Video: Gum Lift and Porcelain Veneers
The existing composite veneers and past gum lift 15 years ago have served well.
High gummy smile with general dark gum discolourations is a concern for this patient.
Treatment: Smile rejuvenation with improvement in level of tooth display using gum lift and construction of maxilla (upper arch) using porcelain veneers to improve: tooth shape, colour, display, arch form and shape to complement facial aesthetics of this lovely patient.
This study will show:
Patient had restoration work completed in the practice some 15 years ago. However with time the restorations required revisiting.
Past smoker, stopped now for 2 years.
Now we have a unique opportunity to improve on the diagnosis and design of proposed treatment plan: The difficulty here is the gum pigmentation that is present with the proposed tooth length using combination of gum lift and porcelain veneers. Therefore the direct diagnostic composite mock-up is critical in formulating how we design these restorations for an optimal aesthetic outcome.
Chief concerns: improving the aesthetic appearance of her smile:
Diagnosis: Unacceptable tooth an gum display, assymetry and narrow upper arch: creating an aesthetic disturbance.
Once we have determined their needs and expectations and when the patient is ready, we begin to restore their teeth to optimal function and aesthetics.
Diagnostic: mock-up and assessment. Finalise degree of gum and tooth showing during smile and speech dynamics, maxillary arch form and smile width.
We tested the diagnostic mock up for patient acceptance that guided the final desired aesthetic outcome.
Our Aim: to improve the aesthetics of upper arch: Gum level, tooth shape, display, tooth colour, length, symmetry and smile line in general along the upper arch involving 12 maxillary teeth porcelain veneers.
This was accomplished with minimal discomfort to the patient and using no tooth intervention. No provisional veneers were required, since the existing composite veneers placed by myself 15 years ago and required no tooth intervention. Therefore, the tooth enamel is intact and helped in gum healing process following gum lift.
Patient guiding the diagnostic mock-up
Following a discussion of all risks and treatment modalities with our patient that included:
Gum lift and 12 porcelain veneers to complete the high smile line: molar to molar. No tooth intervention.
Gum level diagnostics
The work was completed in two visits. In general it takes about 3-4 weeks from diagnosis to final outcomes.
I would prefer 3 weeks for gum healing. Is best not to rush biology and allow optimal healing.
We tested the diagnostic mock up for patient acceptance that guided the final desired aesthetic outcome. Note how we designed the final porcelain veneers and tooth emergence for that natural look to create symmetry and balance.
Gum Lift & porcelain veneers
Creating balance and complementing on facial aesthetics: confidence. Note how all compositional elements of teeth gums lips and face are in concert together. The aesthetic effect should establish harmony and balance between dentition and surrounding soft tissues.
Final treatment outcome: we have restored aesthetics, symmetry and harmony. Complemented our lovely patient’s facial aesthetics. We have a confident and happy patient. Hence the term: dentofacial rejuvenation.
Thank you for taking the time to explore this patient's story. I hope this gives you an idea of what I can do for you if you are having difficulty and need help, because there is always hope.
Dr. Sarkis Nalbandian
Visiting Professor YSMU
Specialist Prosthodontist & Implant Surgeon
B.D.S. (Hons), Dip. Clin. Dent. (Oral Implants) Uni Syd, M. Clin. Dent (Prosth) King’s College, Uni London
D. Clin. Dent (Prosth) Uni Syd, FRACDS, MRACD (Prosth) FIADE, FPFA