Dear Dr. Perlmutter,

This is what I've done so far:
• #14 Wax-up for direct bonding. No reduction of tooth structure. Only incisal tip was built-up.
• #13 Wax-up for veneer. Regular amount of tooth structure reduction. The preparation should include incisal and part lingual surface. Consider crown?
• #12 Wax-up for veneer. Reduction: 1 mm off labial (mesial portion) and 1.5 mm on mesial.
• #11 Wax-up for veneer. Reduction: little is needed – please establish the margins. Gingiva: lifted by 2 mm.
• #21 Wax-up for veneer. Reduction: little is needed – please establish the margins. Gingiva: lifted by 2 mm.
• #22 Wax-up for veneer. Reduction: 1.5 mm off labial (mesial half) and 2 mm on mesial.
• #23 Wax-up for veneer. Regular amount of tooth structure reduction. Preparation wraps around the mesial and mesio-lingual. Consider crown?
• #24 Wax-up for direct bonding. No reduction of tooth structure. Only incisal tip was built-up.
For your consideration: With severe wear on most teeth, I am a little concerned with putting only veneers on anterior teeth. Perhaps cuspids should be crowned to provide more strength as well as simplify margin preparation. I would also like to know what you may choose to do on posterior teeth to prevent excess forces on new restorations. Patient was already advised about the need for a splint in the future.
This is NOT a clinical case planning that only a dentist can do, but rather a technical study of the changes we can make and the desired preparations that will make these changes possible. The recommended reduction should be done in ADDITION to the regular preparation amounts.
Feel free to call me if you have any questions or concerns.

Sincerely,

Andre Tal, B.Sc., R.D.T.
Talisman Dental Laboratory Inc.
Phone: 905.450.5156
Email: talismanlab@rogers.com

 

COSMETIC IMAGING

BEFORE	AFTER
This is NOT a photograph of actual treatment. This is a computer drawing of how the teeth could be improved, if treatment is done.