Gotta be honest, this is one of the most challenging cases I’ve done so far. Single anterior discoloured tooth is always hard to deal with, especially with a gummy smile. But I’m excited to share!🤗
To achieve this result:
Smile Design • Gingivectomy • In-office Dental Whitening & Internal Bleaching • Mock-Up • 7 unit Composite Veneers & 1 unit Ceramic Crown
Patient has excessive gingival display (“gummy smile”) with hyperactive upper lip elevator muscle. We’ve discussed the options of:
🦷Orthodontic TX with TADs (“bone screw”)
🦷Botox injection to help reduce the upper lip elevation upon smiling
🦷…or simply accepting the profile and patient just have to learn to smile a little less wide
Patient opt for no Ortho tx nor Botox, and only the treatments I’ve mentioned above. Fully understanding the limitations of the improvement we can bring her, she trained herself to smile to her ideal height and I actually think it looks good.😊Sometimes, no treatment is also a form of treatment, don’t you agree?
Composite veneers weren’t too hard to place. However, it was difficult to mask the discoloured tooth. Root canal treatment was done many years ago and we can actually see the root discolouration showing through the gingiva. (Watch my story to learn more) Even with internal bleaching, the improvement was limited, unless we carry out soft tissue surgery to increase the thickness of the 21 buccal gingiva to mask the root discolouration.
We managed to mask some of the crown discolouration on 21 with procelain-fused-zirconia crown (to match the crown to the rest of the tooth was difficult as well) and the help of a little opaquer, yet there is still room for improvement in my opinion.
Although challenging, I’m blessed to have a very kind patient who’s willing to go through the whole treatment with me. There’s no difficult treatments, as long as our partner (aka patient) is a great one. Of course, it is cases like this which help us become better clinicians. Looking forward to more challenges in the future!🤩
#AestheticDentistry #Dentistry #Veneer #Crown #RestorativeDentistry #Whitening #DentalVeneer #Smile #Makeover #SmileMakeover #CeramicVeneer #CompositeVeneer
