About a decade ago cosmetic treatment meant 8-10 veneers for a patient. For me personally there has been a conscious push towards more conservative treatment. My philosophy is how little work can I do to achieve the patient goal.

Chucks’ case is a great example of this. Chuck has been a patient of ours for many years. One day at his 6 month recall he mentioned wanting to improve his smile.

Before I jump into any ‘sales’ pitch or start thinking for the patient – I take a picture, put it on the big screen, and ask the patient “Tell me more specifically what about your smile you would like to change.”

Patient before smile

Patient before smile

Chuck mentioned that he didn’t want them to look like what he sees on TV. He just wanted them to be a bit whiter and he’d like his front teeth to be a bit more even.

So the plan was pretty simple.

1. Whiten at home until happy with tooth color.
2. Veneers #7 and #10.
3. Shorten #8 and #9 with enameloplasty.

The only decisions in this case were the amount of prep needed for #7 and #10 and how much we could shorten the centrals without adversely affecting his bite pattern. I felt that a no prep situation would create thick laterals and would also present a color challenge. We would determine how much to remove on the centrals based on the mounting and length we created the laterals.

We opted for a minimal prep approach. Remove enough to create room for porcelain strength. Remove little enough where we could utilize the translucency of the porcelain to allow natural tooth to assist with natural shading.

In the end we ended up with a very nice result that required no anesthetic for tooth preparation.

Before and After with At Home Tray Whitening

Before and After with At Home Tray Whitening

 

Minimal preparation of facial. Preps were kept in enamel with thickness of approximately .3mm

Minimal preparation of facial. Preps were kept in enamel with thickness of approximately .3mm

 

A definitive finish line created slightly supragingival

A definitive finish line created slightly supragingival

 

Completed minimal preparations

Completed minimal preparations

 

Smile view after completed treatment

Smile view after completed treatment

 

Retracted view after treatment

Retracted view after treatment

 

Close up view after treatment. Please note the banding discoloration was reproduced in the minimal prep veneers

Close up view after treatment. Please note the banding discoloration was reproduced in the minimal prep veneers

 

Occlusal view showing how the veneers aren't bulky

Occlusal view showing how the veneers aren’t bulky

 

Before and After

Before and After