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34 I I MICD _ Inman Aligner cosmeticdentistry 1_2011 imaginedherveneerswouldhavebeen.Hadveneers been placed, we could perhaps have corrected the golden proportion more fully, balanced the zeniths, improved the canine outlines, widened the buccal corridors, etc. However, that was clearly not what the patient desired. Should she later decide that she does need further improvements, we can proceed with already straightened teeth. The ABB smile de- sign is progressive and not sudden or rushed. In this manner, the patient is given the opportunity for de- cision-making in his/her treatment and the respon- sibility in choice is shared. _Case III (Figs. 18–26) This patient presented with what she described as a “wonky smile”. She had previously looked into the possibility of having porcelain veneers placed so understood some of the aims of smile design. How- ever,onstudyingherteeth,itbecameclearthatthere was potential to pre-align first. Her upper right cen- tral was mesially rotated by approximately 30° and herlateralswereslightlyin-standingandmesiallyin- clined.Furthermore,shehadfairlystainedteeth,with the canines two shades darker than the centrals. On examining the occlusal view, the patient be- came aware of the extent of aggressive tooth pre- paration that would be required to place a veneer. She understood that her teeth needed to be aligned first before we decided on the next step in design. AnInmanAlignerwasusedovertheperiodofeleven weeks to de-rotate the front tooth and to tip out the laterals.Atweekeight,bleachingwasbegunusing35- to45-minuteadayH2O2 gels.Simultaneouswhitening isaveryattractivepartofalignertreatment,asithelps withpatientmotivation.Afteralignment,thecasewas re-examined. Once her teeth had been straightened, it became evident to the patient that her problem con- cerned edgeshape, which had actually worsened with alignment owing to differential wear. In fact, the left central was 2.5 mm shorter than the right. It was very cleartothepatientthatonlytheseincisaledgesneeded buildinginordertoachievethesmileshedesired. Forplacementoftheincisaledgesatweektwelve, no local anaesthetic was administered. Other than slightrougheningofthewornincisaledgesoftheup- per left 1 and 2, no other preparations were needed. A tetric hybrid composite (Tetric Flow, Ivoclar Viva- Fig. 23Fig. 22 Fig. 21Fig. 20 Fig. 19Fig. 18