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.
This study will show:
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
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.
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 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.
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.
Following with discussion of all risks and treatment modalities with our patient that included:
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.
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