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16 I I case report _ smile design _This 61-year-old executive has lived with the effects of tetracycline-stained teeth since she was alittlegirl(Fig.1).Allherlifeshewantedtohaveagreat smile, but she never knew what her dental options were.Thegeneraldentistshehadseenformanyyears told her there was nothing he could do to help her, sohereferredhertoouroffice. Whenthepatientcameforherfirstvisit,shewished to address a number of dental concerns. In addition to theseveretetracyclinestaining,shefeltherteethwere worn from years of grinding. Moreover, she had old resinbondingonherlowerfrontteeththatwasnotonly discoloured,butalsomismatchedfromyearsofpatch- ingandre-patchingeachtimesomethingbrokeoff. After performing a thorough examination (paying particular attention to the areas noted above) and cleaning, we recommended she try deep bleaching. After evaluating the results of the whitening, we rec- ommended a minimum of four minimal preparation Microveneers for her lower front teeth and her upper seventeeth,andazirconiumporcelaincrownfortooth #5,inordertoachievethesmileshedesired. Because her maxillary six anteriors had worn, flat incisaledges,itwasessentialthatweunderstoodwhat the patient desired in terms of shape and length. We examined the Smile Style Guide (www.digident.com) to select a smile design (Fig. 2). With the patient’s in- put, we determined that P3—pointed canines with squarecentralsandroundlaterals—wouldbethebest for her (Fig. 3). The length combination she liked the most was L-2—laterals slightly shorter than the cen- trals and canines (Fig. 4). We submitted her preopera- tivephototoSmilePixforacosmeticimage(Fig.5)and concluded with PVS impressions (Splash, Discus Den- tal)andabiteregistration(VanillaBite,DiscusDental). Fig. 1_Pre-op full face. Fig. 2_Smile Style Guide. Fig. 3_P-3, pointed canines with square centrals and round laterals. Fig. 4_Length code L-2, laterals slightly shorter than centrals and cuspids. CAD/CAM 1_2010 Anew approach for patient acceptance and appreciation Authors_ Dr Lorin Berland & Dr Sarah Kong, USA Fig. 1 Fig. 2 Fig. 3 Fig. 4