creating a smile design patient

Question 1

diastema

Answer 1

1) can be caused by frenum attachment

Question 2

peg lateral

Answer 2

1) abnormal formation

Question 3

tooth size discrepancy

Answer 3

1) lack of height of contour
2) narrow teeth for mouth

Question 4

make a patient

Answer 4

1) #7 reduction
- 0.5-1 mm
- lingual none
- incisal 2-2.5
- do not open mesial and distal
2) #10 peg lateral
- just make it teenytinee
- reduce everything
- lingual wax

Question 5

esthetic case workflow

Answer 5

1) SOAP
2) records
3) simulated smile design

Question 6

why do a smile design

Answer 6

1) helps you get the result you want

Question 7

wax up

Answer 7

1) must be an additive process only
- do not take any stone away at first
2) if you need to take away stone due to misaligned teeth, use a duplicate model

Question 8

order

Answer 8

1) patient
2) mounted model
3) wax up
4) duplicate cast

Question 9

SSD the process

Answer 9

1) capture all the anatomy
2) capture teeth beyond the wax up
3) place notches at the gingiva of the putty
4) load the matrix
- place tip at incisal edge and fill facial surfaces only
- minimize flow towards lingual surface except on #10
5) allow it to shrink for 2.5 minutes
- clean excess
6) polish as needed
- smooth embrasures with treetop carbide
- make it esthetic and comfortable for patient
7) if you made changes take one with alginate impression
- become your new duplicate cast

Question 10

for typodonts

Answer 10

1) put die lube on teeth and gums

Question 11

important points

Answer 11

1) usually they do not wear it home
2) if they are unhappy and unrealistic
- you can walk away or raise your fee until they are worth dealing with

Question 12

digital smile design

Answer 12

1) take their midline, horizon line, and transfer it to the intraoral photo
2) show them in photo form

Question 13

how to conserve enamel

Answer 13

1) you can use SSD to bring smile anterior to conserve enamel
2) it is very important for veneer prep bonding

Question 14

two uses for smile design

Answer 14

1) communication tooth
- show patient the outcome before you start, get feedback and commitment
2) prep guide
- aid dentist in conserving maximum amount of tooth structure

Question 15

prep guide

Answer 15

1) you can make depth cuts into the bis-acrylic and it will tell you that you do not need to remove that much tooth
- mark the depth cuts, remove the acrylic
2) however, you DO need to make a margin

Question 16

preps

Answer 16

1) #10 will be a crown prep
- keep margins conservative
<0.8 mm
2) #8 and #9 we are closing diastema
- bring margin palatal to contact area
- do not wrap onto lingual surface

Question 17

if you have a big diastema

Answer 17

1) you have to go subgingival with the prep
2) to create a more cleansable emergence profile
3 )or just do ortho firstm

Question 18

my temporaization of technique

Answer 18

1) place bond on preps
- to prevent staining, not for retention
- use 5th or 6th gen bond, no etch or primer
2) lightly air thin, no light cure
3) fill matrix and follow same protocol for smile design try in
4) coach patient to use super floss, can dup in chlorohexidine
5) cut off Provisionals at cement visit

Question 19

HW1

Answer 19

1) crat non idea teeth 7-10
2) take upper alginate
3) mount upper cast
4) wax up 7-10
5) duplicate cast
6) make smile design matrix
7) due 5/15