Clinical Case
The patient came to us seeking a subtle yet noticeable smile enhancement. Her primary goal was not to achieve the effect of “overly white teeth,” but rather a naturally beautiful smile—one that looks harmonious, soft, and effortlessly luxurious.
Following a comprehensive examination, we planned an aesthetic rehabilitation of teeth 12,11,21, and 22, which included replacing the existing crowns on teeth 11 and 21 and placing ceramic veneers on teeth 12 and 22.
Why Were Veneers and Crowns Chosen?
This clinical case perfectly illustrates the modern approach to aesthetic dentistry: not every tooth within the smile zone should be treated in the same way.
Veneers are indicated when the tooth structure is sufficiently preserved and only subtle corrections of shape, color, or proportions are required. A crown, on the other hand, completely covers the tooth and is the preferred solution when more extensive restoration is needed or when reliable masking of compromised tooth structure and undesirable discoloration is essential.
This treatment philosophy is supported by both the American Dental Association (ADA) and the American College of Prosthodontists (ACP).
Treatment Process
The treatment was completed over the course of four appointments.
- First appointment: consultation, photographic analysis, discussion of the patient’s expectations, and detailed planning of the future smile.
- Second appointment: tooth preparation, gingival retraction, digital intraoral scanning, registration of the maxillary position using a facebow, and final approval of the shape and shade of the future restorations.
- Two weeks later, a try-in appointment was performed. The ceramic veneers for teeth 12 and 22 and the crowns for teeth 11 and 21 were evaluated. The patient was pleased with the result, and the restorations were subsequently bonded using permanent resin cement.
- One week later, a follow-up examination was carried out.
Materials Used
For the lateral incisors, we selected feldspathic ceramic veneers. This material is particularly valued for its exceptional optical properties, allowing highly refined control over translucency, surface texture, and light reflection, ensuring that the smile never appears flat or artificial.
For the central incisors, layered IPS e.max crowns were fabricated, as an important clinical consideration in this case was the presence of a dark underlying tooth stump.
Scientific evidence demonstrates that the color of the underlying substrate, restoration thickness, and ceramic opacity significantly influence the final esthetic outcome. When restoring teeth with a dark substrate, a more controlled masking approach is often required to achieve an optimal result.
Treatment Outcome
The final result was a comprehensive aesthetic rehabilitation of the four maxillary anterior teeth.
Importantly, in this case the crowns and veneers do not compete with one another—they function as a single harmonious composition, with coordinated shape, shade, incisal edge length, and natural light dynamics.
This is what outstanding aesthetic dentistry looks like: when the patient sees not individual restorations, but a new, naturally harmonious smile.
From a scientific perspective, this treatment outcome is also strongly supported by the evidence.
Systematic reviews of clinical studies demonstrate high long-term survival rates for ceramic veneers, while feldspathic ceramic veneers bonded to enamel have shown 10-year survival rates approaching 95% in the best-performing clinical cohorts.
Similarly, lithium disilicate crowns have demonstrated excellent 5-year survival rates in clinical studies.
This does not mean that restorations last forever. However, it does indicate that, when supported by accurate diagnosis, a meticulous adhesive protocol, proper oral hygiene, and regular maintenance visits, they represent a highly predictable long-term treatment solution.
The follow-up examination performed one week after definitive cementation marked the completion of the active treatment phase.
From that point forward, an equally important stage begins: maintaining the results through gentle daily oral hygiene, regular professional examinations, and preventive care.
Consistent long-term maintenance is essential for preserving both the beauty and the stability of ceramic restorations.
Treatment performed by Chief Dentist Dr. Yarema Miklosh.