again that's where our patients started and she these are the finals it's always fun to
see the transition on our patient from before and after a particular patient came to me
requesting an improvement to her smile she's worked in dentistry for a while and if we look
a little bit closer when we think about what an aesthetic smile is
it typically would be a smile that follows the lower lip line and if we certainly factor the
entire patient's face their smile the lip line is super important right the lip line
it frames the teeth behind it but with aesthetic cases really all restorative cases there is
a lot of confusion out there because whenever maybe if you've had a case like this in the past
you have to kind of decide you make that decision of what material to use there's
a huge array of materials out there and usually you have to kind of decide
in the aesthetic zone are you going to choose strength or aesthetics and with all the different
brands all the different names all of the different terminology of what materials to
use it can be extremely confusing to be like this guy which way do i go what do i choose
and that's the response you're you're wanting you want the patient to
to love it you want them to again if you have that conversation they bring that proposed
design to you you want them to be excited about it if they're not you're probably
going down the wrong path to misery certainly not all patients are the same
but getting them especially if they're coming to you looking for that aesthetic improvement
it's always so beneficial to preview it let them see it but also to let us see it
now from that mock-up i also love using it for the preparation
so you saw that formula of removing anything to facial removing anything to incisally once you've
removed and pre-contoured those areas that are too far in those dimensions incisively and facially
then when you choose a prep burr and i would recommend a round ended tapered diameter a
round-ended diamond bur to create depth cuts so i like doing d-step cuts these vertical depth cuts
there are depth cut burrs that look like a christmas tree with different
thicknesses and and depth that you can create and they would go across horizontally
now here where sometimes you do have to cut off the temporaries depending on how locked on they
are and any areas where there's the resin residue i like using a slow speed carbide round burr to
kind of take that off it will remove the acrylic without really affecting or damaging the two
structure beneath so once the restorations come back i like using a mylar strip or shim stock
to make sure that it has a good contact between each you want to ensure that each of these fit
perfectly down on each prep passively because with these veneers if there's any slight heavy contact
it will throw off the alignment so using a shim stock is going to help determine whether or not
the contacts are heavy if it tears when you pull it through definitely try to adjust the
contact down i don't know if you saw that but i used a i cut a small piece of articulating paper
in the areas where the shim stock was too heavy or it wouldn't drag through
so once we etch with phosphoric acid rinse them off i do apply gluma again a desensitizer let
that soak don't wash it off then a bonding agent in this case i use opti-bond universal from kerr
and then kerr's nx3 their light cured resin cement so you can see i put i start at the centrals when
i'm cementing them i lock each one on again it's important during the try end to make sure that
they fit passively so this way when i go to cement them i can get them down to that ideal position
and because of the unlimited working time with it being a light cured cement i take my time
make sure i load each restoration correctly seat them all the way back canines now on the premolars
once everything is down then i use these wooden sticks i think they're orange wood sticks and so
these were in broxter aesthetic again that's where our patient started and she these are the finals
it's always fun to see the transition on our patient from before and after
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