CDEN0110

08 I I MICD _ diastema closure who exhibited a high dental IQ, evaluated her smile as below satisfactory. After the interview, the disease, force element and aesthetic defects of her smile were explored clinically. Necessary digital photographs were taken, along with diagnostic study models for further ex- ploration of existing diseases, force elements and aesthetic defects. The patient had good oral health, normal function and no para-functional or other destructive oral habits. The collected clinical and diagnostic information, such as extra and intra-oral digital photographs, studymodelsandX-rays,wasfurtheranalysedtode- termine her smile aesthetic grading in terms of her health, function and aesthetics, as well as to gain an overview of the clinical problems and the macro-, mini- and micro-smile defects. We found a high frenum attachment and the space analysis of the studymodelrevealedaMDof3.5mmbetweenteeth #12 and 21. The tooth-size ratio of the centrals was nearly 65 % and lacked central dominance. In the design step, a new smile with a closed gap wasdesigned.Itistobenotedthattheuppercentral incisors are considered key to a smile10,11 and must be given sufficient prominence.12 The aesthetically acceptable width of the centrals is between 75 % and 80 % of their length.12 In the presented case, it was logical to close the diastema completely by increasing the width of the centrals. The types of treatment involved, complexity, possible risk fac- tors, complications and treatment limitation were evaluated, and the tentative costs calculated and presented to the patient. The new smile was proposed through the mo- dified digital photographs and aesthetic mock-up of the study model. In order to correct her MD, a frenectomy with non-invasive indirect partial veneers was proposed as the first option and a direct-bonding restoration without frenectomy as the second option. However, because of finan- cial constraints, the patient preferred the second option. All patient queries related to the proposed new smile and treatment modalities were addressed in detail. The informed consent form was signed prior to proceeding to Phase II. PhaseII: Achieve Inthefirststep,thepatient’shealth,functionand a healthy lifestyle were established. The patient’s smile was graded as Grade B.8 The established pa- rametersofheroralhealthandfunctionwerewithin normal limits, the aesthetic parameters were below theacceptedlevelandenhancementtreatmentwas toimproveheraestheticparametersfurther.Hence, Fig. 8_MD in close-up view. Fig. 9_Teeth #12 and 21 after isolation with gingival retraction cords. Fig. 10_Light touch upon the enamel surface of tooth #12 with diamond point to enhance bonding process. Fig. 11_Enamel etching with phosphoric acid (FL-Bond Etchant) for 20 seconds. cosmeticdentistry 1_2010 Fig. 8 Fig. 9 Fig. 10 Fig. 11