Starting point
This young patient wanted to improve the harmony of her smile and was initially considering veneers. The examination revealed a congenitally missing upper left lateral incisor (tooth 22), unbalanced tooth proportions and an asymmetrical gum line.
Treatment choice
Given her young age and the clinical situation, a conservative approach based on adding composite was preferred to ceramic veneers. Digital planning made it possible to define the new proportions and the volumes to be rebuilt, as well as the areas that needed layering first.
Treatment steps
At-home whitening for three weeks to improve the starting shade.
Digital planning of the shapes and volumes.
Gingivectomy to harmonise the gum line.
Building a palatal wall (the back surface of the tooth) with a key, then layering a dentine-shade composite.
Composite injection to complete the reconstruction following the defined plan.
In this case, the volumes to be rebuilt justified layering first, to better control the anatomy and the aesthetic integration, before completing the shapes by injection.
Result
Combining these steps made it possible to rebalance the tooth proportions and harmonise the smile, using an additive approach. The views of the smile and the intraoral photographs allow the result to be assessed.
