PMC5030409_01
Initial smile.
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However, the patient exhibited a slight asymmetry of the gingival margins on the upper right and left first premolars, with excessive overall gingival display (Figure 1).
Initial intraoral panoramic view.
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The patient underwent a comprehensive clinical examination (Figure 2), as previously described.
Design of new teeth and gingival combined contour in DSD-based planning phase.
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The width and length of the central incisor were 8.9 mm and 8.3 mm, respectively, with a ratio of 107% (Figure 3).
DSD-based diagnostic wax-up.
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Intraoral try-in of an acrylic template based on the DSD diagnostic wax-up.
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The DSD diagnostic wax-up (Figure 5) was used to generate the surgical template that guided the initial incisions and to determine the dimensions of the new clinical crown from the upper right second premolar to the upper left second premolar.
Completed crown lengthening surgery and suture.
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Finally, the flaps were repositioned and sutured (Figure 6).
Retracted gingiva and finished teeth preparation.
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The gingiva was adequately retracted, the sulcus was dry, and the margins of the preparations were clearly visible (Figure 7).
Design of the restorations in CAD/CAM software.
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PW1114PA, Dhpro Rhadartrade Comercial Importadora de Pecas LTDA, Paranagua, Parana, Brazil) and polishing disks (Sof-Lex Extra-Thin XT disks #2382SF and #2382F, 3M ESPE Dental, St. Paul, MN, USA) to optimize smooth surfaces for scanning and adhesive cementation (Figure 8). No design modification was made in any of the samples (Figures 8, 9, 10, and 11).
Design of the restorations in CAD/CAM software (lateral view).
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No design modification was made in any of the samples (Figures 8, 9, 10, and 11).
Design of the restorations in CAD/CAM software (lateral view).
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No design modification was made in any of the samples (Figures 8, 9, 10, and 11).
Design of the restorations and occlusal contacts in CAD/CAM software.
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No design modification was made in any of the samples (Figures 8, 9, 10, and 11).
Immediate postoperative intraoral panoramic view.
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The margins were finished and polished as needed with diamond burs, rubber points, and diamond polishing paste (Figures 12, 13, 14, and 15).
Immediate postoperative intraoral lateral view.
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The margins were finished and polished as needed with diamond burs, rubber points, and diamond polishing paste (Figures 12, 13, 14, and 15).
Immediate postoperative intraoral lateral view.
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The margins were finished and polished as needed with diamond burs, rubber points, and diamond polishing paste (Figures 12, 13, 14, and 15).
Final smile.
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The margins were finished and polished as needed with diamond burs, rubber points, and diamond polishing paste (Figures 12, 13, 14, and 15).