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ePaper created 2016-12-07, 11:04:42 | version 1.38.0
dentistry 4_2016 cosmetic 20 Fig. 11_The gingival contour was modified on the model. Fig. 12_The diagnostic wax-up showing the upward-shifted gingival contour. Fig. 13_Occlusal view of the diagnostic model. Fig. 14_The diagnostic wax- up showing the labially shifted restorations. Figs. 15 & 16_The tooth preparation was guided by the silicone index. The patient had no discomfort and desired not only restoration of the defective anterior teeth but also an aesthetic outcome. However, finan- cial limitations meant not all of her dental prob- lems could be addressed. The dental examination revealed that tooth #22 was missing and tooth #23 had shifted mesially. In ad dition, there were visible defects on teeth #21, 11 and 12. The roots of teeth #21 and 12 were apparently palatally inclined and so were the crowns. Tooth #11 was slightly inclined to the palatal side and so was the crown. During examination of the occlusion, a deep overbite and a large overjet of the anterior teeth became evident. In addition, the contour of the patient’s gingival line was inharmonious. The angle of her mouth was asymmetrical when she smiled (Figs. 1-4). _Treatment plan For patients with malocclusion and misalign- ment of teeth, the restorative procedures should be performed once the primary orthodontic treatment has been completed. However, con- sidering the length of treatment and her finan- cial limitations, the patient refused orthodontic treatment and only accepted the restorative treatment. Since the patient’s inharmonious gin- gival line may have interfered with the final aes- thetic outcome, certain methods to improve the Fig. 11 Fig. 13 Fig. 15 Fig. 12 Fig. 14 Fig. 16 case report _ shaping the gingival contour