Veneers · Yousef B., 50s
The Second Opinion
Twelve crowns proposed elsewhere. Four onlays, two veneers and a night guard delivered instead.
- Treatment
- Veneers
- Duration
- 3 months
- Appointments
- 7 visits
- Clinician
- Dr. Yasmin Al-Rashed
Patient Goal
What they came in for.
He came in holding a treatment plan for twelve full crowns and wanted to know whether it was necessary. He was not looking for a cheaper plan — he was looking for an honest one.
Initial Condition
What we found.
Two cracked upper molars with visible mesiodistal fracture lines on transillumination, and a lower first molar with a large failing amalgam undermining both buccal cusps. The remaining eight teeth in the proposed plan had intact enamel, small sound composites and no cracks. Moderate anterior wear consistent with nocturnal bruxism, which nothing in the original plan addressed.
Final Result
Where it finished.
Six restorations instead of twelve, at roughly a third of the total preparation volume. All four onlays functioning with no sensitivity at the twelve-month review. The eight untreated teeth are unchanged on comparison photography. The night guard shows the wear that would otherwise have gone into his enamel.
Patient Experience
In their words.
He said the part that stayed with him was being shown the transillumination images and the crack lines on a screen — being able to see which teeth had a problem and which did not, rather than being asked to take it on trust.
The plan, before anything started.
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Phase 01
Reassessment
Transillumination, bite analysis and selective anaesthesia to identify which teeth were genuinely symptomatic rather than simply restored.
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Phase 02
Treat what is broken
Bonded ceramic onlays on the three structurally compromised molars, plus one that showed early cracking.
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Phase 03
Aesthetics, minimally
Two veneers on the upper centrals to address the visible wear, rather than crowning eight intact teeth.
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Phase 04
Address the cause
A milled occlusal guard, which was the missing element in the original plan and the reason the wear had occurred.
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Phase 05
Monitor
The remaining teeth photographed and charted for comparison at six-monthly recalls.
Treatment process
What actually happened, in order.
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Visit 1
Full reassessment with transillumination and a bite analysis. Six of the twelve proposed teeth had no clinical finding to justify a crown.
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Visit 2
Two upper molar onlays prepared, scanned, milled and bonded the same day. Preparation depth roughly a third of what a full crown would have required.
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Visit 3
Lower first molar onlay. The failing amalgam was removed and the remaining walls proved sound enough to keep.
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Visit 4
Fourth onlay on the tooth showing early crack propagation, treated preventively rather than after it split.
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Visits 5 — 6
Two veneers on the upper centrals at 0.3mm preparation, designed to restore the worn incisal edges without changing his tooth character.
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Visit 7
Milled night guard fitted and adjusted. Baseline photographs taken of the eight teeth we did not treat.
The same mouth.
Photographed under identical lighting, 3 months apart
- 12 → 6
- Restorations proposed vs placed
- 8
- Healthy teeth left alone
- 1
- Cause finally addressed
Technology used
What it took.
- Transillumination crack detection
- CEREC same-day milling
- IPS e.max onlays
- Digital bite analysis
- Milled occlusal guard
Every item here is in the building. See how it is used.
Start your own
Every case here began with one hour.
An examination, your own images on screen, and a written plan with a price. Whether you proceed is a separate decision, made later.
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