cosmetic dentistry_ beauty & science

I 25 case report _ biomimetic approach I cosmeticdentistry 4_2013 the missing lateral incisor. Normal intercuspation and canine guidance were achieved on both sides. In the mandibular arch on the left side, the left canine assumed the function of the lateral incisor and the left premolar that of the canine. During orthodontictreatment,thepersistentprimarytooth was retained, to provide additional anchorage and to maintain the width of the alveolar process. _Implant-prosthodontic treatment After orthodontic treatment had been com- pleted, a new occlusal analysis was performed to evaluate the aesthetics and to establish the implant-prosthodontic rehabilitation necessary. Photographsweretakenatdifferentanglesanddi- agnostic casts were mounted in an Artex partially adjustable articulator (AmannGirrbach) using the facebow registration and the centric relation reg- istration techniques by Dawson. _Analysis of occlusion and articulation Normal occlusion was present, and incisal and canineguidancewasrestored(disclusionofposte- rior teeth during protrusion and laterotrusion). Normal occlusal contacts and intercuspation were present. In centric relation, no premature contacts and traumatic occlusion were seen in articulation (centric relation = maximum intercuspation). No subjective or objective temporomandibular jointproblemswereregistered.Spaceswereclosed and tooth contacts were restored in the maxillary and mandibular anterior segments. The space necessary to restore missing teeth 24, 25 and 45 wasestablishedbyorthodontictreatment.Inorder to restore missing tooth 14, the space was main- tained by retaining the persistent primary molar (Figs. 5a–d). _White and red aesthetics About1mmoftheincisaledgeswasvisiblewith lips in the rest position. During smiling, normal exposure of the maxillary teeth was present and the incisal line did not follow the curvature of the lowerlip.Inordertomaintainthecanineguidance, elongation of the maxillary incisors was not possi- ble. The anterior gingival margin line was normal. _Treatment plan re-evaluation In order to establish the treatment plan and to analyse aesthetics in the anterior segment, the diagnostic wax-up and mock-up were created, which enable an assessment of the proportions Figs. 13a–d_The maxillary lateral incisors without and with veneers, showing perfect white and red aesthetics. Figs. 14a–d_Gingival shaping with the healing screw and temporary crown (a & b), zirconia abutment and final restoration (c & d). Figs. 15a–c_Teeth contacts after prosthodontic treatment. Fig. 14a Fig. 14dFig. 14c Fig. 13a Fig. 13dFig. 13c Fig. 15c Fig. 13b Fig. 14b Fig. 15a Fig. 15b