Page 20


By Dr. Craig Goldin, FAACD

A look at a typical case and how you can incorporate this cosmetic procedure into your list of services.

I’ve had the opportunity to treat a variety of cases over my career, and would like to share a veneers case I recently completed. It was pretty routine, and new dentists who opt to add veneers to their list of services will likely treat similar cases in their offices as well.

CASE OVERVIEW This case involved 18-year-old Unjanee Wells, who had won the Miss Teen Michigan title prior to treatment. She was ready for a change and interested in the benefits of smile design. Her short teeth and the large diastemas between them were her chief complaints. Because of these large spaces, she had a flat, almost reversed, smile line. The patient’s worn, chipped teeth also needed to be straightened, as her front teeth flared labially. Placing veneers would decrease the severity of the labial flare. It was determined that we would place porcelain veneers on tooth Nos. 4 through 13. Veneers were the best option in this Before. situation because the patient had a tooth jaw-size discrepancy. Even with orthodontic treatment, spaces would have remained in the upper arch. Typically, we would have performed orthodontic treatment before placing the veneers to yield the best result possible, but the patient declined this option. The goal was to increase the length of After.


her incisors so they would follow the contour of her lower lip, while straightening her teeth and maintaining ideal proportions. This would typically be 100 percent length to 75 to 80 percent width ratios on the incisors. This is ideal to keep the tooth from appearing too wide. The patient first had her teeth whitened with our in-office whitening system, Opalescence Boost from Ultradent Products. We then began the veneers treatment process, with the plan to place them all at once. Treating multiple teeth at one time makes it possible for them to share the space between the new veneers so the front teeth don’t end up looking overly wide. We also spent time talking with the patient about tooth shape and shade selection. She wanted a very light shade, and even though we suggested she go with something closer to her natural tooth color, she chose light, BL1. She plans to have veneers placed on her lower teeth in the future.

PREPARING THE CASE We completed this case in four visits: the lab preparation appointment, the tooth preparation appointment, the cementation appointment and the delivery of the occlusal guard. Lab Preparation Appointment: Once the patient decided she wanted to go forward with treatment, we sent upper and lower models, a stick bite and photographs to Burbank Dental Laboratory, our lab of 20 years. Burbank Dental is an all-service laboratory that does cosmetic cases as well as single crowns, implant restorations, dentures and occlusal guards. We use the lab’s Smile By Design group. For this case, the lab fabricated a diagnostic wax-up, a putty matrix of the wax-up (for fabrication of the provisionals) and a preparation guide. After we received the diagnostic waxup, which acted as our communication tool with the lab and the patient, we completed PHOTOS COURTESY OF DR. CRAIG GOLDIN

s a cosmetic dentist, I must determine the best method of treatment to give patients the beautiful smiles they desire. It’s rewarding work I’m passionate about, and it’s something I would encourage new dentists to pursue.

The New Dentist Winter 2017  
The New Dentist Winter 2017