the plan is to enhance your smile with veneers to increase the size close the spaces and also to go
much lighter she wants to aim for a Hollywood bl1 shade we have a 41 year old female that
presents with some worn maxillary anterior teeth some on the mandibular as well and she's really
just unhappy with the aesthetic appearance of her maxillary teeth when she smiles you can see
they are a bit worn seven through ten actually six through eleven all of these are relatively worn at
the inciso edges and she also wants to correct the diastomata between five and six we want to
get an idea of what we can achieve with this and where our possible limitations are in order to do
that we create a diagnostic wax up and just want to let you see the wax up here this wax set was
created with the patient's ideal smile in mind so the patient actually submitted a picture of
of what she thought was the ideal smile and if we kind of compare the wax up that we created for her
it's pretty similar it's certainly longer at the centrals and what we consider aesthetically
pleasing slightly shorter laterals canines that have some prominence to them from the wax up it's
important for us to be able to transition this or at least have the patient preview what this
model is going to look like so in order to do that we create a putty Matrix that is shaped to
the wax up so this putty Matrix is created once that ideal diagnostic wax up has been made and
the putty Matrix we will then apply some bissacro material into here and seated on the patient which
you'll see and at least have the patient trial fit this they can wear it for a day and I recommend
actually having them wear it for a week this way they can see if they're comfortable with the
plan and sizable Edge positions the added bulk if there is any and if just to see if there's speech
patterns are the same there are several several things that we want to look into and certainly
having their family's approval friends approval but usually this is a great way to have the
patient get comfortable with the planned treatment so whenever we seat the viscro the excess material
that flows out along the facial once the entire Matrix has been set it's really easy to remove
the excess material once it's scalloped so that's just my preference so after the patient's approval
with the mock-up and we know what our limitations or where we're actually going with this case from
there I will apply the acrylic mock-up on the patient and actually prep directly through the
mock-up for me prepping through the mock-up is one of the best ways to guide yourself on where
tooth structure needs to be removed where you may not need to remove as much material
so I recommend highly recommend having a diagnostic wax up for all of your aesthetic cases
so I wanted to review the prep sequence that I went through for this case based off the
diagnostic wax up that we have and from the putty Matrix we create a mock-up that goes right over
the patient's existing dentition and since the mock-up is going to guide us on the preparation we
prepare right through the mock-up on the patient so I first create three depth Cuts using an 850
014 Burr we make three depth cuts on all of the incisal edges and I use more of the body of the
Burr which is about 1.4 millimeters in diameter and create the depth Cuts along the incisal
and then the tip of this Burr is approximately 0.8 millimeters in diameter so I create the depth cuts
on the facial aspect first along the gingival margins ensuring that I get down to where the
tip of the Burr is buried and then I transition and round this over since this surface is flat
I create ensure that the marginal depth cuts are created first and then I will roll this
over to the incisal edges on each of the teeth and I create three along the facial and then one
on each of the line angles to make sure that enough reduction is created in those aspects
so for the actual preparation this is what the finals look like you can see here that
with just a single cord you'll see on the clinical video a single cord was used to
create enough retraction all the margins were brought right to the gingival margins the free
gingival margins on each of the teeth and with one single size one cord used to help displace
the tissues apically and you can see it also pushed the tissues out laterally allowing the
light body PVS material to flow into the sulcus and have that separation once the depth Cuts have
been marked I switched to a larger 850 018 Burr to expedite the finishing of the preparations