The patient’s request
His request concerned the appearance of his smile, and he wanted treatment with ceramic veneers. The examination showed that the condition of the gums had to be treated before any restoration: this was the step that came first.
The plan was therefore organised in successive stages, each one a prerequisite for the next.
Preparing the gums before the veneers
Priority was given to periodontal treatment, together with oral hygiene instruction: how to brush, how to clean between the teeth, how often maintenance is needed. The aim was healthy, stable gums, so that the future restorations could then be designed on tissues that were no longer changing.
The aesthetic plan was built only once this foundation was in place.
Adapting the plan to the teeth and the gums
Orthodontic treatment was suggested before the veneers, to improve the alignment of the teeth. The patient preferred not to take up this option. The plan and the preparations were therefore adapted to the position of the two upper central incisors (11 and 21), which was taken into account rather than corrected. A veneer does not move a tooth: it changes its shape and surface, and the restorations were designed around the existing positions of the teeth.
To increase the visible height of the teeth and even out the gum line, a gingivectomy was carried out from the upper right second premolar (tooth 15) to the upper left second premolar (tooth 25). This rebalanced the level of the gum margins before the veneers were made.
The result with eight feldspathic veneers
Eight feldspathic veneers were then made and fitted. Feldspathic ceramic is built up by hand, layer by layer, which makes it possible to work on the translucency and the subtle shade variations of each tooth. The aim was a bright but believable result, one that respects the individuality of the smile rather than standardising it.
In the photographs, the teeth look longer, the gum line more regular, and the shapes and surfaces continuous from one tooth to the next. How the veneers blend with the untreated teeth and with the gums is part of the visible result; how stable it remains over time depends on maintenance and regular check-ups.
