The patient complains about the COLOR ( TOO YELLOW ). After the first bleaching she complains also about the SHAPE ( the FLAT SMILE not following the Lower Lip, the DIASTEMA and a little vestibular enamel wearing ). She hasn’t any canine disclusion ( bilateral ) and a protrusion on all the incisors.

After those personal consideration I decided to add vestibular volume to the two central incisors and to lengthen all the group from canine to canine to improve frontal and lateral disclusion, and aesthetic at the same time too.

Using Style Italiano My Shade Guide, a simple, smart and fast system to achieve by ourselves a personalized shade guide with the composite we decided to use, is very easy and predictable to match the color, before starting.

First of all: Cleaning and roughing of enamel vestibular surfaces using 50 microns Aluminium Oxide Sandblasting. Etching with phosphoric 37 % acid gel after protecting the neighbors with teflon tape to avoid any surface contamination.

Free hand palatal enamel composite shells. First hand free application of dentin mass from cervical to incisal, modeling the dentin body anatomy. And leaving a very little free space on the third incisal. For an effect flow to increase the depth of the restorations.

Final results: The new shape allows to have an effective canine and incisor disclusion.

The patient had agenesis of the upper lateral incisors, and the space was closed with an orthodontic treatment. So her canines were moved to replace the lateral incisors, and premolars to replace the canines.

The patient also complained about her canines being too yellow, so as a first step, we have to achieve a better, meaning whiter shade. Remember that patients, today, strongly believe that white means healthy. We chose a home whitening protocol using a 10% carbamide peroxide bleaching gel.

As a first step, we used a total etching protocol with 37% orthophosphoric acid, and a universal bonding agent on all the 6 teeth.First restorative step, after a normal adhesive 37% etching agent on enamel.

These matrices can be used throughout all the different adhesive and layering steps.

The final restorations immediately improved the patient’s smile, by “very good and simple means of restoring aesthetics”.

The final result, our patient’s happiness and satisfaction. Operative techniques and aesthetic composites are today a perfect choice in no prep approaches, thanks to their increasingly sophisticated optical and mechanical properties. Their longevity/price ratio makes them a fantastic solution for many patients, and their dentists.