Pre-operative lateral smile also showing less than ideal tooth display due to incisal wear with incisors that appear shorter than posterior teeth and canines.
Pre-operative close up view showing damaged enamel with incisal edge fracturing and stress craze lines as well as inappropriate central incisor proportions.
Initial pre-op shade reference (prep shade) used for discussion with patient and laboratory ceramics technician.
Clinical pre-op Incisor length 8.5 mm to be used for calibration with 2 D design template.
Full contour 3D additive design ready for model printing and fabrication of silicone transfer template which will be used for test drive and provisionals. Note buccal of pre-molars are built out which will fill in buccal corridor in the patient’s smile.
Full contour 3D additive design ready for model printing and fabrication of silicone transfer template which will be used for test drive and provisionals. Note buccal of pre-molars are built out which will fill in buccal corridor in the patient’s smile.
Silicone Template filled with BISGMA temporary material placed over pre-op teeth allows for an easy “smile try-in” or test drive for patient approval, midline marked for easy positioning intraorally.
Test drive smile prior to excess material removal. Accurate 3D designs and full seating of template should result in minimal flash.
Verification guide fabricated over final printed model showing clearance available after mock up is removed and realization that minimal reduction is necessary.
Prep shade image made for lab communication, always moisten tooth surfaces for this image for more accurate shade reference.
Final provisionals spot bonded in the mouth using a "Shrink-to-fit technique." Final shade discussions begin at the provisional stage so images are made to send to the lab for reference.
A complete and quality etch of all bonded surfaces is possible when no facial enamel is removed. This creates ideal bond strengths and restorations that are extremely reliable with many years of clinical serviceability.
Final full contour smile showing improved tooth display, color and improved buccal corridor when compared to the original smile.
Final lateral smile now offers a beautiful result showing natural incisal embrasures, ideal line angles and facial anatomy that compliment the patients smile.
Retracted smile showing beautiful tissue health and integration. Establishing ideal tooth proportions is pleasing but also allows for improved anterior guidance and function.
Two week post op images showing close up view of ceramic characterization and incisal translucency, note ideally fitted margins resulting in excellent gingival health.
Thanks to - Scripps Dental Care Team and Matt Roberts at CMR Dental Lab.
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