We present the clinical case of a middle-aged adult patient with permanent dentition who comes to the consultation for aesthetic reasons, reporting Dental misalignment and lack of harmony in the smile. Facial analysis revealed a slight asymmetry, while the intraoral study showed crowding in both arches and one localized crossbite on tooth 33. Likewise, the absence of 36, conditioning the rehabilitation planning of the case.
Treatment plan
The diagnostic study was performed using a fully digital flow, including intraoral scanning, 3D model analysis, and CBCT, which allowed for a precise assessment of both the dental situation and the bone structures. From the outset, the case was approached from a final restorative approach, integrating orthodontics, implantology and aesthetics within the same plan.
The orthodontic phase using aligners allowed the dental alignment and leveling, as well as the crossbite correction and the appropriate preparation of the spaces for subsequent rehabilitation. This step proved key to ensuring a stable foundation on which to build the final aesthetic result.
One of the most relevant aspects of the treatment was the constant communication between clinic and laboratory, especially in the design phase. Based on the patient's digital records and facial photographs, a Digital smile design using CAD software (exocad), Integrating facial information with dental models allowed for precise definition of the position, shape, and proportion of the restorations before their execution, facilitating clinical decision-making and reducing uncertainty in the final result.
In this context, the choice of materials played a decisive role. For the rehabilitation of the 36, a Zirconia implant-supported crown, prioritizing mechanical strength and durability in a rear section subjected to load. On the other hand, the veneers in the anterosuperior sector (15 to 25) were carried out in lithium disilicate, material that allows for excellent aesthetic integration thanks to its optical properties, favoring a natural and harmonious result with the adjacent dentition.
He bottom line shows a correct dental alignment and a significant improvement in the aesthetics of the smile, respecting the initial functionality. This case highlights the importance of precise digital planning, as well as fluid communication between clinic and laboratory, and appropriate selection of materials to achieve predictable and highly personalized results.
Case process and evaluation
1. Start
2. Starting aligners
3. Implant
4. Aligners
5. Final aligners
6. Mock up veneers
CAD design
Final veneers
End of treatment
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