Figures 2a, 2b: While discussing options, I always show patients my completed cases to help them understand the procedure and expected outcome. These before-and-after photos were shown from a similar case to illustrate how Obsidian ceramic on the central incisors can enhance a smile. Having a visual example of the possibilities went a long way in promoting treatment acceptance and confidence in her decision.

Figures 3a, 3b: When changing the length of a tooth or moving the midline, the first step is to make the change preoperatively on the patient’s tooth. This can be achieved by either adding composite material or removing tooth structure. Then, a pretreatment scan of the changes is overlaid on the preparation in the design software to mimic the desired dimensions in the final design. Using my fastdesign.io™ Software and Design Station, I was able to receive a proposal with just a few clicks, keeping the design as minimally invasive as possible while still achieving ideal material thickness.

Figures 4a, 4b: Most of my anterior work is completed using Obsidian ceramics due to its high flexural strength, highly bondable nature, and ability to be characterized using a variety of stains. I milled the restorations chairside using my fastmill.io™ In-Office Mill. Prior to characterizing the veneers and placing them in the oven, the fit was verified in the patient’s mouth and the adjacent teeth were evaluated for color and texture.

Figures 5a, 5b: A thin layer of glaze was added over the facial surfaces of both veneers. The glazing material should be the consistency of warm honey. If the glaze is too thick it could leave unwanted visible streaks. If the consistency is too thin, the glaze can appear dull. An IPS e.max^® CAD Crystall stain and glaze kit (Ivoclar Vivadent, Inc.; Amherst, N.Y.) was used to add shade A stain to the gingival third of the restoration, then blended toward the incisal edge. I often add a blue or light purple stain to the incisal edge to create the appearance of translucency and achieve a halo effect with white and grey, mimicking the appearance of a natural incisal edge. This process takes only a couple of minutes.

Figures 6a, 6b: Once fired, the restoration was again tried in the mouth. Clear NX3 Nexus™ Try-In Gel (Kerr Corporation; Brea, Calif.) was used to verify the fit of all restorations at the same time, while also allowing the patient to view and accept the final esthetics of the restoration. After try-in, the restorations were cleaned along with the patient’s teeth with Vista Apex 3% Sodium Hypochlorite mix (Inter-Med, Inc.; Racine, Wis.) to ensure no salivary contamination disrupts the bonding. The veneers were bonded using OptiBond™ eXTRa Universal (Kerr Corporation; Brea, Calif.) and NX3 Nexus light-cure cement.