CDE0211

I 15 case report _ veneers I cosmeticdentistry 2_2011 The patient did not understand the need for the gumlift on tooth #8, so we added bonding to the gumline to give the illusion of a more uniform gumline that the patient could see and understand. At this stage, we pointed out that his premolars appeared to fall away from his smile and become lost in the buccal corridor. The premolars on one side were mocked up as resin veneers so he could see the difference the built up teeth would make in comparison to the other side. Multiple images of the various mock-up op- tions were taken and e-mailed to the patient, along with multiple treatment plan options. After careful consideration, the patient opted for the resin veneers on teeth #7 to 10, as well as the gumlift. It was because of the mock-up and pho- tographs that the patient realised the value of the gumlift in creating a more attractive smile. He wanted to consider the resin veneers for the premolars and possibly have them done in the future. _The procedure The patient presented for the bonding ap- pointment with his teeth already whitened. We began by placing topical anaesthetic before anaesthetising teeth #7 to 10 with The Wand (Milestone Scientific). Subsequent injections of lidocaine were placed around the gumline of teeth #7 to 10 before electrosurgery of the gums. Using Bident (Synergetics), a bipolar electro- surgery unit, the gingiva around tooth #8 was contouredtoidealproportions(Figs.6&7).Once the gingiva had been removed, it was discovered that the underlying bone had grown into the cervical divot of tooth #8, right on top of the enamel. It was then decided that crown length- ening was indicated, so a small, round diamond bur was used to contour the bone to match the ideal gumline. We proceeded to contour the gin- givaonthemesialsofteeth#7and10andtocre- ate symmetry of tooth #9 with tooth #8 (Fig. 8). The Bident unit allowed for gentle, clean coagu- lation in a wet field. There was no grounding needed, and because the unit is meant to be used with water, there was no tissue charring or shrinkage. A more effective, more precise and safer result was achieved, with essentially no post-operative bleeding—a perfect scenario for bonding teeth immediately with no fear of a contaminated field. The teeth were now ready to be bonded. They were carefully cleaned with pumice to remove any surface debris and stains. Metal strips were placed interproximally to isolate each tooth. Thereafter, they were micro-etched Fig. 4_Full-face with mock-up of teeth #7 and 10. Fig. 5_Mock-up, close-up of veneers on teeth #7 to 10. Fig. 4 Fig. 6 Fig. 7 Fig. 5 Fig. 6_Bident on tooth #6. Fig. 7_Gumline after Bident and CCL.