A comparison of the patient’s pre- and postoperative photographs show how we achieved our goal of delivering a “Hollywood Smile Makeover.” By using the right tools and materials, we obtained esthetic final results with the most ideal function. The gingiva and papilla healed beautifully and the patient was very happy with the final result.

The Final Result: Within one week, all the restorations were adhesively cemented and the occlusion and esthetics verified. These photos were taken within hours of cementation.

Step 6: On the model, the stained and glazed restorations demonstrated the ideal alignment and perfect occlusion between the upper and lower arches. I also photographed the restorations on the model using a Nikon D750 camera with a micro lens and dual flash to scrutinize the delicate characteristics on the incisal third of the anterior restorations. (Close-up photographs of beautiful restorations on the model are also helpful for demonstrating quality craftsmanship to your dentist-clients.)

Step 5: After pressing and divesting, I fit the restorations back on the model to check the contacts and occlusion and ensure smooth canine guidance and protrusive movements. I stained the restorations using IPS Ivoclar Essence E01, E03 and E23 stains which minimize cutback and thus maintain maximum strength of the IPS e.max Press. Then I glazed them using Glaze powder FLUO mixed with Longlife glaze liquid, both part of the Ivocolor Essence Glaze Kit.

Step 4: To attain the “Hollywood Smile” the patient requested, we had two ingot options with the IPS e.max Press system. The HT BL 1 ingot offered a bleached white color but, due to its high translucency, it’s most appropriate for cases with a reasonably light preparation color. Since the patient’s stump color was ND 4, I used the MT BL 2 ingot to cover the dark stump shade as much as possible and add translucency.

I verified the overall esthetics and occlusion on the articulator prior to investing the waxup. Using the proper articulator setting, I checked all the movements to ensure ideal occlusion and function had been established, emphasizing perfect canine guidance.

Step 3: I always create a full waxup to ensure individualized esthetics, form and function. For example, after I completed the lower arch waxup, I made the waxups for teeth #8 and #9 in order to evaluate the midline and measure overall length. Then I finished the waxups for the maxillary laterals and canines. At this point, I’ve achieved a smile line consistent with the Golden Proportion.

Step 2: Of paramount importance to achieving perfect occlusion and function in a full-mouth rehabilitation case is the use of the proper articulating system with the correct settings; I used the Panadent 1650 AR Magnetic Model PCF Articulator. The dentist obtained a preoperative facebow and determined the proper vertical dimension measurements to accurately set the articulator, enabling me to accurately mount the case, create clean preparations and trim the dies perfectly.

Step 1: To establish a clear and accurate understanding of the patient’s condition, I made a pre-operative study model to determine the best preparation design. Due to the patient’s schedule, we didn’t have time to fabricate a diagnostic waxup or provisional restorations.