Smile Makeover · Faisal K., 40s
The Worn Dentition
Two decades of grinding had shortened the upper front teeth by nearly four millimetres. Rebuilding them meant rebuilding the bite first.
- Treatment
- Smile Makeover
- Duration
- 7 months
- Appointments
- 11 visits
- Clinician
- Dr. Yasmin Al-Rashed
Patient Goal
What they came in for.
He did not arrive asking for a cosmetic result. He arrived because his front teeth were chipping and the edges felt sharp against his lip, and because he had begun covering his mouth in photographs without deciding to. What he wanted was for the damage to stop. What he would not accept was anything that looked, in his words, "done".
Initial Condition
What we found.
Severe attrition across the upper anterior segment with an average of 3.8mm of lost incisal height, measured against the original enamel contour still visible on the palatal surfaces. The lower incisors showed matching wear facets. Loss of vertical dimension had allowed the lower jaw to over-close, deepening the bite and crowding the tongue space. Two existing composite repairs on the upper centrals had already failed at the margin. Gum health was good; bone levels were normal throughout.
Final Result
Where it finished.
Incisal height restored to within 0.3mm of the original contour on both centrals. Vertical dimension opened 2.5mm and stable at the twelve-month review, with no reported joint symptoms. The lower posterior onlays carry the new bite, so the anterior ceramics are protected from the load that destroyed the natural enamel. He has worn the night guard every night since.
Patient Experience
In their words.
His comment at the review was that nobody had mentioned his teeth — which, he said, was the entire point. He had been braced for compliments and would have hated them. What he did notice was that he had stopped waking with a tight jaw, and that he no longer thought about which side to chew on.
The plan, before anything started.
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Phase 01
Diagnosis
Full occlusal analysis on a mounted digital articulator, joint assessment, and a wear-pattern study to establish where the original tooth contour had been.
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Phase 02
Vertical dimension
The bite was reopened by 2.5mm and tested on a removable splint for nine weeks before anything permanent was made.
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Phase 03
Trial smile
The restored contour was printed and worn for ten days, then adjusted twice at the incisal edge on his feedback.
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Phase 04
Ceramics
Ten hand-layered feldspathic veneers on the upper arch, four bonded lithium disilicate onlays restoring the lower posterior support.
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Phase 05
Protection
A milled night guard delivered at the fitting appointment, with a hard acrylic occlusal surface matched to the new bite.
Treatment process
What actually happened, in order.
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Month 1
Records, articulator mounting, joint imaging. The wear was mapped against the untouched palatal enamel, which gave us the original edge position rather than a guess at it.
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Months 2 — 3
Splint therapy at the proposed new vertical dimension. He adapted within four days and reported that his jaw felt less tired on waking, which confirmed the direction.
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Month 4
Digital design, then the printed trial smile. He wore it for ten days. Two revisions followed: the central incisors shortened by 0.4mm, and more character built into the lateral edges.
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Month 5
Preparation of the upper arch to an average of 0.5mm, guided by the approved design. Lower onlay preparations the following week. Temporaries reproduced the trial smile exactly.
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Month 6
Ceramic layering. Three shade appointments under calibrated light, because matching new porcelain to a 45-year-old canine is the hardest part of a case like this.
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Month 7
Try-in dry, approved in daylight, then bonded quadrant by quadrant under isolation over two appointments. Night guard fitted at the second.
The same mouth.
Photographed under identical lighting, 7 months apart
- 3.8mm
- Incisal height restored
- 14
- Restorations placed
- 2.5mm
- Vertical dimension opened
Technology used
What it took.
- Digital articulator mounting
- 3Shape TRIOS 5 scanning
- Printed trial smile
- Hand-layered feldspathic porcelain
- Milled occlusal guard
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