The existing composite veneers and past gum lift 10 years ago have served well. General discolourations of existing veneers had become a concern for this patient.
Treatment: Smile rejuvenation with improvement in level of tooth display of maxilla (upper arch) using porcelain veneers to improve: tooth shape, colour, display, arch form and width to compliment facial aesthetics of this lovely patient.
This study will show:
Chief concerns: improving the aesthetic apperance of her smile:
Diagnosis: Unacceptable tooth discolouration: creating an aesthetic disturbance.
Patient has this work completed in the practice some 10 years ago. However with time the restorations required revisiting.
Now we have a unique opportunity to improve on the design of proposed restorations using minimal intervention porcelain veneers, especially developed in collaboration with our laboratory team.
Note the optimal aesthetics features: lip thickness, symmetry and outline. The aim is to “fit” the upper arch frame within the face and this is where science and art meet. In many ways the arch width (negative spaces to be reduced) needs increasing
Therefore the direct diagnostic composite mock is critical in formulating how we design these restorations for an optimal aesthetic outcome.
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.
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 composite veneers were placed by myself 10 years ago, the teeth required no tooth intervention. Therefore, the tooth enamel is intact and helped in gum healing process following gum lift.
Following with discussion of all risks and treatment modalities with our patient that included:
The work was completed in two visits. In general it takes about 3 weeks from diagnosis to final outcome.
Creating balance and complementing facial aesthetics: confidence.
The aesthetic effect should establish harmony and balance between dentition and surrounding soft tissues. Note how all compositional elements of teeth gums lips and face are in concert together.
Final treatment outcome: we have restored aesthetics using porcelain veneers. However most importantly we have complemented our lovely patient’s facial aesthetics. Hence I use the term: dentofacial rejuvenation. We have a confident and happy patient.
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 Sydney) Uni Syd, M. Clin. Dent (Prosth) King’s College, Uni London
D. Clin. Dent (Prosth) Uni Syd, FRACDS, MRACD (Prosth) FIADE, FPFA