Sometimes getting a new smile may seem impossible or very hard to get.
Many patients think that their treatment will very expensive or that it requires extensive reduction of healthy tooth structure. The truth is, that in many cases getting a new smile may be done easily in a few steps only.
What you need is a dentist that will address all your concerns, will think all the alternative treatment options and will suggest treatment plans that are fitted to your special needs and concerns.
Today I present a case that has been treated in our clinic in a short period of time, without orthodontics and extensive restorative work and with minimal cost.
N. was very hesitant when she visited our clinic. She was very disappointed with her smile because your teeth where crowded and discolored.
She had consulted an orthodontist but she decided she didn't wish to have an orthodontic treatment since she was already 25 years old and wasn't comfortable with the idea of having to use braces for some time. She didn't wish to have huge changes in her smile, she only wished to have her teeth look straight and whiter without spending a fortune on her treatment.
Upon examination, the following were the most important esthetic concerns:
- Two front teeth, a central and its neighboring lateral incisor had root canal treatments and they had slowly developed a brownish color that is very characteristic of the teeth that had root canal treatments in the past.
- Lateral incisors on both sides were located lingually to the mandibular incisors when the patient was closing her teeth.
- Gums were healthy but they were inappropriately positioned because of the position of the corresponding teeth.
- N. had a gummy smile, meaning that both her teeth and the gums were showing a lot when she was smiling.
We started the restoration by repositioning the gum line, a procedure performed by a periodontist. Ideal gum position is important because it creates the ideal frame for the new teeth. If the patient doesn't show any gums then its up to them to decide if they wish to have the gum line addressed or not. If on the other hand the gum line is shown upon smiling then we have to establish its ideal position in order to make an appealing final restoration.
Correcting the gum line was necessary on N. 's case because it would provide us with more tooth structure to work with and would also create an ideal frame for the restoration.
The following picture presents the result after gum repositioning and the whitening that followed.
The gum procedure is done in one appointment and then a period of 40 days follows during which we wait for the tissues to mature and get ready for teeth restoration.
When gums healed completely we performed teeth whitening. During the procedure that was done with customized trays and lasted two weeks, teeth were whitened significantly but not to the same degree. One central incisor for example was white enough but the lateral next to it was still darker than expected. This is why we did internal bleaching to this tooth and in two sessions improved the tooth color significantly.
The patient did not wish to have all her teeth involved in a major teeth restoration. We made two porcelain veneers only in the lateral incisors, aiming to improve their position on the arch. A small part of the tooth that was occluding lingually to the mandibular incisors, was removed and then two porcelain veneers were fabricated matching the color of the rest of the teeth.
The picture above presents the right side of the mouth before and after the treatment. Note the change of the gum position. The ideal gum position for lateral incisors is just below the gum line that is formed between the central incisor and the canine of the same side. The porcelain veneer changed the tooth position and made it look on the arch.
Left incisor had been more challenging. The treatment was the same for this side too and the result is shown in the following picture. 
This is how the teeth looked six months after the conclusion of the treatment. The treatment lasted 3 months and the patient had to visit the clinic 6 times. It was simple and actually involved only two teeth.
Teeth and smile characteristics remained the same and the cost was kept as minimal as possible. Good treatment outcome, results from a simple treatment plan and its careful execution.
In the end I can only present the clinical outcome one more time.
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