Creating a hybrid smile design workflow: The analog brain drives the digital technology.

Objective: This article will explain and demonstrate the application of analog smile design techniques and concepts as a precursor for digital smile design implementation. The application of these techniques will be described with two case presentations that will demonstrate the incorporation of these analog methods into digital smile design programs.

Clinical Considerations: Digital smile design workflows can be more efficient and require less chair time but must be based on an understanding and application of basic smile design principles to apply the digital techniques successfully.

Applying Classical Esthetic Principles to Create a Predictable Illusion of Symmetry While Using Digital Technology.

Having a thorough understanding of classical esthetic principles, including basic tooth shape and form rules, is crucial for clinicians to achieve successful esthetic outcomes, even when implementing digital technologies in their dental offices. The use of advanced, cutting-edge digital tools does not negate the need to adhere to timeless fundamentals of esthetic dentistry. This article reviews key esthetic principles and describes their application in treating a challenging cosmetic case.

Esthetics built to last: treatment of functional anomalies may need to precede esthetic corrections.

In this case of a 33 year-old male patient seeking a more esthetically pleasing smile, comprehensive restorative treatment planning included recognition of the patient's incisor position and morphology, dentofacial requirements, and appropriate vertical dimension. The accepted treatment plan consisted of orthodontic correction of the patient's anterior constriction, followed by placement of eight maxillary veneers and composite augmentation on the mandibular incisors and canines. Keys to achieving a successful outcome included knowledge of smile design, material selection, and preparation techniques.

Conservative restoration of a traumatically involved central incisor.

The use of a direct composite material known for excellent polishability, polish retention, and wear resistance is described in this case of a fractured central incisor restoration. The method used enabled the clinician to conserve tooth structure and maintain full control of the outcome while creating an esthetically imperceptible, reliable, and durable restoration for a young male patient. Emphasized in this case are the techniques of layering, contouring, and polishing of a nanocomposite used to maximize esthetics and meet patient expectations.

There is more to front teeth than looks alone: diagnosis and treatment planning.

When treating high-risk parafunctional cases, patient compliance and understanding of the disease is paramount in the success and longevity of the restorations. Controlling the patient's expectations for augmenting the length and blocking out the dark color was accomplished (Figure 15 through Figure 18).

A cognitive systematic approach to analyzing preparation design for a difficult space management case.

There are at least two different techniques for preparing teeth prior to bonded porcelain restorations. The first involves using depth cutters guided by the existing tooth structure. A more recently developed approach integrates an additive wax-up that represents the final volume of the teeth, with indices used to guide the preparation design.

Restoring tetracycline-stained teeth with a conservative preparation for porcelain veneers: case presentation.

Tetracycline exposure in utero and in early childhood often results in intrinsic tooth staining that varies in severity based upon timing, duration, and form of tetracycline administered. Traditionally, dental aesthetics compromised by tetracycline staining have been restored with modalities requiring aggressive tooth preparation. In this case involving a patient with extremely severe staining of healthy and aesthetically shaped dentition, a conservative tooth preparation strategy and porcelain veneers were utilized to preserve tooth shape and arch form while restoring natural color.