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Ultra-thin Porcelain Veneers used to Create Facial Symmetry
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Ultra-thin Porcelain Veneers used to Create Facial Symmetry - Patient Story

This patient initially came to me to improve the aesthetic appearance of the upper teeth arch: teeth display, colour and arrangement (crowding). Orthodontics was not an option for her as she had tried treatments before that were not satisfactory for her.

This study will show:

  • Complexity of treatment
  • Treatment outcome
  • Patient’s assessment – please refer to the video

Initial Presentation

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The patient was referred to me by her friend, an existing patient, seeking specialist’s opinion and treatment in relation to fixed crowded upper and lower teeth arches. The lower teeth arch was a lesser concern for her. On the other hand, the position of the upper lateral incisors and narrow upper teeth arch was a considerable concern for her.

This beautiful patient has a symmetrical face, which I find is a unique feature of hers. I knew given such a symmetrical face we can easily complement it by restoring the teeth and positioning the arches to complement her facial aesthetics. You will notice symmetrical lips with optimal thickness and outline. The cheek bone and the eye levels. As an experienced specialist in aesthetic dentistry I needs to appreciate aesthetic beauty and learn how to complement it for patients in general, however especially for this beautiful woman, who is so conscious of her problematic teeth. The upper arch is narrow for her face and we need to balance the teeth and face. This is the art form which I enjoy everyday in my practice.

Our chief concern was improving the aesthetic appearance of her smile by improving the upper arch shape and smile line as well as teeth colour.

Diagnosis & Patient Centered Treatment Planning

My diagnosis in this case was: unacceptable dental aesthetics. I proceeded to create a diagnostic mock-up directly in the patient’s mouth, with patient input into the overall design of the smile and the feel and function of the resulting smile line. She was able to assess the speech comfort, smile line, level of teeth exposure and most importantly overall dentofacial aesthetics.

With the diagnostic mock-up, we achieved the following;

  • Improved upper arch form teeth display
  • Improved level of teeth display, shade and shape of teeth
  • Symmetry across the midline
  • Arch width & lip/facial support improved lip symmetry – please refer to images provided
  • Optimal speech, comfort and smile dynamics
  • Lower crowding is not concern

My aim was to improve the aesthetics of upper arch: Tooth shape, display, tooth colour, length, symmetry and smile line in general, as well as placing 12 upper teeth arch (maxillary) porcelain (eMAX-lithium disilicate) veneers. This was accomplished in two visits, following the important diagnostic visit.

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Treatment

I discussed all risks and treatment modalities with our patient that included:

  • No treatment: not accepted by the patient
  • Orthodontic treatment: not accepted by the patient
  • Composite veneers: not accepted by the patient
  • Porcelain veneers: accepted

Procedure & Results

The work was completed in two visits and the final treatment outcome, we have a happy and confident patient. My dental colleagues and referring dentists often asked me how I manage to create such beautiful natural smiles specific to each and every patient. My answer is that you must like your patients, enjoy their company, be genuinely interested to understand the reason for their dental and aesthetic concerns, desires, request and help your patients achieve this with minimal biologic intervention.

DIAGNOSTIC MOCK UP

Following the diagnostic mock-up, we achieved the following;

  1. Improved upper arch form teeth display
  2. Improved level of teeth display, shade and shape of teeth.
  3. Symmetry across the midline
  4. Arch width & lip/facial support improved lip symmetry – please refer to images provided
  5. Optimal speech, comfort and smile dynamics.
  6. Lower crowding is not concern

Our Aim:  to improve the aesthetics of upper arch: Tooth shape, display, tooth colour, length, symmetry and smile line in general, as well placing 12 maxillary (upper arch) porcelain ( eMAX-lithium Disilicate veneers.

This was accomplished in two visits, following the important diagnostic visit (please Videos provided).

 

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We have restored aesthetics comfort and function. However most importantly we have complemented our lovely patient’s facial aesthetics. 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