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Fig 3: Due to orthodontic treatment, brown and white spots had Fig 4: The initial situation was scanned in order to be able to create a
formed. digital mock-up.

Fig 5: A front-angle photo of the patient Fig 6: The face of the patient and the esthetic Fig 7: First the shape of the teeth was
smiling was taken using the tablet. zone were analyzed. determined in the esthetic zone.

Designing the perfect smile documented in a second photo and video shoot and then discussed.
From the front, the patient was photographed smiling using a tablet Finally, the patient agreed to commence the final treatment.
and the DSD app from Christian Coachman. Here, her face was
analyzed in line with the esthetic rules of digital smile design. This was gingivectomy anD preparation
used as a basis for creating an ideal virtual tooth morphology in 2D for Using a scalpel, guided resection of the gingiva was performed along
the upper incisors and both premolars. In the NemoDSD 3D software the margin of the mock-up in order to shape the new gingival gradient
application (Nemotec Software, Madrid, Spain) the intraoral scan data in line with digital smile design. Controlled mock-up preparation
and the data from digital smile design was matched in order to create a was then carried out for 10 veneers from 15 to 25, to ensure enamel
virtual wax-up model. The ideal scenario was created and printed in 3D preservation. In doing so, minimally-invasive chamfers were created
(Rapid Shape, Heimsheim, Germany). The model was used to create a at the preparation margins of the anterior teeth and the four premolars
key made from rigid and viscose silicone. Using a scalpel, the silicone in the upper jaw. After smoothing the preparations with a fine rubber
key was shaped carefully along the scalloped margin of the gums on polishing disc, a second intraoral scan was performed to create a
the printed model. Dual-curing composite for temporary crowns and digital model. The veneers were constructed virtually using VITA
bridges was then applied in the silicone key before it was positioned ENAMIC multiColor 1M1 HT in the 3Shape CAD software (3Shape,
intraorally. During the gel phase, it was possible to easily remove the Copenhagen, Denmark) based on the virtual wax-up. The veneers
excess composite along the cervical shaped area of the silicone key. were then milled using a CORiTEX 250i milling machine (imes-
Once the material had cured, the silicone key was removed leaving the icore, Eiterfeld, Germany). Finishing was performed using the VITA
virtually-shaped mock-up on the upper dental arch. The mock-up was ENAMIC Polishing Set technical. After etching with hydrofluoric acid

Dental Practice i November-December 2023 i Vol 19 No 6 55