Dr. Robert Ritter
Case Study #1

Overview of Case: This wonderful patient was unhappy with her smile and wanted to change it for many years.

When this patient arrived at the office for a cosmetic consultation, she was already unhappy with her smile, yet didn’t know what her options were. Initially, looking at her discolored and worn teeth the idea was to place porcelain veneers. Unfortunately, after taking a chair side intraoral scan and digital pictures, utilizing landmarks, we realized that there was not enough room to use porcelain veneers and that to fully give her the smile she never had, we would have to open her bite to place the appropriately sized teeth. Opening the bite on a patient is a workflow that we use consistently, the protocol we established is followed by the patient for 2 days to 3 weeks and gives us the pathway to the correctly sized teeth. Once the digital smile design is produced, we can transfer that to the mouth and test drive it. Once the patient approves, it becomes a simple choice of final color for her new smile design. The final result fits her face and gives her the smile she always wanted. We are so happy for her and that she trusted us to deliver the spectacular results!

Step 1
Primary Concern

Primary Concern: misshapen teeth, unhappy with color, size of teeth.

Step 2
Analysis

Analysis: Wear of teeth due to grinding resulting in the uneven appearance of the edges of the
teeth.

Step 3
Micro Smile Design

Micro Smile Design: A digital smile design is then transferred to the mouth, overlaying the
unprepared teeth to give a preview of the new shapes before we move forward.

Step 4
Macro Smile Design

Macro Smile Design: Verification of design proposal, taking into account, patient face, shape and lip movement. These are the first set of temps.

Step 5
Temp Swap

Temp Swap: When we swap out first set of temps called Bis-acryls to the second set called PMMA’s, we do so after we recontour the first set to get the ideal shapes.

Step 6
Custom Shade
Try-In

Custom Shade Try-In: At this visit we remove the temps and try in 2 different shades of final ceramics to help guide the patient into what they are looking for in the final smile color.

Step 7
Micro Analysis

Micro Analysis Smile: Confirming shape, texture, length, and final shade. The display of the proper amount of teeth is important for the final outcome to meet and exceed the patients expectations.

Step 8
Global Analysis

Global Analysis Full Face: Confirming the initial goal of correcting the wear, color, shape and contours. Does this smile look like it belongs to this patient, and that they have a gorgeous smile? Yes