Guidelines

The sequence for each patient will depend upon the treatment plan.

In my case my anterior teeth had worn down over the years because of disocclusion and bruxism. The subsequent slides show the treatment plan and sequence my dentist Dr Humphrey Walker B.D.S. www.taradaledental.co.nz, followed.

A deprogrammer was worn and premature contacts adjusted to correct disocclusion.

Preoperative Photographs

Photographs were taken showing

• My natural smile at rest with relationship of the lips to the incisal edges.
• Me wearing a retractor to show the preoperative alignment and buccal corridor.

Impressions and facebow recordings were taken and study models mounted on an articulator.

Recordings of midline and horizontal plane were taken with a clinometer. Alternatively this can be done with a stick bite and transferred to the articulator.

Information from the dentist’s clinometer was transferred to an articulator with the aid of a dental technician’s clinometer.

A diagnostic waxup was done following Smile Design Principles e.g.height to width ratio, proportions between centrals, laterals and canines and evening out the buccal corridor.

In this case the treatment plan included crown lengthening the centrals and veneering the centrals, laterals, upper right second premolar and the upper left first molar.

An incisal edge and labial index matrix were made for the dentist to use for an aesthetic preview.

Prior to tooth preparation the dentist built up the teeth in composite using indexes as part of the aesthetic preview.

After acceptance of the aesthetic preview a model was prepped to the ideal tooth reduction to achieve the desired aesthetic outcome. Silicone indexes were made to aid the dentist.

Before preparing the teeth a shade was taken. The shade takes into consideration the patient’s expectations while maintaining harmony with the surrounding teeth.

Teeth were prepared with the aid of the index.A shade was taken of the stump.

When restoring teeth with all-ceramics the colour of the stump is essential as it can affect the shade of the final restoration. The technician needs this information so he can compensate for this in his veneering technique.

Temporaries were made using labial and incisal indexes.

Crown lengthening and temporisation were completed.

Veneers were manufactured and a night guard made.

Even though my occlusion was corrected I had a history of wearing down my anterior teeth so thought it best to play it safe and to wear a night guard.

Have lightened and lengthened the teeth but tried to maintain natural character e.g. irregular