"Rejuvenating" a smile with veneers? What needs to be considered?

It always starts with a thorough evaluation of the gums and the health of the teeth. In this smile makeover case, we ruled out any periodontal disease and noted the desired position of the gum line within the biological parameters of the periodontal attachment of the teeth. A surgical gum lift was performed. After three months, impressions were taken to develop a smile design on the dental models (diagnostic wax-up). Reduction guides were fabricated that would provide the future outline of the veneers, hence allowing us to prepare the teeth as conservatively as possible (minimally invasive dentistry). See also How much tooth structure needs to be removed for porcelain veneers.

Once the diagnostic wax-up has been approved by the patient, the preparation of the teeth is scheduled. The reduction guides are used to determine the conservative removal of tooth structure within the requirements for the thickness of the porcelain as described in the preparation-for-veneers video above. New impressions and a bite record are taken of the prepared teeth. An imprint of the diagnostic wax-up is used to make the acrylic temporary veneers that will serve as a reference for the final porcelain veneers. These provisional veneers have the exact same shape as the smile-designed teeth of the study models. The patient now has four days to refine the aesthetic goals for his/her new smile, such as tooth color, incisal tranlucency, dental outline, and dental proportions. The patient is invited to select his/her favorite smile makeover from my Instagram.

Once patients have refined their envisioned smile rejuvenation, the information is transferred to the cosmetic dental laboratory, and the processing of porcelain veneers is initiated to align with the patients' specifications and desires.

After additional ten days, a total of two weeks from preparation of the teeth to delivery of the final porcelain veneers, the new laminates are bonded to the teeth. This entails an intricate process to assure a permanent bond between teeth and veneers. The bonding process is shown here: Bonding Procedure.

The patient returns after two weeks for a final check-up to ensure that all excess cement is eliminated and the bite is dialed into the the natural function of the patient's chewing function.

Dr. Jorg-Peter Rabanus has been designing smiles and practicing smile makeovers as described above for many years. At his San Francisco downtown location he has rejuvenated the smiles of many patients.