cosmetic dentistry - beauty & science

special topic _ porcelain laminate veneers I and detailed treatment plan first be completed. It is equally critical that the treatment plan be dis- cussed with the patient. Based on the author’s ex- perience and recommendations from other promi- nent authorities in aesthetic dentistry, a dentist must obtain the big picture, from the initial pa- tient evaluation all the way to maintenance of the completed PLVs. The purpose of this article is to introduce a step- by-step guide for PLVs. We could title it “the Pros GPS”, since it is intended to guide readers to suc- cessfulveneerrestorationoutcomes,bothaesthetic and functional, by helping them avoid some of the pitfalls encountered by many dentists during PLV treatment.TherearefivephasestotheProsthodon- tic GPS: diagnosis, preparation design, provisional- isation, material selection and cementation. _Diagnosis A 61-year-old Caucasian female patient with minimal medical history presents for correction of her maxillary anterior teeth. She wants you to make her teeth more rounded in order to enhance her feminine and youthful smile. How would you pro- ceed? First, start with facial and smile analysis. If you do not need to change the vertical dimension of occlusion, a profile evaluation such as E-line or the nasolabial angle is more important than a fa- cial proportion evaluation (Fig. 1). The E-line profile evaluation is based on the maxillary anterior tooth position (sagittal angulation). If there is a large dis- crepancybetweentheaverage(anatomic)valueand thepatient’svalue,youmayneedtoconsiderortho- dontictreatmentpriortoPLVtreatment.Inaddition, thesymmetryandshape(suchasovoidorsquare)of the patient’s face must be evaluated. For smile analysis, record the patient’s gradual smile change from a rest (repose) position to a dynamic and full-smile position (Figs. 2a–d). This series of photographs will enable you to evaluate the patient’s lip mobility and the smile line, which is an imaginary line drawn along the incisal edges of the maxillary anterior teeth. Based on the rest posi- I 07cosmeticdentistry 2_2012 Fig. 11a Fig. 11b Fig. 12a Fig. 12b Fig. 10a Fig. 10b Fig. 10c Fig. 10d Fig. 16a Fig. 16b Fig. 17a Fig. 17b Fig. 13 Fig. 14 Fig. 15a Fig. 15b