Diastema closure with porcelain veneers – Mauro ́s Story

Diastema Closure - Step-by-step

Find out how to achieve outstanding esthetic results in diastema closure treatments using porcelain veneers.

Why we have chosen a treatment approach based on ceramic veneers over orthodontic therapy:

Maxillary interincisor diastema may interfere with the patient’s personal esthetic imagination by compromising the dentofacial harmony and may also provoke dyslalia.

Midline diastema is frequently reported as a malocclusion.

To start with, an orthodontic diastema closure treatment seems to be the perfect solution. However, long-term stability is in general very difficult to achieve in the anterior region. More importantly, it frequently causes the problem of a relapse incidence after orthodontic treatment.

There are also some additional problems the patient is unlikely aware of prior to the orthodontic treatment. These relate to the use of a retainer throughout a patient’s lifetime, which is recommended by the orthodontist.

The retainer can cause:

  • Hygiene Proplems (Caries)
  • Periodontal Problems 
  • Discomfort
  • Phonetic Problems

Owing to the fact that a midline diastema is easily visible, anterior spaces are one of the most important reasons why patients look for long-lasting stable treatment outcomes. With this intention, we demonstrate a restorative dentistry training video to describe a patient type and energy oriented therapeutic mock-up for a diastema closure treatment with porcelain veneers.

Treatment Team: Dr. Reza Saeidi Pour, MDT Otto Prandtner

Diastema Closure - Patient Type Analysis

Patient Type and Energy assessment

It is not art to make what the patient is asking for. It is art to make what the patient really wants!

Every patient is unique and therefore every dental treatment must be unique too. Finding the right esthetic restoration is not only about achieving the most perfect results, but matching the results to the patients type and energy.

While most patients would assume, that creating the most symmetrical and “perfect” teeth would make them happy, they often find that the smile doesn’t match their personality. 

Our solution: By analyzing what type of person our patients are – whether they smile and laugh a lot, are more reserved or tilt their head a lot for example – we make sure, that the treatment fits and ensure a minimally invasive procedure. For Mauro we used this method to determine the suitable appearance of his porcelain veneers in the anterior region for his diastema closure treatment.

Check out the relating tutorials 

Dental Restoration - Backward Planning (Work Flow)

Backward Planning Redefined

Type and Energy assessment guideline.
Innovative approach in the rehabilitation of complex cases!

Vision is the art of seeing what is invisible to others. – Jonathan Swift

We always test all your ideas (vision) first in one or multiple mock-up’s before we make any material or preparation decisions.

“The patient creates the restoration” is our philosophy. We assist with idea’s, science and abstract presentations. This will create an innovative knowledge for the patient-oriented esthetic dental restoration.

This slide presents the red line in a patient oriented planning with type analysis and patient energy analysis.

Patients should be properly evaluated, correctly diagnosed, and carefully monitored, especially regarding the etiology of a tooth/teeth. When the esthetic and/or functional consequences affect a patient’s quality of life, use of a wax-up and mock-up to guide the treatment steps ensures the application of a minimally invasive approach and the achievement of a predictable and satisfactory result.

The Digital Smile Design simulation is not enough for the patient to understand the adjustments emotionally and physically.

However, the feedback we get from the patient by checking their new smile on a computer screen is not the same as a mirror visual feedback!

Tip: When presenting the DSD to the patient we show the regular and mirror view to receive a more accurate feedback.

Digital Smile Design is for the treatment team only an abstract simulation and a good guideline as a first step to create a wax-up.

Creating a transfer mock-up index for the mouth is the best communication tool for the patient and the treatment team.

We are not alone with this patient-oriented treatment approach:

Dr. Otto Zuhr always requests a mock-up with the final tooth length for an anterior periodontal treatment.

Dr. Ueli Grunder also always requests a mock-up with the final tooth length for an anterior implant treatment.

Therefore, the mock-up needs to be tested in terms of phonetics, aesthetics and function.

 

 

Porcelain Veneer Mock-up

Achieving the best esthetic results through trial and error - the Mock-up.

Esthetic dentistry or cosmetic dentistry is mainly a question of taste and something general. It often creates an indifference or a lack of interest for the patient and the reality in which they live.

Our goal is to understand the patient better through the mock-up try ins.

After carefully analyzing our patient we proceeded with the dental Mock-up of his porcelain veneers. 

For the first Mock-up try-in we used the MATRIX Form 60 silicone curing putty by anaxDENT which we surrounded with the MATRIX Form 85 for more stability. These materials we used in combination with the Visco 3 for the first try-in. 

 

Veneer Mock-up - Clear Index

Creating a Clear Mock-up Index

For a more permanent solution we relied on the Flow Kit by anaxDENT with the light-curing material Matrix Flow 70 clear. We surrounded the clear material with a DURAN® foil which allows the dental technician to make minor or even bigger subsequent adjustments on the wax-up. An additional advantage of light-curing is that you can use any composite material. Even under polarized light the esthetic results are fantastic.

Tip: A clear mock-up index has the advantage that it can be easily changed by maintaining the Duran foil and the Matrix Flow 70 material by anaxDENT again taking the modified wax-up.

Therefore, we take the time – even for minor wax-up adjustments – to try the mock-up until we have the final concept.

 

 

Diastema closure - The patient's experience

Find out, how our patient Mauro experienced his esthetic diastema closure treatment with porcelain veneers. (Interview in german)

Our patient Mauro was unsatisfied with the appearance of his teeth for a long time and therefore used to hide them when smiling. Watch out post-treatment video interview with him to find out how the diastema closure treatment with porcelain anterior veneers changed his smile.

“Emotions and beliefs are masters, reason their servant. Ignore emotion, and reason slumbers; trigger emotion, and reason comes rushing to help.”– Henry M. Boettinger