- 17 Gerard St, Cremorne, Sydney, NSW, 2090
- I Mon to Fri: 8:00AM-6:00PM Sat: 8:00AM-12:00PM
Severe tetracycline discolouration and a worn smile was a concern for this patient.
Treatment: Smile rejuvenation with improvement in level of tooth display, teeth form, arch form and shape and colour on both arches using porcelain veneers to improve: tooth shape, colour, display.
This study will show:
Crowded lower arch with spacing and wear. Note the severe wear also on the upper arch
The patient, when presenting, was most concerned about her worn smile line and severe tetracycline related tooth discolouration.
The difficulty here is not only the tooth discolouration but also the severe wear caused by bruxism (tooth grinding – in this case night time bruxism). We need to control these forces on proposed porcelain veneers, therefore an important part of the treatment protocol is the wearing of a nightguard to protect the new porcelain veneers.
To improve the length of teeth, display during smile and speech dynamics, the direct diagnostic composite mock is critical in formulating how we design these restorations for an optimal aesthetic outcome.
Chief concerns: improving the aesthetic appearance of her smile:
Note the extent of tooth wear and flat/reverse smile line. Crowded lower arch with severe tooth wear.
Diagnosis: Unacceptable tooth colour and wear: 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 and assessment. Finalise the degree of gum and teeth showing during smile and speech dynamics, maxillary arch form and smile width.
We tested the diagnostic mock up for patient acceptance that guided the final desired aesthetic outcome.
Our Aim: to improve the aesthetics of the upper arch: 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.
We tested the diagnostic mock up for patient acceptance that guided the final desired aesthetic outcome.
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 3-4 weeks from diagnosis to final outcomes.
Smile Lift with porcelain veneers on both arches creating balance and symmetry. 20 Porcelain Veneers, 10 veneers per arch to complete the smile.
Note how all compositional elements of teeth gums lips and face are in concert together. We have improved tooth: colour, shape form & arrangements
The aesthetic effect should establish harmony and balance between dentition and surrounding soft tissues
Final treatment outcome: we have restored aesthetics using porcelain veneers on both arches. However most importantly we have complimented our lovely patient’s facial aesthetics. Hence the term: dentofacial rejuvenation.
Should establish harmony and balance between dentition and surrounding soft tissues
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
17 Gerard St, Cremorne, Sydney, NSW, 2090
Mon to Fri: 8:00AM-6:00PM
Sat: 8:00AM-12:00PM
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