"I'm beautiful!"
Richard has been a patient of mine for the last eight years. He’s 32 years old, single, and an overall great guy. Earlier this year he made a consultation appointment for his front teeth to discuss veneers. When we finally sat down, I asked him what made him decide to move forward with this treatment. He mentioned that he was tired of being single and knew that he needed to do something about his smile if he wanted to feel confident enough to enter the dating scene and find a life-long partner.
We had a lengthy conversation about what he wanted to be sure I could meet his desire. His request was simple: make is teeth white. Overall, the position of the teeth was good; no ortho or soft-tissue treatment was required. As this was a straightforward case and the patient wished to begin treatment as soon as possible, I elected to begin without a wax-up. While this is not my normal protocol, I felt confident I could deliver and the patient would be happy. A pre-op putty was taken and his teeth prepared.
CEREC images were captured and the putty was used to fabricate the provisionals. Even though the temps were the same shape/position prior to preparation, he was quite happy at the fact that his teeth were no longer discolored. Without a wax-up to copy, I decided to send the case to Weston Hatcher and allow him to design it. Weston and I spoke about the case and I let him know what I was looking for regarding facial anatomy (minimal to none), embrasures, etc. The final design was emailed back to me a few days later and the restorations were milled in-office.
After the congratulations, handshakes, and hugs, I walked him to the front door. When he walked outside, he raised his hands in the air Rocky Balboa style and shouted, “I’m beautiful!” Cases like these make all the tough days hard to remember. I wish the young man well in his social life with his new-found confidence. These restorations are Emax BL4 and were hand polished only. I chose not to add any incisal or cervical characterization as the patient’s primary desire was to have teeth that were simply one color.
Steven
Did you print up a model so that you could place your laminates on it for any adjustments you made in the lab. Very nice.
Bob
On 8/22/2019 at 8:13 am, Robert Clapcich said...Steven
Did you print up a model so that you could place your laminates on it for any adjustments you made in the lab. Very nice.
Bob
Yup. For me, def a MUST DO prior to delivering a multi-unit case.
I agree, the mission was accomplished and I'm sure he's quite happy. The color change alone was enough to please 99.9% of patients...great job.
However, are you confident there was "no soft tissue" treatment needed? The pictures are limited enough that it is hard to say with certainty, but it looks like 10 and 11 gingival zeniths do NOT reach the level created with a straight line from 6 through 8 and/or 9. Either 6 is too high, or 10 and 11 are too low FROM THE PICTURE PROVIDED. Would a little diode laser treatment not created a better esthetic outcome? A different picture (retracted anterior and/or full face smile) could prove my eyes wrong, that is why I am asking.
On 8/22/2019 at 9:06 am, Ernie Johnson said...I agree, the mission was accomplished and I'm sure he's quite happy. The color change alone was enough to please 99.9% of patients...great job.
However, are you confident there was "no soft tissue" treatment needed? The pictures are limited enough that it is hard to say with certainty, but it looks like 10 and 11 gingival zeniths do NOT reach the level created with a straight line from 6 through 8 and/or 9. Either 6 is too high, or 10 and 11 are too low FROM THE PICTURE PROVIDED. Would a little diode laser treatment not created a better esthetic outcome? A different picture (retracted anterior and/or full face smile) could prove my eyes wrong, that is why I am asking.
You're right. It could have been better with some minor contouring. I should have stated that he felt it wasn't needed and I agreed.
On 8/22/2019 at 9:21 am, Steven Hernandez said...On 8/22/2019 at 9:06 am, Ernie Johnson said...I agree, the mission was accomplished and I'm sure he's quite happy. The color change alone was enough to please 99.9% of patients...great job.
However, are you confident there was "no soft tissue" treatment needed? The pictures are limited enough that it is hard to say with certainty, but it looks like 10 and 11 gingival zeniths do NOT reach the level created with a straight line from 6 through 8 and/or 9. Either 6 is too high, or 10 and 11 are too low FROM THE PICTURE PROVIDED. Would a little diode laser treatment not created a better esthetic outcome? A different picture (retracted anterior and/or full face smile) could prove my eyes wrong, that is why I am asking.
You're right. It could have been better with some minor contouring. I should have stated that he felt it wasn't needed and I agreed.
Perfect.....that makes sense as well. I 100% realize his chief complaint was the coloration of his teeth and was focused 100% on that....just wanted to make sure he doesn't focus on another flaw AFTER the beautiful work was completed. That would suck!
Love it, looks stunning! Great job Dr. Hernandez. absolutely thrilled to play a part in this man's transformation.
On 8/22/2019 at 8:09 am, Jeremy Bewley said... You’re beautiful, too! And people like you, darn it!
Pretty sweet case Steve.
You guys are funny. The Michael Jordan/ Stuart Smalley is an all-time great.
On 8/22/2019 at 12:05 pm, Michael Mingle said...On 8/22/2019 at 8:09 am, Jeremy Bewley said... You’re beautiful, too! And people like you, darn it!
Great case Steve! I wouldn't have touched the soft tissue you either ;)
I like that the most stark thing he noticed was so dramatically improved, but that while getting the shade and shape and spaces, he still has some character of the smile he's always had.... He looks like the best version of HIM. 
Mark
