Designer Smiles Dentistry

Case Study-23 Smile & Bite correction symmetry

Correction of Bite Tooth Form Arch Form Creation of Symmetry Improvement in tooth display during speech and smile dynamics

Case Study-23 Smile & Bite correction symmetry

Correction of Bite Tooth Form Arch Form Creation of Symmetry Improvement in tooth display during speech and smile dynamics


Correction of Bite Tooth Form    Arch Form
Creation of Symmetry
Improvement in tooth display during speech and smile dynamics
This study will show
Complexity of treatment
Treatment outcome
Patient’s assessment
Please refer to the video provided


Ms M was referred by her general dental surgeon for specialist assessment in improving the aesthetic appearance of upper teeth: presence of generalised gum recession, moderate discolouration, correction of asymmetry of the upper arch due to missing upper right lateral incisor (12, as well as improvement to overall smile). The lower teeth were of a lesser concern at this stage (small dark triangles between triangular central incisors etc) where past tooth whitening had resulted in sensitive lower teeth.

Dental asymmetry: tooth12 is missing, midline shifted to the right into RHS area.

We noted the following;

  1. Optimal lip thickness and outline symmetry, great lip frame,Tooth: 11 also retroclined, bruxing patient and severe wear incisally of 11, creating step in the incisal plane during smile and speech dynamics.
  2. Tooth12 is missing. Contralateral tooth 22 is present
  3. Cross bite on RHS: this is more skeletal then dental/functional. There is also slide at this site and this slide can be contributing to slight clicking on the right TMJ. Small occlusal/bite refinement will help to reduce this slide when restoring the lateral smile. We note that having missing 12, combined with retroclined 11 and cross bite on RHS, slightly deviated mandible (lower jaw); gives more pronounced asymmetry on RHS due to presence of large negative spaces.
  4. This combined with thin biotype, triangular teeth; high smile line scalloping gingival margins and multiple gum recessions with sensitive erosive lesions on premolars makes the treatment quite complex that requires careful planning for optimal function, comfort and aesthetics.
  5. The presence of generalised gum recession is due to probable excessive tooth brushing and presence of thin tissues (thin biotype). However we do have periodontal (gum) stability.

Following composite mock up we agreed with the colour,symmetry, level and arrangement of tooth display, improving the arch width, shape and teeth exposure and gum level.  Composite mock up corrected the centerline and recreated 13 into 12, 14 to 13 16 to 14, built the RHS of the collapsed arch laterally, where considerable build up was required. Patient wishes to have white teeth; however some incisal translucency is required to create that natural look to complement overall dentofacial aesthetics.


Teeth were minimally prepared requiring no local anaesthetic, since the preparation is very slight and since we employed the diagnostic guide, the procedure required minimal tooth intervention.The provisional veneers were constructed directly to allow patient habituation and to add that additional assessment time for the best outcome. Now the patient can “wear” these veneers and test the system.


Provisional Veneers refinedto test the systemfor comfort function and aesthetics.

Improved:   colour, symmetry: level and arrangement of tooth display, improving the arch width, shape and teeth exposure and gum level.  Correction of collapsed arch and cross bite on RHS.Excellent lip support and anterior tooth display during speech and smile dynamics

Temporary veneers and new smile line at rest.

Beautiful lips complementing provisional veneers.

Now we have the definitive final cementedporcelain veneers: This is called Bio-mimesis. Imitating nature. Can you see where the missing upper right lateral was?

Can you see how, with the help of an aesthetically understanding and realistic patient, we were able to restore andimproveher smile?

Consonant smile: Most desirable smile

Smile line consonant with the curvature of the lower lip

Establishing an optimal symmetry to complement this beautiful patient’slip form and facial aesthetics


These veneers are placed above the gum and “hidden below toe gum. This reduced the chances of future gum recessions. These veneers are specially constructed by Dr Nalbandian’s technical team.

Smile: tooth form shape/arch form shape/lip form/shape

& BITE CORRECTION simultaneously


The procedure required four visits

  1. Assessment
  2. Diagnostics mock up
  3. Procedure for porcelain veneers & temporisation
  4. Final porcelain veneer cementation

Please Note thefollowing improvements

  1. Correction of arch form.
  2. Improvement in arch outline
  3. Reduction in negative spaces
  4. Fuller smile that complements patients lip form/thickness

This is the art & science behind Dr Nalbandian’s creations in achieving Biomimessis.

Smile must look natural in all angles in 3Dimension.


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I've been a customer of Designer Smiles for over 20 years and I cannot say enough good things about them! From the moment you walk into the office, you are greeted with a warm and friendly atmosphere that immediately puts you at ease. The staff is knowledgeable, professional, and caring. They use the latest technology and take the time to explain everything. I highly recommend them!

Ken Baumli

Dr Sarkis is the maestro of cosmetic dentistry….for years I suffered with 2 slightly darker front teeth due to a childhood accident. I’ve had composite veneers before but nothing compared to the composite veneers Dr Sarkis did……now I feel so confident smiling again……Dr Sarkis I can’t thank you enough…

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Michelle Lacasse

My journey with Dr Sarkis began about 10 years ago. I did not realise that I had lacked self confidence and shone away from "my true smile". Dr Sarkis was honest, reassuring and professional throughout my process and not only was he able to achieve that perfect smile but achieve same without compromising the health of my teeth and gums.The ongoing care at Designer Smiles is 5 star whether it is a routine check, clean minor or major dentistry. Thank you Dr Sarkis and also your team.

Christina Vergotis

I found Designer Smiles from one of their YouTube videos showcasing the Icon treatment to fix white spots on teeth. Dr. Sarkis Nalbandian's consultation provided me with a thorough plan and showed me how their practise could give me predicable results for my concerns. I knew I was in safe hands. I had Kristy Gupta perform both of my procedures and she was very professional and so kind. I am very happy with my results!

Winsome Kain

I cannot express how grateful I am for Sarkis and the team at Designer Smiles. Around 11 years ago my life changed when Sarkis first transformed my smile with composite veneers. This month, with my original teeth in tact I returned to have my composite veneers upgraded to porcelain. I was amazed that Sarkis and his team could do this without an injections, no pain and whilst still keeping my original teeth in tact. I absolutely love the result and I would highly recommend that anyone that is unhappy with their smile in any way, must visit designer smiles

Matt Williams

Started my treatment with the team at Designer Smiles in 2019. Had other dental treatments including Maxillofacial, expanders, straightening and gum grafting but out of all the procedures and surgeries Dr. Sarkis was the key as he was applying the ‘finishing product’ which included composite veneers. I am gobsmacked by the incredible job done. He talks the talk and definitely walks the walk. And his support team there are simply incredible and make you feel part of a family not just another dental clinic to take your money. Can not recommend highly enough. Customer for life here!!

Shaun Meader

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