I clinical technique _ smile design A new approach for patient acceptance and appreciation Authors_ Dr Lorin Berland & Dr Sarah Kong, USA the severe tetracycline staining, she felt her teeth were worn from years of grinding. Moreover, she had old resin bonding on her lower front teeth that was not only discoloured, but also mismatched from years of patching and re-patching each time something broke off. After performing a thorough examination (paying particular attention to the areas noted above) and cleaning, we recommended she try deep bleaching. After evaluating the results of the whitening, we recommended a minimum of four minimal preparation Microveneers for her lower front teeth and her upper seven teeth, and a zirconium porcelain crown for tooth #5, in order to achieve the smile she desired. Because her maxillary six anteriors had worn, flat incisal edges, it was essential that we understood what the patient desired in terms of shape and length. We examined the Smile Style Guide (www.digident.com) to select a smile design (Fig. 2). With the patient’s input, we determined that P3—pointed canines with square centrals and round laterals—would be the best for her (Fig. 3). The length combination she liked the most was L-2—laterals slightly shorter than the centrals and canines (Fig. 4). We submitted her preoperative photo to SmilePix for a cosmetic image (Fig. 5) and concluded with PVS impressions (Splash, Discus Dental) and a bite registration (Vanilla Bite, Discus Dental). Fig. 1_Pre-op full face. Fig. 1 Fig. 2_Smile Style Guide. Fig. 3_P-3, pointed canines with square centrals and round laterals. Fig. 4_Length code L-2, laterals slightly shorter than centrals and cuspids. _This 61-year-old executive has lived with the effects of tetracycline-stained teeth since she was a little girl (Fig. 1). All her life she wanted to have a great smile, but she never knew what her dental options were. The general dentist she had seen for many years told her there was nothing he could do to help her, so he referred her to our office. When the patient came for her first visit, she wished to address a number of dental concerns. In addition to Fig. 2 Fig. 3 Fig. 4 18 I cosmetic dentistry 4_ 2009