A Smile: Meeting Patients' Expectations
A 33-year-old female presented with a chief complaint of, "My teeth are wearing and dark around the gums, and I do not like my smile. I no longer want to place my hand over my mouth when I laugh." The patient wanted to have a beautiful smile and she wanted to smile with confidence.
A comprehensive examination was performed, including x-rays and photos (intraoral, Digital Doc; digital camera, Canon EOS). Maxillary and mandibular diagnostic models were taken (Splash!, DenMat), as well as bite registrations (Symmetry Bite, Clinician's Choice), and the patient's occlusion was evaluated. The maxillary and mandibular impression and bite registration were sent to Williams Dental Laboratory for fabrication of a diagnostic wax-up of teeth Nos. 5 through 12. A Siltec Stent (Ivoclar Vivadent) was fabricated from the diagnostic wax-up for the fabrication of the patient's temporaries.
After discussing treatment options and viewing the diagnostic wax-up, the patient chose to have a smile makeover with porcelain veneers. One of the patient's requests was to use conservative preparation to preserve healthy tooth structure. Her teeth had previously been restored with composite.
The patient's teeth were prepared and a final impression was made using Imprint 3 (3M). A NV Microlaser (Zila, a Tolmar Company) was used at the preparation appointment to sculpt the gingival height of contour and zenith, allowing me to achieve the ideal length-to-width ratio. Williams Dental Laboratory fabricated the final veneers. Temporaries were fabricated with ProTemp (3M). Proper communication between the dentist and dental laboratory is essential to achieve the patients desires. We could not have met the patient?s expectations without a great laboratory technician.
The final restorations were cemented with Excite-F DSC Soft Touch (Ivoclar Vivadent) and Variolink Veneer Cement (Ivoclar Vivadent) and cured with FlashLite Magna (DenMat). Only small adjustments were necessary because of the accuracy of the laboratory. The patient was extremely happy with the outcome because we achieved her esthetic desires and she can now smile with confidence.