

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One Visit Smile Lift, nodrilling, no injections and nopain.

One Smile says it all!

Very few practitioners in the world can perform these procedures directly in the mouth: However this can be taught in Dr Nalbandian’s courses. Please ask your dentist to write to us.

Some period of habituation will be also required, which is usually transient. This will improve colour, broaden the smile line, aesthetics in general.  We need to regard this as a long term provisional measure to serve us as a guide in future reconstructions: porcelain veneers if required, crowns on teeth with compromised structural integrity etc. However we can from time to time extend the life of these restorations by resurfacing the veneers with new composite materials at a minimal cost. Once your initial treatment is complete, with time we will make provisions to reconstruct back teeth that have discolouration, but most importantly are structurally compromised and in need for full crowns.

We pride ourselves with the quality of dentistry we provide however, there are always limitations placed on us by materials and oral environment.  One can be reassured at the end of the treatment that all should be well, however if anything unexpected does show up or unusual symptoms occur, we ask our patients to let us know. We are always here to look after our patients.

Bruxing/grinding habits will play an important role in longevity of the restorations and the dentitions as a whole.

All above procedures were performed by Dr Sarkis Nalbandian.

Education and Experience are everything.

Designer Smiles® is the centre for implant, surgical and reconstructive (prosthodontic) oral rehabilitation solutions.


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