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Case Study #1

Overview of Case : This wonderful patient was dissatisfied with the uneven edges, and color of her upper teeth.  We always work with the end in mind. To this end, the design phase is critical. Our initial design lengthened the teeth at the edges, reversing the wear, and increased the height in some areas at the gumline, restoring the lost space due to shifting.  Once we and the patient were all happy with how the proposed final outcome looked, we proceeded. The increased height in gum tissue, or gum lift, was achieved with a very predictable surgery facilitated by guide based on our design. After healing, the teeth were minimally (0.3mm) prepared for porcelain veneers. As the master ceramist fabricated the veneers, the patient's temporaries reflected our initial design. We and the patient approved of the appearance of the veneers when we tried them in. We proceeded to bond the veneers in place in pairs under total isolation. This isolation provides the best, most predictable bond strength: a critical step in longevity of veneers. The final result is very natural and fits the patient's smile and face well. We were so happy this patient trusted us to provide this care!

Step 1
Primary Concern

Primary Concern: uneven edges of teeth, unhappy with color, and uneven gum margins.

Case 1 Initial Presentation 2

Step 2
Analysis

Analysis: wear pattern due to functional wear and night time grinding resulting in uneven appearance of edges of teeth and shifting of gum margins.

Case 1 Design Mockup

Step 3
Macro Smile Design

Macro Smile Design: a design proposal taking into account face shape, size of smile, and lip movement.

Case 1 Design Mockup 2

Step 4
Micro Smile Design

Micro Smile Design: verification of design proposal. Shape and position of individual teeth look natural within patient’s smile

Your smile is a reflection of your personality. Call capital dental design Today.

804.320.8894

Case 1 Surgical Guide

Step 5
Gum Recontouring

Gum Recontouring: using a guide based on the approved design, high accuracy and predictability is achieved in placement of desired gum margins.

Case 1 Immediately Post Surgery

Step 6
Post Recontouring

Post-Gum Recontouring: immediately post gum recontouring. Minimal swelling and discomfort due to minimal amount of recontouring needed and guided nature of procedure.

Case 1 Veneer Prep

Step 7
Veneer Preparation

Veneer Preparation: minimal veneer preparations, 0.3mm of reduction, to allow best position, form, and bonding of porcelain veneers.

Case 1 Veneer Delivery Isolation

Step 8
Veneer Bonding

Veneer Bonding: following approval of veneer esthetics, total isolation is critical to quality of the bond strength of the veneers. Better isolation = better longevity.

Your smile is a reflection of your personality. Call capital dental design Today.

804.320.8894

Case 1 Veneer Delivery After

Step 9
Veneers Bonded

Veneers Bonded: immediately following veneer bonding, still under total isolation. Highly technical but a critical, frequently overlooked, step in quality veneer placement.

Case 1 After 3

Step 10
Micro Analysis

Micro Analysis: confirming texture and shade matches expectation. Porcelain texture is a very important component of natural teeth and should be reflected in the porcelain.

Case 1 After 2

Step 11
Macro Analysis

Micro Analysis: confirming texture and shade matches expectation. Porcelain texture is a very important component of natural teeth and should be reflected in the porcelain.

Case 1 After 1

Step 9
Global Analysis

Global Analysis: confirming the smile achieves the initial goal of correcting the uneven wear patterns and color. Does this smile look like it belongs to this patient? Yes! An night wear orthotic, or occlusal guard, was fabricated to protect the porcelain.