The art of ultra-aesthetic dentistry

Nasser Shademan

Fri. 20. August 2021

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There are times when we copy the natural teeth of patients and fabricate an identical yet improved version of them. This means that we apply improvements on many different levels, including colour or smile arrangements, in order to turn the old, misaligned and broken natural smile into an almost identical but beautified version. Natural smiles are not always aesthetically suited to the individual face of a person, and if a patient agrees to undergo aesthetic treatment, then we have a good opportunity to turn something good into something even better.

There are sometimes instances when a patient has anterior teeth that are relatively large in size and their anatomy, arrangement and texture do not particularly support the patient’s facial make-up, sex or age. In addition, there are situations where the patient has lateral incisors which are somewhat large in size or are deformed, or has poorly shaped canines.

In many cases, we are able to improve the colour arrangements of teeth. Naturally, we do not follow the previous colour map of the patient’s natural teeth, but we recast it into a new, more aesthetic tooth colour map. You might come across a patient who is very slim and small in size and has a tiny feminine face, but who has a surprisingly masculine smile owing to a relatively large set of anterior teeth. This is, of course, natural, but it might create an unpleasant impression regardless. Once aesthetically enhanced, the smile will actually appear more harmonious and therefore even more natural-looking.

Reproducing natural aesthetics is an uncompromising journey, which is best completed when we pay close attention to detail in every step. I always produce the highest aesthetic provisional restorations and test these closely for ultimate colour, form, texture and tooth arrangement with my type of most superior aesthetic provisional restorations, which I call “ultra-aesthetic provisional restorations”. This is very helpful in guiding me and the entire aesthetics team towards understanding all possible aesthetic challenges that may lie ahead, so we can plan the most natural and best-fitting solutions accordingly. Achieving highly aesthetic outcomes is only possible when dentists, ceramists and patients team up in a sincere way in order to achieve individualised ideal outcomes.

Techniques and materials

This case shown in the image presented a number of aesthetic challenges, including discoloured natural abutments. Hence, a medium- transparency zirconia core was used with a multilayer ceramic build-up (according to the technique used to create ultra-aesthetic provisional restorations). The finest details were produced under 6–8 × magnification.

Editorial note: A list of references is available from the publisher. This article was published in CAD/CAM―international magazine of digital dentistry vol. 12, issue 1/2021.