Dentistry |2 min read

Live in the Op: Planning for Smile Design Symmetry

I am privileged to present a 2 day live in the op program called Anterior Aesthetics.

In this program, I prepare one patient and seat another so that attendees get from A to Z a predictable approach to achieving exquisite aesthetics in all of their cases.

This is a follow up, to a case I prepped and the results. I wanted to share with doctors who follow aesthetic cases, I also welcome any questions you may have!

Stephanie was a young professional who desired less canine dominance and more symmetry in her smile. We needed to address the inter proximal decay and discuss treatment options. Unwilling to pursue a combination orthodontics plan as an option, she accepted a treatment plan of #4-13 in e.Max (Observe cases like this at Anterior Aesthetics).

Designing her smile based on ideal incisal edge position was the first step in determining length and appropriate dimensions for her final design. As a rule in my aesthetic cases, I prescribe a Diagnostic Wax Up Kit for 2 reasons, 1) to ensure my patient and I are on the same page regarding shapes, lengths, embrasures and texture and 2) to determine the exact amount of reduction required for the cramist to provide the most aesthetic option (learn to treatment plan any case in our Advanced Treatment Planning Workshop).

My goal in preparation design is to be precise in removing what is required, and also developing a design that minimizes fracture and maximizes aesthetics. This is all accomplished with a Diagnostic Wax Up Kit. (Click here for a free technique guide on how to use this kit).

When treatment planning her case, here was my problem list:

– Interproximal decay 7,8, 9, 10
– Dominant canines
– Rotated #7, shorter than #10
– Tissue assymetry between #7 and #10
– Deficient buccal corridor each side
– Smile line discrepancy

I made a decision based on incisal edge display at rest that Stephanie’s incisal position of #6, 8, and 9 should stay in the same position pre-operatively. By gaining some tissue height, with some slight soft tissue contouring, I was able to correct gingival symmetry.

Once the diagnostic wax up was received, we utilized the preparation reduction guides to achieve ideal reduction. This is done in part by creating a bisacryl overlay using a 2 stage matrix fabricated from the laboratory wax-up, and preparing through that mock up with specific prep reduction burs. (Learn Dr. Olitsky’s step by step method of tooth preparation)

I’m happy to report that Stephanie’s seat was easy and unremarkable. The patient loved the result! Register for Anterior Aesthetics LIVE in the Op with Dr. Jason Olitsky!

We are looking forward to an awesome program October 20, 21st 2017 in Englewood Cliffs, NJ (just outside of Manhattan) Sign up TODAY. For more information, contact or call 480.489.5551.

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