Digital Smile Design, fully digital protocol

110 Rating(s).


Posted on By daniela grgić miljanić In Anterior/Esthetic

Gummy smile resolved with crown lenghtening,performed by
Snježana Pohl.
Trios scan. Material Zirconia.


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23 Comments

Daniela,

fabulous! tell me your workup - photos- videos- CBCT and trios- Crown lengthen- bone and soft tissue ? did you design the lengthening guide off of the trios model? how long did you wait before you placed veneers - crowns-

Did you do any injectable facial rejuvenation ?

Top,

Richard


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Richard, thank you very much ! The surgery was planed over my dsd planing. We did a guide over a printed model. Surgery was performed by Snjezana Pohl. She can explain everything regard the surgery part.
It was a bone removal case.
I waited 3 weeks before 1.st provisoionals. Then I did some smooth modifications and since the patient is coming from very far she couldnt come as much as I would like... so I had to finish today crowns. We didnt do any face and lip filers, becouse in her case the problem is in position of lower jaw.. when she gives a big smile canines grab the lower lip. But It can still be an otpion. She is in a plan for semptember, needs olso 16,26 crowns and we are starting a lower jaw, ex and implnats.
The material is a new zirconia zolid from Amann Girbach. Great outcome becouse all her teeth are endo treated and that usualy is a limitation for high aesthetics.. with this new zirconia this problem is in a certain way resolved.
Thanks again
Daniela


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Life changing....patient has been restored to beauty and health. Bravo to you and your team. Dr. S


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Thank you Maurice Salama! This is why I do digital smile design in my every case that includes anterior restorations becouse is facialy driven aproach. We design before we plan.
Thank you again coming from you means realy a lot!
Daniela


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Daniela. Great case! It even put a smile on my face. Congratulations. Best regards. Chuck


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Thanky you very much Chalres,it was a big challenge, and techicians played a ver big role as always but in this case particulary...
thx again


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Daniela,
What a fabulous outcome. No doubt you and Snjezana have changed this patients life. Congratulations !!
A question, did the patient get RCT on all the teeth due to the amount of reduction that was necessary ?

Thank you for sharing
Ehab


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Daniela,

again top case did you do DSD motivational mock up ( Nemo) ?and show patient before you did the case? And what tooth library did you use to select the teeth shape & form- and like Ehab asked .. minimal tooth reduction
And can Ask Dr Pohl to comment to see if she did a lip lengthening procedure aka VY. Closure ?

Cheers,

Richard


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Richard in her case I didnt perform mock up. Substractional is sometimes very hard to perform. We have Nemo 2D but somehow I pefrer keynote still... to do designing and I do with trishape design.
We have a in house digital lab so it is easy to comunicate.I designed a shape together with my technician.
Of course you can ask Snježana!
Thank you again very much!


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Dear Richard,
no one should ask me, be sure that I read all comments:)) Unfortunately, I can`t find pics from clinical crown lengthening (in my vacation I am going to sort all images from last 10 months :((). But it`s always the same: Daniela provides me with a guide. I attach pics from an other case.


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After gingivectomy I use the guide to determine the extent of osseous surgery.


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Rich, as you know, I like post in post:))
Lip reposition is not performed yet. If patient wants, I`ll gladly do it in September. I love the effect of this technique!
There are some very good video presentations on XP to this topic.
Cheers
Snjezana


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Ehab Moussa Thank you!lAll the patients teeth already had rct, under her old restoration I founded a lot of work to do. We did a few retretmeant of root teraphy, Done by Snježana Glavičić, endo specialist. The problem was color of endo treated roots. It is the first time I used this zirconia zolid and the result is amazing. It is zirconia but has this transparency like a Celtra press.
I will look for rx and post later. Thx
Daniela


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Absolutely fabulous result, Daniela, How long from start to finish? And what type cement did you use for the final restorations. And I love the facial and life changing transformation you did for your patient...Both you and Snjezana deserve tons of credit for a job so well done!!


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Ronald Goldstein, complimnets coming from you are so rewarding!
Thank you very much!
The patients is far away distanced from our clinic so the procedure could be finished even before but she has some coming limitations due to her work. So the case was finished in a few months... but still we are going to work a lower jaw.
This is Zolid zirconia. I used speed cem transparent for final cementation.
Thank you again.
Kind regards
Daniela


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Amazing work and life changing results. I'm excited to hear what Snjezana has to say about the surgery. Do you have any pre and post-op radiographs? Regards, Naheed


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Thank you Naheed,Snježana can answer about surgery everything you need to know.I will have post op radiographs later in semptember.
thx
Daniela


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Dear Naheed,
Daniela makes my life easy and the result predictable giving me a surgical guide (please look my answer to Richard :))
Do I see you in NY?
Best regards
Snjezana


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Thank you for the reply. Unfortunately I will not be able to attend the XP symposium next month in New York. I will miss you again. Hopefully soon we shall meet. Regards, Naheed


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Add
We didn`t like the dark gingiva shadow coming from devitalised (long time ago) root #9 and decided to mask it. Gerald Benjamin, it is the small OP for free, that I mentioned yesterday:)


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snjezana,

perfect!

cheers,

Richard


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Daniela and Snjezana; Simply beautiful. This is exactly how to manage these cases...Our motto is: " Know before you go." Diagnose and treatment plan properly so that the execution can be predictable and beautiful. This is WHY we go to work everyday. This is HOW we get our 'fix.' World class!!! Regards, Gerald


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