--- title: 6 Smile Design Cases description: Deep dive into these six Smile Design Cases that ponder on effective dental processes that deliver great results by achieving that beautiful smile. Read now! image: https://media.digitalsmiledesign.com/hubfs/Smile%20Design%20Cases%20790x400.png --- [![DSD_MAINBRAND_LOGO-02-1](https://media.digitalsmiledesign.com/hubfs/DSD_MAINBRAND_LOGO-02-1.svg "DSD_MAINBRAND_LOGO-02-1")](https://www.digitalsmiledesign.com/) # [BUSINESS & MARKETING BLOG](https://media.digitalsmiledesign.com/business-marketing) [ GO BACK TO THE BLOG HOMEPAGE ](https://media.digitalsmiledesign.com/business-marketing) [Christian Coachman](https://media.digitalsmiledesign.com/business-marketing/author/christian-coachman) - Feb 14, 2019 # 6 Smile Design Cases ## ![Smile Design Cases](https://media.digitalsmiledesign.com/hs-fs/hubfs/Smile%20Design%20Cases%20790x400.png?width=845&name=Smile%20Design%20Cases%20790x400.png) ##  SMILE DESIGN CASE 1  **GUREL/COACHMAN WORKFLOW FOR SMILE DESIGN PATIENTS (2009)** - **STEP 1 : **Pre-op ![Pre-op](https://media.digitalsmiledesign.com/hs-fs/hubfs/Step%201.png?width=237&name=Step%201.png) - **STEP 2 : **Direct mock-up. For dentist with smile design and hand skills. The direct mock-up is a very good strategy to motivate the patient. ![Direct mock up for dental patient](https://media.digitalsmiledesign.com/hs-fs/hubfs/Step%202.png?width=249&name=Step%202.png) - **STEP 3 : **Motivation. Presenting the direct mock-up to the patient. ![Presenting direct mock up to patient](https://media.digitalsmiledesign.com/hs-fs/hubfs/Step%203-1.png?width=228&name=Step%203-1.png) - **STEP 4 : **Facial dynamic analysis ![Facial dynamic analysis](https://media.digitalsmiledesign.com/hs-fs/hubfs/Step%204.png?width=250&name=Step%204.png) - **STEP 5 : **Initial interview. This appointment includes morpho-psychological interview for smile design customization (visagism). ![Initial interview including smile design](https://media.digitalsmiledesign.com/hs-fs/hubfs/Step%205%20(1)2.png?width=308&name=Step%205%20(1)2.png) - **STEP 6 : **Facially driven 2D digital smile design project is performed based on the direct mock-up and visagism interview. ![Facially driven 2D digital smile design project](https://media.digitalsmiledesign.com/hs-fs/hubfs/Step%206.png?width=251&name=Step%206.png) - **STEP 7 : **Transferring the 2D Project to the model to guide the wax-up ![Step 7Transferring the 2D Project to the model to guide the wax-up](https://media.digitalsmiledesign.com/hs-fs/hubfs/Step%207.png?width=261&name=Step%207.png) - **STEP 8 : **Wax-up quality control ![Wax-up quality control](https://media.digitalsmiledesign.com/hs-fs/hubfs/Step%208.png?width=268&name=Step%208.png) - **STEP 9 : **Based on the wry-up, indirect mock-up is performed and adjusted. Here, a black marker is used to check the incisal length of the centrals before shortening it. ![Indirect mock-up is performed and adjusted](https://media.digitalsmiledesign.com/hs-fs/hubfs/Step%209-1.png?width=600&name=Step%209-1.png) - **STEP 10 : **This technical direct mock-up is also known as apt and will be the prep and provisional guide. ![technical direct mock-up](https://media.digitalsmiledesign.com/hs-fs/hubfs/Step%2010.png?width=385&name=Step%2010.png) - **STEP 11 : **Tooth preparatory by design. Tooth preparation is performed through the apt using depth cutters to obtain the most minimally invasive prep with ideal clearance for material resistance and color change. ![minimally invasive tooth prep by design](https://media.digitalsmiledesign.com/hs-fs/hubfs/Step%2011.png?width=395&name=Step%2011.png) - **STEP 12 : **Final tooth prep and shade taking. Always taking photos with the stump shade and the desired shade. ![Final tooth prep and shade taking with stump and desired tooth shade](https://media.digitalsmiledesign.com/hs-fs/hubfs/Step%2012.png?width=326&name=Step%2012.png) ![Desired tooth shade and final tooth prep](https://media.digitalsmiledesign.com/hs-fs/hubfs/Layer%200.png?width=326&name=Layer%200.png) - **STEP 13 : **Provisional. An immediate provisional is made using the same silicone index made over the wax-up. ![A tooth provisional ](https://media.digitalsmiledesign.com/hs-fs/hubfs/Step%2013.png?width=341&name=Step%2013.png) - **STEP 14 : **Lithium dissilicate pressed restoration core. The cut back is controlled with the silicone guide. ![pressed restoration core](https://media.digitalsmiledesign.com/hs-fs/hubfs/Step%2014.png?width=353&name=Step%2014.png) - **STEP 15 : **Ceramic build-up. Also guided by the silicone index to keep the same approved shape of the mock-up. ![Ceramic build-up](https://media.digitalsmiledesign.com/hs-fs/hubfs/Step%2015.png?width=369&name=Step%2015.png) - **STEP 16 : **Final outcome ![Final result](https://media.digitalsmiledesign.com/hs-fs/hubfs/Step%2016.png?width=373&name=Step%2016.png) - **STEP 17 : **Follow up (3 years) ![Three years post treatment follow up](https://media.digitalsmiledesign.com/hs-fs/hubfs/Step%2017.png?width=373&name=Step%2017.png) --- ![Top set of teeth](https://media.digitalsmiledesign.com/hs-fs/hubfs/3%20-%20Image%20Banner.jpg?width=612&name=3%20-%20Image%20Banner.jpg) **![monolithic bridge](https://media.digitalsmiledesign.com/hs-fs/hubfs/40%20pic%201.jpeg?width=126&name=40%20pic%201.jpeg)** **1 | ****MONOLITHIC BRIDGE**   ** ** **![cutback + layered crown](https://media.digitalsmiledesign.com/hs-fs/hubfs/40%20pic%202.jpeg?width=127&name=40%20pic%202.jpeg)** **2 | CUTBACK + LAYERED CROWN**     **![cutback + layered veneers](https://media.digitalsmiledesign.com/hs-fs/hubfs/40%20pic%203.jpeg?width=128&name=40%20pic%203.jpeg)** **3 | ****CUTBACK + LAYERED VENEERS**     **![monolithic veneers](https://media.digitalsmiledesign.com/hs-fs/hubfs/40%20pic%204.jpeg?width=128&name=40%20pic%204.jpeg)** **4 | MONOLITHIC VENEERS**     **![monolithic onlay](https://media.digitalsmiledesign.com/hs-fs/hubfs/40%20pic%205.jpeg?width=128&name=40%20pic%205.jpeg)** **5 | ****MONOLITHIC ONLAY**   ** ** ***![Perfect smile and lithium dissilicate solutions](https://media.digitalsmiledesign.com/hs-fs/hubfs/4%20-%20Image%20Banner.jpg?width=600&name=4%20-%20Image%20Banner.jpg)*** *Clinical work performed by [Dr. Galip Gurel,](http://www.dentalxp.com/xperts/ggurel) Lab work perfomed by [Christian Coachman](http://www.dentalxp.com/xperts/ccoachman) and Adriano Schayder*     ##  SMILE DESIGN CASE 2  ![Smile Design Case](https://media.digitalsmiledesign.com/hs-fs/hubfs/5%20-%20Image%20Banner.jpg?width=611&name=5%20-%20Image%20Banner.jpg) ##### ![Oval and Triangular teeth](https://media.digitalsmiledesign.com/hs-fs/hubfs/Screenshot%202019-06-13%20at%2010.35.11.png?width=528&name=Screenshot%202019-06-13%20at%2010.35.11.png) ![rectangular and square teeth](https://media.digitalsmiledesign.com/hs-fs/hubfs/Screenshot%202019-06-13%20at%2010-35-33.png?width=528&name=Screenshot%202019-06-13%20at%2010-35-33.png)   ##### Smile Visagism Analysis (Braulio Prolucci Concept),** ****The choice of this case was to create a mix design between the Oval/Melancholic/Sensible with the Triangular/Sanguine/Dynamic.**   ##### **![Wax-up & 2D digital design & mock up](https://media.digitalsmiledesign.com/hs-fs/hubfs/5%20-%20Image%20Banner%20-%203.jpg?width=622&name=5%20-%20Image%20Banner%20-%203.jpg)** ##### ![Tooth preparation by Dr Leonardo Bacherini](https://media.digitalsmiledesign.com/hs-fs/hubfs/Image%20Banner%20-%206.jpg?width=621&name=Image%20Banner%20-%206.jpg) **EMAX HT PRESS** **was the material of choice, pressed with a thickness of 0.2-0.3mm**   ![Ceramics by Christian Coachman](https://media.digitalsmiledesign.com/hs-fs/hubfs/IB%20-%207.jpg?width=627&name=IB%20-%207.jpg) *Ceramics by [Christian Coachman](http://www.dentalxp.com/xperts/ccoachman) *   ##  SMILE DESIGN CASE 3  ![worn dentition and gummy smile](https://media.digitalsmiledesign.com/hs-fs/hubfs/48%20pic%201-1.jpeg?width=558&name=48%20pic%201-1.jpeg) Patient with worn dentition and gummy smile.    ![younger smile](https://media.digitalsmiledesign.com/hs-fs/hubfs/48%20pic%202-1.jpeg?width=553&name=48%20pic%202-1.jpeg)   Always very interesting for the smile designer to ask for pictures of the patient smile when they were younger or smile pictures from relatives that look alike the patient. It's what we call **Morphological research,** as I've learned from **CDT Juvenal de Souza.**   Also always adding the dynamic facial analysis to the **smile design process.** A simple facial video that shows lip dynamics and between teeth face in different angles and different moments.    ![2D smile frame with guidelines](https://media.digitalsmiledesign.com/hs-fs/hubfs/49%20pic%201-1.jpeg?width=546&name=49%20pic%201-1.jpeg)   2D smile frame with facial guide lines     ![ideal tooth proportion](https://media.digitalsmiledesign.com/hs-fs/hubfs/49%20pic%202-1.jpeg?width=547&name=49%20pic%202-1.jpeg)   Digitally testing some option, starting from ideal tooth proportion. First option was to achieve ideal proportion by lengthening only incisally, avoiding crown lengthening but **increasing functional interference and not for the face/lip integration.**     ![moving teeth upward](https://media.digitalsmiledesign.com/hs-fs/hubfs/49%20pic%203-1.jpeg?width=548&name=49%20pic%203-1.jpeg)   Second option was to move the teeth up completely,** not changing the incisal edge position.** Facilitating function by creating a biological problem with an aggressive crown lengthening procedure and exposing cementum.     ![between common sense position](https://media.digitalsmiledesign.com/hs-fs/hubfs/49%20pic%204-1.jpeg?width=546&name=49%20pic%204-1.jpeg)   Final decision was the in between common sense position. Little incisal edge that can be handled from the functional stand point and **less invasive crown lengthening** keeping most of the prep in enamel.     ![2D smile design to pre-op working model](https://media.digitalsmiledesign.com/hs-fs/hubfs/50%20pic%201-1.jpeg?width=547&name=50%20pic%201-1.jpeg) Transferring the 2D smile design to the pre-op working model.     ![quality control wax-up](https://media.digitalsmiledesign.com/hs-fs/hubfs/50%20pic%202-1.jpeg?width=548&name=50%20pic%202-1.jpeg) Quality control of the wax-up    ![motivational mock-up](https://media.digitalsmiledesign.com/hs-fs/hubfs/50%20pic%203-1.jpeg?width=546&name=50%20pic%203-1.jpeg) Motivational mock-up   !["snap on" removable crown lengthening guide](https://media.digitalsmiledesign.com/hs-fs/hubfs/50%20pic%204-1.jpeg?width=548&name=50%20pic%204-1.jpeg) A "snap on" removable crown lengthening guide was made.   ![guide in position](https://media.digitalsmiledesign.com/hs-fs/hubfs/51%20pic%201-1.jpeg?width=547&name=51%20pic%201-1.jpeg) Guide in position   ![surgery](https://media.digitalsmiledesign.com/hs-fs/hubfs/51%20pic%202-1.jpeg?width=551&name=51%20pic%202-1.jpeg) Surgery performed using the guide and respecting the biological width measurements.   ![soft tissue healing](https://media.digitalsmiledesign.com/hs-fs/hubfs/51%20pic%203-1.jpeg?width=548&name=51%20pic%203-1.jpeg) After soft tissue healing.   ![final tooth preparation and impression](https://media.digitalsmiledesign.com/hs-fs/hubfs/51%20pic%204-1.jpeg?width=545&name=51%20pic%204-1.jpeg) Final tooth preparation and impression. *** *** ***![perio-prostho and ceramics 1](https://media.digitalsmiledesign.com/hs-fs/hubfs/52%20pic%201-1.jpeg?width=600&name=52%20pic%201-1.jpeg) *** ***![perio-prostho and ceramics 2](https://media.digitalsmiledesign.com/hs-fs/hubfs/52%20pic%202-1.jpeg?width=600&name=52%20pic%202-1.jpeg) *** ***![perio-prostho and ceramics 3](https://media.digitalsmiledesign.com/hs-fs/hubfs/52%20pic%203-3.jpeg?width=307&name=52%20pic%203-3.jpeg)***   ***![perio-prostho and ceramics result](https://media.digitalsmiledesign.com/hs-fs/hubfs/52%20pic%204-2.jpeg?width=600&name=52%20pic%204-2.jpeg)*** * Perio-Prostho Clinical work by [Eric Van Dooren, ](https://www.dentcof.net/eric-van-dooren)Ceramics by [Christian Coachman](http://www.dentalxp.com/xperts/ccoachman)*   ##  SMILE DESIGN CASE 4  ![intraoral photo](https://media.digitalsmiledesign.com/hs-fs/hubfs/54%20pic%201-1.jpeg?width=414&name=54%20pic%201-1.jpeg) Intraoral photo is calibrated to the facial photo with the guidelines.   ![2D smile design project](https://media.digitalsmiledesign.com/hs-fs/hubfs/54%20pic%202-1.jpeg?width=413&name=54%20pic%202-1.jpeg) 2D Smile Design Project   ![quality control procedure](https://media.digitalsmiledesign.com/hs-fs/hubfs/54%20pic%203-1.jpeg?width=414&name=54%20pic%203-1.jpeg) After orthodontics, **quality control procedure** is done by overlapping the drawings to check if tooth movement respected the initial project.   ![recalibration](https://media.digitalsmiledesign.com/hs-fs/hubfs/54%20pic%204-1.jpeg?width=420&name=54%20pic%204-1.jpeg) After removing the braces the 2D project is recalibrated.    ![wax-up](https://media.digitalsmiledesign.com/hs-fs/hubfs/55%20pic%201-1.jpeg?width=407&name=55%20pic%201-1.jpeg) The wax-up is done over the model after ortho.   ![silicone guide](https://media.digitalsmiledesign.com/hs-fs/hubfs/55%20pic%202-1.jpeg?width=411&name=55%20pic%202-1.jpeg) Silicone guide done over the wax-up for the motivational mock-up.    ![additive mock-up](https://media.digitalsmiledesign.com/hs-fs/hubfs/55%20pic%203-1.jpeg?width=413&name=55%20pic%203-1.jpeg) The additive mock-up.   ![patient's smile transformation](https://media.digitalsmiledesign.com/hs-fs/hubfs/56%20pic%201-1.jpeg?width=600&name=56%20pic%201-1.jpeg) ![technical details and modifications](https://media.digitalsmiledesign.com/hs-fs/hubfs/56%20pic%202-1.jpeg?width=600&name=56%20pic%202-1.jpeg) Presenting the mock-up to the patient initially with photos instead of the mirror is **much more powerful from the emotional aspect. **After this appreciation, the patient can have the mirror to go over technical details and modifications can be made with the black marker and discs.   ![orthodontic movement 1](https://media.digitalsmiledesign.com/hs-fs/hubfs/57%20pic%201-1.jpeg?width=417&name=57%20pic%201-1.jpeg) ![orthodontic movement 2](https://media.digitalsmiledesign.com/hs-fs/hubfs/57%20pic%202-1.jpeg?width=416&name=57%20pic%202-1.jpeg) ![orthodontic movement 3](https://media.digitalsmiledesign.com/hs-fs/hubfs/57%20pic%203-1.jpeg?width=421&name=57%20pic%203-1.jpeg) ![orthodontic movement 4](https://media.digitalsmiledesign.com/hs-fs/hubfs/57%20pic%204-1.jpeg?width=408&name=57%20pic%204-1.jpeg) This image shows the final prep without any reduction on the **buccal ****neither on the incisal,** just inter proximal preps were needed to allow ideal tooth shapes on the ceramic veneers. This image also shows **a ****very well planned orthodontic movement** to allow for almost prepless case to achieve the final ideal design. *Clinical procedures by [Dr. Andrea Ricci](http://www.dentaledglobal.com/speakers/136-dr-andrea-ricci)*   ![monolithic restoration](https://media.digitalsmiledesign.com/hs-fs/hubfs/58%20pic%201-1.jpeg?width=600&name=58%20pic%201-1.jpeg) # **MONOLITHIC RESTORATION ** This was my first anterior Monolithic case ever. Using **Emax press LT A1 ,** stained and glazed. I was quite impressed with the result.  *Clinical procedures by [Dr. Andrea Ricci,](http://www.dentaledglobal.com/speakers/136-dr-andrea-ricci) Lab work by [Christian Coachman](http://www.dentalxp.com/xperts/ccoachman)*   ![monolithic restoration 1](https://media.digitalsmiledesign.com/hs-fs/hubfs/58%20pic%202.jpeg?width=215&name=58%20pic%202.jpeg) ##  SMILE DESIGN CASE 5    ![pre-op situation](https://media.digitalsmiledesign.com/hs-fs/hubfs/61%20pic%201-1.jpeg?width=600&name=61%20pic%201-1.jpeg) Pre-op situation. The issues were: color, diastemas, space distribution, incisal abrasion, recession/metal margin and black triangles.   ![proper emergence profile](https://media.digitalsmiledesign.com/hs-fs/hubfs/61%20pic%202-1.jpeg?width=619&name=61%20pic%202-1.jpeg) The goal was to close the gaps without orthodontics so a careful study was done on the model to plan the shapes using **optical illusion and finishing line of the preps** to allow for **proper emergence profile** and *avoid disproportional teeth and **black triangles*.   ![mock-up](https://media.digitalsmiledesign.com/hs-fs/hubfs/61%20pic%203-1.jpeg?width=600&name=61%20pic%203-1.jpeg) The mock-up demonstrated that shapes were good and orthodontic could be avoided.   ![pre-op](https://media.digitalsmiledesign.com/hs-fs/hubfs/61%20pic%204-1.jpeg?width=347&name=61%20pic%204-1.jpeg) Pre-op   ![tooth preparation](https://media.digitalsmiledesign.com/hs-fs/hubfs/61%20pic%205-1.jpeg?width=345&name=61%20pic%205-1.jpeg) **Tooth preparation.** Breaking the contacts and going slightly **sub gingival inter proximally to achieve better emergence profile** and ideal contacts without black triangles.   ## **THE BLACK SPACE ANALYSIS** I always enjoyed taking photos of my own work, placing it on the slide and playing with contrasts and saturation to create a complete black and white images. **Analyzing these images is very powerful to help our eyes evaluate the incisal embra****sures and incisal edge silhouette.** I usually do this before final glaze, allowing me to fine tune the shapes. It is like looking at the teeth without looking at them and instead trying to visualize the shapes of the background, **THE NEGATIVE SPACE**. When filling up extra space is important to work with the line angles and push the challenge towards the most distal area. On this case line angles of centrals and laterals were kept almost ideal and the extra space was mainly distributed by the canine. Also longer contacts were designed to close the black triangles, but the line angles were kept more triangle to give a natural look.   ![the black space analysis](https://media.digitalsmiledesign.com/hs-fs/hubfs/62%20pic%201-1.jpeg?width=600&name=62%20pic%201-1.jpeg)   ***![patient's teeth](https://media.digitalsmiledesign.com/hs-fs/hubfs/62%20pic%202-1.jpeg?width=270&name=62%20pic%202-1.jpeg) ***   *Clinicial procedures by [Dr. David Garber](http://www.dentalxp.com/xperts/dgarber), Lab work by [Christian Coachman](http://www.dentalxp.com/xperts/ccoachman)*   *** ***   ##  SMILE DESIGN CASE 6  ![Smile design case](https://media.digitalsmiledesign.com/hs-fs/hubfs/Merged%20(1).png?width=1588&name=Merged%20(1).png) --- ## [![Digital Smile Design education](https://no-cache.hubspot.com/cta/default/3439767/3bedc06b-4d35-4892-be34-5cfda19b456f.png)](https://cta-redirect.hubspot.com/cta/redirect/3439767/3bedc06b-4d35-4892-be34-5cfda19b456f)  [Smile Designer](https://media.digitalsmiledesign.com/business-marketing/tag/smile-designer) [Dentistry](https://media.digitalsmiledesign.com/business-marketing/tag/dentistry) [Esthetics](https://media.digitalsmiledesign.com/business-marketing/tag/esthetics) [Treatment Planning](https://media.digitalsmiledesign.com/business-marketing/tag/treatment-planning) [DSD Magazine](https://media.digitalsmiledesign.com/business-marketing/tag/dsd-magazine) [2D Digital Smile Design](https://media.digitalsmiledesign.com/business-marketing/tag/2d-digital-smile-design) [2D Smile Design Project](https://media.digitalsmiledesign.com/business-marketing/tag/2d-smile-design-project) Share - [** ](https://www.facebook.com/sharer/sharer.php?u=https://media.digitalsmiledesign.com/business-marketing/six-smile-design-cases&title=6%20Smile%20Design%20Cases&picture=https://cdn2.hubspot.net/hubfs/3439767/Smile%20Design%20Cases%20790x400.png&description=Deep%20dive%20into%20these%20six%20Smile%20Design%20Cases%20that%20ponder%20on%20effective%20dental%20processes%20that%20deliver%20great%20results%20by%20achieving%20that%20beautiful%20smile.%20Read%20now!) - [**](https://twitter.com/share?source=https://media.digitalsmiledesign.com/business-marketing/six-smile-design-cases&text=6%20Smile%20Design%20Cases%20-%20https://media.digitalsmiledesign.com/business-marketing/six-smile-design-cases) - [**](http://www.linkedin.com/shareArticle?mini=true&url=https://media.digitalsmiledesign.com/business-marketing/six-smile-design-cases&title=6%20Smile%20Design%20Cases&summary=Deep%20dive%20into%20these%20six%20Smile%20Design%20Cases%20that%20ponder%20on%20effective%20dental%20processes%20that%20deliver%20great%20results%20by%20achieving%20that%20beautiful%20smile.%20Read%20now!) - ** - [**](mailto:?subjetc=&body=6+Smile+Design+Cases%20-%20https://media.digitalsmiledesign.com/business-marketing/six-smile-design-cases) Next Post [Becoming A Smile Designer **](https://media.digitalsmiledesign.com/business-marketing/becoming-a-smile-designer) ### Written by [Christian Coachman](https://media.digitalsmiledesign.com/business-marketing/author/christian-coachman) [Content Title](https://media.digitalsmiledesign.com/business-marketing/six-smile-design-cases#) Description ### Subscribe and Stay Informed We're committed to your privacy. Digital Smile Design uses the information you provide to us to contact you about our relevant content, products, and services. 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